Agenda and minutes

Cllr Andrew Gravells to welcome everyone to the meeting before inviting representatives from the participant organisations to give a brief introduction.

Cllr Andrew Gravells, as Chair of the Gloucestershire Health Overview and Scrutiny Committee meeting, welcomed the members of the Adult Social Care and Communities Scrutiny Committee,(ASCC), and the Health Overview and Scrutiny Committee, (HOSC), to the meeting. Cllr Gravells explained that, in response to concerns raised at scrutiny committee meetings held in July, the members of both committees had agreed to arrange a joint scrutiny committee meeting to consider issues impacting on the delivery of urgent and emergency care systems in Gloucestershire.

To note any apologies for absence.

Apologies were noted from:

Cllr Lisa Spivey (Vice-Chair of the ASCC)

Cllr Linda Cohen (HOSC)

Cllr Helen Fenton (HOSC)

Cllr Helen Molyneux (HOSC)

Cllr David Drew (Vice Chair of HOSC) attended the meeting remotely

To note any declarations of interest.

Cllr Stephen Andrews declared a non-prejudicial interest in relation to his work as a volunteer first responder with SWAST, (Southwest Ambulance Service Foundation Trust).

No other declarations of interest were made at the meeting.

In response to ongoing issues impacting on Urgent and Emergency Care Systems in Gloucestershire, (raised at county scrutiny committee meetings held in July and at a workshop event in September), the members of the Gloucestershire Health Overview and Scrutiny Committee (HOSC) and the Adult Care and Communities Scrutiny Committee (ASCC), to consider a single item agenda on the delivery of urgent and emergency care in the county. 

The meeting will be held in the Council Chamber at Gloucestershire County Council, Shire Hall, Westgate Street, Gloucester GL1 2TG.

Cllr Andrew Gravells to invite a representative from each of the following participant organisations to give a brief (5 minute) verbal overview on the environmental issues affecting the performance of the organisation in the delivery of urgent and emergency care in Gloucestershire.

1. Gloucestershire County Council
2. NHS Gloucestershire Integrated Care Board
3. NHS Gloucestershire Hospitals Foundation Trust
4. NHS Gloucestershire Health and Care Foundation Trust
5. NHS Gloucestershire Primary Care
6. NHS 111 Service
7. South-West Ambulance Service Foundation Trust
8. Police and Crime Commissioner/Gloucestershire Constabulary
9. Newton Europe - members to also receive a presentation on the conclusions and findings of diagnostic work undertaken by consultants, Newton Europe, in partnership with Gloucestershire County Council and NHS Gloucestershire. Please see attached report and slideshow presentation.

In response to ongoing issues impacting on Urgent and Emergency Care Systems in Gloucestershire, (raised at county scrutiny committee meetings held in July and at a workshop event held in September), the members of the Gloucestershire Health Overview and Scrutiny Committee (HOSC) and the Adult Care and Communities Scrutiny Committee (ASCC), received an update on the delivery of urgent and emergency care in the county.

Included in the update was a presentation on the conclusions and findings of diagnostic work undertaken by consultants, Newton Europe, in partnership with the NHS Gloucestershire Integrated Care Board and Gloucestershire County Council.

Cllr Andrew Gravells invited representatives from each of the following organisations to give a brief overview of current challenges and issues impacting on performance.

1. NHS Gloucestershire Integrated Care Board

2. NHS Gloucestershire Hospitals Foundation Trust

3. NHS Gloucestershire Health and Care Foundation Trust

4. Gloucestershire County Council

5. NHS Gloucestershire Primary Care

6. NHS 111 Service

7. South-West Ambulance Service Foundation Trust

8. Police and Crime Commissioner/Gloucestershire Constabulary

Newton Europe

Stuart Appleby and Sam Newton from Newton Europe opened the discussion with a detailed presentation on their work commissioning by NHS Gloucestershire/Gloucestershire County Council.

It was reported that performance across the urgent and emergency health and care system in Gloucestershire had been significantly challenged during the Winter of 2021/22, particularly impacting on older and frail people who make up the majority of the people categorised as Delayed Discharges, also known as those with No Criteria to Reside (NCTR) in hospital beds. Over the winter months, there had been a significant increase in NCTR levels. Details of the No Criteria to Reside (NCTR) performance data reported at the meeting are attached to the minutes.

Members were informed that each person experiencing delayed discharges were at risk of experiencing a detriment to their overall experience and care. The cumulative effect of the volume of NCTR impacting on the county was subsequently impacting on the ability to provide responsive high-quality health and care services to the people of Gloucestershire. In response, health and social care organisations had agreed to come together to review the challenges to the system and to work together to consider a radical transformation to the current approach.

The proposal was to commission external help involving a two-step process. The first stage had been to commission support from the Local Government Association (LGA) who had offered a support package at no cost linked to their wider supporting role from the Better Care Fund. The second stage, was to commission a large-scale consultancy intervention to work across all the health and care partners of the Gloucestershire integrated care system to reform urgent and emergency care, reform system flow and ultimately improve care outcomes and experiences for people in the county requiring care.

Newton Europe commenced its work in July 2022, with the aim of developing an integrated approach to the delivery of urgent and emergency care services and improving system flow based on the needs of the person and carer. The work  ...  view the full minutes text for item 4.

Cllr Andrew Gravells to summarise the outcomes of the discussion before seeking the agreement of members on proposed next steps.

Having considered the various representations and engaging in extensive discussion on the issues impacting on the delivery of urgent and emergency care in Gloucestershire, members agreed this was not a quick win situation that could be easily resolved.

Chair of HOSC, Cllr Andrew Gravells, acknowledged there were some serious issues to address, but felt that the meeting today had been a good start to the scrutiny process.

Seeking to invite individual organisations to update the committee at future meetings, and confirming that Nelson Europe would be asked to present their findings to members following conclusion of their work, Cllr Gravells thanked everyone for their time, courtesy and their invaluable contributions at the meeting.