Meeting documents

Apologies were received from Carl Etholen, David Martin and Jean Teesdale.

Andy Huxley has replaced Darren Hayday on the Health and Adult Social Care Select Committee.  The Chairman welcomed Mr Huxley to the meeting.

There were no declarations of interest.

The Chairman started by explaining that the background to the  meeting today is an extension of the 2013 work that the Health and Adult Social Care (HASC) Committee commenced in response to the Keogh Report into the quality of care and treatment at Buckinghamshire Healthcare NHS Trust.  She made the following points.

·         Whilst the Keogh team reported on the quality of services, the HASC is mindful of continued strong feeling concerning local urgent care services.  This is evident from feedback received by committee members from the public, local media coverage and petitions submitted to the Council.

·         In responding to these concerns this committee has tried to separate concerns over quality, from those concerning the design of the urgent care pathway and where people go for care.

·         The HASC’s earlier report, which was published in October, in response to the Keogh review of the Trust was concerned with issues of quality, and the HASC will continue to monitor quality improvements at the Trust, with items at the February and April committee meetings coming up. 

·         Other quality concerns around aspects of the urgent care pathway or particular providers could be looked at by the HASC in future.

·         Todays’ meeting is focussed on the Urgent care pathway design locally - basically where people go when they need urgent healthcare advice or treatment, and the public understanding of the pathways in place.

The Chairman welcomed Lou Patten (Aylesbury Vale Clinical Commissioning Group), Annet Gamell (Chiltern Clinical Commissioning Group), Neil Dardis (Buckinghamshire Healthcare NHS Trust) and Steve West (South Central Ambulance Service).

The Chairman explained that a number of public questions have been received in advance of the meeting and these will be read out by Committee Members.  The names of the members of the public have been kept confidential.

Ms Patten took Members through the presentation which set both the national and local scene and she made the following main points.

·         A model for transforming urgent and emergency care services has been developed by Sir Bruce Keogh and Professor Willet and it suggests that a new urgent and emergency care system needs to shift more people from the acute hospital setting to care as close to home as possible.

·         Over 1 million emergency admissions in 2012/13 were considered avoidable.

·         50% of 999 ambulance calls could be managed at the scene.

·         40% of patients who attend A&E are discharged having needed no treatment at all.

·         20% of GP consultations relate to minor aliments which could largely be dealt with by self-care and support from the community pharmacy.

·         Sir Bruce Keogh recognises that it is a 3-5year transformation process.

·         NHS 111 telephone service – the right call to make to get to the right place first time for treatment.  The service is headed by trained call handlers and clinicians.  They have a local directory of services so they know what is open and where to direct the patient.  It is a standalone service.  SCAS are the providers of the 111 service.

·         Minor injury and illness services must be local but not necessarily connected to a hospital.

·         Serious injury and illness (A&E type services) – these services must be alongside other hospital services, e.g. Intensive care, Orthopaedics.

·         Regional specialists – for example, Cardiac and Stroke services.  These services must be alongside other specialist services, e.g. vascular, neuro-surgery.  There are two specialist units at Wycombe Hospital for cardiac and stroke patients.

During discussion, Members read out the public questions as well as asking their own questions.

Section A – Current A&E and Urgent Care Pathway design

Public Question from Kate in High Wycombe who was drawing on her own ambulance trip to A&E following an asthma attack: "I want to know why the local hospital does not treat anything worthy of hospitalisation….I want every event that lead to the hospital being little more than a bandage dispenser investigated and the reasons behind each of these events made public".  [Similar questions around concern over the diminished service provision at Wycombe Hospital have also been received].

In the interest of public understanding, do you think there is a need for a definitive explanation to be published and made available on the CCG’s and BHT’s websites to outline where people need to go for different levels of care and what services are available across the county – a" one-stop" shop?  Dr Gamell agreed that  ...  view the full minutes text for item 4.

The Chairman asked Members to note the service configuration topic paper which was included in the agenda pack.

To be discussed and agreed at the meeting.

The draft report will be presented to the Health and Adult Social Care Select Committee meeting in March.