Meeting documents

Apologies were received from Mr R Reed, Mr C Etholen and Mrs M Aston.

Mr N Brown declared an interest in item 4 as a family member had recently joined the ITU department at Frimley Park Hospital.

of the meeting held on 26^th July 2016 to be confirmed as a correct record.

The minutes of the meeting held on 26^th July were confirmed as a correct record.

Follow-up on actions

·         Lynton House – Ms Patten updated the Committee on this.  A piece of engagement work across all the localities will commence over the coming weeks’.

·         The Committee & Governance Adviser had met with the Council’s media and communications to discuss ways of engaging further with members of the public.

·         Dove Ward – awaiting dates from the CCGs for Member visits.

For Committee Members to receive an update on maternity services which will include the following.

1.    An overview of maternity services in Buckinghamshire against national and local performance targets;

2.    Understanding how choice is managed and met;

3.    How services are meeting current demand and modelling to meet future demand for ante-natal & post-natal support services.

Attendees:

Carolyn Morrice, Chief Nurse, Bucks Healthcare Trust

Andrea Anderson, Deputy Head of Midwifery, Wexham Park Hospital

Monica Warren, Matron for Intrapartum Maternity Services

Dal Sahota, GP, Clinical Commissioning Group

The Chairman welcomed the following people Mrs C Morrice, Chief Nurse (Bucks Healthcare Trust), Ms A Warren, Head of Midwifery (Bucks Healthcare Trust), Ms L Duncan, Deputy Head of Midwifery (Bucks Healthcare Trust), Dr D Sahota, GP (Clinical Commissioning Group), Mr N Flint, Head of Commissioning for Planned Care and Maternity (Clinical Commissioning Group), Ms M Warren, Matron for Intrapartum Maternity Services (Frimley Park Trust) and Ms L Patten, Chief Executive (Clinical Commissioning Groups).

The following main points were made during the presentation:

·         Between April 2015 and March 2016, Buckinghamshire Healthcare Trust (BHT) provided labour care to women who delivered 5,541 babies.

·         30 complaints were received last year compared to a total of 13 this year.  Lessons had been learnt and the aim was to reduce the number of complaints still further.

·         Sharing information and ideas for improvement was an important consideration.

·         A tool called "Birth rate plus" was used to establish the correct staffing levels.

·         BHT had a slightly higher than national benchmark best practice rate for Caesarean sections and was currently looking at ways to reduce the number.

·         BHT had been accepted to participate in a pilot labour ward leadership programme which promoted team working.

·         In partnership with Oxford Health NHS Foundation Trust, BHT had made perinatal mental health a priority and had employed a specialist mental health midwife.

·         Wexham Park Hospital and Frimley Health merged in October 2014 and since then much work had been undertaken to bring the two units together.

·         A total of 35 guidelines had been ratified and adopted across both sites and it would take approximately three years to complete all 92 guidelines.

·         The CQC inspection in October 2015 rated the Women and Children Services as "Good".  There had been a shift in leadership and culture of the organisation.

·         There was a reported shortage of 10 midwifes within the unit.  Consultant cover to the Labour Ward was now 132 hours per week.

·         The current midwife to mother ratio funded at 1:30 with a 90/10 split between midwife and healthcare assistant.

·         A Perinatal Mental Health specialist midwife, a Diabetic Midwife specialist and a Clinical Skills facilitator had recently been recruited.

·         The biggest challenge for the Trust was around capacity of the ultrasound scanning.  There was a national shortage of sonographers as well as a shortage of midwifes.

·         Maternity Services had been given a focus within the Sustainability and Transformation Plans.

·         An Open Day was being planned to find out the views of women.

·         Ms Morrice confirmed that the transfer of care back to the Wycombe Maternity Unit was on track for 31 October with the Unit re-opening on 1 November.

·         In response to a question around the challenge of an older workforce and recruiting new midwifes, the maternity team at BHT confirmed that they had two intakes each year – May and September and the challenge was to ensure they remain with BHT.  BHT had over-recruited this year.

·         A Member asked for the percentage of women in Bucks giving birth where English was  ...  view the full minutes text for item 4.

This is an opportunity for members of the public to put a question or raise an issue of concern, related to health.   Where possible, the relevant organisation to which the question/issue is directed will be present to give a verbal response.  Members of the public will be invited to speak for up to four minutes on their issue.  A maximum of 30 minutes is set aside for the Public Questions slot in total (including responses and any Committee discussion). This may be extended with the Chairman’s discretion. 

For full guidance on Public Questions, including how to register a request to speak during this slot, please follow this link:

http://www.buckscc.gov.uk/about-your-council/scrutiny/getting-involved/

There were no public questions.

To include an update on the Bedfordshire and Milton Keynes Healthcare Review.

The Chairman updated the Committee on the following issues.

The Bedfordshire and Milton Keynes Healthcare Review

Milton Keynes had decided to work with Bedfordshire and Luton to produce its 5 year Sustainability and Transformation Plan (STP) and they had issued the following update:-

"Following detailed discussions with our STP partners and Regulators we have agreed that it would be confusing to have two parallel processes – ie. the Healthcare Review and the development of an STP both attempting to deliver similar things.  We will, therefore, be consolidating the work of the Healthcare Review into a single STP process."

ACTION: Committee and Governance Adviser to invite representatives to attend the October meeting to provide an update on the plans.

Ridgeway Centre closure and transfer to Dove Ward

An email was received on Friday 2 September with the following update:

"The closure of the Ridgway Centre, which was due to be completed yesterday, has been delayed by a couple of weeks. This is because we need to ensure that remaining patients are being transferred or discharged in a safely manner and within a time scale that is their best interest. As soon as we have been able to ensure that all patients are safe, the centre will close. We anticipate this to be around the middle of September."

Pharmacy cuts

The Chairman reported that the Government’s proposed cuts to the Pharmacy services had been withdrawn at a national level.  An email had been sent to the Local Pharmacy Council for an update from a local perspective. And a response was awaited.

Forthcoming meetings

·         Clinical Commissioning Group’s AGM – Thursday 15 September at 6.30pm (Oculus, The Gatehouse)

·         Buckinghamshire Healthcare Trust’s AGM – Thursday 29 September at 6pm (Education Centre, Stoke Mandeville Hospital)

·         Committee Member visit to Dove Ward – still to be arranged

·         Care Home visits – Aylesbury Vale visits had already taken place, South of the County visits are due to take place on 13 September.

An opportunity to update the Committee on relevant information and report on any meetings of external organisations attended since the last meeting of the Committee.  This is particularly pertinent to members who act in a liaison capacity with NHS Boards, for District and HealthWatch representatives.

District Councillor Sandra Jenkins updated Members on her recent care visits as part of the follow-up on the 15 minute care visit review.

Further to the briefing paper on the re-configuration of the vascular service which was circulated to Members in May and the subsequent meeting between the Chairman and the relevant clinicians, this item will provide further information on the following areas.

1.    Communications plan;

2.    Patient pathways both pre and post the change;

3.    Patient Reported Outcome Measures (PROMs) data update

Attendees:

Aarti Chapman, Associate Director, Strategic Clinical Network and Senate

Andrea Collins, Head of Communications and Engagement, NHS England South (South Central)

Cliodhna Ni Ghuidhir, Thames Valley Vascular Network and Service Manager, Oxford University Hospitals NHS Foundation Trust

The Chairman welcomed Dr A Chapman, Associate Director, Strategic Clinical Network and Senate, Ms A Tysom (in replace of Ms A Collins, Head of Communications and Engagement, NHS England South), Ms Cliodhna Ni Ghuidhir, Thames Valley Vascular Network and Service Manager, Oxford University Hospitals NHS Foundation Trust.

The following main points were made during the presentation:-

·         Clinical Senate was made up of a group who can provide information and make recommendations on issues which had been referred to then by NHS England.

·         Ms Tysom circulated copies of all the communications which were provided in the run-up to the 1 September when the Carotid Endarterectomy Surgery moved from Wycombe Hospital to the John Radcliffe Hospital.  These materials had been shared with all the key stakeholders and those patients who would be affected by the change.

·         Carotid Endarterectomy was described as a surgical procedure to unblock a carotid artery, which, if left untreated, could lead to a stroke.

·         Patients requiring this specialist procedure would have access to a specialist vascular team 24 hours a day, 7 days a week.

·         Day surgery, pre-operative care and follow-ups will continue to be offered locally to reduce the need to travel.

·         The changes were based on national clinical guidance and best practice and ensure the safety of patients and ongoing provision of services.

·         The Clinical Senate would be reviewing the service in 6 months’ time.

·         PROMS (Patient Reported Outcome Measures) update - A mixed-methods approach to investigating patient experiences in the network was chosen, entailing a questionnaire sent to all patients in the network and qualitative interviews with a specific patient cohort.  This project sought to gain feedback from patients on their experiences of care across the network.

·         The questionnaire was posted to each inpatient treated in the Thames Valley Vascular Network whose primary cause for admission was a vascular condition, starting with those discharged in May.  The response rate of patients was approximately 34%.

·         The network team decided to focus on patients treated for urgent conditions.  The Network manager undertook to interview a minimum of three patients from each trust on different pathways in order to compare experiences across the network – eight interviews had taken place to date.  It was agreed to report the results of both the qualitative interviews and questionnaires research to the Committee once a sufficient sample size for the questionnaire is reached.

ACTION: NHS England to share this research with the HASC when it has been completed.

·         A Member commented that transport was a key issue for patients and family members but through Patient Transfer Services and Patient Community Transport, some patients were eligible for assistance with getting to and from their Hospital appointments.  It was acknowledged that access to specialist services would involve an increase in travel times but every effort would be made for follow-up calls to be undertaken locally.  A Member referred to the Better Healthcare in Bucks review which highlighted transport as a major issue at the time.

The Chairman concluded by highlighting the need  ...  view the full minutes text for item 8.

For Members to consider the 12 month progress report on the recommendations made in the 15min Care Visit Review and to delegate authority to the Chairman to complete the status of recommendations on the Committee’s behalf.  The completed recommendation monitoring report will be published with the Minutes of the meeting. 

Attendees:

Mike Appleyard, Deputy Leader and Cabinet Member for Health & Wellbeing;

Steven GoldenSmith, Strategic Commissioner Later Life, Adults, Health & Communities

The Chairman welcomed Mr M Appleyard, Deputy Leader and Cabinet Member for Health & Wellbeing, Mr S GoldenSmith, Lead Commissioner Later Life, Adults, Health & Communities and Mr A Willison, Commissioning Manager.

Five recommendations were made to Cabinet through the 15 minute Care Visit Inquiry and this item looked at the progress made of each recommendation.  The following main points were made by the Cabinet Member and Officers.

·         All recommendations had been implemented.

·         In terms of travel costs, carers receive an hourly rate which includes an element for travel.  It was acknowledged that remuneration was a difficult issue as the providers are responsible for remunerating their staff.

·         All carers were DBS checked.

·         Regular meetings took place between the providers and the County Council.  It was agreed that Committee Members would be invited to future meetings with Wendy Mallen and Brian Adams attending the next meeting.

ACTION:  Mr S GoldenSmith to send the Committee & Governance Adviser the details of the meetings.

The Committee AGREED to award a green RAG status to all the recommendations ("Recommendation implemented to the satisfaction of the Committee").

The completed recommendation monitoring report is attached.

SEE WEBSITE FOR FULL DETAILS

For Members to discuss and agree the items for the October meeting.

Members noted the provisional items for the next meeting and discussed holding a workshop in November/December time to agree the items for the future meetings.

The next meeting is due to take place on Tuesday 18 October at 10am in Mezz Room 2, County Hall, Aylesbury.

The next meeting is due to take place on Tuesday 18^th October at 10am in Mezzanine Room 2, County Hall, Aylesbury.