Meeting documents

Apologies: Mr Carl Etholen

Changes in membership:  Wendy Mallen is no longer on the HASC.

Julia Wassell confirmed that all her declarations of interest were up to date.

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None received

For Members to receive an update on the Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Plan, including an update on delivering the "Bucks" chapter.

Attendees:

Lou Patten, Chief Accountable Officer, Clinical Commissioning Groups

Neil Dardis, Chief Executive, Buckinghamshire Healthcare NHS Trust

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

Graeme Betts, Interim Managing Director, Adult Social Care

Attached is a copy of the draft Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Plan and the vision and programme for digital transformation in health and care.

Lou Patten, Chief Executive, Clinical Commissioning Groups, Neil Dardis, Chief Executive, Buckinghamshire Hospital Trust, and Graham Jackson, Clinical Lead for Aylesbury Vale attended the meeting to give an update on the Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Plan. The presentation in full can be found here (will attached presentation to notes)

The Committee discussed the individual work streams contained in the STP.

The following points were discussed:

·         How the finances would be set out across the footprint and the debt inherited that would be factored into the baseline

·         The 70/30 split referred to the Bucks "chapter" with 70% efficiencies coming from local plans and that this would be monitored through progress checks

·         The assurances needed that the STP would not result in reductions for Bucks residents and the confidence that the plans would build services locally for residents

·         Assurances relating to the Governance of the decision making process

·         Ensuring key stakeholders were involved so have a whole system integrated working

·         The need to ensure services were accessible to all including those in deprived areas or that did not have access to digital solutions and the requirement to give people options

Prevention

The following points were discussed:

• The link between the STPs project plans, how they were broken down to a County level and if timescales would be included in the project tracker.  It was confirmed that the plans would be shared with key stakeholders in May
• Assessing would the success of the agenda for patients and ensuring the patient voice was heard.  Examples were given of engagement happening already and feedback used from patients to inform the plans

Urgent Care

The following points were discussed:

• Who decided if a request put through by a GP was urgent or put on the routine list
• The need for the treatment pathway to be communicated to patients and put in place so that delays were minimised.  
• The requirement to maximise the use of technology between departments and the GP
• How  extended GP services could be put in place to prevent patients visiting A&E
• How Wexham Park Hospital/Frimley were integrated into the plans to overcome the current disjointed nature of provision.  It was confirmed that there were links with Wexham Park discharge planning and links between the teams.  It was also confirmed that some capital funding for GPs had been sought in order to be able to talk digitally with the hospitals
• The need for engagement with the ambulance service.  It was confirmed that the South Ambulance Service has been heavily involved

Acute Care

The following points were discussed:

• The Committee questioned whether the £7.2m saving from Acute services included procurement and sought reassurance that savings would be made from procurement.  Members were assured that numbers in the STP were realistic and if not made would present challenges

Mental Health

The following points were discussed:

·         Concerns were raised about what needed to be done for Mental Health in Buckinghamshire and the feeling that the County was behind what others were doing  ...  view the full minutes text for item 4.

This is an opportunity for Committee Members to receive an update on Buckinghamshire Healthcare NHS Trust’s plans for developing care in the community.

Attendees:

Neil Dardis, Chief Executive, Buckinghamshire Healthcare NHS Trust

Dr Tina Kenny, Medical Director, Buckinghamshire Healthcare NHS Trust

Dr Martin Thornton, GP, Trinity Health

Dr Tina Kenny, Medical Director, Buckinghamshire Healthcare NHS Trust, Dr Martin Thornton, GR, Trinity Health and Carolyn Morrice, Chief Nurse attended the meeting to give a presentation on their vision for developing care closer to home.  The full presentation can be found here.

Tina Kenny highlighted the following developments:

• The clinical evidence and patient feedback and the themes that had emerged
• Community Hub pilots to start from April 2017 which would see the introduction of locality integrated teams, rapid response intermediate care and community care coordinators

The Committee discussed the following points:

• The details of the community hubs were discussed including their locations and how they would work.  It was confirmed that although the term ‘hub’ alluded to them being a physical entity, the hubs were in fact the combination of integrated teams working together to manage referrals, coordinate outpatient appointments, assessment clinics, rapid response in order to avoid hospital admissions and improve patient experience
• The importance of communications relating to the pilots and the services that would be offered, for example the messages to older people to understand that having contact with health professionals did not necessarily mean hospital or a care home
• The Committee discussed self-funders and how they would access the service.  It was confirmed that assessments would be carried out in the same way they were now and would only depend on treatment or service  required
• The Committee discussed community engagement and how this was achieved.  Support from Healthwatch Bucks was offered

The Committee thanked colleagues for their informative update and asked that they provide a further update on progress on the pilots at the September HASC Select Committee meeting.

The next meeting is due to take place on Tuesday 28^th March at 10am in the Large Dining Room, Judges Lodgings, Aylesbury.

There will be a special HASC meeting on Tuesday 14March at 2pm to discuss and agree the Hospital Discharge Inquiry report. 

The next Committee meeting will be on Tuesday 28March at 10am.  Both meetings will take place in the Large Dining Room, Judges Lodgings.