Agenda and minutes

Venue: The Oculus, Buckinghamshire Council, Gatehouse Road, Aylesbury HP19 8FF. View directions

Contact: Liz Wheaton 

Media

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Items
No. Item

1.

Apologies for Absence/Changes in Membership

Additional documents:

Minutes:

Apologies were received from Cllr George Sandy.

 

Cllrs Jane McBean and Caroline Jones were no longer members of the committee.

 

Cllrs Sue Chapple and Diana Blamires were now members of the committee.

 

The Chairman thanked Cllrs McBean and Jones for all their hard work and wished them well in their future endeavours. He welcomed Cllrs Chapple and Blamires.

2.

Appointment of Vice-Chairman

For the Chairman to appoint the Vice-Chairman of the Health & Adult Social Care Select Committee for the ensuing year.

Additional documents:

Minutes:

The Chairman confirmed the appointment of Councillor Diana Blamires as the Vice-Chairman for the ensuing year.

3.

Declarations of Interest

Additional documents:

Minutes:

There were no declarations of interest

4.

Minutes of the Previous Meetings pdf icon PDF 178 KB

To confirm the minutes of the meetings held on Thursday 11th April 2024 and Wednesday 15th May 2024 as correct records.

Additional documents:

Minutes:

The minutes of the meetings held on 11th April 2024 and 15th May 2024 were confirmed as correct records.

5.

Public Questions

Public Questions is an opportunity for people who live, work or study in Buckinghamshire to put a question to a Select Committee. The Committee will hear from members of the public who have submitted questions in advance relating to items on the agenda. The Cabinet Member, relevant key partners and responsible officers will be invited to respond.

 

Further information on how to register can be found here: https://www.buckinghamshire.gov.uk/your-council/get-involved-with-council-decisions/select-committees/

Additional documents:

Minutes:

There were no public questions.

6.

Chairman's update

For the Chairman to update Members on health and social care related scrutiny activities since the last meeting.

Additional documents:

Minutes:

Members of the committee had completed a key piece of work by submitting a HASC statement for inclusion in Buckinghamshire Healthcare Trust’s Annual Quality Account. A copy of the published item had been circulated to Members. The Chairman thanked Cllrs Thomas and Wassell for their work on this item.

7.

Buckinghamshire Healthcare NHS Trust Quality and Performance update pdf icon PDF 2 MB

Representatives from Buckinghamshire Healthcare NHS Trust will provide an update on the Trust’s performance over the last year, including quality of services, estates, digital improvements and progress in delivering the Trust’s key objectives.

 

Presenters:

Duncan Dewhurst, Chief Digital and Transformation Officer

Raghuv Bhasin, Chief Operating Officer

Andrew McLaren, Chief Medical Officer

 

Papers:

Presentation attached

Additional documents:

Minutes:

The Chairman welcomed the following contributors to the meeting:

  • Raghuv Bhasin, Chief Operating Officer
  • Andrew McLaren, Chief Medical Officer
  • Gemma Thomas, Director of Strategic Delivery

 

The Chief Operating Officer introduced the report making the following key points:

  • The Trust had been working closely with patients, volunteers and partners and there had been an improvement in key waiting times.
  • The Trust had been graded by the regulator as level 2, up from level 3, showing a greater confidence in the ability to deliver services.
  • There had been a significant backlog in diagnostic scans for which there was increasing demand. New scanners would be installed at Amersham hospital in September 2024 and at Wycombe hospital in October 2024. This would help in the treatment of cancer patients.
  • The Trust had continued to reduce the number of patients waiting for 65 weeks for surgery. Despite problems with the estate, all the operating theatres had been brought back online.
  • A new skin centre had been established at Amersham hospital which had minor operation suites.
  • Same day emergency care had been used to offer more intensive medical support to patients and reduce hospital admissions.
  • Discharge procedures had been integrated with the council and a discharge ward created at the Olympic Lodge.
  • All this had been achieved within the funding parameters for two consecutive years. Buckinghamshire was the only acute trust in the ICB to achieve this.

 

The Chief Medical Officer noted:

  • The Hospital Standardised Mortality Ratio (the national measure of people dying in hospital) showed the Buckinghamshire Healthcare Trust (BHT) was 10% below the average. This meant that patients were receiving high quality care in the elective and emergency pathways.
  • The staff vacancy rate was good at 5%. The best way of offering care to patients was to retain and support staff.
  • The staff turnover rate for the NHS nationally was 15% which imposes a great strain on staff. In Buckinghamshire the rate was 10% and the aim was to reduce this figure.
  • The workload for the NHS had been increasing due to an ageing, frailer and less healthy population. Much of this was due to health inequalities and lifestyle choices. Breast cancer was given as an example - being overweight or obese doubles the risk. Regular exercise was also a preventative measure for all types of cancer.

 

The Director of Strategic Delivery noted:

  • In order to reduce healthcare inequalities there was a focus on four initiatives: cardiovascular health, early years, frailty and health inclusion groups. Working together in integrated neighbourhood teams will have the largest impact in these areas.
  • Part of the future ambitions for BHT were around more personalised care and delivering more of a preventative approach, including pharmacy and dentistry. More resources would be directed towards community services rather than acute provision. There would be different priority decisions which the BHT would share publicly.

 

During the discussion, the following questions and key points were made:

8.

Maternity services pdf icon PDF 239 KB

Committee Members will receive an update on maternity services following the changes brought in last year to improve the service.

 

Presenter:

Michelle East, Director of Midwifery, Buckinghamshire Healthcare NHS Trust

 

Paper:

Update report attached

Additional documents:

Minutes:

The Chairman welcomed Michelle East, Director of Midwifery, Buckinghamshire Healthcare NHS Trust to the meeting.

 

The Director of Midwifery made the following key points:

  • The background to this update to the Committee was the closure of the midwifery led birthing centre in Wycombe and the re-purposing of the site to provide ante-natal and post-natal care with the labour and birthing services being provided by a consultant-led service at Stoke Mandeville Hospital.
  • The review focused on 3 areas:

o    how the new model had been performing against key metrics;

o    the ongoing codesign and engagement work that will be taking place to help shape the development of additional ante- and post-natal services at Wycombe;

o    Next steps for the further improvement of maternity services in Buckinghamshire

  • The ante-natal service in Wycombe had been focussing on the two areas which can prevent disease in a child’s later life: cessation of maternal smoking and breastfeeding.
  • The national target for women who smoke during pregnancy was 6% but in Buckinghamshire the figure of 4% had been achieved. 95% of smokers had engaged with the tobacco dependency service. 80% of mothers were fully breastfeeding their baby on discharge.
  • In future, there needed to be an emphasis on ante-natal and post-natal mental health.  The teenage pregnancy midwives provide antenatal and postnatal care to all teenagers.  Referrals were made to Oxford Health for all women that were identified as having additional mental health support needs.
  • During January to March 2024, a co-design project had been undertaken with service users where women had said that they wanted a sense of community and peer support during pregnancy. To meet this need, face-to-face antenatal classes would be re-established at Wycombe and Stoke Mandeville hospitals.
  • Plans were being developed to provide a women’s health hub at Wycombe to provide a more integrated service. Ms Z McIntosh added that Healthwatch Bucks would be conducting a survey to find out which services women wanted at a health hub.
  • A pilot scheme had started in May 2024 to take mobile midwifery services to the deprived areas of Wycombe. These would be available at locations such as supermarkets and churches and would avoid the need for patients to travel.

 

During the discussion, the following questions and key points were made:

  • Black women were 4 times more likely than white women to die in childbirth and Asian women twice as likely. Improvements had been made in engaging with the South Asian community. The Director of Midwifery would be grateful for any suggestions of community groups which the Trust could engage with to reach out to black women more effectively.
  • To improve mental health in new mothers, it would be important to link up with primary care providers and concentrate on assessing new mothers at the 6 to 8 week postnatal GP check.
  • It would be helpful to work with GPs and health visitors to identify and provide support for women who had had traumatic experiences in a previous pregnancy and were having another child. There was  ...  view the full minutes text for item 8.

9.

Healthwatch Bucks update pdf icon PDF 170 KB

Healthwatch Bucks collect feedback from the public about local health and social care services every day.  Each month this feedback is processed and reviewed for trends.  The Chief Executive of Healthwatch Bucks will present the service feedback from the public (Jan 2024-May 2024). 

 

Presenter:

Zoe McIntosh, Chief Executive

 

Paper:

Update report attached

Additional documents:

Minutes:

Ms Z McIntosh introduced the July 2024 update, and made the following key points:

  • This update gave a high-level summary on the feedback gained from the public between January and May 2024. The feedback had followed the themes set out by Healthwatch England.
  • There had not been a major change from the feedback gathered in the previous year, most of the comments related to the difficulties in accessing primary care.  There may be a number of reasons for this, including Healthwatch Bucks increased presence in primary care through its work with Patient Participation Groups and greater numbers of the public accessing primary care.
  • There were more positive comments from residents this year from residents than the previous year, including on “staff attitudes”, an area which often received predominantly negative feedback.
  • Healthwatch Bucks received less feedback relating to secondary care but would increase its engagement work to encourage more feedback in the future.

 

During the discussion, the following questions and key points were made:

  • Healthwatch Bucks had increased its capacity to attend more face-to-face events.  A Member asked whether Healthwatch Bucks would consider having a permanent presence at the Health on the High Street centre.  Funding to do this was an issue and would need to be increased in order for that to happen.
  • The annual report published by Healthwatch Bucks would be launched at an event at the Gateway on 11th July 2024.
  • A Member complimented Healthwatch Bucks on the value of its social media interaction, which he described as “second to none”.

·       Some of the engagement events attended by Healthwatch Bucks included events at local libraries, Community Board meetings and the Festival of Wellbeing. There was a strong focus on engagement in the Opportunity Bucks wards. The Healthwatch Bucks team were always open to invitations to attend events.

10.

Q4 performance report pdf icon PDF 818 KB

For Committee Members to review and discuss the Q4 performance report for the Health & Wellbeing portfolio.

 

Paper:

Q4 performance report – Health & Wellbeing portfolio

Additional documents:

Minutes:

The Chairman referred to the Q4 performance reports included in the agenda pack.

  • A Member asked for a short briefing note, from the Cabinet Member, on the items shown in red on the performance reports going forward.
  • A Member asked how much the shortage of social workers was impacting on the provision of care and expressed concern about social workers who were working for Buckinghamshire Council but living outside the county.

                                                                                       

11.

Work programme pdf icon PDF 70 KB

For Committee Members to discuss and agree the work programme for the forthcoming council year.

 

Paper:

Draft work programme attached

Additional documents:

Minutes:

  • The Scrutiny Officer outlined the items to be included in the October meeting, explaining that the Carer’s Strategy would be in draft format. Linked to this item, the Bucks Healthcare Trust Carer’s Passport would also be considered. A 12-month monitoring review would look into how the recommendations of the rapid review “The Demetia Journey” were being implemented.
  • The Scrutiny Officer explained that the item from Oxford Health for the December 2024 meeting, would need to be scoped as mental health was a sizeable area to cover. Members were asked to consider this and let the scrutiny officer know which areas they wished to hear about.         

Action: Members/Scrutiny

Officer

 

During the discussion, Members made the following comments:

  • It would be useful to know how Oxford Health was performing and to see if any improvements had been made since representatives attended the HASC Select Committee about 2 years ago. The Committee should be provided with granular details including statistics and facts. Information on mental health in young people was requested. A Member asked if continuity of care for mental health patients who moved house into a different health authority could be investigated.
  • A Member suggested that the Committee could review the work of Be Healthy Bucks.
  • A Member suggested including details on the support that unpaid carers receive, noting that carers provide an invaluable resource and often neglected their own physical and mental health.
  • A Member suggested additional information on communications between patients and secondary carers, specifically to understand how the digitisation of patient records would help.

                                                                                       

12.

Date of Next Meeting

The next meeting will take place on Thursday 10th October at 10am.

Additional documents:

Minutes:

Thursday, 10th October 2024 at 10am.