Agenda and minutes

Apologies had been received from Councillors S Adoh and C Jones.

Cllr R Caster substituted for Cllr Jones.

Cllr Chris Poll declared an interest in items 6 & 7 as  South Central Ambulance Service was a dormant client.

Cllr Alan Turner declared that he is a Trustee of the Princes Centre, an independent day care provider.

To confirm the minutes of the meeting held on 20 July 2023 as a correct record.

The minutes of the meetings held on 20 July 2023 were confirmed as a correct record.

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/getinvolved-with-council-decisions/select-committees/

There were no public questions.

The Chairman will update Members on recent scrutiny related activities since the last meeting, including the joint response to the draft autism strategy.

Papers:

Joint response attached

The Chairman updated the Committee on the following:

Autism Strategy

·         A joint response had been sent from the committee and the Children’s & Education Select Committee to the recent draft Autism Strategy public consultation.  The Members on the working group, Cllrs Mordue, Stuchbury and Poll, were thanked for their time in preparing the response.

·         Members would have an opportunity to hear how their feedback had helped shape the final strategy at its meeting on 29^th February 2024.

Joint Health Scrutiny Committee

·         Local authorities in Bedfordshire, Luton and Milton Keynes had set up a joint health overview and scrutiny committee to review the work of the BLMK Integrated Care System. 

·         Buckinghamshire Council had been allocated one seat on the joint committee

·         The Chairman thanked Cllr Mordue for agreeing to take up the appointment to the joint committee.

·         The first formal meeting would be taking place on  27^th November 2023

Primary Healthcare Planning Rapid Review

·         Two days of evidence gathering had taken place as part of the Primary Healthcare Planning Rapid Review.

·         The Chairman thanked the four Committee Members who were part of the rapid review – Cllrs Poll, Stuchbury, Thomas and Turner. 

·         The report was due to be discussed at the next Committee meeting in November.

The Committee will hear from key health and social care colleagues about this years’ system winter plan.

Presenters:

Caroline Capell, Director of Urgent and Emergency Care

Angela Macpherson, Cabinet Member, Health & Wellbeing

Craig McArdle, Corporate Director, Adults and Health

Tiffany Adonis-French, Service Director, ASC Operations

Tracey Ironmonger, Service Director, Commissioning

Raghuv Bhasin, Chief Operating Officer, Buckinghamshire Healthcare NHS Trust

Martin Thornton, Interim Deputy Director for Bucks GPPA and FedBucks Director

Daryl Lutchmaya, Chief Governance Officer, South Central Ambulance Service (SCAS)

Paul Stevens, Assistant Director Commercial Services, SCAS

Emma Crozier, PTS Area Manager, SCAS

Mark Begley, Head of Operations, SCAS

Papers:

System Winter Plan

The Chairman welcomed the following presenters to the meeting:

Caroline Capell, Director of Urgent and Emergency Care

Angela Macpherson, Cabinet Member, Health & Wellbeing

Tiffany Adonis-French, Service Director, ASC Operations

Tracey Ironmonger, Service Director, Integrated Commissioning

Raghuv Bhasin, Chief Operating Officer, Buckinghamshire Healthcare NHS Trust (BHT)

Martin Thornton, Interim Deputy Director for Bucks GPPA and FedBucks Director

Mark Begley, Head of Operations, South Central Ambulance Service (SCAS)

Daryl Lutchmaya, Chief Governance Officer (SCAS)

Paul Stevens, Assistant Director, Commercial Services (SCAS)

Emma Crozier, Patient Transport Service Area Manager (SCAS)            

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

·       The planning for winter 2024 to 2025 would start in February and would focus on same day care, increasing capacity, reducing discharge delays and demand caused by surges such as the increase in streptococcal A infections.

·       Healthcare provision had improved since last winter and should be the first year “back to normal” after the Covid pandemic.

·       In response to a question about improved dementia care, the Chief Operating Officer for BHT outlined two improvements. The first Admiral nurse had been recruited and it was hoped that another nurse would be recruited soon.  There was also a better relationship with a small number of care homes who had formed a hub to provide dementia support. This had resulted in patients staying in care for shorter periods of time whilst their care packages were established (reduced from an average of 85 to 35 days).

·       The Chairman asked for more information on the effectiveness of these care hubs.  The Service Director for Integrated Commissioning explained that, over the last year, joint working with care providers had been effective.  There were five hubs providing 26 beds as well as 22 beds in the Olympic Lodge facility at Stoke Mandeville.   The Service Director for ASC Operations said that the working model had been tested before the winter challenges started and that the multi-disciplinary approach was producing better outcomes for patients.

·       A Member raised concerns about Buckinghamshire residents who were discharged from neighbouring hospitals, such as Milton Keynes and Wexham Park Hospitals, particularly when there were social care needs.  The Service Director for ASC Operations explained that there was a dedicated team who were handling out of county hospital discharges.

·       The Head of Operations highlighted that the South Central Ambulance Service (SCAS) had a number of pathways available to them to ensure patients were treated at the right place and ambulance crews would do their best not to take patients to hospital. He went on to say that 50% of patients who called 999 did not go to hospital.

·       A Member asked how Olympic Lodge would be staffed and the impact future industrial action would have on being able to staff this facility over the winter.  The Chief Operating Officer advised that there would be a dedicated team of nursing staff and that the ward was nurse and therapy led and would not be adversely affected by any industrial action.

·       In response  ...  view the full minutes text for item 6.

The Committee will review the progress in implementing the actions outlined in the recent Care Quality Commission’s report (August 2022).  This item will also be an opportunity for Members to examine the current arrangements in place for the Non-Emergency Patient Transport Service.

Presenters:

Daryl Lutchmaya, Chief Governance Officer

Paul Stevens, Assistant Director Commercial Services

Emma Crozier, PTS Area Manager

Mark Begley, Head of Operations

Papers:

Report attached

The Chairman welcomed the following presenters to the meeting:

Daryl Lutchmaya, Chief Governance Officer

Paul Stevens, Assistant Director Commercial Services

Emma Crozier, Patient Transport Service Area Manager

Mark Begley, Head of Operations

The following key points were made:

·       The Care Quality Commission (CQC) report in 2022 identified 11 must-do and 20 should-do items for South Central Ambulance Service (SCAS) to undertake.

·       There was one must-do item remaining which was to implement an escalation and decision-making process at board level.  This was  planned for December 2023.

·       The remaining should-do item was to consider ways of monitoring outcomes for patients who were not transferred to hospital to see if other pathways were  working effectively.

·       Staff wellbeing was being prioritised with 27 Freedom to Speak Up champions being appointed and winter wellness packs had been distributed to all staff An improvement plan had been launched to help staff reach their own performance targets.

During the discussion, Members asked the following questions:

·       A Member asked whether the service was responsible for ensuring that when vulnerable patients were  discharged from hospital, an appropriate care package was in place. The Assistant Director replied that SCAS deals with transporting patients to the most appropriate place and they would return a patient to hospital if they felt that the patient would be unsafe in their home.  Wraparound care was provided by a number of different health and care providers.

·       A Member asked about reasons for the significant increase in safeguarding referrals to the Council and asked if the Oliver McGowan advocacy guidelines were being followed. The Chief Governance Officer stated that SCAS was encouraging staff to identify and raise safeguarding issues and that this could account for the increase.

·       A Member asked about the situation on mandatory appraisals and training for staff, referring to the paper which states that training was below target levels. The Chief Governance Officer explained that the percentage of staff who had completed mandatory training had risen from 64% to 83%.  He added that sometimes training had to be paused due to work pressures. 

·       The Chairman asked Philippa Baker, as Place Director for the Integrated Care Board (ICB), to update Members on funding.  Philippa explained that the ICB worked very closely with SCAS, looking at services such as 999 and 111 but there was no specific update on funding for this meeting.

·       A Member asked how patient safeguarding had been impacted after the recent failure of IT software. The Head of Operations explained that the SCAS software needed to be updated and there had been challenges when the Electronic Patient Records (EPR) system failed but it had not affected the safeguarding of patients.  The Chief Governance Officer said that the Board was discussing how to prioritise its spend on updating IT systems.

·       A Member asked about the whistleblowing procedures within SCAS and asked if openness and transparency had improved. The Chief Governance Officer explained that any allegations were dealt with by the Board.  The Assistant Director of Commercial Services added that SCAS  ...  view the full minutes text for item 7.

Ms Z McIntosh, Chief Executive, will update Members on recent projects undertaken by Healthwatch Bucks.

Papers:

Update attached

Zoe McIntosh took Members through the Healthwatch Bucks update in the agenda pack and said that one of the top issues was patient access to a GP.  The update also looked at other areas of primary care, mainly community pharmacies.

For Committee Members to discuss and agree the items for the next meeting.

Papers:

Work programme

Members discussed items for the next meeting and agreed the following:

·         Primary Care Network Inquiry - 12 month recommendation monitoring;

·         Director for Public Health Annual Report.

Evaluation of the Winter Plan and an update from Oxford Health around mental health services were raised as potential items to add to the work programme.

The next meeting is due to take place on Thursday 30 November 2023 at 10am.

Thursday 30^th November 2023 at 10am