Agenda and minutes

To receive any apologies for absence.

Apologies were received from Councillor Martin Boiles. Councillor Lance Quantrill, as the Conservative standing deputy, was in attendance in his place. 

Apologies were also received from Councillor Tonia Craig. Councillor Dominic Hiscock, as the Liberal Democrat standing deputy, was in attendance in her place.

Apologies were also received from Councillor Jane Frankum and co-opted member Councillor Trevor Cartwright.

All Members who believe they have a Disclosable Pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to the circumstances described in Part 3 Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore all Members with a Non-Pecuniary interest in a matter being considered at the meeting should consider whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, consider whether it is appropriate to leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with the Code.

Members were mindful that where they believed they had a Disclosable Pecuniary Interest in any matter considered at the meeting they must declare that interest at the time of the relevant debate and, having regard to the circumstances described in Part 3, Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter was discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore Members were mindful that where they believed they had a Non-Pecuniary interest in a matter being considered at the meeting they considered whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, considered whether it was appropriate to leave the meeting whilst the matter was discussed, save for exercising any right to speak in accordance with the Code.

Councillor Jan Warwick declared a personal non pecuniary interest that she had been an expert advisor to the Care Quality Commission, however not in Hampshire.

To confirm the minutes of the previous meeting (16 January 2019 and the Call In meeting of 14 March 2019)

The Minutes of the meeting of the Health and Adult Social Care Select Committee (HASC) held on 16 January 2019 and the Minutes of the Call In meeting held on 14 March 2019 were confirmed as a correct record and signed by the Chairman.

To receive any deputations notified under Standing Order 12.

The Committee did not receive any deputations.

To receive any announcements the Chairman may wish to make.

The Chairman made the following announcement:

Southern Health Restructure

In December 2018, Southern Health consulted stakeholders including the HASC seeking feedback on options to re-shape their operational organisational structure. The Chairman had responded to the consultation on behalf of the HASC. Southern Health had since shared their planned structure, following that engagement. The purpose of the restructure was to enable Southern Health to align their mental health and physical health services, with the ultimate aim of delivering better, more joined-up and holistic care to people and communities across Hampshire. Following the meeting the information received from Southern Health about their restructure would be forwarded to HASC Members.

To consider the report of the Director of Transformation and Governance on proposals from the NHS or providers of health services to vary or develop health services in the area of the Committee.

Items for Monitoring

a)    Hampshire Hospitals NHS Foundation Trust and West Hampshire Clinical Commissioning Group: Andover Hospital Minor Injuries Unit - Update

b)    Southern Health NHS Foundation Trust: Move of patients to Eastleigh & Romsey Community Mental Health Team - Update

a) Hampshire Hospitals NHS Foundation Trust and West Hampshire CCG: Andover Hospital Minor Injuries Unit - Update

Representatives from the Hospital Trust and Clinical Commissioning Group presented a report providing an update on the situation with Andover Hospital Minor Injuries Unit (see report, Item 6a in the Minute Book).

Members heard that the Trust continued to hold four vacancies for Emergency Nurse Practitioners and therefore was continuing to close the Minor Injuries Unit (MIU) at 6:00pm. No increase in attendance at the Emergency Departments of the Trust’s other hospitals had been seen. Nationally there was a move to consolidate services treating minor injuries into the Urgent Treatment Centre (UTC) model, therefore commissioners were looking to transition the offer at Andover hospital to an UTC. The UTC model included extended access to primary care services at evenings and weekends.

NHS England had indicated that UTC services should be available by July 2019, however it was unlikely this would be achievable in Andover. Commissioners locally were aiming for October or December 2019, although there was a chance this would slip into 2020. Commissioners were reviewing the demand from the local population, to consider whether a service open for twelve hours a day every day was necessary for the Andover population.

In response to questions, Members heard:

·      It was hoped the new model would help with recruitment to staff the revised service

·      Engagement had been undertaken nationally on the UTC model, and communications would be provided locally when the new UTC was ready to launch

RESOLVED

That the Committee:

a)    Note the progress on transitioning the MIU at Andover War Memorial Hospital to an Urgent Treatment Centre.

b)    Request a further update for the November 2019 meeting.

b) Southern Health NHS Foundation Trust: Move of patients to Eastleigh & Romsey Community Mental Health Team - Update

The Select Committee received a report providing an update on the move of patients who had previously been supported by the Southampton East Community Mental Health Team to come under the care of the Eastleigh and Romsey Community Mental Health Team (see report, Item 6b in the Minute Book).

RESOLVED

That the Committee:

a)    Note the update on the transition

b)    Request a further update be circulated to HASC Members once the transfer is complete

The Chairman took the next item earlier than the published agenda, as observers were in attendance who had a particular interest in this item.

To consider initiating a Working Group to contribute to the consideration of all wider options regarding the future of the Orchard Close Respite Centre.

The Select Committee considered a report of the Director of Transformation and Governance, regarding a proposed Working Group to feed in to further consideration of options relating to Orchard Close respite centre (see Item 10 in the Minute Book).

It was discussed that the first meeting of the Working Group was likely to be held in late May or June, to allow time for the Officers in Adults Health and Care to prepare. It was noted that the Terms of Reference proposed the Working Group comprise four Members and the Liberal Democrat spokesperson requested this be extended to enable more than one opposition member to take part. Councillor Harvey indicated that as Chairman of the Autism Partnership Board she would like to take part in the Working Group. It was noted that as part of the investigation of options being undertaken by officers, further engagement with stakeholders would be undertaken and the feedback received fed in to the Working Group.

RESOLVED:

To initiate a Working Group to feed in to the consideration of options relating to the future of the Orchard Close respite unit on Hayling Island, as per the proposed Terms of Reference attached to the report.

That the membership of the Working Group would be determined following the meeting, and consideration would be given to increasing the size of the group.

To consider a report of the Director of Transformation and Governance on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.

a)    Southern Health NHS Foundation Trust – Update on actions following CQC report

b)    Portsmouth Hospitals Trust – Update on actions following CQC report

c)    Solent NHS Trust – CQC Inspection Report

The Chairman took the items within Item 7 in a different order to the published agenda in order to accommodate availability of presenters:

b) Portsmouth Hospitals Trust – Update on actions following CQC report

The Medical Director from Portsmouth Hospitals Trust presented a report providing an update on action taken by the Trust in response to the areas the Care Quality Commission had identified as requiring improvement, following their inspection of the Trust’s services in 2018 (see report, Item 7b in the Minute Book).

Members heard that the Trust had been implementing a detailed quality recovery plan in response to the inspection findings. A re-inspection against a section 29A notice was expected, and three section 31 notices had been removed. The Trust view was that some improvements had been made, but in some areas there was still more to do.

In response to questions, Members heard:

·      It was disappointing that the caring rating had slipped from Outstanding in 2013 to Requires Improvement in 2018. The Trust was focused on promoting values and culture to improve this

·      CQC had recognised that for the Well Led category it would take time for the new leadership team in place to make an impact

·      The layout of the A&E area was a limitation and funding had been secured for an emergency care redevelopment project, however this would take a couple of years to reach fruition

·      Pressures were being experienced due to an unprecedented increase in demand. While the system had delivered improvements to delayed transfers of care over the past year, February 2019 had seen an 18% increase in attendances compared to February 2018

·      Some elective procedures had been suspended for a period in the past to help manage the emergency demand, however this had led to a backlog for some areas e.g. orthopaedics. The Trust had a recovery plan in place to deal with the backlog

RESOLVED

That the Committee:

a.    Note the update on action taken by the Trust in response to the 2018 CQC inspection findings.

b.    Request a further (paper only) progress update for the July 2019 meeting.

c.    Request PHT attends the November 2019 meeting to provide a further update and take questions.

a) Southern Health NHS Foundation Trust – Update on actions following CQC report

Representatives from Southern Health NHS Foundation Trust provided slides to give an update on action taken by the Trust in response to the areas the Care Quality Commission had identified as requiring improvement, following their inspection of the Trust’s services in 2018 (see slides, Item 7a in the Minute Book).

It was noted that the slides and the Trust’s Quality Improvement Plan would be circulated to Committee Members after the meeting. Members requested that the Trust provide a further update to a future meeting and provide a written paper in advance, so that Members have a chance to review the detail.

RESOLVED

That the Committee:

a. Note the update on action taken by the Trust in response to the 2018 CQC inspection  ...  view the full minutes text for item 127.

To receive an update on progress with the actions in the action plan following the CQC Local System Review, relating to actions targeted to be achieved within six months.

The Select Committee received an update from the Director of Adults Health and Care at Hampshire County Council regarding progress with the actions in the action plan developed following the CQC Local System Review undertaken in 2018 (see Item 8 in the Minute Book).

Members heard that following concerted efforts by the County Council and system partners over the past year, in December 2018 there had been a 75% reduction in people waiting in hospital for social care support to enable them to leave compared to December 2017.

The Health and Wellbeing Board was responsible for overseeing the Local System Review Action Plan and had recently refreshed the Joint Health and Wellbeing Strategy for Hampshire. It was noted that the HASC had a remit to scrutinise the Health and Wellbeing Board, and this could be reflected in future work programme items.

The Chairman congratulated the Director on the reductions achieved in Delayed Transfers of Care. It was noted that as the Review and Plan covered the system not just the County Council, representatives of other partners in the system could be invited to the meeting when the HASC considered the full year performance against the action plan.  

RESOLVED

That the Health and Adult Social Care Select Committee:

a)    Notes this update of the Care Quality Commission’s Local System Review Action Plan that has been jointly developed by Hampshire’s health and care system leaders to respond to the Review’s findings.

b)    Receives a progress update on the Action Plan due for completion in July 2019.

To receive an update from the HASC working group that has been considering the Sustainability and Transformation Partnership.

The Chairman gave a verbal update on the work of the Working Group the HASC had established in 2018 to scrutinise work taking place under the Sustainability and Transformation Partnerships covering the Hampshire population (Hampshire and Isle of Wight STP and the Frimley STP).

The Working Group had met three times across the year, and received presentations on:

·         H&IOW STP: Mental Health Work Stream Update

·         Frimley STP: Overall Programme Update

·         H&IOW STP: New Models Of Care Update

·         Frimley STP: Urgent & Emergency Care Programme Update

·         HIOW STP: System Reform Proposals - Integrated Care System Developments

It was planned that the Working Group hold further meetings in 2019. In addition, the County Council’s Cabinet had considered the Hampshire and Isle of Wight Sustainability and Transformation Partnership - System Reform proposals at it’s meeting on 1 February 2019. The Cabinet supported the direction of travel, and requested a further update on the progress of these arrangements and in particular the progress of the systems of democratic accountability that should support these important developments.

RESOLVED

The Select Committee note the update

To consider and approve the Health and Adult Social Care Select Committee Work Programme.

The Director of Transformation and Governance presented the Committee’s work programme (see Item 11 in the Minute Book).

The Chairman announced that for the next HASC meeting in May it was proposed to add items on the Hampshire Suicide Audit and Prevention Strategy, and the Joint Health and Wellbeing Strategy recently refreshed by the Health and Wellbeing Board.

RESOLVED:

That the Committee’s work programme be approved, subject to any amendments agreed at this meeting.