Agenda and minutes

To receive any apologies for absence.

Apologies were received from co-opted member Councillor Trevor Cartwright who had recently stood down from his position on this Committee. The Chairman paid tribute to his contribution to the work of the Committee.

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.

No declarations were made.

To confirm the minutes of the previous meeting

The Minutes of the meeting of the Health and Adult Social Care Select Committee (HASC) held on 6 July 2020 were confirmed as a correct record.

The Chairman added that under minute 204 he wished to place on record his thanks to Cllr Marge Harvey for her contribution to the work of the HASC.

To receive any deputations notified under Standing Order 12.

The Committee received a deputation from Mr Geoff Hill regarding Item 9b Southern Health NHS Foundation Trust: Out of Area Beds Update. Mr Hill suggested that the Trust had been disingenuous in its reporting of Out of Area Beds figures, as different figures were given to the media in July compared to what was referenced in their Council of Governors papers in July and Trust Board papers from July. He requested the Committee challenge the Trust on their figures.

Mr Hill also referenced a previous deputation he had made to the Committee in March along with two other individuals regarding safeguarding and expressed his dissatisfaction with the response to the issues they had raised.

To receive any announcements the Chairman may wish to make.

The Chairman made two announcements:

Extra HASC Meeting

The Chairman announced that as one of the meetings of this Committee had been cancelled during the lockdown period, to ensure the HASC could address it’s lengthy work programme an additional meeting had been scheduled for Thursday 22 October.

Portsmouth Hospitals University Status

The Chairman reported that he was pleased to learn at the end of July that Portsmouth Hospitals NHS Trust had been awarded university hospital status. This change was expected to bring benefits to patients, students, colleagues and local communities. The Trust would now be known as Portsmouth Hospitals University NHS Trust (PHU). Achieving university hospital status was the first step in a long-term programme to enhance research partnerships to drive innovation and develop new treatments more quickly, as well as investing further in academic partnerships to strengthen their workforce in the future. On behalf of the HASC he welcomed this development and congratulated the Trust on taking this step.

To receive a Public Health overview update on Covid progression and monitoring including; current status; future modelling/second wave planning; Local Outbreak Control Plan. (to follow)

The Committee received a report from the Director of Public Health (see Item 6 in the Minute Book) providing an update on the public health response in Hampshire to the Covid-19 pandemic. The Director summarised the written report and provided the latest figures on the state of coronavirus in Hampshire. It was noted that as of 12 September there had been 5579 diagnosed cases in Hampshire, an increase of 99 in the last seven days, and this equated to a rate of 11.3 per 100,000 population (compared to a rate of 26.7 for all of England). While the rate locally was lower than in other parts of the country, it was rising.

The importance of testing for the virus was acknowledged and it was noted that it was the responsibility of the Director of Public Health to ensure appropriate measures to do so were in place locally. However, there was reliance on nationally run laboratories which were experiencing some capacity issues.

Work had been going on to develop approaches to managing the threat from the virus in high risk settings such as care homes and schools. On 2 September the ‘major incident’ approach to the response to the pandemic had been stood down, with a system around Local Outbreak Control planning taking its place.

Members asked questions to explore the issues. Regarding testing, it was noted that mobile units to offer testing were deployed across the county to different locations on different days, and local test facilities were being developed. To access a test people should use the government website or phone 119 to be advised of where to go or request a home test kit be posted to them. Details could be circulated to the Committee.

RESOLVED:

1. To note the COVID-19 situation.

2. To note the leadership role of the Public Health Director and function.

To receive an update on the Adult Social Care aspects of the pandemic including regarding support for those in the Shielding category, Care Homes, and Service Recovery.

The Committee received an update from the Director of Adults’ Health and Care (see Item 7 in the Minute Book) providing an update on the Covid-19 response by Adults’ Health and Care. The report and accompanying presentation covered support to vulnerable residents and people supported by adult social care services, moves towards recovery of services, and work undertaken to support the care home sector.

Members heard that on 31 July the national shielding programme had ceased, which affected 53,000 Hampshire residents. There was then a campaign ‘It’s Ok to…’ to help them reconnect safely etc. A skeleton of the support structure that had been used to support those shielding would be retained, so it could be scaled up again in future if needed.  

The department was undertaking learning reviews to reflect on the response to the pandemic to date. The department was providing support to the care home sector and would continue to do so heading in to winter. Regular testing for the virus in care homes was an issue. 83% of care homes were now reporting access to regular testing kits, however lab capacity to produce the results remained an issue. 

Members asked questions to explore the issues. A risk based approach was being taken to recovery of face to face services such as day services and respite services e.g. for those with a learning disability. Approaching 50% of users were back to using day services.

RESOLVED:

1.    That the Health and Adult Social Care Select Committee notes the work that has taken place to date by Adults’ Health and Care, public and voluntary sector organisations and their partners in Hampshire to support the needs of its most vulnerable citizens and the wider community.

2.    That the Health and Adult Social Care Select Committee is assured by the systems that have been put in place across Hampshire, as set out in this report, to support the county’s most vulnerable residents as well as the wider community during the COVID-19 pandemic.

3.    That the Health and Adult Social Care Select Committee recognises the impacts upon the care home sector and wider social care sector but is assured by the work underway to support the care home sector.

4.    That the Health and Adult Social Care Select Committee notes actions taken and currently underway to support moves toward recovery of services, systems and processes across Adults’ Health and Care and receives further updates at future meetings.

To receive an update on the NHS Hampshire and Isle of Wight system approach to COVID including second wave/winter planning and recovery.

Including updates from the following Trusts:

a.    Hampshire Hospitals NHS Foundation Trust

b.    University Hospitals Southampton NHS Foundation Trust

c.    Portsmouth Hospitals University NHS Trust

The Committee received an update from the Clinical Commissioning Groups covering Hampshire and the Isle of Wight providing an update on the response of the NHS in Hampshire to the Covid-19 pandemic (see Item 8 in the Minute Book). A written report and accompanying presentation provided an overview of the health element of the Hampshire and Isle of Wight Local Resilience Forum response to Covid-19; the NHS restoration and recovery work; and planning work being undertaken across Hampshire and the Isle of Wight (HIOW) for winter and a potential second wave of Covid-19. A written update had also been received on the position for Hampshire Hospitals NHS Foundation Trust, University Hospitals Southampton NHS Foundation Trust and Portsmouth Hospitals University NHS Trust.

Members heard that planned care was ceased during the peak of the pandemic. These services were re-starting but there was a backlog that had resulted in long waiting times. Effort was being put in to ways to see additional patients to help reduce this. It was noted that over time different treatment methods for covid-19 had been developed, some of which did not require anaesthetist supervision, therefore if hospitalisations from the virus increase in a second wave the impact would hopefully be less than in the first wave. There had been learning from the first wave that it was hoped would mean the system would be better prepared to respond to a second wave.

RESOLVED:

That the Health and Adult Social Care Select Committee:

1.    Note the system wide update

2.    Note the Trust specific updates provided

3.    Request that updates continue to be provided at each meeting of the HASC.

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 Action

a)    Southern Health NHS Foundation Trust: Proposed Closure of Willow Ward (inpatient unit for adults with learning disability and challenging behaviour)

Items for Monitoring

b)    Southern Health NHS Foundation Trust: Out of Area Beds Update

Written only updates:

c)    Andover Hospital Minor Injuries Unit (Hampshire Hospitals Foundation Trust and commissioners)

d)    Orthopaedic Trauma Modernisation Pilot (Hampshire Hospitals Foundation Trust and commissioners)

e)    Integrated Primary Care Access Service (Clinical Commissioning Group Partnership)

a)    Southern Health NHS Foundation Trust: Proposed Closure of Willow Ward (inpatient unit for adults with learning disability and challenging behaviour)

The Committee received a letter and briefing note from the Chief Executive of Southern Health NHS Foundation Trust regarding the proposed closure of Willow Ward (see Item 9a in the Minute Book). Members heard that the 6 beds at the unit had never been fully occupied and in the last few years occupancy had been around two or three patients. At the current time one patient remained and discussions were underway to agree alternative care plans. The intention was to close the unit, once that patient had been moved to alternative supported living accommodation. Instead of inpatient care, care packages would be developed to support such individuals in other settings in future.  

RESOLVED:

The Health and Adult Social Care Select Committee:

1.    Consider that the engagement undertaken in relation to this service change is appropriate.

2.    Support the proposed closure of Willow Ward and replacement with a community-based service as in the interest of service users and the local health system.

b)    Southern Health NHS Foundation Trust: Out of Area Beds Update

The Committee received an update from the Chief Executive of Southern Health NHS Foundation Trust regarding out of area mental health placements (see Item 9b in the Minute Book). Members heard that patients were sometimes treated in beds outside of the Hampshire area if there wasn’t capacity to accommodate them in facilities in Hampshire. The Trust had been working to reduce the number of patients treated outside of Hampshire and there were none in this category on the meeting date.

It was highlighted that some patients were accommodated in beds run by other providers in Hampshire (up to 23 beds contracted from private providers), and these were not counted as Out of Area placements by NHS England. However, the Trust was planning to address it’s inhouse capacity over the next year or so, so that patients being treated by other providers could be reduced.

Members commented that Southern Health had in previous years reduced it’s inpatient bed capacity, and the current reliance on other providers suggested a revised assessment of an appropriate number of beds for the Hampshire population was needed.  

The Chief Executive confirmed that the Trust would be happy to respond to the points raised in the deputation on this topic following receipt of the details.

RESOLVED:

The Health and Adult Social Care Select Committee:

1.    Note the update and welcome the reduction in use of out of area beds.

2.    Note the intention to explore increasing inhouse bed capacity to reduce reliance on other providers, and request a further update when progress has been made in this regard. (written update in January 2021 requested)

c) Hampshire Hospitals NHS Foundation Trust and commissioners:

Andover Hospital Minor Injuries Unit Update

The Committee received a written only update regarding the Minor Injuries Unit at Andover Hospital (see Item 9c in the Minute Book).

RESOLVED:

The Health and  ...  view the full minutes text for item 219.

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.    Hampshire Hospitals Foundation Trust – Care Quality Commission latest report (published in April 2020)

b.    Clinical Commissioning Group Reform in Hampshire and the Isle of Wight

a.    Hampshire Hospitals NHS Foundation Trust – Care Quality Commission latest report (published in April 2020)

The Committee received the latest Care Quality Commission inspection report for Hampshire Hospitals NHS Foundation Trust (see Item 10a in the Minute Book). The Chief Nurse from the Trust was in attendance to summarise the findings and the response of the Trust to any areas for improvement.

Members heard that the previous inspection in 2018 put the Trust at ‘Requires Improvement’ rating overall. The Trust were proud to report that at the most recent inspection undertaken in January 2020 improvement had been found across all key strands and the overall rating was now ‘Good’. One ‘must do’ recommendation had been made relating to medicine management. The Trust was on track with responding to the majority of the recommendations.

RESOLVED:

That the Health and Adult Social Care Select Committee:

1.    Note the outcomes of the most recent inspection.

2.    Request an update on any improvement actions by email.

b. Clinical Commissioning Group Reform in Hampshire and the Isle of Wight

The Committee received an update from the Chief Executive of the Hampshire Clinical Commissioning Group Partnership (see Item 10 b) in the Minute Book) regarding the intention of six Clinical Commissioning Groups covering the Hampshire area to merge in April 2021.

Members heard that the intention was to enable some elements of commissioning to be provided at a larger scale where it was efficient and effective to do so, including across the Hampshire and Isle of Wight footprint that matched the Integrated Care System. However, it was intended to maintain a focus on other areas at a local level. It was also expected that this merger would make it easier to integrate with social care which is provided at a Hampshire wide level by the County Council. However, it was noted that the Portsmouth City Clinical Commissioning Group and North East Hampshire and Farnham Clinical Commissioning Group would not form part of the new arrangement.

RESOLVED:

That the Health and Adult Social Care Select Committee:

1.    Note the plans to merge outlined.

2.    Request a further update in early 2021 with further detail on how these changes impact the development of an Integrated Care System (ICS) for the Hampshire area.

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 indicated that while the pandemic was underway non-Covid items would be prioritised and kept to a minimum.

Members requested that NHS Covid updates cover recovery of services that had been reduced including dentistry, diagnostics, podiatry etc.

RESOLVED:

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