Agenda and draft minutes

Health Scrutiny
Tuesday, 7th September, 2021 6.00 pm

Venue: Crompton Suite, Civic Centre, Oldham, West Street, Oldham, OL1 1NL. View directions

Items
No. Item

1.

Apologies For Absence

Minutes:

There were no apologies for absence received.

2.

Declarations of Interest

To Receive Declarations of Interest in any Contract or matter to be discussed at the meeting.

Minutes:

There were no declarations of interest received.

3.

Formal election of the Vice-Chair 2021-22

The Committee to formally elect a Vice-Chair for the municipal year 2021-22.

Minutes:

As the previous meeting held on 6th July 2021 had been informal, the Committee was requested to formally nominate a Vice-Chair for the duration of the Municipal Year 2021/22.

 

RESOLVED - That Councillor McLaren be elected Vice-Chair of the Health Scrutiny Committee for the duration of the Municipal Year 2021/22.

4.

Minutes of Previous Meeting held on 6th July 2021 pdf icon PDF 319 KB

The Minutes of the previous meeting held on 6th July 2021 are attached for approval.

Minutes:

RESOLVED - That the minutes of the meeting held on 6th July 2021 be approved.

 

5.

Urgent Business

Urgent business, if any, introduced by the Chair

Minutes:

The Committee was asked to consider an item of urgent business in relation to the Joint Health Overview and Scrutiny Committee for Pennine Acute Trust

 

Councillor McLaren advised the Committee that the Joint Health Overview and Scrutiny Committee for Pennine Acute Trust had been dissolved following the meeting that had taken place on 6th September 2021, as the Pennine Acute Trust was to be dissolved on 30th September 2021.

 

Councillor McLaren further advised that preparations were being made to establish a new Joint Committee under the auspices of the Northern Care Alliance and a meeting had been provisionally scheduled for 7th January 2022.

 

It was reported that the Pennine Acute Committee had scrutinised issues relating to joint services delivered in Oldham, Rochdale, Bury and North Manchester, with the latter now being transferred to the new Manchester Foundation Trust. Salford Royal Hospital would come within the Northern Care Alliance from 1st October 2021.

 

It was further reported that the unanimous view of the Members present at the Joint Committee meeting on 6th September 2021, was that the joint committee should be allowed to continue its invaluable work. It was anticipated that Bury MBC, who serviced the Committee, would be contacting all Councils to ascertain if they wished the Committee to continue.

 

It was moved by Councillor McLaren and seconded by Councillor Salamat that the Health and Scrutiny Committee endorse the view that the Joint Committee should continue.

 

RESOLVED – That the Health Scrutiny Committee endorse the view that the Joint Health Overview and Scrutiny Committee be continued.

 

6.

Public Question Time

To receive Questions from the Public, in accordance with the Council’s Constitution.

Minutes:

No public questions had been received.

7.

Healthy Child Programme pdf icon PDF 311 KB

A report providing an overview of the delivery of the Healthy Child Programme in Oldham, and the progress over the past twelve months.

Minutes:

The Committee considered a report and presentation providing an overview of the delivery of the Healthy Child Programme (HCP) in Oldham, and the progress over the previous twelve months. The report also outlined the current performance of the related services, and the engagement work that was happening with parents, and young people.

 

The Committee was reminded that the HCP had been launched 11 years ago and was still the national evidence based universal programme for children aged 0-19. The programme provided the bedrock for health improvement, public health and supporting families. The HCP was not the responsibility of any individual service but was instead a partnership approach.  The programme was led by health visiting and school nursing: our 0-19 public health nursing services.

 

The Committee noted that Local Authorities were mandated to provide some key public health services, and Bridgewater Community Healthcare NHS Foundation Trust provided a number of them on the Council’s behalf:-

·         Health Visitor review of pregnant women and children

·         Weighing and measuring children at Reception and Year 6, and

·         Oral health promotion programmes as deemed necessary for the area

 

Members were informed that, compared with England averages, the health and wellbeing of children in Oldham was below average. Health outcomes for children were impacted by poverty in a similar way that health outcomes for adults were. As the recent 10-year update on the Marmot Review argued “Poverty experienced during childhood harms health at the time and throughout the rest of life”. In Oldham, there were areas of high rates of deprivation and the latest figures were that 38% of children in Oldham lived in

poverty.

 

The Committee noted that the service generally performed well in relation to the mandated contacts by health visitors. Other than the New Birth Visit, the service completed more than the England average for contacts. There were some challenges to meeting the New Birth Visit target which the service was working on.

 

There had been an increase in demand in relation to safeguarding since the start of the pandemic and the service had implemented the following changes in practice over the past year in order to support families through the pandemic:-

·         Ensured the focus was on those most vulnerable by carrying out caseload reviews and identification of all vulnerable children (Child Subject of Child Protection Plan / Child in Care / Child in Need / child with SEND / extremely clinically vulnerable children)

·         Provided ongoing support to families identified with lower level needs to prevent escalation including creative opportunities for face to face assessments (pram walks / garden visits / park visits / doorstop child growth monitoring)

·         The service provided daily appointment-based healthy child clinics for parents who were reluctant to allow professionals into their homes as well as for the delivery of packages of care

·         The service developed a video in an attempt to allay parental fears of accessing services. The video described the COVID-19 safe arrangements that were in place in order to keep both families and staff safe whilst also  ...  view the full minutes text for item 7.

8.

HIGH-LEVEL ELECTIVE RECOVERY pdf icon PDF 1 MB

A report advising the Committee on local and Greater Manchester-wide elective waiting lists and clinical prioritisation considerations.

Minutes:

The Committee considered an update report from the Strategic Director of Commissioning/Chief Operating Officer outlining the position in relation to recovery of elective activity across GM following Covid which was outlined within the report. 

 

The Committee was advised that the pandemic had created significant challenges for providers in Greater Manchester in their processing of patients, irrespective of whether they are on admitted or not-admitted pathways and that this difficulty spans all ages and all specialities. 

 

It was reported that the consequences of this was a substantial increase in waiting times, including a level of patients waiting more than 52 weeks.  The Committee was advised that this scenario had not been seen for many years. 

 

It was further reported that addressing the challenge would require collaborative working across providers, including the use of the Independent sector and a focus on pathways between primary and secondary care.  This work will provide opportunities for transformation and innovation in many of our specialities including within community and primary care services.

 

The Committee was advised that collaborative working across hospital and community cells in GM had clearly been delivered successfully during the COVID pandemic and despite all the challenges new pathways, and innovative clinical practice has been delivered to the benefit of the GM population.  The provision of mutual aid for critical care had exemplified this collaborative practice.

 

The Committee was further advised that GM had been disproportionately affected by the Covid pandemic, experiencing three waves, each having a significant impact on ability to deliver wider elective activity.  The decline following the third was also notably slower in GM than other parts of the North West Region and across England with critical care capacity still 50% Covid in GM compared to c 33% in Lancashire and Cumbria and Cheshire and Mersey.

 

Highlighted within the report was the GM Elective Recovery position, the GM Trust Recovery position and the overall GM approach to recovery.  Recovery of elective activity was continuing across GM.  There had been an improvement in performance across several points of delivery, including day case and ordinary elective.  There was concern that the ongoing Covid 19 and urgent care pressures would impact this delivery over the coming weeks.

 

It was reported that the GM elective indicated that the total number of patients waiting was 395,805, with the number of patients waiting over 52 weeks having increased to 33,156 patients (9% of total waiting list).  The three specialities with the biggest number of over 52 weeks continued to be Trauma and Orthopaedics, General Surgery and ENT.  Details of Recovery and Reform within prioritised elective specialities was also outlined within the report.  Details of latest Independent Sector activity was also detailed in the report showing performance against the 2019/20 baseline contracted activity.

 

Details of Health Inequalities in Elective Recovery were outlined in the report along with actions being considered to address the issue.  It was reported that the GM communications team have developed an updated stakeholder briefing in response to the increase in demand being experienced  ...  view the full minutes text for item 8.

9.

Pennine Acute Transaction - Update pdf icon PDF 1013 KB

An update on the Pennine Acute Transaction Programme.

Minutes:

The Committee was provided with an update on the transaction

and future arrangements for Pennine Acute Trust (PAT)

hospitals.

 

The key messages highlighted to the Committee were that:

·         Since the previous update to the Committee, there had been significant inroads towards the completion of the transaction, and there now remained no significant risks to transaction completion.  SRFT and PAT had worked closely with the NHSE1 review team to submit a range of documentation and undergo a number of review meetings.

·         SRFT had undertaken a number of meetings with the NHSE1 review team as part of the transaction progress.  The NHSE1 review team had also met with PAT colleagues.  These meetings had been positive and constructive.

·         SRFT and PAT executives and non-executives had met regularly to discuss the delivery of services under the management agreement and operation issues.

·         The NHSE1 review team will submit their recommendations on the transaction to the Provider Oversight Committee on 14th September 2021.

·         As a result of the transaction being phased, there had been additional opportunities to reduce any remaining risks prior to transaction taking place.

·         There remain no significant risks to transaction completion.  There is one risk scored at 10 – Financial and operation performance falling across both SRFT and PAT may fall further before the transaction takes place, mitigation of continuing QI programmes and Oldham CQC improvement plan.

·         In terms of operational risk following transaction, there remains one risk rated at 10 – Capital funding for transformation, discussions are ongoing between NCA and NHSE1 NW/other system stakeholders.  This risk is expected to be closed as part of the agreement of the ICS capital control total for 2022/23.

 

Post-Transaction Changes and Impacts on Patients were detailed as below:

·         Immediately following transaction, there will be no changes to any services. Our key focus will be the delivery of a “safe landing” for all services and for patients in order to ensure a seamless transition to the new organisation.

·         SLA exit timetables have been agreed between NCA and MFT. Exit plans have been agreed for the SLAs concluding in September 2021 following the NCA transaction completion, with plans for the rest in development. There may be some changes as services disaggregate, and relevant partners will be engaged as appropriate.

·         The key visible change will be the organisational name change from SRFT / PAT to Northern Care Alliance NHS Foundation Trust. A new email address will be put in place for all staff as of transaction, ending @nca.nhs.uk rather than @srft.nhs.uk or @pat.nhs.uk. Existing email addresses will continue to operate for an extended period of time.

·         The new NCA website (www.northerncarealliance.nhs.uk) will be launched on 1st October and PAT and SRFT old websites decommissioned. Public, patients and external stakeholders will be able to access all information as before in one place and updated content and guidance.

·         The four Care Organisations (Bury, Oldham, Rochdale, Salford) will continue to have distinct identities, and with no changes to the leadership or clinical teams.

 

Details of  ...  view the full minutes text for item 9.

10.

Overview and Scrutiny Work Programmes 2020/21 - Outturn pdf icon PDF 217 KB

A report to present the outturn Overview and Scrutiny Work Programme for the 2020/21 Municipal Year.

 

Additional documents:

Minutes:

RESOLVED that the Committee note the Outturn Policy Overview

and Scrutiny Programme 2020/21 Municipal Year.

11.

Health Scrutiny Work Programme 2021/22 pdf icon PDF 157 KB

For the Health Scrutiny Committee to review the Committee’s Work Programme for 2021/22.

 

Additional documents:

Minutes:

RESOLVED that the Committee note the Health Scrutiny Committee Work Programme for 2021/22.