Agenda and minutes

RESOLVED -

That the minutes of the last meeting held on1 July 2016 were agreed as a correct record.

The Committee received a report and presentation from Dr Steve Kirk, Long Term Conditions Lead, Newcastle Gateshead CCG and Jane Mulholland, Director of Delivery and Transformation, Newcastle Gateshead CCG on the proposals for the future of the acute stroke services in Gateshead. Councillors were reminded that this was an engagement session and not a consultation session.

NHS Newcastle Gateshead Clinical Commissioning Group has been reviewing the current Gateshead model of acute stroke care to ensure it is compliant with evidence based best practice and national guidance. In addition there are capacity issues at the Queen Elizabeth Hospital (QEH) that reflect the national picture.

When a patient presents with suspected stroke they need rapid assessment, diagnosis and treatment by specialist staff. The team at the QE is depleted, carrying vacancies they have been unable to fill.  Currently the team is supported by their colleagues in South Tyneside and Sunderland out of normal working hours. This support is delivered remotely using telemedicine, however, changes in treatments now mean that a face to face assessment is considered the gold standard for treatment and delivers the best outcomes for patients.

National policy is driving change in how stroke services are arranged locally. NHS England advocates a new model for stroke services which involves services being delivered through a Hyper-Acute Stroke Unit where patients are transferred for specialist rehabilitation, usually 2-3 days after their stroke following their initial treatment and stabilisation.

Along with the national recommendations the Local Stroke Network (North East and Cumbria) has produced a paper summarising how ideally we can meet these standards and recommends that there is a maximum of 6 Hyper Acute Stroke Units supported by acute stroke units. Importantly, there are not the numbers of stroke consultants available to be able to provide the extended hour’s emergency cover for acute stroke patients under the current configuration.

There has been a vacancy in one of the two stroke consultant posts at the QEH since April 2014 which the Trust has been unable to fill. There is also a stroke consultant vacancy in South Tyneside NHS Foundation Trust, which provide out of hours cover for Gateshead. This is causing an additional strain on the stroke service in Gateshead.

All of these factors have put pressure on the Stroke Service in Gateshead and in 2014 the QE approached the CCG to ask if we would consider a new stroke pathway moving the initial care of stroke patients to a larger unit based at the RVI.5

The Committee were advised that the current situation is no longer sustainable. The QE unit has 2 consultant posts, 1 of which has been vacant for over 12 months despite several attempts to recruit. The QEH clinical and management team have approached the CCG and suggested that they would like to work in collaboration with Newcastle Hospitals to update and improve the Stroke Services.  With this in mind three options have been considered in order to meet national and regional guidance on stroke services:-

1) Gateshead Stroke  ...  view the full minutes text for item CHW11

The Committee received the first update report on progress made against recommendations and actions identified from the review of GP Access in Gateshead.

Access to GP services continues to be a key issue for local communities across the borough as a whole, whether from urban or more rural areas. The Committee received a significant amount of evidence as part of the review and undertook a series of visits to GP practices and other sites across the borough in order to scrutinise current arrangements in place, gain a better understanding of both the challenges and opportunities relating to GP access and the quality of care provided.

In particular, the evidence gathering sessions and site visits focused on:

·         Key issues relating to ‘Access’ to GP services, drawing on survey findings and other evidence on GP appointments, opening hours, out-of-hours etc;

·         Issues relating to the quality and experience of care;

·         GP Access and quality of care in the broader context of service developments/initiatives relevant to the review topic

Committee members acknowledged the input of GP practices to the review and expressed their thanks to their practice managers. The Committee also expressed its thanks to Newcastle Gateshead CCG, NHS England Cumbria and North East, Healthwatch Gateshead and Gateshead Community Based Care Ltd for their contributions to the review.

The Committee noted that a strong partnership approach is essential to ensure appropriate, timely and quality GP services can be accessed by Gateshead residents. Patients themselves also have a key role to play in providing feedback to their practice.

It was reported to Committee that Practice Action Plans are developed by all practices working with Newcastle Gateshead CCG and NHS England and are reviewed and updated annually. In continuing to develop these plans in the future, it was recommended that a specific focus is placed on ways individual practices can enhance access to GP services for their patients and actions that can be taken in  this area. It was also noted that practice facilitators will continue to support practices in taking these actions forward.

The headline findings of the review acknowledged the opportunity to build upon existing work and continue the direction of travel set by local NHS Partners and GP practices themselves to enhance access to GP services in Gateshead.

Six priorities and actions were identified and the Committee received an update on the progress to date in these areas:-

1) Access and Appointments

2) Addressing Variation in Quality

3) Estates

4) Workforce

5) IT

6) Patient Engagement

The Committee noted that some key achievements were that the most recent national General Practice Patient Survey reports that overall good experience of out of hours services in the Gateshead area has increased from 55 to 70%. In addition 90% of those responding to the GatDoc Survey regarding satisfaction with the out of hours service gave a rating of Good to Excellent as at June 2016.

In addition 100% of GP practices had signed up to the Practice engagement scheme with a 100% return of practice engagement  ...  view the full minutes text for item CHW12

The Committee received a report from Healthwatch Gateshead outlining the key activities undertaken over the last 12 months.

The Committee were advised that Healthwatch Gateshead have raised concerns with the North East Ambulance Service about the NHS 111 Service and examples of delays experienced by the residents. Concerns were also raised about booking patient transport from nursing homes in Gateshead.

The Committee requested that they be advised once a response had been received.

The Committee agreed that the focus of its review in 2016-2017 will be the role of housing in improving health and wellbeing.

The scoping report agreed by OSC on 1 July 2016 set out housing related issues that are known to have an influence upon health and wellbeing. It is proposed that the review considers how these housing and health issues are considered and reflected in local practice according to the three themes of Gateshead Council’s Housing Strategy 2013-18. These are:-

·         Housing Standards

·         Housing Supply

·         Housing Support

In addition to hearing evidence from Council and Gateshead Housing Company staff, it is proposed that further evidence will be provided by Gill Leng, Public Health England’s National Home and Health Lead, and Peter Smith, Head of Policy and Research at National Energy Action, the national charity seeking to end fuel poverty.

The Committee were advised that the evidence gathering sessions, based on the three themes as outlined above, will be delivered accordingly:-

1 November 2016  - Improving health through Housing Supply – the right homes in the right place

6 December 2016 – Health and Housing Standards

24 January 2017 – Health and Housing Support

Speakers will be drawn from Economic and Housing Growth, Development and Public Protection, Health and Social Care Commissioning and Quality Assurance.

At the meeting on 1 July 2016, members of the Committee requested that they themselves also provide evidence based upon their experience of dealing with housing and health related issues.

It is therefore proposed that members of the committee be invited to a focus group session, to be held subsequent to the evidence gathering sessions. Councillors unable to attend the focus group will be invited to provide written evidence by way of questionnaire.

It is also proposed that members of the committee be offered the opportunity to visit relevant housing developments. Details of these will be shared once confirmed.

RESOLVED – That the information be noted and that the approach, content and timescale as set out be agreed.

The Committee received the annual report on Adult Services Complaints and Representations April 2015 – March 2016.

The Committee were advised on the following points of interest:-

·         53% (33) of complaints were around the quality of services received and remains the greatest cause for complaint

·         Quality of service involves alleged failure of service delivery, for example:

·         Home carers not turning up;

·         Non return of telephone calls;

·         Late or missed social work visits;

·         Lack of timely response after a request for service

·         34% (10) of complaints were not upheld after investigation

·         41% (12) of complaints were partially upheld

·         20% (6) were fully upheld after investigation

·         Complaints decreased by 3% compared to the  number received during 2014/15, (64)

·         There has been a 11% increase in formal recorded contacts since 2014/15

·         However this increase is due to  the number of compliments received regarding individual members of staff or services (1074)

The OSC was particularly concerned about complaints relating to late or missed social worker visits and sought clarification in relation to this and action taken. The OSC was advised that such circumstances are rare and considered unacceptable and action is picked up directly between managers and practitioners to address this.

Compliments continue to be received about the quality of the Adult Care Services provided by the Council. Some compliments are about individual members of staff or about whole teams and services. Compliments reflect the high regard in which our customers have for employees and the services provided to them. Information is always fed into operational services, including the Commissioning Team, to highlight good practice and possible improvements to services.

The Committee were advised of the following points of interest relating to compliments:-

·         There has been a 17% increase in compliments compared to the amount received during 2014/15

·         32% (347) of compliments received in 2015/16 focused on the care provided by the Councils Promoting Independence Centres.

·         30% (327) were regarding Council provided Domiciliary Care

·         55% (181) of Council Domiciliary Care compliments were about the START service. The START Service is a short term reablement team who concentrate on providing service users with the skills to remain at home. This service can help prevent the need for  larger or more long term packages of care.

·         14% (154) of compliments were regarding Services provided by Assessment and Personalisation

·         58% (89) of compliments about Assessment and Personalisation were about Physical Disability Teams

·         5% (56) of all compliments were regarding Health and Housing Support

The OSC was particularly pleased to note that compliments accounted for 85% of all representations made about Adult Social Care Services during 2015/16 which was considered a testament to the quality of services being delivered.

RESOLVED – that the information be noted and the thanks of the committee be passed onto all the staff concerned for their hard work.