Agenda and minutes

To agree the minutes of the last meeting held on 22 January 2024.

RESOLVED that the minutes of the meeting held on 22 January 2024 be agreed.

Committee members to declare an interest in any particular agenda item where applicable.

The following declarations of interest were made:

Councillor M Hall – Director of Prism Care and CNTW Governor

Councillor J Shaw – CNTW Governor

Councillor S Rahman – Employee of North East Ambulance Service

Councillor B Jones – Employee at NENC ICB

Professor Edward Kunonga, Director of Transformation & Population Health Management at NECS, will provide the Joint Committee with an update on health inequalities.

Professor Edward Kunonga, Director of Transformation and Population Health Management at NECS provided the joint OSC with an update on health inequalities.

Professor Kunonga set out that the North East North Cumbria Health and Care Partnership has a transformational Healthy and Fairer Programme aimed at improving health outcomes and extending healthy life expectancy.  It was noted that 32% of the NENC population are estimated to live in the two most deprived neighbourhoods, based on ONS mid 2020 population estimates and index of multiple deprivation.

The NENC Health and Care Partnership has developed an integrated care strategy aimed at better health and wellbeing for all.  The four key goals of the strategy are longer and healthier lives; fairer outcomes for all; better health and care services; and giving children and young people the best start in life.

In order to achieve those four key goals, the strategy set out eight supporting goals:

-       Reduce the gap in life expectancy for people in the most excluded groups;

-       Halve the difference in the suicide rate in our region compared to England;

-       Reduce smoking rates from 13% of adults in 2020 to 5% or below by 2030;

-       Increase the number of children, young people and adults with a healthy weight;

-       Reduce alcohol related admission to hospital by 20%;

-       Reduce drug related deaths by at least 15% by 2030;

-       Reduce social isolation, especially for older and vulnerable people; and

-       Increase the percentage of cancers diagnosed at the early stages.

Professor Kunonga set out the governance arrangements for the implementation of the strategy and provided the Committee with information on a number of prevention workstreams including alcohol, tobacco and obesity.

Alcohol:

This workstream is focused on partnership and collaborative work across a number of organisations in order to improve system wide pathways and to increase the awareness of the risks to health associated with alcohol, both physically and mentally.

Tobacco:

Fresh is a programme designed to motivate smokers to stop, reduce uptake of smoking, and protect from tobacco related harms.  It is a national leader on effective advocacy, focused on ‘Stopping the Start’.  It was noted that adult smoking rates have reduced 54% since 2005 in the NENC, which is the biggest reduction of any region and the highest public support for more action.

Obesity:

The Healthy Weight and Treating Obesity project is working with partners in supporting the whole system to tackle obesity, to reduce the complications linked to being overweight and obese, along with working towards the classification of obesity as a disease.

The strategy also has a number of workstreams relating to health inequalities, including Inclusion Health and Waiting Well.  In relation to the Inclusion Health, this was a new workstream to consider the healthcare inequalities experienced by people who have multiple, complex and overlapping needs due to being socially excluded.  Waiting Well relates to a project to support people on an elective surgical waiting list who are identified to have the poorest outcomes, i.e.  ...  view the full minutes text for item 34.

Peter Rooney, Director of Strategy and Planning, NENC ICB, will provide the Joint Committee with an update on the joint forward plan.

The Committee received a presentation from Peter Rooney, Director of Strategy and Planning at North East North Cumbria Integrated Care Board, in relation to the refresh of the Joint Forward Plan.

Members were informed that the Joint Forward Plan (JFP) is a requirement of Integrated Care Boards (ICBs) and partner NHS Trusts.  The JFP is aimed at demonstrating how ICBs and NHS Trusts will deliver services to meet the population’s physical and mental health needs, deliver the NHS mandate and NHS Long Term Plan in the area and meet the legal requirements for ICBs.  Following the publication of the Integrated Care Strategy in December 2022, work had been undertaken with partner organisations to produce the JFP.

It was noted that the JFP is aligned to the ICP Better health and wellbeing for all strategy, which is aimed at the goals of longer and healthier lives; fairer outcomes for all; better health and care services; and giving children and young people the best start in life.

The Committee was informed that the joint forward plan provides a strategic overview of key priorities and objectives for the medium term, a high-level summary of priorities and objectives and a summary of the work programmes that will be delivered to achieve medium-term objectives.

Priorities in the JFP relating to longer and healthier lives and fairer outcomes included NHS prevention ambitions and health care inequalities, along with an NHS contribution to reducing social and economic inequalities.  The goal of providing the best start in life is linked to services including maternity and postnatal support, and physical and mental health.  It was noted that priorities related to improving health and care services focussed on community and acute and secondary care themes.

The Joint Forward Plan was published in September 2023 and was currently being refreshed, with approval being sought from the ICB Board at its meeting on 26 March 2024.  The intention was to recommit to the version created in September 2023, rather than there being a rewrite of the plan.  Work programme leads reviewed their respective sections and provided updates where applicable.

A version of the draft JFP had been circulated to members of the committee.  It was highlighted that there had been new sections added in relation to the following topics:

-       Working with the voluntary, community and social enterprise sector

-       Long term condition management

-       Dementia and organic mental health

-       Gender dysphoria services

-       Individual care packages

-       Neurorehabilitation

It was noted that the draft forward plan would be considered by the ICB Board on 26 March 2024 and then published on the ICB website.  A summary and easier read versions would also be available.

Following the presentation, the Committee discussed ill health prevention and benefits that there would be from reducing long-term sickness in workplaces.  It was explained that there were ongoing discussions with the Department for Work and Pensions around the topic of fit to work and the need for workplaces to be healthy promoting.  It was noted that  ...  view the full minutes text for item 35.

Ken Youngman, NENC ICB, and Geraint Morris, Chief Officer, North of Tyne Local Pharmaceutical Committee, will deliver a presentation in relation to access to pharmacy services.

The Committee received a presentation from Ken Youngman NENC IBC, and Geraint Morris, Chief Officer, North of Tyne Local Pharmaceutical Committee, in relation to access to pharmacy services and the role of the community pharmacy.

The Committee was informed that community pharmacies are funded according to a contractual framework agreed by Community Pharmacy England, the NHS and the Government.  The framework accounts for 90% of pharmacies income.  The remaining 10% comes from locally commissioned services and retail income.

In relation to local pharmacy access, it was highlighted that 96% of the population are able to access a pharmacy within a 20-minute walk.  Patients are able to be seen without an appointment, with the average patient visiting a pharmacy 14 times a year.  It was noted that many pharmacies open extended hours and offer a wide range of clinical services to support the community.

Members were informed of the wide range of services available at community pharmacies.  This included dispensing medicines, minor ailments, emergency contraception, stop smoking advice, urine infection services and NHS health checks.

It was explained to the Committee that over the next decade, community pharmacies will undergo significant transformation, becoming central to the delivery of joined-up, responsive, and person-centred community-based health and care services.  It was highlighted that increased investment from commissioners reflects the increased significance of community pharmacy in the health care ecosystem.

The future role of community pharmacy was noted as:

-        Preventing ill health and promoting well-being

-        Providing clinical care

-        Living well with medicines

-        Be part of an integrated primary care offer for neighbourhoods

The short term challenges to community pharmacies were highlighted to the Committee.  It was noted that, due to funding issues, 24 pharmacies have closed in the North East and North Cumbria so far in 2023/24.  Deprived communities, where the need is greatest, have seen the biggest decline.  It was noted that over 50 pharmacies have reduced their opening hours from 100 hours a week to 72 hours a week in 2023/24.  Action being taken to address these challenges included regular updates to Health and Wellbeing Boards, a risk based approach to access issues and reviewing the closure process, including the engagement and communications processes.

The Committee was informed of new community pharmacy services happening as part of the transformation programme.  Pharmacy First is a new advanced service that will include 7 new clinical pathways and replaces the Community Pharmacist Consultation Service.  The 7 conditions included in this service are: sinusitis, sore throat, acute otitis media, infected insect bite, impetigo, shingles and uncomplicated UTI.  Patients can walk into a pharmacy to access these services or for 6 out of the 7 conditions, have a remote consultation over video call.  A public communications campaign funded by the ICB would direct patients to community pharmacy for advice and treatment of common conditions, whilst also raising awareness of the availability of the service.

It was highlighted that £75 million additional funding has been made available, per year, for the expansion of contraceptive  ...  view the full minutes text for item 36.

Mark Cotton, Assistant Director of Communications and Engagement, and Tracy Gilchrist, Deputy Director of Quality & Safety at North East Ambulance Service, will deliver a presentation in relation to the 2023/24 Quality Account.

The Committee received a presentation from Mark Cotton, Assistant Director of Communications and Engagement at North East Ambulance Service, to provide an overview of the 2023/24 Quality Report.  The presentation provided Members with an overview of Quality Report requirements, current position and performance, and an update on 2023/24 quality priorities.

It was noted that NHS Improvement provide detailed guidance on the requirements of the report.  The report must be shared with commissioners, governors, staff, Healthwatch, Overview and Scrutiny Committees or the Health and Wellbeing board and providers must upload their final Quality Report onto their website by 30^th June.

The Committee was provided with data in relation to patient safety.  It was noted that in 2023-24 there were 2,209 patient safety incidents, compared to 3,702 in 2022-23.  In 2023-24, there had been 140 serious incidents recorded, an increase from 61 in the previous year.  This increase was attributed to a change in the reporting criteria to now include one hour plus delays.  It was noted that not all ambulance trusts declare delays as series incidents, so comparable figures are not available.

In relation to patient experience and feedback, the top three themes on complaints were staff attitude, timeless of response and quality of care.  Complaints had fallen from the 375 received in 2022-23 to 316 in 2023-24, whilst the number of appreciations received from patients has increased.

Benchmark performance data on Category 1 response times demonstrated that the NEAS mean response time was under the target for England and response times were below those of other ambulance services across the country.  In relation to Category 2 response times, it was noted that these were more challenging and NEAS response times were higher in 2023-24 than the targeted times.  It was explained that 7 out of 10 calls are category 2 responses, which means a high volume of responses required under a challenging time standard.  To address this, more resource has been put into the validation of calls and the prioritisation of urgency, with clinician involvement in monitoring calls and statistics.  This led to 22% of category 2 calls being diverted to another category.  It was noted that Category 3 and 4 response times were also higher in 2023-24 that the target times.

The Committee was informed that the 2023/24 quality priorities were:

Patient safety:

-       To continue working with system partners to reduce handover delays

-       Respond to patient safety incidents in a way that leads to service improvements and safer care for all our patients

Clininal effectiveness:

-       Implementation of clinical supervision

Patient experience:

-       To increase service user and colleagues involvement in our patient safety and patient safety and patient satisfaction activities

In relation to handover delays, it was noted that there had been partnership working to improve effectiveness across the system and risk management and escalation arrangements during times of demand had been reviewed.  Going forward, further work needed to be undertaken in relation to understanding the impact on patients and staff.  In relation to patient  ...  view the full minutes text for item 37.

To discuss potential items for inclusion in the 2024/25 work programme for the Joint Committee.

Members received a report which sought topics suggestion for inclusion in the 2024/25 work programme for the joint committee.

It was noted that through consideration of topics at its meetings throughout 2023/24, the following updates have been requested for consideration by the Committee during the next municipal year:

-       Update on Children and Young People’s Mental Health

-       Update on neonatal care

-       Update on Dentistry Provision

-       Update on progress in implementing a strategic model for Non-Surgical Oncology Services

Members of the committee were invited to raise any other topics for inclusion in the work programme.  The Chair requested that any topic ideas be sent through to the scrutiny officer.