Agenda and minutes

Health Overview and Scrutiny Panel
Thursday, 23rd February, 2017 6.00 pm

Venue: Conference Room 3 and 4 - Civic Centre. View directions

Contact: Ed Grimshaw, Democratic Support Officer  Tel:- 023 8083 2390

Items
No. Item

19.

Minutes of the Previous Meeting (including matters arising) pdf icon PDF 20 KB

To approve and sign as a correct record the minutes of the meetings held on 19th December 2016 and 18th January 2017 and to deal with any matters arising, attached.

Additional documents:

Minutes:

RESOLVED: that the minutes for the Panel meetings on 19th December 2016 and 18th January 2017 be approved and signed as a correct record.

20.

Emergency Department Performance pdf icon PDF 70 KB

Report of the Chief Executive, University Hospital Southampton Foundation Trust, providing the Panel with an update on the performance of the Emergency Department at Southampton General Hospital.

Additional documents:

Minutes:

The Panel considered the report of the Chief Executive, University Hospital Southampton Foundation Trust, providing the Panel with an update on emergency flow in University Hospital Southampton.

 

Fiona Dalton Chief Executive, University Hospital Southampton (UHS) and John Richards Chief Executive Officer, NHS Southampton City CCG were in attendance and, with the consent of the Chair, addressed the meeting.

 

The Panel discussed a number of matters of concern including:

·  The performance against targets for Emergency Department flow.

o  It was explained that overall the figures showed that performance had stabilised despite increased attendances to the Emergency Department.  It was noted that locally numbers attending the emergency department had increased at a lesser rate than the national rate.

·  That the Trust had received an offer of match funding from the Treasury to fund a specialist emergency department for children.

o  It was explained that it was hoped that this would alleviate pressure on the Emergency Department (ED) and enable the more effective flow of patients through the system.  It was additionally noted that the establishment of the Minor Injuries Unit and arrangements in the local GP surgeries had continued to provide a ready alternative to queuing in the ED.

·  That the Department had to combat different types of pressure on the service seasonally.

o  It was explained that the summer saw a higher number of attendees than winter.  The Panel noted that the summer saw a higher number of accident and trauma cases that were more easily processed and discharged whilst winter saw an increase in the attendance of patients with more complex and difficult care demands, often associated with older patients.  It was noted that these patients often required longer term treatment and the establishment of an effective care package prior to being able to return home.

·  The Panel questioned whether the Trust were able to alleviate pressure by adjusting the numbers of patients treated by elective surgery over the winter.

o  It was explained that this was not always possible because of targets relating to treatment times.  However, it was noted that as a last resort the hospital would reschedule or cancel appointments for elective surgery.

·  The Panel questioned whether there were clear links in the winter to respiratory cases that could be caused by the quality of air within Southampton.

o  It was noted that it was not entirely clear why there was an increase in ED attendances this winter but it reflected a national trend.

 

RESOLVED that the Panel noted the improvements that had been made and requested that the issue be brought back to Panel at a future meeting.

21.

Update on Discharges from University Hospital Southampton pdf icon PDF 63 KB

Report of the Chief Executive of University Hospital Southampton and the Acting Service Director – Adults, Housing and Communities, providing the Panel with an update on discharges from University Hospital Southampton.

Additional documents:

Minutes:

The Panel considered the report of the Chief Executive of University Hospital Southampton and the Acting Service Director – Adults, Housing and Communities, providing the Panel with an update on discharges from University Hospital Southampton.

 

Fiona Dalton Chief Executive, University Hospital Southampton (UHS), John Richards Chief Executive Officer, NHS Southampton City CCG and members of the public were in attendance and, with the consent of the Chair, addressed the meeting.

 

The Panel discussed the following issues:

·  The improving performance of the Integrated Discharge Unit (IDU).

o  It was noted that there had been continued improvement in the rates of discharge for the hospital, however considerable progress still needed to be made.  The Panel was told that since the development of the IDU efforts had been made to bring employees from the different organisations together as one team.

·  Additional investment in the provision of domiciliary care services.

o  It was noted that additional resources had been allocated in order to provide additional care packages that would enable people to return home rather than stay in a hospital bed.

·  Improvements in the monitoring of care packages.

o  It was explained that efforts had been made to improve the monitoring of health care packages and ensure that the correct level of care could be delivered for the correct period of time.

·  The integration of IT systems.

o  It was noted that work was still ongoing in working towards an integration of IT systems.

·  How the discharge process would be affected by the Sustainable Transformation Plan for Hampshire and the Isle of Wight.

o  It was noted that the IDU was a good example of how the systems were being pulled together to provide better care.

 

RESOLVED that the Panel noted the improvements that had been made and requested that the issue be brought back to Panel at a future meeting.

22.

Draft Health and Wellbeing Strategy (2017-2025) pdf icon PDF 78 KB

Report of the Director of Public Health seeking comments and feedback on the draft Health and Wellbeing Strategy 2017-2025.

Additional documents:

Minutes:

The Panel considered the report of the Director of Public Health seeking comments and feedback on the draft Health and Wellbeing Strategy 2017-2025.

 

Councillor Shields (Cabinet Member for Health and Sustainability and Chair of the Health and Wellbeing Board); the Director of Public Health and the Service Lead, Policy, Partnerships and Strategic Planning; Annabel Hodgson from Healthwatch Southampton and Joe Hannigan and Penny Turpin members of the public were in attendance and, with the consent of the Chair, addressed the meeting.

 

The Panel discussed a number of matters and concerns including:

·  the 5 areas of focus and priorities set out within the draft Strategy;

·  the welcomed emphasis on children as a priority within the Strategy;

·  the broad approach of the strategy and the need to advocate and deliver approaches even if they were politically challenging; and

·  the potential to use funding collected through the Community Infrastructure Levy to contribute to health and wellbeing projects.

 

RESOLVED that

 

(i)  the Panel welcomed the priorities set out in the strategy and the 5 stated areas of focus.  The Panel were encouraged by the emphasis on children’s health and urged the Cabinet Member to prioritise issues such as diet, dental health and obesity to improve outcomes for children in recognition that this will in time improve health outcomes across the city.  The Panel recognised that this cannot be achieved in isolation and welcomed the commitment to working with schools, and other partners to help deliver improvements in children’s health.

(ii)  the Panel considered that wording relating to the management of risk by adolescent children be given further consideration to give it a greater resonance and make it realistic and achievable.  In addition the Panel requested that emphasis on workplace wellbeing should be broadened to include employers and employees.

(iii)  that the Panel requested that mental health be given a greater prominence within the strategy.

(iv)  the Panel looked to the Health and Wellbeing Board to demonstrate strategic leadership, to learn from best practice from around the world to inform action, and to champion initiatives that would improve health and wellbeing outcomes in the city, even if it presents potentially challenging political conversations with residents. 

 

23.

Update on the implementation of Southampton City Foot Care Pathway pdf icon PDF 156 KB

Report of the Director of Quality and Integration providing the Panel with an update on the implementation of the Foot Care Pathway.

Additional documents:

Minutes:

The Panel considered the report of Director of Quality and Integration providing the Panel with an update on the implementation of the Foot Care Pathway.

 

Graham Bowen - Solent NHS Trust and Georgina Cunningham - Southampton City CCG were in attendance and, with the consent of the Chair, addressed the meeting.

 

The Panel discussed and number of matters and concerns including:

·  Ongoing transformation of foot care within the City. 

o  The Panel noted the improvements already made and the timelines involved.

·  The support given to diabetics.

o  The Panel noted that as part of care offered to diabetics within the City patients should be offered an annual foot care assessment.  It was explained that patients diagnosed with diabetes should be supported by the GP’s specialist nurse.  

·  The timescales involved in seeing a reduction in amputations related to diabetes. 

o  The Panel noted that it was likely that, given the current cohort, the statistics would show an increase in minor amputations in the short term.  .  It was A reduction in amputations was expected by 2018/19.

·  The shortage of podiatrists within the Country.

o  It was explained that there were relatively few trained podiatrists employed by the NHS.

 

RESOLVED that the Panel welcomed the progress made and that they would continue to monitor performance at future meetings.