Agenda and minutes

To approve and sign as a correct record the minutes of the meeting held on 29 June 2017 and to deal with any matters arising, attached.

RESOLVED: that the minutes for the Panel meeting on 29 June 2017 be approved and signed as a correct record.

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

Jane Hayward (Director of Transformation, University Hospital Southampton), Gail Byrne (Director of Nursing, University Hospital Southampton) and Sharon Stewart (Service Lead - Prioritisation, Safeguarding and Initial Response) were in attendance and, with the consent of the Chair, addressed the meeting.

The Panel discussed a number of matters including:

·  The improved performance with regards to discharging Southampton residents from University Hospital Southampton;

·  The difficulties providing home care in some parts of Hampshire;

·  The appointment of domestic care assistants by the hospital to help increase the level of care support for patients who live in parts of Hampshire;

·  Staffing shortages - The Panel were briefed on the hospitals efforts to ensure that the right number of appropriately trained staff were available through a number of recruitment, training and retention practices, including the creation of a skills ladder and the use of NVQs.  It was stated that the hospital continued to value the work of carers;

·  Efforts being employed to safely reduce patients length of stay in hospital by ensuring that they kept as active as possible during their stay.  It was noted that patients tending to stay most inactive when they had visitors and it was hoped to encourage visitors where possible to use the facilities on site to encourage patients to be more active. 

·  That the hospital continued to learn from the examples of other health providers to ensure that best practice was undertaken.

RESOLVED that the Panel noted the ongoing improvements across the system but, given the challenging improvement targets set, the Panel would continue to review performance relating to discharges from University Hospital Southampton. 

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

Jane Hayward (Director of Transformation University Hospital Southampton) and Peter Horne (Director of System Delivery, NHS Southampton City CCG) were in attendance and, with the consent of the Chair, addressed the meeting.

RESOLVED that

The Panel discussed a number of matters including:

·  The ongoing steps to improve performance and flow within the Emergency Department (ED), and the national initiative to introduce an on-site GP led service to support the ED;

·  The hospitals continued aim to reduce, where possible, the length of stay within the hospital for patients in order to free up space and enable a better flow from the ED into other areas of the hospital;

·  The pressure for the target to be reached by end of March 2018; 

·  The potential for a specialist Children’s Emergency Department.  The Panel noted that the Trust was still trying to raise funds for the facility and that no construction work had yet started; and

·  How the number of patients attending the ED was offset by an increase in the seriousness of the health conditions of those attending, linked in part to the increase in the number of old and frail people within the wider population.

RESOLVED that the Panel noted the performance information set out within the report and agreed to continue to monitor the performance of the Trust with regards to Emergency Flow in University Hospital Southampton.

The Panel considered the report of the Chair recommending that the Panel note the outcome of the 2017 CQC inspection and discuss the actions that the Trust intend to take in response to the findings.

Gail Byrne (Director of Nursing - University Hospital Southampton) and Anabel Hodgson (Healthwatch Southampton) were in attendance and, with the consent of the Chair, addressed the meeting.

The Chair and the Panel congratulated the Trust on the result of the latest inspection and discussed a number of matters including:

·  The hard work that had been put in by staff to achieve the CQC rating;

·  That the Emergency Department had been visited by the inspectors on this occasion;

·  Actions to address the areas of improvement set out within the CQC report

o  It was noted that a clinical working group had been set up to resolve issues where there were mixed sex wards at the hospital; and

o  It was noted that the fridge temperature issue across the site had been resolved; and 

·  Issues relating to DNR (Do Not Resuscitate) / CPR (Cardiopulmonary resuscitation) processes. It was explained that matters had arisen in the processing of the paperwork of these incidents because of a disparity between national and regional guidelines.  It was further explained that the Trust was taking specific action to resolve this issue.

RESOLVED that the Panel congratulated the Trust on the result of the inspection and noted the report.

The Panel considered the report of the Report of the Director - System Delivery providing an update on the progress and planning for the delivery of Southampton City CCG’s strategy – “Transforming Primary Medical Care in Southampton 2017-2021”.

John Richards (Chief Executive Officer, NHS Southampton City CCG), Peter Horne (Director of System Delivery, NHS Southampton City CCG), Sue Robinson (Chair of the NHS Southampton City CCG) and Annabel Hodgson (Healthwatch Southampton) were in attendance and, with the consent of the Chair, addressed the meeting.

The Panel discussed a number of issues including:

·  The split of GP practices over the City.  Members requested that information that detailed the practices in the City be forwarded to the Panel by officers; 

·  The disparity of the financial settlement assumptions based on population growth versus the actual growth of the City’s population and the shortfall of funding that this produced;

·  How merging the GP back offices and processes had encouraged a uniformity of service.  It was noted that merging of practice back offices was possible across the City boundary but that would not see a reduction of the number of practices within the City;

·  The continuing issues relating to the workforce.  It was noted that there is a national shortage of GPs and that whilst there has been a widely publicised increased in the numbers of GPs being trained it would take some time to impact on numbers of staff available.  However, it was explained, in the meantime, that the CCG had been looking to make Southampton a good and interesting place to work in order to recruit staff;

·  How the improved communication of more appropriate and effective care pathways to patients was being encouraged and noted that patients could now refer themselves to a physiotherapist for back issues.  In addition it was explained that electronic reminders were being more effectively used and that GP receptionists were being trained and encouraged to suggest alternative routes of treatment to patients that could alleviate the pressures on a GPs timetable; 

·  The potential implications of the local Sustainable Transformation Plan (STP) being classified with the 3^rd quartile of assessment by NHS England.

RESOLVED that the Panel

(i)  noted the progress and planning for the delivery of the Southampton City CCG’s strategy “Transforming Primary Medical Care in Southampton 2017-2021”; and

(ii)  requested that the information requested information regarding the location of GP practices and the number of patients be circulated to the Panel.

The Panel noted the report of the Service Director, Legal and Governance detailing the actions of the Executive and monitoring progress of the recommendations of the Panel.