Agenda and minutes

None declared.

To confirm the minutes of the meeting held on the 2 March 2020.

JHOSC20 – Shrewsbury and Telford Hospital – Winter Pressures Planning

It was confirmed that there had been a 50% increase in uptake in flu vaccinations by staff at SaTH compared to the same period in the previous year.

RESOLVED – that the minutes of the meeting held on 2 March 2020 be confirmed and signed by the Chair.

To receive a report from Steve Trenchard, Interim Director for Transformation, Shropshire, Telford & Wrekin CCG’s.

The Joint Health Overview & Scrutiny Committee (JHOSC) received a presentation from Steve Trenchard, Interim Executive Director of Transformation, Shropshire, Telford & Wrekin Sustainability and Transformation Partnership on the recovery and restoration of services post COVID-19 in Shropshire, Telford & Wrekin. The presentation covered the following topics:

·         Recovery planning.

·         The 8 tests Shropshire, Telford & Wrekin must meet.

·         Making visible system changes: transformation oversight during COVID-19
 - Phase one: central record of change across System to inform restart position.

·         Making visible system changes: transformation oversight during COVID-19
- Phase two: informing system models post COVID-19.

·         Understanding crisis-response measures.

·         Caring for our people: psychological support.

·         Support offer.

·         Looking back at Shropshire, Telford and Wrekin principles

·         Shropshire, Telford and Wrekin Integrated Care System principles & expectations

·         Shropshire Telford and Wrekin, Sustainability and Transformation Plan, Long term Plan vision.

·         System strengths in response to COVID-19.

·         Recovery & new normal governance structure for Shropshire, Telford and Wrekin system.

Members asked the following questions and received the below responses.

Members asked the Interim Executive Director for Transformation about the amount and type of support that had been offered to domiciliary care sector during COVID-19 in Shropshire, Telford and Wrekin. The Interim Director for Transformation responded by saying that the system had offered support into domiciliary care and care homes, that both local authorities were a part of this support and that the People System Plan highlighted that.

Members recognised that staff support had been covered in the presentation, but wanted to know more about the staff burnout in Shropshire, Telford & Wrekin hospitals, whether there were any particular types of staff and what could be done to help them.The Interim Executive Director for Transformation invited Nigel Lee, the Chief Operating Officer of Shrewsbury and Telford Hospitals NHS Trust (SaTH) to respond to this question. The Chief Operating Officer emphasized that this was something that Shropshire, Telford and Wrekin had tried to address as a system, as a number of different types of staff had been affected by COVID-19, but noted that those working in acute care and COVID-19 wards had been particularly affected. The Chief Operating Officer outlined the care package that been put together to support staff such as psychological support, along with additional expertise provided by the mental health trust, other companies and the workforce team at SaTH. He concluded by saying that staff were encouraged to take the appropriate leave during the summer in order to recuperate.

Members asked about the Phase Three letter that was sent out to all NHS system leaders by Sir Simon Stevens, Chief Executive for NHS England and Amanda Pritchard, Chief Operating Officer for NHS England, especially in regards to acute care and how those requirements could be met:

·         In September at least 80% of their last year’s activity for both overnight electives and for outpatient/day case procedures, rising to 90% in October (while aiming for 70% in August);

·         This means that systems need to very swiftly return to at least 90% of their last year’s levels of MRI/CT and endoscopy procedures, with an  ...  view the full minutes text for item JHOSC3

To receive a report from Pam Schreier, Head of Communications and Engagement at Shropshire, Telford & Wrekin Sustainability and Transformation Partnership.

The Committee received a presentation in advance of the meeting from Pam Schreier, Head of Communication and Engagement, Shropshire, Telford & Wrekin Sustainability and Transformation Partnership and was presented by Kate Manning, Communication and Engagement Manager, from Shropshire, Telford & Wrekin Sustainability and Transformation Partnership. The presentation covered the following topics:

·         Communications and engagement for restore and recovery of services following COVID-19

·         Communication and engagement Documentation

·         Stakeholder and system engagement

·         Public and staff engagement. 

·         Current focus area.

Members asked what techniques were being used for targeted communications for the age group 16 to 30 years old and also individuals from the BAME community. The Communication and Engagement Manager responded by saying that STW STP had been working closely with both Councils and using social media to reach the younger age group to encourage them to follow necessary guidelines. Likewise, for individuals which English is not their first language, they STW STP had been working with the faith communities to translate key messages to reach these people. The Accountable Officer added that Shropshire CCG and Telford & Wrekin CCG had advertised and appointed lay members to join the joint board for both CCG’s, which included a lay member for inclusion, diversity and equality.

To receive a presentation from Dr. Jane Povey, Medical Director for Shropshire Community Health NHS Trust, Julie Davies, Director of Performance at Shropshire Clinical Commissioning Group and David Evans, Accountable Officer for NHS Shropshire CCG and NHS Telford & Wrekin CCG.

The JHOSC received a presentation from Dr Jane Povey, Clinical Lead for the Shropshire, Telford and Wrekin Sustainability and Transformation Plan (STW STP) and Dr. Julie Davies, Director of Performance for Shropshire Telford and Wrekin Clinical Commissioning Groups (STW CCG) outlining the proposed approach for undertaking a system review on End of Life Care. The authors stressed that they were not bringing a finished approach rather that they were hoping to co-create the approach through discussion in the meeting. The meeting covered the following topics:

·         Background
- Where the need for the review came from
- Conversations with healthcare partners
- Chief Executive leadership provided by David Evans, Accountable Officer for STW CCG and David Stout, Chief Executive of Shropshire Community Health NHS Trust.

·         What was done as a system so far
- Established End of Life group with strategy.
- System wide implementation of Recommended Summary Plan for Emergency Care and Treatment (ReSPECT)
- 24/7 palliative care helpline

·         Local Health Economy End of Life and Palliative Care Strategy for Shropshire, Telford & Wrekin.

·         Purpose
- Outlined the reasons as to why the review was needed.

·         Principles
- Outlined the principles which would guide the review.

Members noted the refreshing approach that was being taken by the presenters, however outlined that one of the key issues faced by patients was that there wasn’t a smooth transition through the system.

Members reflected on the struggles faced on accessing End of Life care in Shropshire, Telford & Wrekin in cross-border situations. The Director of Performance recognised that more work needed to be done to link up the out-of-area network to ensure a smooth transition in and out of Shropshire, Telford & Wrekin End of Life care, if that was the wishes of the patient.

Lynn Crawley, Chief Executive of Healthwatch Shropshire asked if staff were trained to have these difficult conversations with patients in relation to end of life care. The Clinical Lead for the STW STP responded by saying that training had occurred but had not reached every single member of staff, and additional support was available from other teams. The Clinical Lead for the STW STP continued by saying the end of life conversation with a patient needed to occur at the earliest point possible, when it became clear that a curative approach cannot be taken, and instead anticipatory medicine should be prepared.

The Chief Executive of Healthwatch Shropshire was invited to responded, and said that a Healthwatch Shropshire report made reference to examples whereby patients hadn’t been recognised as end of life. The Clinical Lead for the STW STP agreed and continued by saying there needed to be a recognition of the language used, which is why they referred to end of life conversations as “important” rather than “difficult”.

Members suggested that there be a centralised complaints or feedback system. The Accountable Officer for STW CCG welcomed the suggestion as complaints were made to individual trusts or the CCG and that there wasn’t a joined up approach to the way feedback  ...  view the full minutes text for item JHOSC5

Cllr Karen Calder, Co-Chair of the Joint Health Overview & Scrutiny Committee (JHOSC) outlined some of the work that the Committee had recently undertaken and the plans moving forward. The Co-Chair made reference to a meeting that the Co-Chairs had had with Sir Neil Carr and Cathy Riley from Midlands Partnership NHS Foundation Trust (MPFT) where it was agreed that Mental Health Services would be an item that was explored in the committee, likely spread over a number of meetings. Cllr Derek White Co-Chair of the JHOSC added that the JHOSC, Healthwatch Shropshire and Healthwatch Telford & Wrekin had recently met and had agreed to work together more closely moving forward. Finally, there was a reference from the Co-Chairs to undertake a piece of work reflecting on how the JHOSC can work better and more closely with the health community.