Agenda and minutes

Joint Health Overview & Scrutiny Committee - Thursday 14 October 2021 2.00 pm

Venue: Shrewsbury Room, Shirehall, Abbey Foregate, Shrewsbury, Shropshire, SY2 6ND

Contact: Lorna Gordon  01952 384978

No. Item


Declarations of Interest




Minutes of the Previous Meeting pdf icon PDF 301 KB


The Committee noted that all outstanding minutes would be presented at the next meeting of the Committee.



West Midlands Ambulance Service pdf icon PDF 726 KB

Additional documents:


The Chairman invited Mark Docherty, Director of Nursing, Quality and Clinical Commissioning and Murray MacGregor, Communications Director, both from West Midlands Ambulance Service to address issues that had been raised by the Committee, particularly in relation to closure of Community Ambulance Station sites in Shropshire.


Mr MacGregor outlined issues facing the service including the background to the closure of the Community Ambulance Station Sites.


He explained in detail how: only a small fraction of emergency incidents were responded to by crews at the local sites; all ambulances in the county were currently cleaned and stocked with supplies in Shrewsbury or Telford, meaning crews at community stations needed to swap vehicles for those readied in the two main towns; how there were no spare ambulances located at community ambulance station sites, which meant if a crew was delayed at hospital, a crew coming on to relieve them would not have an ambulance to use.  Crews also spent a whole shift travelling from job to job and did not have an opportunity to return to a community ambulance station site.

The delays caused by using community stations added up to up to sometimes over one and a half to two hours per shift and the closures had been expedited to help improve the poor performance of the service which was primarily caused by delays of ambulances at Princess Royal and Royal Shrewsbury Hospitals. Closing the sites would help improve performance with crews getting to more patients more quickly.  


Mr MacGregor explained that the closures did not represent a substantial variation of service, meaning that there was not a legal requirement to consult on these, but the Ambulance Service did accept that it should have made contact with the Council earlier and he apologised that it had not done so.  Members commented that hearing about the closures from the local media had caused anxiety.


He went on to explain that the main reason for poor performance was the number of ambulance crews delayed at hospitals with particularly high average waiting times at  Princess Royal Hospital and the Royal Shrewsbury Hospital


The Chairman acknowledged that closing the buildings would free up more time but asked about the welfare of the ambulance drivers, eg, access to toilet facilities.  He also asked about ambulances going out of county and Hospital Ambulance Liaison Officers (HALOs) whose role was to reduce handover delays for ambulance services which would help take over the patient allowing the ambulance to get back on the road.


Addressing the Committee’s concerns that Shropshire Ambulances were going out of region, Mr MacGregor reported that the data provided for June, July, August and September showed that Shropshire had consistently been a net importer of ambulances into the county.


Responding to concerns about crew welfare raised by Members, it was reported that crews went from job to job and were no longer able to return to local stations to use the facilities. Crews were having to use toilet facilities at hospitals and in locations such as  ...  view the full minutes text for item JHOSC8


End of Life Care Review pdf icon PDF 497 KB


The Chair welcomed Professor Derek Willis, Medical Director, Severn Hospice and Steve Trenchard, CCG to the meeting. 


Professor Willis explained that he chaired the End of Life Group for Shropshire and Telford and Wrekin and that this now would be linking directly into the Integrated Care System (ICS).  He highlighted two areas of real progress, firstly the implementation of the Respect Document which now applied in all settings in Shropshire.  It had been designed to record the wishes of patients and was making a real difference to patient care, avoiding the need for repeat conversations.   


He went on to describe the Advanced Care Plan Document which followed the patient in all settings, and had been very successful in reducing uncertainty, preventing unwanted treatment and hospital admissions and helping determine future goals for end of life. 


Mr Trenchard thanked Professor Willis for his work and leadership in achieving this progress.  He reminded the Committee of the background to the End of Life Care Review describing each of the phases, the process and governance and the pathway key actions identified.  His presentation covered outputs to date, next steps and whether the four questions identified in phase 1 of the review were answered satisfactorily.  


Professor Willis went on to describe the work and training to help embed best practice end of life care across the county and members asked questions about how progress could be measured and how it would be known it was working.  It was hard to measure but talking to people with lived experience would help, and more compliments and less complaints would be expected along with a positive CQC assessment.


Professor Willis confirmed that those who supported carers of those near end of life were represented on the End of Life Group. The hospice had a 24 hour helpline and Shropdoc also had a dedicated line for those identified as having end of life needs. He acknowledged that it could be confusing where to go for general help.


A Member provided an example of how a recent end of life request had not been accommodated.  Whilst being sorry to hear that story, Professor Willis said that he respect form should reduce instances of people’s wishes not being taken into account. A learning from deaths group had been set up to review cases such as this.


Members asked how it would be known that implementation of the respect form was working and Professor Willis reported that there was a 60% completion rate and it was a nationally recognised document.   Mr Trenchard said clear metrics and a strategy would help demonstrate success at a future meeting of the committee.


The Committee thanked Mr Trenchard and Professor Willis for attending, welcomed the excellent progress and asked for a further update in about a year’s time.



Work Programme pdf icon PDF 352 KB


The Committee noted proposals for the work programme which would be updated as necessary as required.  It was confirmed that the Committee wished to explore further the reasons for ambulance delays at the hospitals and receive an update on end of life care in 12 months time.



Co-Chair's Update