Agenda and minutes

None.

To confirm the minutes of the meetings held on 19 November 2020, 15 April 2021, and 14 October 2021.

RESOLVED – that the minutes of the meetings held on 19 November 2020, 15 April 2021 and 14 October 2020 be confirmed and signed by the Chair.

The Director of Planning, NHS Shropshire, Telford & Wrekin Clinical Commissioning Group reported that the NHS was currently experiencing unprecedented levels of demand and that It was anticipated that as winter approached pressures would continue. They outlined the work that was underway to develop the delivery of urgent and emergency care within the Borough and improvements made.

Following the update Members asked a number of questions:

The report noted a recruitment drive for 22,000 allied workers to provide same day capacity within primary care. How many of those are in post currently?

The Committee heard that the recruitment drive was underway and had been rolled out to additional areas across the County and that each practice will have the option to recruit or diversify. It was expected that full coverage would be available by the end of March 2022. The Director of Planning advised that they would be happy to provide further information to the Committee following the meeting.

Had the funding been allocated for the implementation of the Winter Plan and required recruitment drives?

The Director for Planning noted that this was a complex issue with many factors that needed to work in tandem. Prior to Covid the improvements put in place would have had a wider impact but Covid had changed the dynamic of gains made. To mitigate it had required future planning to remain ahead of the curve. Changes already made included bringing on extra beds, access to the rapid response team in more areas across the county and direct access to medical and surgical. The Director for Planning recognised the significant challenges presented by workforce and requested the Committees support in speaking to the public regarding accessing services in the correct way.

The report refers to exploring the suitability of Urgent Treatment Centre model locally. Was more being done to promote them within the Community?

The Urgent Treatment Centre's were important to assist in diverting urgent need patients away from A&E to prevent extended delays. There were a number of centres across the County and that 111 directed patients. It was noted that it was a constantly evolving picture under constant review dependent of funding and public behaviour.

How many additional beds were available and how were they funded?

The Local Authorities opened and funded additional beds so partnership working was required. As of the day of the meeting five additional community beds had become available and a further five were expected the following week.

In order to alleviate pressures on 111 & A&E had more funding been made available to primary care?

Across Shropshire, Telford & Wrekin they had invested in a number of schemes to improve primary care and how it was accessed. This had included an assessment of patients attending A&E unnecessarily and identifying which practices they belonged to and reasons behind this. They found that in some cases it had been due to difficulties with the Telephone systems which had resulted in investment to increase capacity in addition to closer working with  ...  view the full minutes text for item JHOSC14

This item was deferred.

The Director of Public Participation, the Operations Manager for Cardiology and Clinical Director for Cardiology for Shropshire, Telford & Wrekin NHS Trust provided members with an overview of the recommended changes to Cardiology Inpatient Services. As an interim measure it was proposed that all Cardiology inpatient services are moved to Princess Royal Hospital (PRH) in order to prevent diagnostic delays and interventional procedures that had been experienced by Royal Shrewsbury Hospital (RSH) patients and strengthen the cardiology workforce. At present there was a Cardiology service at both hospitals for both inpatients and outpatients, however the majority of patients accessed the service through PRH (70%). The proposed changes would only effect inpatient services and would be on a temporary basis.

Members heard that centralising the Cardiology service supported the workforce by mitigating the challenged they had faced in recruiting speciality nurses and consultants. It was also noted that the move resulted in more general medicine beds at RSH during winter pressures. The Operations Manager for Cardiology informed the Committee that although some patients were travelling further they remained at the site they were admitted to rather than having to transfer from RSH to PRH for further treatment, meaning that there length of stay was shortened overall. The Clinical Director for Cardiology advised that due workforce challenges, one-site working had become the norm across NHS England and HTP was still a long way off and changes needed to be implemented now.

The Head of Public Participation outlined what engagement had been undertaken throughout the process with patients, staff, communities and stakeholders. The key themes that had emerged through the engagement had centred on travel concerns and how long the temporary change would be in place for. They acknowledged that the proposal impacted on travel time but had found that the public accepted that was mitigated by the shorter length of stay. The planned changes were to be implemented by winter so sought JHOSC approval before taking the plans to the Trust Board.

During the debate Members raised a number of questions.

What considerations have been made for staff and visitors having to travel further?

Whilst at present neither hospitals were accepting visitors there was a bus service between the two hospitals that could be utilised by both staff and visitors. Members heard that from the engagement undertaken, patients' friends and family were accepting of the further distances due to the shorter stays. Similarly, staff from both RSH and PRH were supportive of the move as they believed it was necessary to provide a better service.

When the move is complete will there be additional cardiac beds available?

There was slightly less beds available overall. However, due to patients' stays being shorter it was predicted that there would still be more than necessary.

Was there direct access from the ambulance straight to the ward when patients arrived at PRH? And was there travel arrangements in place upon discharge?

Whilst direct access wasn’t planned they were developing training in conjunction with Stoke hospital for a  ...  view the full minutes text for item JHOSC16

The Co-Chair's invited Cllr Ruth Houghton to address the Committee regarding their concerns regarding the closure of the Bishop's Castle Community Hospital and the loss of 16 winter beds with little notice. The Co-Chair's agreed that this was an important issue and required further review with the Community Health Hospital Boards.