Agenda and minutes

Councillors Richard Baxter-Payne (Nuneaton and Bedworth Borough Council), Peter Eccleson (Rugby Borough Council) and Judy MacDonald (North Warwickshire Borough Council).

Rose Uwins (Coventry and Warwickshire Clinical Commissioning Group(CCG)).

Councillor Jerry Roodhouse declared an interest as a Director of Healthwatch Warwickshire.

The Chair welcomed everyone to the meeting, especially the return after illness of Councillors Kate Rolfe and Tracey Drew. She confirmed membership changes and welcomed new members to the Committee, being Councillors Peter Eccleson (Rugby Borough Council), Chris Kettle (WCC) and Penny-Anne O’Donnell (Stratford-upon-Avon District Council).

A welcome also to Mark Docherty and Murray McGregor, who would be providing an update from WMAS. 

To receive the Minutes of the meeting held on 29 September 2021.

The Minutes of the meeting held on 29 September 2021 were accepted as a true record and signed by the Chair.

It was reported that five people had registered to speak at the meeting.

Carolyn Pickering, representing South Warwickshire Keep Our NHS Public (SWKONP), submitted a statement and question about Coventry and Warwickshire Integrated Care System (ICS) Public Accountability. A copy of the submission is attached at Appendix ‘A’ to the minutes.

Anna Pollert, Secretary of SWKONP, submitted a statement and question about Coventry and Warwickshire ICS. A copy of the submission is attached at Appendix ‘B’ to the minutes.

Mr David Passingham spoke about the Community Hospital Review and specifically in relation to the Ellen Badger Hospital. His address covered the value of community hospitals, the reported and perceived aims and outcomes of the review. He spoke of bed capacity within the NHS and drew comparison to medical provision in other countries. This review should have been holistic, and he listed areas that should have been included. The benefits of the hospital were stated, especially for frail elderly patients. There were wider benefits in terms of local staff skills and environmental benefits through reducing travel requirements for staff, patients and their families. He concluded that the review should have been holistic.

Professor Bryan Stoten also spoke on the Community Hospital Review, providing background on the Ellen Badger hospital. It had been anticipated the hospital would be closed. A league of friends was formed, land adjacent to the hospital was acquired with local funding and a commitment was given by South Warwickshire Foundation Trust for the site to be restored and developed. However, this did not materialise, and further fundraising had since been discouraged. He referred to the review paper, the now stated purpose of the hospital for discharge to assess patients which differed from the original vision for community hospitals to avoid admission to an acute hospital setting. He drew comparison to a similar review in Alcester and the outcome from that review. He similarly expected that there would not be a hospital, but instead a GP surgery at this location. This approach was being repeated and was losing public support.

Mr Martin Drew, representing SWKONP, submitted a statement regarding forthcoming changes to data protection legislation. A copy of the submission is attached at Appendix ‘C’ to the minutes.

The Chair responded that the matters raised would be considered, and a written response provided to the questions after the meeting. Regarding the ICS the Council was in discussion with health colleagues and was planning to hold a meeting in public, focussed on the ICS. She did not want the concerns raised to be taken out of context, expanding on a few of the points made by speakers about the perceived dismantling of the NHS, the potential benefits which could come from public/private partnerships and referring to a previous community hospital review.

Up to 30 minutes of the meeting is available for members of the Committee to put questions to the Portfolio Holder: Councillor Margaret Bell (Adult Social Care and Health) on any matters relevant to the remit of this Committee.

Councillor Jan Matecki asked Councillor Margaret Bell a question on the Prevent Service. An accusation had been made by a member of the public which concerned the disproportionate referral of people with mental health issues or learning disabilities. Context was sought from the portfolio holder on the total number of referrals to the service in the last 12 months and how many individuals had mental health issues or a learning disability. Councillor Bell gave thanks for the prior notice of the question. The detail had been requested and would be provided to Councillor Matecki.

Members of the Committee are invited to give notice of questions to NHS commissioners and service providers at least 10 working days before each meeting. A list of the questions and issues raised will be provided to members.

None.

An update which will include a focus on the review of community ambulance stations. This item was raised at Council on 28 September and all members of Council have been invited to submit questions and lines of enquiry which have been forwarded to the Ambulance Service.

The Chair welcomed Mark Docherty, Director of Clinical Commissioning and Murray McGregor, Communications Director from West Midlands Ambulance Service (WMAS).

WMAS had been asked to address members on its review of community ambulance stations. This item had been raised at Council on 28 September and all members of Council were invited to submit questions and lines of enquiry. These were forwarded to the Ambulance Service, with initial written responses provided and circulated to members.

Murray Macgregor spoke initially on the following areas:

• An acknowledgement that WMAS performance in Warwickshire was not good enough, evidenced by the performance data provided to members in the circulated pack. This was disappointing and reflected data from across the country.
• A recent report highlighted cases of harm due to hospital handover delays. The hospitals serving the Coventry and Warwickshire area were not the worst offenders, but there was room for improvement.
• From data there were some 28,500 lost hours of service across the region due to hospital handover delays, impacting severely on the ability to respond to further patients. He spoke of the impact for patients, the risk of harm and for staff, finishing late, affecting their welfare and when they could commence their next shift.
• This was one of the reasons for the decisions around closure of community ambulance stations.
• Previously, response targets were based on the time taken to get to the patient. A detailed review was undertaken in 2017-18 to look at improvements. Using the example of a stroke case, it was not about when the paramedic reached the patient, but when that patient received the specialist treatment in hospital which determined their likelihood of survival and a good outcome.
• Community ambulance stations provided an inefficient system. An outline was provided of the way the hub model operated and staff had an ambulance checked, equipped and ready to use immediately for their full shift. Compared to this, the community ambulance station model had a number of inefficiencies which were explained and equated to 2½ to 3 hours per site per day. It was estimated that the increased efficiency from this proposal would enable response to 5000-6000 extra calls per year.
• There was concern that this change would remove the ambulance cover from Stratford and Rugby. This was not the case and an outline was provided of the operating model. In many cases, patients were treated at the scene and did not need transport to hospital. This meant the ambulance was available in that locality for the next patient. Data showed that ambulances based at a community ambulance stations only attended 5% of cases in their immediate area. 

Mark Docherty outlined his background working in the NHS and spoke on  the following areas:

• His involvement in a document ‘zero tolerance’ raising concerns some nine years ago about the implications of delayed hospital handovers for ambulance services.
• Data was provided and nearly 30k hours were lost due to hospital delays, the equivalent of taking 83 ambulances out of service.
• Across the region WMAS worked  ...  view the full minutes text for item 5.

This report provides an overview of the purpose, scope and progress of the South Warwickshire Foundation Trust Community Hospital inpatient review.

The Chair sought members approval and then confirmed that this item would be deferred to the next meeting.

To review the Committee’s work programme for 2021/22.

The Committee reviewed its work programme. Councillor Penny-Anne O’Donnell referred to the GP Services task and finish group, asking if a nuanced approach would be taken as the county had a large geographic area and there would be differing patient experience of GPs. The comments raised would be included.

Resolved

That the Committee notes its work programme.