Agenda and draft minutes

Apologies for absence had been received from Councillors Andy Jenns, David Johnston (SDC), Ish Mistry (Rugby Borough Council), Pam Redford (Warwick District Council) and from Chris Bain (HWW).

The Chair advised that until recently she had served on the board of governors of SWFT and been Portfolio Holder for Health and Wellbeing at SDC. She served on the Shipston Health and Wellbeing Partnership. Councillor Holland declared that he was a governor of SWFT.

The Chair recorded thanks to her predecessor, Councillor Clare Golby.

She welcomed new members to the Committee and introduced Alice Battersby who was on a work experience placement with the Council this week. The Chair advised that a joint meeting with the Children and Young People OSC would be arranged. These proved very useful for discussing areas of common interest and further details would follow.

To receive the Minutes of the committee meetings held on 19 April and 16 May 2023.

The Minutes of the committee meetings held on 19 April and 16 May 2023 were approved as true records and signed by the Chair.

Notice had been received from Mr John Dinnie and Mr David Passingham to address the committee, both about the SWFT review of community hospital provision. A copy of their respective questions and statements are reproduced at Appendices ‘A’ and ’B’ to these Minutes. Glen Burley had been advised of the public speaking and would respond to the points raised as part of the item later on the agenda.

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.

None.

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.

The Committee is asked to consider and comment upon the tailored performance report for the period April 2022 - March 2023.

Dr Shade Agboola, Director of Public Health introduced this item and gave a presentation to pull out the key messages. The report provided a retrospective summary of the Council’s performance at the year-end against the strategic priorities and areas of focus set out in the Council Plan 2022-2027. This report drew out relevant areas within the Committee’s remit from that presented to Cabinet on 15 June. Sections of the report together with detailed supporting appendices focussed on:

·   Performance against the Performance Management Framework

·   Progress against the Integrated Delivery Plan

·   Management of Finance

·   Management of Risk

The report provided a combined picture of the Council’s delivery, performance and risk. Overall, for the Council’s performance at year-end, there had been a consistently strong performance delivered. There were ten key business measures (KBMs) within the remit of the committee. A table set out the quarterly performance data, with seven of the KBMs assessed as being on track and three were not on track.

The report detailed key emerging themes. These included the impact of capacity and workload issues on service delivery and difficulties in recruiting and retaining staff in a highly constrained national and local labour market. Whilst there were some improvements at the year-end, there remained issues within specific service teams. The report included notable aspects of positive performance and the performance challenges experienced.

The report set out services’ projected performance trajectory. This was positive, in terms of delivery of the 30 Adult Social Care actions set out in the Integrated Delivery Plan, with 80% being on track and 20% completed.

One of the Council’s strategic risks related to Adult Social Care and Health directly and currently had a ‘red’ status. Two other red-rated strategic risks related to inflation and the cost of living, and the economy might impact on service provision and service demand. At the service level, two risks were rated ‘red’, being the risk of care market failure and the risk of an ongoing impact on Public Health resources of responding to Covid-19.

The presentation included slides on:

·   Council Plan 2022-2027: Strategic Context and Performance Commentary

·   Performance relating to this Committee

·   Area of focus: Support people to live healthy, happy, and independent lives and work with partners to reduce health inequalities 

·   Projection

·   Integrated Delivery Plan

·   Financial performance

·   Management of risk

Questions and comments were invited with responses provided as indicated:

• Clarification was provided on the business measures within the remit of the committee and each quarterly report included those where data was available.
• More information was sought about the percentage of people aged over 65, eligible to access adult social care services, who were supported in the community. Figures for this indicator were below the target level. Pete Sidgwick advised that the target was 60% and the level achieved was 59%. This was about the proportion of people going into a care establishment rather than being supported in their own home. The impact of the Covid pandemic was one contributor. The majority of admissions to care homes  ...  view the full minutes text for item 5.

For the Committee to consider and comment upon the Annual Feedback Report for Adult Social Care and Public Health covering the period 1 April 2022 to 31 March 2023.

Pete Sidgwick introduced the annual feedback report for Adult Social Care (ASC) and Public Health covering the period 1 April 2022 to 31 March 2023.

He was supported by Paul Aitken and Sandra Archer (Customer Relations) and Shannon Nicholls (Business Intelligence).

The report summarised the compliments, complaints, questions and comments received by the two services including lessons learned. The data, trends and themes had been collated over the last three years. 

Key sections of the report focussed on:

·       The complaints process

·       Analysis of the Customer Feedback Received During 2022 and 2023 

·       Methods of how the report had been collated

·       Trends in received cases over time

·       Complaints received

·       Complaints closed

·       Remedy

·       Outcome

·       Lessons learned

·       Compliments, comments, and questions

·       Customer platform 

Members reviewed the report and appendix, raising the following points:

• A discussion about the complaints process, being the written policy document, and the customer platform which was an IT solution used to log the feedback received. Pete Sidgwick summarised the difference between the complaints process for adult and children’s services, the latter having more stages. He mentioned referrals to the Ombudsman.
• Some complaints were mis-recorded as compliments and vice versa. More information was sought about data cleansing and the lessons learned. In over half the cases, no lessons learned were reported. It was asked whether this proportion could be improved. Paul Aitken, the Acting Complaints Manager responded. He spoke of the current Contact Us software system, and the move to a new Microsoft Dynamics solution. The system relied on input, which Business Intelligence then used to produce the data reports. There were ongoing discussions to ensure the new platform would include lessons learned feedback and to simplify the extraction of this information. Officers were encouraged to input as much information as possible, including the lessons learned, but this was an area which could be improved.
• It was quite common for customers to select the wrong feedback category recording a complaint as a compliment. More detail was sought on the numbers involved and whether changes were required to make this clearer to customers. Officers were able to correct the feedback category within the portal. A related point was the language used, given the proportion of people with functional illiteracy. There was a need to make this system as easy as possible for the public to use.
• A discussion on the statistical complaint data and the reasons for such complaints. Sections of the report explained the complaint categories, with the examples of finance issues and commissioned services being used. It was noted that the low number of complaints made it difficult to be too specific, due to data protection aspects. However, officers would seek to provide themes or identified issues, with hospital discharge being referenced as an example. Nigel Minns added from the report the section on practical examples and the three highest categories of complaints received.
• Positive feedback had been received about the hospital discharge arrangements at the George Eliot Hospital.
• It was noted that there had been no complaints about the  ...  view the full minutes text for item 6.

A presentation and discussion item on the South Warwickshire Community Hospital Review.

The Committee received a presentation from Glen Burley, Chief Executive of South Warwickshire University NHS Foundation Trust (SWFT). The presentation included slides and additional comments on:

·   Background on the strategic review involving the inpatient facilities at Ellen Badger Hospital in Shipston on Stour and the Nicol Unit at Stratford Hospital, a total of 35 beds.

·   Review to date – a timeline of the key stages from May 2021 to present. Reference to the engagement undertaken, including with the Committee. As a result, two additional options were included in the review. There were periodic briefings for the Council’s Portfolio Holder. Reference to more recent stages, including the latest NHS planning guidance which had been included in the review. The SWFT Board had considered and approved recommendations, submitting them to the Coventry and Warwickshire Integrated Care Board (ICB), of which he was a member.

·   Options appraisal – details of the five options appraised fully

1. Retain the community hospital bed base ‘as is’

2. Increase the number of community hospital beds

3. Change the type of services provided at community hospitals

4. Reduce beds and invest in community alternatives

5. Retain the community hospital offer but change the location

·   Options appraisal criteria, assessed in terms of effectiveness, efficiency and feasibility.

·   Mr Burley reflected that next week would be the 75^th anniversary of the NHS. Historically, bed rest was seen as part of the treatment pathway, but this was no longer the case. A ‘home first’ approach with ongoing support and care was shown to be significantly better for patients. There would always need to be some inpatient bedded services.

·   Projecting future need – the future bed requirements had been projected by combining usage data and three clinical scenarios around End of Life, Orthogeriatric and Discharge to Assess.

·   The Community Recovery Service. This was part of a national pilot programme to provide capacity and linked to discharge to assess, in the patient’s home. This was going very well and evidenced that the home first approach should drive the way that services were delivered in the future.

·   He touched on the improvements being made in patient flow, benefits for the patient and the economics of this model. The modelling had included the scenarios and the population demographics, with an increasing population and more elderly people. It showed that there was an ongoing need for 19 beds (in one ward), which was less than presently, and he was uncomfortable with that. 

·   Patient access and a postcode analysis which had recently been refreshed. It showed that patient numbers from the immediate locality was very small with only 17 patients from Shipston in the last financial year, comparing to 313 from the Warwick, Leamington and Kenilworth areas. This led to the recommendation to locate the beds in the areas of biggest population.

·   Recommendation. This was to increase from 35 - 41 beds in two wards, one located at the Leamington Spa site and one at the Nicol Unit at Stratford Hospital. He considered this was an  ...  view the full minutes text for item 7.

For the Committee to review and update its work programme.

The Committee discussed its work programme. It was noted that a joint meeting would be arranged with the Children and Young People OSC, on a date to be confirmed. The Chair would like to see an item regarding the local response to the Covid pandemic and lessons learnt included.

Resolved

That the Committee notes the work programme as submitted.