Agenda and draft minutes

The Chair welcomed everyone to the meeting, including members of the Children & Young People OSC for the item on Bladder Services, which spanned the remit of both committees. A welcome was extended to the presenters for this item. For item six, the Chair welcomed members and contributors to the task and finish review of Menopause Services.

Apologies for absence had been received from Councillors Penny-Anne O’Donnell (WCC) and Colin Cape (Nuneaton and Bedworth BC).

None.

The Chair referred to a meeting with Becky Hale, Executive Director and Democratic Services, to discuss ways to extend the Committee’s activity. She planned to meet personally with various organisations and then report back on those discussions. This would be coordinated with the additional meetings held by the Portfolio Holder for Adult Social Care & Health and Chair of the Children & Young People OSC on health and children’s services. A key aspect was the Memorandum of Understanding on activity undertaken by the two OSCs, the Health and Wellbeing Board (HWBB) and Healthwatch Warwickshire (HWW), which had not been refreshed for several years. She sought affirmation that the Committee was supportive of it being refreshed. The aim was to avoid duplication and areas not being considered.

In Councillor O’Donnell’s absence she had submitted questions about the catheter service, which may need to be scrutinised. Councillor Bell added that for some catheters, district nurses had previously been able to change them. There was now a training requirement and the training had been delayed. Councillor O’Donnell had reported an incident where an absence of qualified staff resulted in a patient needing ambulance transportation to hospital and a consultant to change the catheter. Councillor Bell suggested that a briefing was needed to understand how the required training would be provided, to enable district nurses to undertake this role.

Councillor O’Donnell had also submitted a point about falls clinics. The Chair was mindful this service used to be provided at the Ellen Badger Hospital. The service was not provided currently. The Chair had spoken recently with Mike Wells, Lead Governor at South Warwickshire Foundation Trust (SWFT), who was determined that the new facility would be open by the end of Summer. She was mindful that the ICB had not responded to the outstanding request for a consultation on the South Warwickshire Community Hospital Review and sought the Committee’s support to write to the ICB to pursue this.

To receive the Minutes of the committee meeting held on 14 February 2024.

The minutes of the Committee meeting held on 14 February 2024 were approved as a correct record and signed by the Chair.

None.

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 Rolfe referred to the Hathaway Clinic based at Stratford Hospital, which provided sexual health services. The clinic had closed at the end of March and an outline was provided of the services delivered there previously. In future the services would be based at Leamington. Councillor Rolfe referred to a Public Health survey, but this had not referenced relocation. She asked who had taken this decision and when, whether there had been public consultation about the services moving and how people unable to travel to Leamington would be supported. She asked if the new C&W sexual health hub had commenced on 1^st April as planned and sought more information about the proposed outreach services in Stratford, including where it was based, and the services being provided. She added that Healthwatch was similarly not aware of this service change. Councillor Rolfe requested a briefing and potentially adding an item to the Committee’s work programme to consider this matter. The Chair was supportive of it being added to the work programme. Councillor Bell, Portfolio Holder for Adult Social Care and Health requested a copy of the detailed question and undertook to seek a response.  

Councillor Pam Redford submitted a question about care packages for armed forces veterans, asking how many were currently receiving help and a care package. On the Portfolio Holder’s behalf, Pete Sidgwick advised that a response had been provided to this question, raised at a previous committee and this would be recirculated to members.

Councillor David Johnston understood that the regulations allowing health scrutiny committees to submit matters to the Secretary of State for Health and Social Care had changed. He asked for a briefing to be provided on the changes. Paul Spencer confirmed the changes made regarding service reconfigurations. The Government had provided revised guidance for health scrutiny committees, which would be circulated.

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.

A briefing document is provided. NHS colleagues will provide a presentation on the bladder service. This includes services for adults and the new children and young people bladder service. Members of the Children and Young People Overview and Scrutiny Committee have been invited to attend the meeting for this item.

Members of the Children and Young People (C&YP) Overview and Scrutiny Committee had been invited to attend the meeting for this item. A briefing document had been circulated with the document pack which informed on bowel and bladder services for children and young people in Warwickshire. This included context that 6.4% of C&YP were affected by continence problems. An outline of the guidance was provided, together with the transfer of commissioning responsibilities to Public Health and the challenges experienced. Historically, different continence services were provided in Coventry and Warwickshire. Feedback from Warwickshire parents and carers showed the impact of a lack of continence services.

The Coventry and Warwickshire Integrated Care Board (C&W ICB) had considered a business case from South Warwickshire Foundation Trust (SWFT). The briefing outlined the development of a new bladder and bowel service. The lead provider for the interim two-year service would be  Coventry and Warwickshire Partnership Trust (CWPT), working in partnership with SWFT, to deliver the following:

•        Fully scope the needs of the population for a tiered approach using existing capacity.

•        Consider opportunities for efficiency of working across the footprint.

•        Co-produce a new set of clinical pathways with the parent carer forums across each area of clinical need.

•        Define a set of outcome measures.

•        Review the services following the two-year period to identify and outline the ongoing business case to the ICB.

The briefing reported on the recruitment activity, development of clinical pathways, and the initial priority was for those with the highest clinical need. The new service would be rolled out from May. Details were provided of the interim support available, through school nursing, primary care, and charitable groups. Free on-line training would be available for service providers from April. There would be evaluation throughout this two-year pilot, before further decisions were made about the sustainability and future delivery of the service.

A presentation was provided by Jamie Soden of the C&W ICB, supported by Amanda Parsons and Lindsey Sandler of CWPT to highlight key aspects and respond to questions. The presentation covered:

•        Adult Service Structure

•        Access and Purpose

•        Context

•        Current Provision

•        The ‘Set up’ Phase

•        The Service

•        Next Steps

Questions and comments were invited with responses provided as indicated:

•        The Chair referred to timescales asking about support for children who were in mainstream rather than specialist schools. She asked about securing funding to ensure the continuation of services and to avoid gaps in service in the future.

•        Jamie Soden responded on the funding aspect, explaining how this pilot would look at scoping and then development progression and agreement of the business case.

•        Amanda Parsons confirmed the new service would be open to referrals from 1^st May including for children not in special schools. She outlined the preparatory work to build staff capacity with recruitment of specialist nurses. As capacity was built, services would be available for children who had received tier one interventions  ...  view the full minutes text for item 5.

For the Committee to consider the report and recommendations from the Menopause Services Task and Finish Review.

Councillor Kate Rolfe, Chair of the Menopause Services Task and Finish Group (TFG) introduced this item. She acknowledged the attendance of members of the TFG and contributors to this review.

The Overview and Scrutiny Committee had commissioned the review to undertake research, to assess the sufficiency of services, any gaps in provision and to make recommendations to those responsible for the services. In doing so, the Committee outlined the areas to be included, being NHS menopause services and those which the County Council provided.

The TFG held three evidence sessions with the Integrated Care Board, with groups providing ‘lived experience’ of the services, and the County Council’s staff on the internal support offer. The review provided a detailed understanding of the way that Menopause Services were commissioned and the learning from those with lived experience of services. It demonstrated that there were a lot more services than was understood at the outset of the review, especially in third sector organisations. It was clear that the County Council had developed a substantial ‘offer’ of support and advice for its own staff.

The resultant report was submitted for the Committee’s consideration. The TFG proposed recommendations for the Coventry and Warwickshire Integrated Care Board (C&WICB), and for the Council in respect of those services within its remit. The recommendations were set out in the covering report, together with the rationale for each recommendation. The appended review report provided the supporting information, detailing the evidence heard, the stages of the review and its findings.

Councillor Rolfe highlighted the recommendation on information sharing, considering that the Council provided an exemplary service to its menopausal staff. On behalf of the TFG she thanked Paul Spencer of Democratic Services for his support and the work undertaken on this review. This had been an interesting review to sit on, providing a lot of information, especially about the services available.

The Committee Chair considered this a brilliant report and piece of work, being delighted at the information found on the service availability. Questions and comments were invited from members:

• Councillor Falp commented that the TFG had been well chaired. She was disappointed that no male councillors had participated as men were also impacted in supporting their partner through the menopause. She recognised the input from Healthwatch in providing public feedback and reflected on her own learning from this review. There were services but these were ‘patchy’ in some areas, and they should be Warwickshire wide. She echoed the recognition of the support WCC provided for its staff.
• The Chair referred to the recommendation on securing access to primary care menopause specialists. It was known this was limited and she spoke about GP training on this important area, asking what could be done.
• Caroline Graham of HWW thanked the TFG for including in its review the findings of the Healthwatch survey. She spoke of the feedback received from over 300 people, with only 56% of respondents being happy with the primary care service received. There were comments about  ...  view the full minutes text for item 6.

For the Committee to review and update its work programme.

The Committee gave consideration to its work programme with the following items being discussed:

• It was suggested that an update be provided on Child and Adolescent Mental Health Services. This would be an item for the periodic joint meeting with the Children and Young People OSC.
• The Chair reminded of the suggestion to refresh the Memorandum of Understanding between the overview and scrutiny committees, the Health and Wellbeing Board and Healthwatch.
• A briefing had been provided to Councillor Drew on the subject of young carers, which would be discussed in more detail at the next Chair and Spokesperson meeting.
• A letter would be sent to the Integrated Care Board to seek an update on the planned consultation regarding the South Warwickshire Community Hospital review.
• Councillor Mills provided an update on plans for a primary health centre at Upper Lighthorne. A meeting would be held with the local Member of Parliament, Sir Jeremy Wright MP, the ICB and lead Council officers to discuss this in more detail. Councillor Mills paid tribute to Andy Smith for his tireless work in progressing this.
• Councillor Rolfe referred to her earlier question to the Portfolio Holder and suggested an item should be added to the committee’s work programme on sexual health services. Becky Hale clarified that a briefing had been provided to members on 13^th May on the launch of the Integrated Sexual Health Service. This would be recirculated and a response would be provided to the question submitted.
• Chris Bain referred to an item on the future work programme on annual health checks by GPs. HWW was doing work with veterans about accessing annual health checks. He asked if the two items could be combined into a single item, which was agreed.

The work programme was updated accordingly.