Agenda and draft minutes

Apologies for absence had been received from Councillor Sharon Dhillon (Nuneaton and Bedworth Borough Council), Councillor Sandra Smith (North Warwickshire Borough Council), Zoe Mayhew and Pete Sidgwick (WCC Officers) and Rose Uwins (Coventry and Warwickshire Integrated Care Board (C&WICB)).

None.

The Chair mentioned the valuable meetings held with spokespeople and was grateful for the open dialogue at these meetings.

To receive the Minutes of the committee meeting held on 18 September 2024.

The minutes of the Committee meeting held on 18 September 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.

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.

To provide an update/presentation on service developments at the St. Cross Hospital in Rugby and the recent closure of the Hoskyn ward.

The Committee received a presentation from Professor Andy Hardy, Chief Executive and Justine Richards, Chief Strategy and Transformation Officer of UHCW. There had been reported concerns regarding the closure of the Hoskyn ward at the St Cross Hospital, Rugby and the presentation informed members of the service developments taking place at this hospital. The slides covered the following areas:

• Transforming services at the Hospital of St Cross, Rugby.
• The vision for the hospital, with context on how this had been developed, the aims for some services to be delivered in communities and in partnership, with a focus on elective surgical procedures at this hospital:
  • ‘More than a Hospital’ committed to transform the Hospital of St Cross, build modern facilities and improve staff and patient experience.
  • Regional leader for elective care – GIRFT (get it right first time). The hospital was one of only 36 sites nationally to be accredited as a surgical hub.
  • To deliver expanded and modern elective services to meet the needs of a growing population in Rugby. Evidence of the high proportion of orthopaedic services already delivered at this hospital.
  • Separating emergency and planned care onto two distinct sites, with less disruption to planned procedures and driving down waiting lists.
  • ‘Health on the High Street’ development for some outpatient services to improve accessibility. The former Wilko retail premises was being leased. Reference also to the better transport links to the town centre and economic benefits of increasing footfall from the use of such premises.
  • Multi-phase 10-year plan with a Strategic Partner – Development Control Plan.
• Investing in the Hospital of St Cross since 2021:
  • Modular build of two new theatres – expanding surgical capacity.
  • £1 million Haematology and Oncology Maple Unit opened in 2021 - increasing outpatient appointments numbers for local people.
  • A specialist breast care unit offering surgical and nurse-led clinics, reconstruction, plastic surgery and breast surgery physiotherapy.
  • New ultrasound unit in outpatients. An extra scanner doing 4000 more procedures each year.
  • New modular endoscopy unit, with a dedicated two-storey unit, delivering 30% more tests for patients with potentially life-threatening conditions. This had resulted in 73,000 additional tests from Rugby since the start of the diagnostics programme.
  • Investment in wayfinding and signage, with a new site map and plans for a single entrance to the hospital.
  • An Urgent Treatment Centre (UTC), which currently was adjacent to the out of hours GP service. This formed part of a C&W wide review by the ICB. The expectation was for a doctor-led UTC at this location. There had been investment in a virtual consultant link to UHCW.
  • Over £4 million in energy-saving measures. It was one of greenest hospitals in the country, utilising air source heat pumps and solar panels which would contribute to becoming to carbon neutral by 2045.

Andy Hardy concluded that the St Cross Hospital was central to the UHCW vision, with significant investment being made.

In response to this part of the presentation, more detail was sought on surgical hubs, what impact they had  ...  view the full minutes text for item 5.

For the Committee to consider and comment on the Quarter 2 Integrated Performance Report 2024/25.

Shade Agboola presented a summary of the Council’s performance at Quarter 2, which covered the period April to September 2024, against the strategic priorities and areas of focus set out in the Council Plan 2022-2027. The report provided a combined picture of the Council’s delivery, performance, finance and risk, enabling scrutiny and transparency for the organisation, partners, and the public.

The detail of the report and supporting appendices comprised:

•        Progress against the Council Delivery Plan (CDP)

•        Performance assessed against the Key Business Measures (KBMs) contained within the agreed Performance Management Framework (PMF)

•        Management of financial resources; and

•        Management of risk.

The CDP and PMF had been refreshed to focus on key priorities. Members could monitor performance via the Power BI platform. Of the activities in the CDP, nine were attributed to this committee and all were currently on track. There were eleven KBMs within the committee’s remit, with nine available for reporting in this quarter. A table within the report showed that four of these were not ‘on track’ at quarter two. Context was provided in the report detail on the direction of travel for each of the nine KBMs and key influencing factors of the current operating environment.

Shade Agboola spoke about the KBM for provision of safe accommodation units which was currently not on track. The position had been static, due to changes required in the leases between the provider Refuge and a third party, meaning that no new properties were able to be onboarded. This seemed to have been resolved and should be reflected in the next quarterly performance update showing eighteen completed units instead of the reported twelve. A service review was being undertaken to look at performance overall, highlighting areas of success and challenges, with Shade reporting some of the successes and positive activity not captured by the ‘red’ rating of this indicator.

Reference was made to the financial pressures and the mitigation measures to help stabilise this in year. In common with the whole sector, significant medium-term financial challenges remained. A forecast overspend of £15.04m was reported, equivalent to 6.1% of the revenue budget. Saving targets were forecast to be underachieved by £0.204m, 3% of the current year’s target. The delivery of the planned capital programme remained on track. 

Two of the strategic risks related to the work of this committee. These were being able to keep children and vulnerable adults safe and a mismatch between demand and resources. At the service level, fourteen risks related to this committee, with detail of each area being reported.

Members submitted questions and comments:

• The Chair asked if the position at quarter three was expected to improve, which was confirmed.
• Councillor Shenton commented that the total overspend on Social Care was £17.3m or 8.2% when including the use of reserves. There had been some savings, but he was unsure if the shortfall would reduce, when services were likely to be more in demand. Becky Hale stated the significant service demands and complexity of  ...  view the full minutes text for item 6.

For the Committee to review and update its work programme.

The Committee reviewed its work programme. The Chair confirmed that an additional meeting would take place on 22 January 2025. She referred to the briefing circulated on bowel and bladder services. This would be followed by an update on this service area at the February Committee. A further briefing had been circulated on the joint work by HWW and Action Menopause Warwickshire on their recent survey.

Councillor Holland referred to the Health Visiting Service. This included a supporting role for new parents. He linked this to objectives on reducing domestic violence, which had been the topic of the last Director of Public Health Annual Report. He was aware of the current tendering process for this service and once that had concluded, suggested that the Committee consider Health Visiting. The Chair agreed this should be added to the work programme and it would have been a useful area for scrutiny to consider beforehand.    

Councillor Johnston asked if a date could be agreed for the Committee to receive the presentation ‘Right Care, Right Person’ listed on the work programme. He was concerned that the police were the first agency responding to cases when a person was in mental health crisis. 

Councillor Timms asked for a follow-up item to be added to the work programme on developments at St Cross Hospital, Rugby and the ‘Health on the High Street’ initiative. This would be within the next year.

Chris Bain mentioned that an Integrated Urgent Care review had recently taken place and he thought it should be reported to the Committee. This should be within a short timescale.

A request was also made to revisit stroke services.

Paul Spencer advised of the agenda setting meetings with the Chair and spokespeople. The above proposals would be included for discussion at that meeting. In addition to the extra meeting in January, further meetings were scheduled for February and April, although the latter was in the pre-election period for the County Council elections. NHS colleagues may decline to attend meetings in the pre-election period. The Chair added that briefings could also be requested to update on those service areas.