Agenda item

A clinical commissioning group update on the restoration of services and proposals for developing a case for change regarding the potential relocation of neuro-rehabilitation beds.

Anna Hargrave, Chief Strategy Officer of South Warwickshire Clinical Commissioning Group (CCG) introduced this item. The report concerned the potential relocation of neuro-rehabilitation beds from University Hospitals of Coventry and Warwickshire (UHCW) to South Warwickshire Foundation Trust’s (SWFT) Central England Rehabilitation Unit, located at Royal Leamington Spa Hospital. It also concerned the current temporary closure of the Stratford Minor Injuries Unit and Ellen Badger First Aid Centre, both being to support the response to COVID-19. The committee’s support was sought to develop a case for change and to consider the benefits of these service changes for the local population, prior to making a decision regarding the current arrangements.

It was confirmed that any service change proposals would be assessed to see if there was system-wide support, before a detailed case for change was prepared and subjected to engagement with patients, staff, the wider public and stakeholders.

The following questions and comments were submitted, with responses provided as indicated:

• This was a good opportunity to rethink the location of services and their delivery.
• Clarified that the service had been relocated to increase capacity for acute services at UHCW.
• Regarding the rethink of urgent care, a plea to look across the county to ensure that facilities were provided in all areas, including for general rehabilitation.
• Points about the short-term response and longer-term aspects for the review of rehabilitation services, including the estates strategy. This review concerned the specialist neuro rehabilitation service and patients from Coventry, Warwickshire and beyond who had been at UHCW were currently treated at the Central England Rehabilitation Unit. Further information would be sought about rehabilitation generally from WNCCG and be provided to the committee.
• Reference to the increasing number of Covid-19 infections and a question on the restoration of services. Helen Lancaster from SWFT replied that all three trusts had virtually returned to pre-covid service delivery levels for many services. The restoration of services was discussed regularly between the three trusts, with mutual support being provided. Some patients remained nervous about attending hospital. Use of the independent hospitals was also raised, together with the measures required to provide safeguards when standing up services. A lot of work had been done over a short period of time and the winter pressures would be exacerbated by the pandemic this year.
• Earlier in the meeting, reference had been made to the delays in getting blood tests and results in the north of the county, which would be pursued with the WNCCG
• Councillor Roodhouse raised concerns regarding the wording of recommendation two in the report, seeking support for the business case. He explained the role of the scrutiny committee was to consider the evidence on what the CCG had done in formulating the business case. As a director of HWW, he was interested in securing the patient voice. He concluded that the committee should note the report at this stage. The Chair acknowledged these points. The suggestion to note the report was endorsed by another member.
• A member was concerned at the formation of the business case and what this may mean for the Ellen Badger Hospital, whilst also seeking more information about the plans for a wellbeing hub.
• The business case would provide an appraisal of all options, include robust engagement and there were no pre-determined ideas. The report at this stage was advance notice of the process to be followed. Because of the urgent closures or changes required, there was a duty to keep the committee informed ahead of the planned further work.

·       Sophie Gilkes spoke about the progress with the Ellen Badger development, investment plans, development of a localities hub and integrated care. There was ongoing work with both WCC Public Health on the needs of this community and Trevor Russell, Chair of the Shipston on Stour Health and Wellbeing Partnership.

·       A commitment to work with Healthwatch Warwickshire (HWW) and via the Chat dialogue, Chris Bain confirmed that HWW would be pleased to play a full part in the engagement strategy

• Councillor Barker declared an interest due to her involvement in the league of friends supporting the development of the Ellen Badger Hospital.

·       Councillor Bell noted the lack of representation from WNCCG or the George Eliot Hospital (GEH) at this meeting. Rose Uwins confirmed that she was representing both WN and Coventry & Rugby CCGs and would refer back the points raised at the meeting. Councillor Caborn added that he had monthly meetings with GEH and any issues could be passed to him to raise. It was suggested that a regular attendee from GEH should be invited to attend future meetings.

Resolved

1.          That the Committee notes the proposal for NHS Coventry and Rugby CCG, in collaboration with UHCW and SWFT, undertaking the process to develop a full decision-making business case regarding the future location of the neuro-rehabilitation level 2b beds.

2.          That the Committee notes the process to develop a full decision-making business case regarding the future of the Stratford Minor Injuries Unit and Ellen Badger First Aid Centre, as part of a wider look at urgent and emergency care services in South Warwickshire.

The Chair thanked Anna Hargrave, Sophie Gilkes and Helen Lancaster for their attendance at the committee.