Hampshire County Council Health and Adult Social Care Select Committee Meeting

Apologies were received from Councillors Burgess, Branson, Craig and Harrison.

Members were mindful that where they believed they had a Disclosable Pecuniary Interest in any matter considered at the meeting they must declare that interest at the time of the relevant debate and, having regard to the circumstances described in Part 3, Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter was discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore Members were mindful that where they believed they had a Non-Pecuniary interest in a matter being considered at the meeting they considered whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, considered whether it was appropriate to leave the meeting whilst the matter was discussed, save for exercising any right to speak in accordance with the Code.

Councillor Pankhurst declared an interests as an NHS 111 employee and noted that she would leave the meeting room when the item was discussed.

The minutes of the previous meeting held on 24 January 2023 were agreed as a correct record and signed by the Chairman.

The Committee did not receive any deputations.

The Chairman updated the Committee on some recent business from the Health and Wellbeing Board. Members noted the progress on both Integrated Care Partnership Strategies for Frimley ICS and Hampshire and IOW ICS with discussion on synergies with the Hampshire Health and Wellbeing Board Strategy, the Hampshire Public Health Strategy and the development of the Hampshire Place Assembly.

The Committee also heard that, at the Board’s most recent meeting, they had received an update on ‘Ageing Well’. The Ageing Well priorities remain consistently focussed as operating context changes with the challenges of an ageing population. Furthermore, the Board had received a report on the Aim for Smokefree (or tobacco free) Hampshire by 2030 with all agencies working together to achieve this.

a)    Project Fusion: Recommendation to create a new community and mental health trust (Southern Health NHS Foundation Trust and Solent NHS Trust)

The Committee considered an update on project proposals to bring together services from four existing organisations (Southern Health, Solent, Portstmouth Hospitals NHS Trust and Isle of Wight NHS Trust) into one Hampshire body. Some examples of engagement activity undertaken were provided. 

It was noted that all four organisations had signed off the strategic outline case and a letter of support received from the Integrated Care Board. Members heard that NHS England would also receive a letter at regional leevel to scrutinise the strategic case. The final business case was being worked upon with the aim to have this approved by September 2023.

The Committee noted that no services were planned to change as part of the project. If service changes were planned for the future, it was emphasised that these would be brought back to the Committee with the appropriate detail for consideration.

In response to Members’ questions, it was noted that:

·         Project Fusion would aim to provide more professional wellbeing support in schools and in other part of the community to help young people. They were also working with teachers in training to provide support. Currently, CAMHS and the School Health Visiting service were provided by different organisations but it was felt that one of the benefits of coming together would be a more cohesive approach.

·         Working to meet the needs of children with autism was a priority for the new organisation as agreed with the Hampshire and IOW ICB. The currently unacceptable waiting times for assessment were noted.

·         There was already significant joint working taking place on linking with social care to ensure those leaving hospital could receive the most appropriate level of support and care. Close working with Local Authorities on this was planned to continue.

·         North Hampshire and Frimley were being considered as part of the plans with close discussions taking place with the Surrey and Borders NHS Trust and Frimley NHS Trust. Members remained concerned, however, that North Hampshire needed to be considered to ensure that the service provision across the county was fair for all.

·         Lots of engagement and outreach with stakeholder groups had already taken place with plenty more planned including hard to reach groups. It was confirmed that part of the next project phase was to co-produce the design of the organisation alongside those with lived experience.

Members agreed that no service changes were planned at the current time and therefore recommendation 1 in the report was removed. If any service changes were proposed at a later date then they would be reported and scrutinised following the normal process.

RESOLVED:

i)             That the Committee request a further update on Project Fusion at it’s June 2023 meeting.

b)    Acute Services Partnership (Portsmouth Hospitals NHS Trust)

The Committee received a briefing note regarding changes to the Acute Services Partnership across Portsmouth and the Isle of Wight.

In response to a Member question it was confirmed that patients from the Isle of Wight would not necessarily be required to attend Portsmouth for acute services.

RESOLVED:

i)     That the Committee request a further update on the Partnership at it’s June 2023 meeting following the appointment of the joint leadership team.

a)    Independent Review of Southern Health NHS Foundation Trust (Southern Health NHS Foundation Trust)

The Committee received an update on the Trust’s action plan following the Stage 2 Independent Investigation and heard how improvements against specific actions had been implemented.

Members noted that most action areas had now been signed off the Integrated Care Board and those actions which would continually be ongoing and under review with no determined end point. Furthermore, it was noted that the Trust had received the official certificate from NHS England lifting the restrictions previously put into place and demonstrating NHS England’s satisfaction that the improvements had been made.

In response to Members’ question it was confirmed that:

·         Mandatory training, as referred to in the Trust’s action plan at recommendation 1, was constantly under review and figures routinely reported to the Trust Board. Furthermore, the Trust were involved in the national pilot for complaints and this would provide and opportunity for further training. It was confirmed that the draft evaluation report would be available via the Trust’s website.

RESOLVED:

i)                That the Committee welcomes the actions the Trust has taken to date in response to the recommendations made in the Independent Investigation Report.

ii)               That the Committee notes the review that had taken place as noted in Section 1 of the Trust’s briefing note (appended to this report) and that, as such, the themes from the Stage 2 Independent Investigation Report will, as appropriate, be worked into the Trust’s regular cycle of reporting to the HASC.

b)    Care Quality Commission Inspection - Safeguarding (South Central Ambulance Service)

The Committee considered an update from SCAS following their CQC inspection in November 2021 and actions in regard to safeguarding improvements which had been identified as part of the inspection.

Members noted the updates since the last report and that the full Governance team had been recruited to. Members noted the impact that safeguarding training had had upon referrals with an increase as a response to the training undertaken. It was also confirmed that no training had been cancelled throughout the recent industrial action.

The Trust confirmed that they were moving into Phase 2 of their improvement plan and would keep the Committee updated on progress as part of regular updates to future meetings.

RESOLVED:

i)             That the Committee notes the progress made so far against the CQC recommendations and requests a further update at the  September HASC meeting.

Councillor Pankhurst noted that she was an employee of NHS 111 and left the meeting whilst this item was discussed.

Members noted that the 111 service provided via South Central Ambulance NHS Trust was performing well when benchmarked against other 111 services in the South East of England for transfers to 999 and Emergency Departments. A key challenge was resourcing and retaining staff which reflected the circumstances across the NHS. Strategies to help support staff at work and reduce sickness levels were being prioritised for times of high demand and the aim of opening a new call centre site in Milton Keynes was hoped to help with staff retention.

In response to Members questions, it was confirmed that:

·         The pathway scripts for call handlers needed to be generic to cover a range of potential scenarios and that some key questions had to be included. Continual feedback was given to the pathways team to improve algorithms and additional clinicians available on the phone were being introduced to help support call handlers.

·         Call handlers were still able to access clinician support when working remotely and also the support of team leaders. Furthermore, each shift had a senior nurse leader available who did not take calls but was available for call handlers to seek advice.

·         The complexity and high demand of calls was noted and staff were able to seek additional support via resilience training, assurance coaches and wellbeing officers who were able to signpost towards appropriate help.

RESOLVED:

      i.        That the Committee note the update and continue to monitor the performance of the services as part of the Work Programme.

      ii.            That a further update is requested for the HASC meeting in September 2023.

A request was made for an update on the Basingstoke PCN review and whether this impacted any other areas in Hampshire. It was agreed that the Hampshire and IOW ICB would be approached for further information.

RESOLVED:

That the Committee’s work programme be approved.