Hampshire County Council Health and Adult Social Care Select Committee Meeting

Apologies were received from Councillors Craig, Jackman and North.

Councillors Ford and Porter were in attendance as the substitute members for the Conservative group and Liberal Democrat group respectively.

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.

The minutes of the previous meeting held on 23 May 2023 were agreed as a correct record and signed by the Chairman.

The Committee did not receive any deputations.

The Chairman noted that the 15 June Health and Wellbeing Board meeting had been well received with key themes of Mental Wellbeing and Suicide Prevention and the Dying Well strand of the Health and Wellbeing Strategy. The meeting had been followed by a very well attended Hampshire Place Assembly meeting and the Chairman encouraged Members to review the agenda documents via the County Council website.

The Chairman was pleased to announce that Bill Dyet from Malmesbury Lawn residential care home had recently won the Manager of the Year award at the Hampshire Care Association Awards. Furthermore, the team at Malmesbury Lawn had won the Excellence in Dementia Care of the Year award. The Chairman congratulated all involved for these outstanding achievements.

The Chairman noted that he had attended the Equality and Inclusion World Café event managed by the Adults’ Health and Care Directorate which had taken place on 12 June 2023. Members heard that the event had been organised to help improve understanding of inequalities in health, care and support and encourage staff to think about what they could individually do in their roles, to reduce inequalities in care and support.

a)    Care Quality Commission (CQC) Inspection – Mental Health Inpatient Units (Southern Health NHS Foundation Trust)

The Committee received a report setting out recent developments from within Southern Health NHS Foundation Trust (Southern Health) and also included some information on a recent CQC Inspection on their mental health inpatient units which had returned a rating of ‘requires improvement’.

It was noted that the action plan against the improvements was available and would be circulated to Members post-meeting. Southern Health agreed to return to a future meeting to discuss the action plan.

With regards to the other developments and topics mentioned in the report, and in response to Members’ question, it was confirmed that:

·         There had been a reduction in demand for the Crowlin House facility and that this, combined with staffing difficulties, had meant that the decision had been reached to close the facility. Southern Health noted that they would provide a full report to a future HASC meeting on the matter. Furthermore, Southern Health noted that there was no planned date for closure and that current residents’ needs would continue to be provided for as long as they remained at Crowlin.

·         Staffing, in particular in mental health wards, remained one of the Trust’s biggest challenges. This was reflective of the national picture within the NHS. Southern Health were continually monitoring safe staffing on a weekly basis to ensure the safety of patients and a new people strategy was due to be launched shortly with a focus on resolving staffing shortages.

·         Reducing the number of beds available as a result of staff shortages would be a ‘last resort’ and measures such as this had not yet been required at the time of the meeting.

RESOLVED:

That the Committee request sight of the CQC action plan and request a further update against the CQC’s recommendations at the November HASC meeting.

That an item on the future of Crowlin House be added to the Committee’s Work Programme.

a)            Proposals to redesign inpatient Older Persons Mental Health services (Southern Health NHS Foundation Trust)

The Committee received the report of Southern Health setting out proposals to re-purpose Beaulieu Ward at Southampton Western Hospital.

It was noted that Beaulieu Ward currently delivered organic dementia care (organic illness (mental health) being a dysfunction of the brain that occurs in Dementia or Alzheimer’s that excludes psychiatric disorders) but that full utilisation of the ward had not been required within the previous two years. Taking this into consideration, Southern Health were proposing to re-purpose the Ward to meet the needs of older people with a functional illness (functional illness (mental health) being a mental health illness that does not relate to dysfunction of the brain such as dementia and includes severe mental illness such as schizophrenia and bipolar mood disorder).

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

·         If there were to be an unexpected increase in demand for organic dementia beds, the Trust would be able to reactively provide this as necessary.

·         The decision to care separately for organic and functional dementia patients was highly complex and that there was no professional view on the best practice for either separating or treating patients together. The Trust were working with service users to try to establish the best approach but it was noted that the patients in question had varying and complex needs and it would be challenging to find a complete solution.

RESOLVED:

i)             That the Committee determined that the proposals did not constitute a substantial change to health services.

b)            Whitehill and Bordon Health and Wellbeing Hub Update (Hampshire and Isle of Wight Integrated Care Board (H&IOW ICB))

The Committee received a report from the H&IOW ICB with a progress update on plans for the Whitehill and Bordon Health Hub.

Since the last update to HASC, recent progress had included public consultation on the planning application which was intended for submission in early July, further patient engagement activity and progressing the design details. A planning decision was expected to be made by October 2023.

In response to Members’ questions it was confirmed that:

·         There remained plans to deliver older person mental health services from the Health Hub as well as talking therapies.

·         Having a range of clinicians working from the same location was expected to improve patient experience and enable clinicians to link with each other more effectively.

·         That linking with all partners at an early stage in planning proceedings was crucial to ensuring the success of any future, similar projects.

RESOLVED:

i)             That the Committee continue to monitor the progress of the development of the hub and request an update at the January 2024 HASC meeting following anticipated planning determination for the site.

c)            Integrated Primary Care Access Service (Hampshire and Isle of Wight Integrated Care Board)

The Committee received a report from the H&IOW ICB with an update on primary care services in Hampshire and additional primary care capacity outside the core hours of GMS contracts formally known as enhanced access services.

There was discussion regarding difficulties in accessing GP services and in contacting GP surgeries which had meant that patients, particularly older people and those in vulnerable groups, felt disempowered and unable to seek the support and care that they required. The ICB acknowledged several examples provided by Members whereby making GP appointments had not been possible for residents. It was confirmed that work was underway to improve the telephony systems at practices and that support and training would be provided to individual practices in terms of setting up the new system. It was intended that this would improve patient experience and enable easier access to GP practices across Hampshire. Furthermore, Members noted that on 9 May 2023, NHS England and the Department of Health and Social Care had jointly published their ‘Delivery plan for recovering access to primary care’. The plan set out an approach intended to tackle the ‘8am rush’ and make it easier and quicker for patients to access primary care services.

Members raised some comments regarding access to dentistry services and it was confirmed that the ICB had been invited to present a specific item on dentistry at the September HASC meeting.

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

·         The ICB would be able to provide a full report on the Primary Care Network Review of North Hampshire and would attend a future HASC meeting to present this.

·         The ICB would aim to better promote awareness of the role of Care Navigators within primary care whose role encompassed signposting patients to the right clinicians to ensure the most appropriate care.

RESOLVED:

i)             That the Committee continue to monitor the item given the importance of enabling access to primary care and request a further update at the January 2024 HASC meeting. That a request be made to Frimley ICB to also attend to present part of the Primary Care update for the January meeting.

ii)            That an item be added to the Committee’s Work Programme regarding the Primary Care Network Review of North Hampshire.

RESOLVED:

That the Committee’s work programme be approved subject to the two amendments agreed earlier on the agenda regarding Crowlin House and the PCN North Hampshire Review.