Agenda and minutes

Health Overview and Scrutiny Committee
Thursday, 26th September, 2019 10.00 am

Venue: Council Chamber, County Hall, Lewes. View directions

Contact: Harvey Winder  01273 481796

Webcast: View the webcast

Items
No. Item

9.

Minutes of the meeting held on 27 June pdf icon PDF 186 KB

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Minutes:

9.1       The Committee agreed the minutes as a correct record of the meeting held on 27 June.

10.

Apologies for absence

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Minutes:

10.1     There were apologies for absence received from Cllr Ruth O’Keeffe and Jennifer Twist.

11.

Disclosures of interests

Disclosures by all members present of personal interests in matters on the agenda, the nature of any interest and whether the member regards the interest as prejudicial under the terms of the Code of Conduct.

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Minutes:

11.1     There were no disclosures of interest.

12.

Urgent items

Notification of items which the Chair considers to be urgent and proposes to take at the appropriate part of the agenda. Any members who wish to raise urgent items are asked, wherever possible, to notify the Chair before the start of the meeting. In so doing, they must state the special circumstances which they consider justify the matter being considered urgent.

 

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Minutes:

12.1     There were no urgent items.

13.

Urgent Care in East Sussex pdf icon PDF 182 KB

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Minutes:

13.1.      The Committee considered a report providing an update on the procurement of a new NHS 111 service; the development of Urgent Treatment Centres in Eastbourne, Hastings and Lewes; and the future of Eastbourne and Hastings Walk-In Centres. The Committee then asked the witnesses present a number of questions.

NHS 111

13.2.      The Committee asked how many staff would need to be recruited to the new 111-Clinical Assessment Service (CAS); whether this would include new GPs; whether they would be recruited to the cost of GP practices; and whether 111 call handlers may be trained to be able to join the CAS.

13.3.      Colin Simmons explained that the winning bidders, South East Coast Ambulance Service NHS Foundation Trust (SECAmb) and Integrated Care 24 Ltd (IC24), already run between them both existing 111 services and an out of hour GP service, which includes over-the-phone clinical assessments. A gap analysis is now being undertaken to understand what workforce the two providers already have and what is needed for the new service.

13.4.      Mr Simmons said that the mobilisation plan for the new 111 service includes developing ways to recruit staff in innovative ways that are attractive to prospective staff but that do not take them from other services. This may include a contract that allows existing GPs to work for the CAS remotely in their own office, rather than physically from a CAS call-centre, whilst still continuing with their traditional GP role. He explained that this proposal will be developed as part of the mobilisation plan, might not be available on day one, and is still subject to full engagement with GPs, however, feedback to date from GPs suggests they are keen to work in different clinical environments and that the CAS could be able to fulfil this desire.

13.5.      Charles Adler added that this kind of ‘virtual working’ is already being established by SECAmb in other areas thanks to the recent availability of new technology. Midwifery calls in Surrey Heartlands for the three hospital sites in the area, for example, are taken in the SECAmb’s 999 contact centre at Crawley by midwives working there, rather than on each of the three separate wards. This allows the same number of midwifery staff to have a far greater impact on patient care and allows them to provide additional clinical capacity at the contact centre for non-maternity calls. It also brings together specialities not used to working together and helps enhance their understanding of each other’s roles.

13.6.      Colin Simmons explained that there is a nationally mandated workforce blueprint for 111 services that includes guidance on supporting the development of non-clinicians’ career paths. This is in recognition that the call handler role needed to be made more attractive due to the high turnover rate of staff nationally. SECAmb’s 111 call handlers will also be trained to do both 111 and 999 calls to increase the resilience of 999.

13.7.      The Committee asked whether the new service will have access to patient records; and how  ...  view the full minutes text for item 13.

14.

Cancer Performance in East Sussex pdf icon PDF 170 KB

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Minutes:

13.1.      The Committee considered a report providing an update on developments in improving cancer care in East Sussex. The Committee then asked the witnesses present a number of questions.

13.2.      The Committee asked whether the national bowel cancer screening programme had been introduced in East Sussex.

13.3.      Lisa Elliott confirmed that bowel scope screening has not started in East Sussex yet due predominantly to endoscopy capacity. NHS England commissions bowel scope screening and the CCGs are working with them to increase the available capacity. The personal test has recently changed from the FOBT (Faecal Occult Blood Test) to the Faecal Immunochemical Test (FIT).  The implementation of the FIT test for screening began in June 2019 for people over 60-74.  For symptomatic patients presenting to their GP, FIT test is also available.

13.4.      Lisa Elliott said that she would feedback the Committee’s concerns that GPs may not be offering the FIT for people under 60, even those with a family history of the disease. 

13.5.      The Committee asked why there is a lack of endoscopy if there are newly opened units at both hospital sites.

13.6.      Lisa Elliott explained that East Sussex Healthcare NHS Trust (ESHT) has increased its capacity, and endoscopy demand is continuing to increase. The Trust is reviewing how it can increase its capacity further.

13.7.      Ashley Scarff added that Brighton & Sussex University Hospital NHS Trust (BSUH) has similar capacity issues around availability of staffing and equipment, so increasing capacity at the trust’s hospital sites is a key area for improvement.

13.8.      The Committee asked to what extent missing the 62-day referral to treatment was due to a shortage of oncologists and other specialists and whether they could be attracted to work in East Sussex

13.9.      Ashley Scarff confirmed that some of the capacity constraints at BSUH were due to lack of workforce capacity and equipment, as well as the need to improve pathways, and plans are in place to address all of these issues.  ESHT is also experiencing workforce constraints and is continuing work to improve cancer pathways in order to meet the 62-day referral target. The focus of these improvements to cancer pathways will be on deploying existing staff more effectively

13.10.   Ashley Scarff added that the increasing demand for diagnosis and treatment from an aging population and higher referral rates, albeit being offset by increasing preventative services, meant that there would be a longer term need to review the size of the workforce required to deliver the target in the future.

13.11.   Jessica Britton said that there is an improving picture of recruitment at ESHT. Ashley Scarff added that the performance of the providers was a virtuous circle and that for both BSUH and ESHT coming out of special measures would help attract staff.

The Committee asked when the Sussex Cancer Board was established

13.12.   Lisa Elliott said the Sussex Cancer Board was established in August 2019. During the previous three years, strategic guidance had come from the Sussex and Surrey Cancer Alliance. However, the  ...  view the full minutes text for item 14.

15.

HOSC future work programme pdf icon PDF 216 KB

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Minutes:

15.1     The Committee RESOLVED to note the work programme subject to the addition of:

1) the reports requested in earlier items;

2) a report at the 28 November meeting on the proposals for a new Patient Transport Service (PTS), including an update on the PTS performance from Healthwatch;

3) a report at the 28 November meeting on the local health and social care system’s winter plan.