The Committee held a minute’s silence in memory of the victims of the recent terrorist atrocity in Brussels.

To receive and if so determined, to approve as a correct record, the minutes of the last meeting of the Joint Health Scrutiny Committee held on 2 February 2016. 

The Committee considered the minutes of the meeting held on 2 February 2016. Dr Nigel Guest disputed that the Secretary of State had agreed the closure of the Accident and Emergency (A&E) Department at Trafford General Hospital was dependent on appropriate alternative A&E provision being established, including the £12 million investment into the A&E at UHSM. The Chair responded that this was a matter of interpretation, to which the Committee agreed.

Decisions:

1. To approve the minutes of the meeting on 2 February 2016 as a correct record

2. To note the comment of Dr Nigel Guest.

To note any declarations of interest.

The following personal interests were declared:

Councillor Harding declared a personal interest in relation to her employment by a mental health charity and as a member of Trafford Carers Centre Board.

The Chair suggested reviewing the decisions made at the meeting held on 2 February 2016, to which members agreed. It was noted that the Committee would continue to receive performance reports on the implementation of the New Health Deal for Trafford and had received such reports for its 22 March 2016 meeting. In respect of the Falls Service members were advised that data collection would commence in April 2016 and as such this information would not be available until later in the year. The request for information on the Orthopaedic Centre had been provided to its 22 March 2016 meeting. The report describing last year’s winter resilience plan had been circulated to members.

Members requested Silas Nichols provided a verbal update on the delayed progress in implementing the £12 million capital investment for the Accident and Emergency (A&E) Department at UHSM. Silas Nichols responded that a business case was provided to the UHSM Trusts board last month and was fully approved. He said that £15 million investment had now been approved due to design changes; which was higher than the £12 million originally required. Enabling works had commenced and it was expected that supply chain partners would be appointed by April, and building work would commence in May. Silas Nichols added that the timetable remained the same and it would be a two year development. He outlined the stages of the development, explaining that the work had to be done whilst ensuring that the A & E remained fully operational throughout. The Chair requested that the verbal update be confirmed in writing to members to which Silas Nichols agreed. Silas Nichols suggested that the development of UHSM A&E become a standing item for consideration by the Committee to which members agreed. The Chair noted that members had recently visited UHSM and welcomed the development.

Members queried the progress made in respect of publicising the services and opening times of the Urgent Care Centre at Trafford General Hospital. Mary Burney responded that social media including Twitter and Facebook had been used; in addition to letters sent to GP’s and Commissioning Centres. She added that the letters included wider information and would become a quarterly update.

Members queried why they had not been notified of the publicity. A member commented that she could not find the entries on social media from key words. Members agreed that a diverse range of communication was needed including face to face. A member added that the road signs outside of the Urgent Care Centre were not easily readable and requested this be addressed.

Dr Nigel Guest advised that GPs held regular meetings and issued press releases regarding the appropriate use of services. Mary Burney responded that there was a 15% increase in attendances at the Urgent Care Centre since the new Communications Strategy had commenced. She said that Trafford Council and Healthwatch had been included in the Twitter publicity. Mary Burney outlined future plans which included visiting supermarkets; and an open day to which Trafford  ...  view the full minutes text for item 25.

To receive update reports on the New Health Deal for Trafford from representatives of Trafford CCG, UHSM and CMFT.

The Committee welcomed Sara Roscoe (NHS England), Silas Nichols (Deputy CEO, University Hospital South Manchester (UHSM) Foundation Trust), Mary Burney, Dr Jon Simpson and Stephen Gardner (Central Manchester Foundation Trust (CMFT)), Julie Crossley, Ellin Swanborough, Gina Lawrence and Dr Nigel Guest (Trafford Clinical Commissioning Group (CCG)). Dr Nigel Guest delivered the presentation entitled ‘Trafford New Health Deal, Review of Urgent Care Centre’ which had been provided in advance of the meeting within the published papers.

In response to a query Dr Nigel Guest confirmed that the Integrated Care Redesign Board (ICRB) had continued to meet explaining that as they were part of the original governance structure they would be required again in due course. In response to a query regarding the audits carried out of the impact on neighbouring A&E’s officers assured members that the data was robust. Silas Nichols said that the main impact was on the A&E at UHSM. He added that over the past year attendances had unexpectedly increased from 250 to 275 per day; and sometimes higher (in particular Sundays and Mondays). However, he felt this was demographic driven rather than directly a result of the changes at Trafford; but increased admissions had impacted on Trafford CCG’s budget. In response to a query Silas Nichols explained that delayed transfers of care sometimes resulted from a hospital’s own systems. There was a need to ensure patients were only admitted for a short time, and resolve ongoing problems of access to care packages. Stephen Gardner said that CMFT continues to receive a payment in addition to tariff for the Urgent Care Centre service, and although this is much smaller than it was originally, it still means that this funding is not available to develop community-based services. He added that performance at CMFT was comparatively good but there was a need to deploy staff where skills could be used.

Members raised concerns regarding mental health provision. Members noted that they had recently visited several Manchester hospitals and staff had raised concerns that it was not acceptable for patients with mental health problems to be waiting excessively within A&E departments. Dr Nigel Guest advised that Trafford CCG commissioned Greater Manchester West, which members agreed provided a good service to UHSM and Trafford General Hospital. Members noted that there were challenges in mental health services in Manchester at the present time and Manchester City Council’s Health Scrutiny Committee were aware of this. Dr Nigel Guest added that a major review of mental health services across Greater Manchester would commence once Greater Manchester gained devolution powers in respect of Health and Social Care.

Members discussed the data provided within the report and asked for clarity on a number of points. Officers confirmed that the statistics provided in respect of urgent admissions were all patients from Trafford; and a reference to 2005 in report should have read 2015. Members agreed that there were issues with the waiting room at the A&E at Manchester Royal Infirmary (located within CMFT).  ...  view the full minutes text for item 26.