Agenda and minutes

Apologies for absence were received from Councillors George Derx, Derek Smith and Sean Gibbons.

There were no declarations of interest made.

The minutes were agreed as a correct record.

[A period not exceeding 20 minutes for

Statements from up to 5 members of the public on

matters within the Panel’s remit, proposing action(s)

which may be considered or contribute towards the

future development of the Panel’s work programme].

There were no public statements made.

The Panel was provided with a presentation from the Chief Executive, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust on the following areas;

•           Strategic issues including future aspirations;

•           Future challenges and impacts;

•           Cancer Care waiting times;

•           Maternity Care – Hospital Services Review

•           Setting the scene

•           Our True North

•           Our Workforce

•           Our Estate

•           Patients 2018/2019

•           People 2018/2019

•           Performance 2018/2019

•           Prevention 2018/2019

•           Partners 2018/2019

•           Quality Improvement 2018/2019

•           Future Challenges 2018/2019

•           Cancer Waiting Times

•           Maternity Times

There was a discussion held and the following issues were raised;

CQC Inspection – A Member raised concern that the last published CQC Inspection report deemed the inspected Urgent and Emergency Care Services as ‘requiring improvement’.  Members were informed that a more recent CQC Inspection had taken place in October 2019 (as part of the inspection cycle the Trust undertakes with core services lines including: - Accident and Emergency, Maternity, Children and Outpatient Services) which was to be made public in January 2020.  It was explained that it was hoped that the outcome would show progress and potentially raise the current rating to ‘good’.  Members were told how following this, it was the intention of the Trust that 2 years forward they would look to achieve an improved rating of ‘outstanding’.  It was also commented that inspections taking place during the autumn/winter period often presented their own challenges.  It was added that part of the rating assessment considered how resources were utilised to their best potential.

Estate – Reference was made to the age of the buildings that formed part of the estate and were now requiring significant costs to modernise, refresh and rebuild as necessary.

Workforce – A Member asked about the potential of individuals being able to become fully qualified nurses within Doncaster. It was stated by the Chief Executive of the Doncaster and Bassetlaw Teaching Hospital NHS Foundation Trust, that the Trust wished to provide an educational facility within Doncaster to further enable this to happen, and were strategic intentions to work with Partners in order to achieve this.  In terms of timescales, the Panel was informed that the Trust was already working with partners to consider how quickly this could be taken forward.

Members were informed that workforce retention was higher in Doncaster than the national average (although it was recognised that there were still challenges within certain fields). For example, it was explained that there were vacancies in Pathology in Yorkshire and the Humber. However, the South Yorkshire and Bassetlaw Pathology programme was in place to support the development of pathology services.  It was commented that in light of increasing demand, NHS services were performing well and specific challenges were being worked through.  Members heard that historically Doncaster had employed staff from wider fields across the commonwealth, it was emphasised that the focus was on recruiting good staff from wherever the opportunity arises.  References were made to those employees who had benefited from working overseas,  ...  view the full minutes text for item 20.

The Panel was provided with a presentation from the Chief Executive of Doncaster NHS CCG and the Chief Operating Officer of Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, which focused on;

•           Winter Planning Context

•           Approach to Winter Planning/Managing Winter

It was reported that there was a well-established system in Doncaster through joint planning undertaken across health and social care involving partners from both the public and private sector.

Members were informed that specific activities had been commissioned although resources could be an issue when planning.  It was explained that there had been a focus on different topics throughout the year using major communication campaigns (including the use of social media).

It was explained that there had been a winter 2018/19 review and evaluation to understand the impact of schemes on the urgent and emergency care system with a demand and capacity analysis for local urgent care system as a whole.

Members were informed about areas being taken forward as the part of the approach to managing winter that included;

•           Established approach to system escalation

•           Planned proactively for Christmas and the New Year period.

•           Commissioned changes.

•           Additional staff and beds plus strengthened processes of DBTH.

•           Use of the LA Winter Pressures Fund

Members were assured that a Doncaster Winter Plan document set to ensure that all actions were aligned and that the urgent care system was sighted on the risks and associated contingencies as a whole.

In terms of continuity, Members were advised that the same grant had been rolled forward from last year.  It was commented that it would be useful to have long term funding within Adult Social Care to be able to plan effectively.   Members were informed that greater investments had been made in independent home care and short stay approaches in care homes to ensure that there was the correct provisions in place.

It was reported that it was a challenging context with unpredictability over the winter period and therefore vital to remain strong to be able to address any future challenges that may arise. 

There was a discussion held and the following issues were raised;

Water born viruses arising from the recent floods within Doncaster – Members were informed that at this time of year there tended to be a rise in cases of norovirus and influenza that generally resulted from the seasonally cold weather.  It was explained that data collected did not always include the causes of such viruses and therefore would be difficult to determine whether a rise in cases would have been due to the recent flooding in Doncaster.   Members were assured that Public Health England would monitor data over that time and investigate any increases arising from geographical data.  A Member commented that groups within emergency services such as the fire service had been effected in the past and recorded statistical information as a result.  It was suggested that this could be considered as part of the recovery work going forward.

Chaperoning people who  ...  view the full minutes text for item 21.

The Panel was provided with a presentation from the Public Health Theme Lead which focused on;

•           2016 – 2018 Data Release (Males/Persons/Females)

•           Patterns and Trends

•           Wave 1 Funding, local Doncaster Delivery/South Yorkshire and Bassetlaw

There was a discussion held and the following issues were raised;

Community Facilities – Concern was raised about the impact caused as a result of the reduction in traditional community facilities such as Working Men’s Clubs.  It was noted that causes behind suicides were so complex than such socioeconomic factors were likely to have an influence.  Reference was made to small grants available in communities to enable them to undertake more within their areas to address this.

It was commented that suicide was ultimately a result of a chain of factors and with ‘at risk’ areas including those with high levels of poverty and debt and family breakdown being more likely to experience higher rates.  It was explained that the challenge was to work as far upstream as possible. It was outlined that there were opportunities though the Integrated Care System to address this and that nationally the Local Governance Association was looking at prevention plans to work backwards through public mental health.  It was explained that the Health and Wellbeing Board concordat work were assessing this issue looking at the resource activity in that area and the flex in spending Public Health Grant money.

Samaritans – A Member requested an update on the role of the Samaritans and it was outlined that they were considered as a key partner in the local Suicide Prevention Group who consistently provided a great deal of support throughout the process.

Public Health Grant (Budget) - In terms of the budget, it was explained that there was guidance in place with statutory instruments guiding where resources should be spent.  Members were informed that the Government was minded to remove the ring-fence from the Public Health grant to become part of business rates retention.  It was explained that there were advantages and disadvantages in undertaking this.

At the same time as proposing changes to the national financial regime there are discussions about how national oversight by Public Health England would work, which could be an OFSTED like regulator or rely on existing Sector Led Improvement methods.  It was acknowledged that there was a good process in place in Doncaster. There were also potential risks around additional burdens for local authorities.

RESOLVED that the Panel note the report and update provided.

The Senior Governance Officer presented the 2019/20 Scrutiny Work Plan for consideration and reminded Members of the current Forward Plan of key decisions.

Members acknowledged the outline of areas that had come out of the Members briefing on Fees and Charges and update that had been circulated separately to Panel Members.  The Senior Governance Officer updated the Panel that the item would be further considered by OSMC with an invite to Health and Adult Social Care Overview and Scrutiny Panel Members, to ensure that there was full consideration of the impact of health services to those effected.  The update of meetings included that future Fees and Charges meetings would take place on the;

•        22nd January 2020 – Members Briefing

•        21st February 2020 – OSMC

There was a brief discussion around future items for the Overview and Scrutiny workplans following the meeting’s discussions.

RESOLVED that:-

1.      The Overview and Scrutiny Work Plan 2019/20 and Forward Plan of key decisions be noted; and

2.      It was agreed that it be suggested for the following to be added to the respective Overview and Scrutiny workplans;

•      Communities and Environment Overview and Scrutiny Panel -  Flooding – lessons learnt – health impacts LA NHS and emergency services exposure to flood water.

•      Health and Adults Social Care Overview and Scrutiny Panel - Ageing well March 2020 – Dementia – navigation around services, use of technology