Agenda and draft minutes

The minutes of the meeting held on 23^rd May, 2016 were agreed as a correct record.

Graham Venables, Clinical lead for Stroke work stream provided a presentation relating to a review of hyper acute stroke services across South Yorkshire, that had been undertaken over the past 18 months.

Consultation had been undertaken with doctors, nurses and healthcare staff in hospitals, NHS staff who commission hospital and GP services and data and clinical experts about what the future for critical care stroke patients might look like in the region.

The Committee learnt:-

·       If HASU centres admit less than the best practice minimum of 600 per unit but over 1,500 then there is a risk of burn out.

·       Doctors, nurses and healthcare staff all agree that the way critical care for stroke patients is provided across the region won’t meet their high standards in the future – this needs to change.  There were currently unsustainable medical rotas.

·       More stroke doctors and nurses to run the services were required – there were not enough locally or nationally

·       There is low QUALITY of care (SSNAP data) across 4/5 hospitals

·       Patients need GOOD care for the first 72 hours (hyper acute stage)

The Committee was provided with details of the appraisal process and preferred options for moving the service forward over the next 5 years.

It was recommended that the services change by adopting a system wide solution, working together better for the benefit of every stroke patient in South Yorkshire and Bassetlaw and North Derbyshire.

Based on feedback from doctors, nurses and regional and national clinical experts, the following option would allow this, with further work being carried out to consider the second option in the future.

A number of options had been discounted by the working group leaving two preferred options:

OPTION 1

The proposal is that if you live in South Yorkshire and Bassetlaw and North Derbyshire and have a stroke, you would receive hyper acute stroke care in:

•Chesterfield Royal Hospital

•Doncaster Royal Infirmary

•The Royal Hallamshire Hospital, Sheffield

This would mean that Barnsley and Rotherham hospitals would no longer provide hyper acute care for people who have had a stroke.

Chesterfield was not a part of this review as it is sited within the East Midlands region.

OPTION 2

The proposal is that if you live in South Yorkshire and Bassetlaw and North Derbyshire and have a stroke, you would receive hyper acute stroke care in:

•Doncaster Royal Infirmary

•The Royal Hallamshire Hospital, Sheffield

This would mean that Barnsley, Rotherham and Chesterfield hospitals would no longer provide hyper acute care for people who have had a stroke.

Chesterfield was not a part of this review as it is within the East Midlands region and so this element is subject to decision elsewhere.  However, we will need to talk to people about this possibility as part of our consultation process.

It was stressed that stroke care was divided into three phases:

1.     Every person enters the acute critical care unit where the physical status is monitored; 

When they are stabilised they move into:-

2.     Rehabilitation in  ...  view the full minutes text for item 5.

RESOLVED that Members noted the items to follow.

The Committee was reminded that at its meeting in May, it was agreed that the consultation process be undertaken.  The Consultation information circulated with the agenda was noted but Members requested if examples of the final consultation literature and how it would be publicised, be circulated to each individual authority giving them an opportunity to comment.  It was recognised that Councillors knew their individual areas well and could advise on the best places to publicise the information.

The Committee continued by requesting that the consultation period be extended by 2 weeks to 20^th January, to take account of the Christmas period as many people would be more focused on the festive season.

It was also stressed that the literature should be written in plain English to ensure maximum participation, for example, surgery be described as planned or emergency.

RESOLVED that: 

A.       The public consultation material and locations be circulated by the end of August to each local authority of the WTP Overview and Scrutiny Committee, for their individual input and comments; 

B.       The material for public consultation be provided in plain English and translation availability, to ensure a good understanding of what is being consulted on by all members of the community;  and

C.       consideration be given to formal consultation on preferred option being extended to conclude on 20^th January, 2017.

          Venue - It was discussed that Oak House at Junction 1 of the M18, Bramley was a preferred site for future meetings.

          Administration - With regard to servicing the next meeting, officers expressed a wish to meet prior to setting arrangements for the next meeting.

RESOLVED that: the next meeting be held sometime in November following agreement on Administration arrangements with the Scrutiny Officers.

The Committee received a presentation from Tim Moorhead, Clinical Lead for Children’s Services work stream.

The Committee learnt that:-

·                 Medical Directors and Chief Executive Officers identified children’s surgery as a priority;

·                 The service had been reviewed identifying current provision, standards and pathways of care and included discussions with doctors, nurses anaesthetists, managers, patients and clinical experts in other parts of the country;

·                 Investigated the numbers of children requiring surgery and the opportunities around wider geographical provision;

·                 Discussed with providers of surgery who agreed it was important to work together as a network of providers to share skills and expertise and to plan more care together as close to home as possible;

·                 Investigated models of changing some for the pathways of care for out of hours urgent care to provide sustainable care pathways that met national standards

The main message was that the current service could not be sustained whilst meeting national standards and the Committee discussed the proposals for consultation detailed in the presentation and supporting papers.  The following areas were discussed:

·                 Elective/non elective surgery – including less non elective sites that could provide surgery particularly for under 3 years old and where a child needs to stay on an inpatient ward for recovery.  The proposals would be for most areas to have elective planned surgery within their local hospital site unless it was a very specialist surgical procedure;

·                 Patient transport to and from hospital;

·                 Yorkshire Ambulance Service – response to child emergencies.  The Committee requested that the agreed 45 minutes to transfer to hospital time be inserted into to the documents;  and

·                 The development of ‘hubs’ over fewer sites so that children requiring surgery out of hours urgently get the standard of care they need.

RESOLVED:  that the above discussion and the progress of the work and implications for moving forward through NHSE Level 2 Assurance and towards public consultation on the options in October, be noted.