To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 19 July 2023.

The minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 19 July 2023 are approved as a correct record.

Councillor Speight referred to the previous meeting where senior members of the hospital management team were in attendance to present a verbal update on the CQC report on Basildon Hospital. Councillor Speight highlighted that it is the Committee’s role to hold people to account and he has subsequently found out that on the same day or the day before the meeting an inquest was held where the coroner gave a damning report regarding the level of care provided to a gentleman at Basildon hospital. Councillor Speight stated it was inconceivable that members of the hospital management team were not aware of the inquest and it was not mentioned.

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972. To agree any relevant briefing notes submitted to the Committee.

There were no items of urgent business.

Councillor Polley declared a non-pecuniary interest as in her role as a councillor she had been appointed by the council to the Council of Governors for MSE for the non-executive directors.

Councillor Polley also declared a non-pecuniary interest in relation to her employment with the NHS Ambulance Service.

Mark Tebbs explained that Kim James from Healthwatch had given her apologies and therefore he was attending in her place. He informed the Committee that Healthwatch has received complaints from residents regarding long waiting lists for cancer care patients. Healthwatch have followed this up and supported residents to make complaints however the normal escalation routes do not seem to be manifesting the response residents need. The wait seems to be worse from the GP referral to initial contact and for decisions being made regarding treatment. Patients feel they are being left.

Councillor Polley responded that in her capacity as a Governor she could challenge this from a different avenue to assist.

Councillor Fish stated that he understood the aim was 4 weeks from visiting your GP to a diagnosis.

The Chair commented that he had also received enquiries from the press regarding delays with blood tests to diagnose cancer. The Chair requested some data or feedback on this issue be provided during the next agenda item.

A verbal update was provided to the meeting from Fiona Ryan (Managing Director for Care Group 1 which covers Basildon and Orsett Hospital from the Mid and South Essex Trust). She explained that at the last meeting there was a briefing on the CQC report that had recently been published. The rating was inadequate for medical services across all 3 hospital sites., nutrition and hydration were a concern. As a result of the inadequate rating a re-visit from CQC took place early in July, an update on the warning notice was expected to be received within a few weeks however this still has not been received. The improvement delivery continues. There is a focus on urgent and emergency care following poor performance due to long waiting times for patients and delays with ambulance offloads. In relation to cancer, the faster diagnostic standard is 28 days. Currently, 66.9% of patients are receiving a diagnosis within 28 days, the target is 75%. In any one month 6000 referrals are received.

·       There is a backlog of 663 patients waiting to receive treatment or discharge for over 62 days. this is however a significant improvement as numbers were previously in the thousands.

·       There is currently a 4 week wait in Thurrock for phlebotomy. The rate of people who do not attend their appointments is quite high.

·       They are working to eliminate all 104 week waits.4. On 12^th July 4603 patients waiting for treatment down from a peak last year of 4800.

·       They are currently winter planning. Acute Hospital sites and their Workforce were overstretched last year.

Councillor Fish queried the current waiting times for the Haematology service. Fiona Ryan responded that she didn’t have that data in front of her.

Councillor Speight commented that the hospitals target of 75% for patients receiving a diagnosis within 28 days seems low. Fiona Ryan responded that the reality is one test doesn’t often give a confirmed diagnosis and the standard reflects that for some patients a number of tests may be required to reach that confirmed position.

Councillor Polley raised that the phlebotomy walk-in service at Orsett has been removed and has gone to appointment only. Residents under treatment are asked to get their bloods done prior to treatment and sometimes at short notice, if residents are unable to use a walk-in service this could affect their treatment if they are unable to get a blood test appointment. Fiona Ryan responded that previously there was a system to prioritise these patients and she will request that a future capacity plan for Thurrock is provided to address the long waits.

Mark Tebb added that the voluntary sector can support with winter planning for example with discharge but he would request time to plan and mobilise those services.

The Chair queried if the hospital was looking into the case raised by Councillor Speight at the start of the meeting where a man died as a result of being discharged from hospital. Fiona Ryan responded that she doesn’t have  ...  view the full minutes text for item 15.

The Head of Information Management introduced the report to the Committee and summarised that complaints have reduced, and 85% of complaints were responded to within the timeframe. The key themes of complaints were standard of care and communication. Compliments have increased. A number of awareness campaigns have been completed detailing how to complain. The contract and commissioning team conduct visits to ensure learning has been embedded from upheld complaints.

The Chair queried if the Council are doing enough to raise awareness of how to make a complaint. The Head of Information Management responded that he did think the Council had done enough.

The Corporate Director for Adults, Housing and Health stated that the Council has a strong compliance and brokerage team which has a good relationship with providers and complaints are followed up by that team. If there is a theme emerging, they will inspect on a regular basis and step inspections up to as frequently as quarterly.

Councillor Speight queried whether there are enough avenues to complain for people who are not in the digital world and queried if the committee could provide more support. The Corporate Director for Adults, Housing and Health responded that he was confident in the resources the team has and stated that it is a really high performing team. He also confirmed that he is confident people can complain through a variety of channels such as by phone and letter. They also actively survey people in their care and complete proactive feedback.

The Corporate Director for Adults, Housing and Health stated that he is always concerned that there are a cohort of people who are reluctant to complain as they are vulnerable and are concerned that it might affect their care going forward however they are doing everything they can proactively and reactively to make it easy to complain.

RESOLVED:

1.1      That Health and Wellbeing Overview and Scrutiny Committee consider and note the report.

The Community Protection Manager provided a PowerPoint presentation. The slides can be found on the following link:

An easy read version of the strategy has been provided for those who don’t want to read the full strategy.

The Safeguarding Adult Board has 3 core duties:

·       develop and publish a strategic plan setting out how they will meet their objectives and how their member and partner agencies will contribute;

·       publish an annual report detailing how effective their work has been;

·       commission safeguarding adult reviews (SARs) for any cases which meet the criteria for these.

Safeguarding Adult Reviews are completed where people have died or become seriously ill and the circumstances require an investigation. The Safeguarding Adults Board complete audits to ensure these are completed.

Councillor Fish raised concern that only 70% of people consulted said they could recognise when abuse is taking place. The Community Protection Manager agreed that recognising the problem is the first issue but the second is reporting it and taking action. With domestic abuse it is hard to observe unless the survivor brings it to someone’s attention. Survivors of abuse need reassurance that they will get a helpful response and what they wanted to happen, happens. Audits are completed to check this.

Councillor Speight raised that there is a great strength of character in the elderly groups and they don’t like to complain and soldier on. He raised the important of human contact and highlighted an organisation called Re-engage which brings together local people. The Community Protection Manager agreed community engagement is important and the Safeguarding Adults Board will be at the Orsett Show on Saturday to raise awareness.

Councillor Polley raised that Thurrock is a diverse borough and she wanted to ensure that non-traditional groups who don’t speak English and may be more vulnerable to exploitation are being engaged with. The Community Protection Manager responded that they do work with faith groups and if members are aware of groups that they might not be to please let them know. 

Mark Tebbs added that Healthwatch have a breadth of reach.

The Community Protection Manager stated that in the delivery plan for the strategy, there are timescales provided and key points which would be a good time to report back to the Committee.

RESOLVED:

1.1      That the Health and Wellbeing Overview Scrutiny Committee Members note the Strategic Plan.

The Director of Public Health introduced the report and confirmed the following key points:

·       Smoking rates have fallen

·       Smoking is a key avoidable driver of premature mortality

·       12 % of the adult population in Thurrock still smoke and they have developed the strategy to reduce this. 

·       The aim is to reduce this to 5% by 2030

·       Certain groups in the community have higher rates such as those who suffer with mental health problems and those that work in manual labour

·       They are embedding smoking cessation in mental health services and working with employers to reach out to these cohorts

·       Work is being completed in schools and with trading standards to prevent young people from starting smoking

·       The rates are much lower with young people starting smoking than previously however vaping is being taken up by young people.

·       At the Health and Wellbeing Board that took place earlier in the day the Assistant Director of Education and Skills confirmed that feedback from young people they had been working with was that is smoking is not seen as socially acceptable but vaping is.

·       Community Health champions can talk to people about smoking cessation services. There has been an increase in uptake of virtual smoking cessation groups.

Councillor Speight queried whether there is an alcohol control strategy in the pipeline. The Director of Public Health confirmed they take a strategic approach. A drug and alcohol Needs assessment was completed recently. They will support people who are willing to engage with services. The service is going out to re-tender next week.

The Corporate Director for Adults, Housing and Health stated that there is a huge overlap between Mental Health, alcohol and housing. The Integrated Care Strategy aims to bring support and professionals together so they can design a single solution.

The Meeting discussed Liverpool’s approach and requirements for smoke free environments included in their strategies, licensing and planning decisions.

RESOLVED:

1.1      That Health and Wellbeing Overview and Scrutiny Committee note the contents of and agree to the publication of the Tobacco Control Strategy 2023-2028 on the Council website.

There were no comments from members on the Terms of Reference and members agreed they were happy with the terms of reference.

The working groups will meet monthly for 4 months with a view to a report being brought back to the Committee in March.

Councillor Polley raised that the EPUT report isn’t until January and they might need to hear from them sooner.