To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 31 August 2023.

The minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 31 August 2023 were approved as a correct record.

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.

The Chair provided an update to the Committee in relation to the Obesity and Mental Health Working Groups. He confirmed it has been a challenge to get officers to facilitate these groups, he has however been assured that by January officers will be available to support these groups. The updates expected in March from the working groups will therefore not be available.

The Chair also confirmed in relation to the Integrated Medical Centres (IMC’s), it was decided in 2017 the Orsett hospital will close but not before the IMC’s were in place. To date only one IMC is up and running and that is the one in Corringham. It looks like the Grays IMC will be on the Thurrock Hospital site which is good. The Tilbury IMC business case was rejected due to cost, Tilbury has a high level of need as the life expectancy there is 12 years shorter than any other part of Thurrock. Purfleet has the largest growing population in the Thurrock area.

At the 19 July 2023 Health and Wellbeing Overview and Scrutiny Committee meeting members were informed that a Plan B would be developed and presented at this meeting. I have received a request that this was deferred. I reluctantly agreed as I wanted to receive a plan that is going to work.

The Chair proposed that he and Councillor Coxshall will write a joint letter to NHS England requesting the reasons why the business case was rejected for Tilbury and Purfleet and what they will be doing to ensure there is adequate funding to develop the IMC’s for Tilbury and Purfleet. The Chair sought the Committee’s agreement to this. The Committee members agreed.

Councillor Thandi queried what the outcome of Orsett Hospital is.

Alex Mecan confirmed the Tilbury and Purfleet Business cases have not been formally rejected. The regional office has identified a number of queries regarding affordability and they will be working through these as part of preparing plan B. This will be brought back to the Health and Wellbeing Overview and Scrutiny Committee in January. The Orsett hospital has not yet formally closed, the site is still being used although certain services are being moved to the Thurrock Hospital site.

Councillor Speight raised concerns about the terminology being used,  Committee Members were told Orsett Hospital would not close until every facility is replicated across the borough.

Councillor Polley echoed Councillor Speights comments and stated that she understood Thurrock would get increased services in the Borough not just a replicate of what is at Orsett Hospital. Councillor Polley stated that she agrees with the Chair’s recommendation and highlighted that it needs to be taken to the highest level.

Councillor Piccolo sought assurance that if they do find somewhere to relocate Orsett Hospital’s services that it will be able to cope with the same level of usage.

Alex Mecan responded that she could provide the assurance that is the intention and she would seek the Council’s help to maintain transport links to those sites.  ...  view the full minutes text for item 22.

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 NSH Ambulance service.

Kim James has given her apologies and there is therefore no report from Healthwatch today.

The Independent Chair of the Thurrock Safeguarding Adults Board provided a Powerpoint presentation of the slides included in the agenda.

-       Members thanked the Independent Chair of the Thurrock Safeguarding Adults Board for a detailed report which as a result members had few questions.

-       Members were assured that the Adult Safeguarding Board work closely with Housing and a representative from the Housing team sits on the Board.

-       Members asked about any future engagement events coming up. The Independent Chair of the Thurrock Safeguarding Adults Board stated that events do slow down in the winter due to the weather. They do receive cases from talking to people in the street.

-       Members queried if they were aware of an event, could they invite the Adult Safeguarding Board to attend. The Independent Chair of the Thurrock Safeguarding Adults Board they would be grateful to receive invites.

-       Members queried the financial situation and if the Adult Safeguarding Board would be affected. The Independent Chair of the Thurrock Safeguarding Adults Board responded that they receive funding from the Police and Health and currently due to the pandemic they have a significant underspend. A cost/ benefit analysis is completed nationally which confirms the work of the Board does save money.

The Executive Director of Adults, Housing and Health presented the report. He confirmed every year NHS England commission a GP Patient Survey. Overall satisfaction with Thurrock GP practices varies considerably, ranging from 30% to 90%. Satisfaction with general practice is multifactorial. It was clear that what is contributing to satisfaction mostly is access, when patients received the services they were largely satisfied with the care they received. The Executive Director of Adults, Housing and Health confirmed that data should be the starting point for further questions to be asked and a much more detailed analysis is required. The Dell Medical Centre scores significantly better than England as a whole. It should be considered if we can spread better practices. 

-       Members queried why Thurrock is finding it hard to get Doctors to come to the area. The Executive Director of Adults, Housing and Health responded that due to being under-doctored the Doctors that are working in Thurrock may be become more stressed or retire early or go elsewhere. Newly qualified Doctors do not want to come to Thurrock. Integrated care will use all Health sources such as social care staff, addiction staff, Housing staff and Community Nurses in a more integrated way. One Doctor has provided feedback that integrated care has revolutionised the way he practised.

-       William Guy, the Director of Primary Care in Mid and South Essex stated that they are trying to attract the right workforce. The national trend is alarming and there has been a reduction in GP’s since the pandemic. Access is where dissatisfaction is the major issue. Everyone has been encouraged to access primary care at 8am in the morning regardless of need. There isn’t enough GP’s in the country if the default is if you go into primary care that you see a GP. Pharmacies and other community assets can provide the solution.

-       Members raised the pressure, stress and abuse that is put on to GP Receptionists and support staff and called for them to be supported as well as GP’s. Receptionists are now required to do more and are called ‘Care Navigators’. The Director of Primary Care in Mid and South Essex stated that they are investing in new training for staff.

-       Members highlighted that Thurrock’s GP’s need to be looked after and asked how they think things can be better. The Director of Primary Care in Mid and South Essex responded that they will complete a visit to every GP Practice.

-       Members queried if there is scope for a Thurrock Health Awards to spotlight what is good and raise expectations.

-       Members queried helping nurses with key worker housing and whether the Planning Committee could assist with this. The Chair suggested that this could be looked at in the Local Plan and stated that housing for Healthcare professionals should be encouraged.

-       The Chair queried how many GP practices take on trainees. This may encourage newly qualified Doctors to stay in Thurrock.

-       Councillor Hooper made an additional  ...  view the full minutes text for item 26.

Fiona Ryan from the Mid and South Essex NHS Foundation Trust presented the briefing note included in the agenda.

-       Members queried why they had not been provided any feedback in relation to the case of a gentleman who died which was raised at the last meeting. Fiona Ryan stated that she was unable to comment on individual cases and will look into this and respond to the Chair with some further information on this.

-       Fiona Ryan clarified that they look at ambulance waiting time for Accident and Emergency around 6 times a day and meet about them face-to-face 4 times a day. All three hospitals are looked at to ensure they are supporting each other and the population. The target is to get 80% seen within 4 hours.

-       Councillor Polley complimented Basildon Hospital on the urgent mental health care department.

-       The Chair commented in relation to the Industrial action that he hoped the Government and Unions can come to an agreement soon as it is having a negative effect on the people of South Essex.

-       Fiona Ryan stated in relation to maternity services it had been some years since they had been inspected, neo-natal death rates are being monitored closely and there is no concern in the MSE data. Staff members are being given additional opportunities to raise any concerns. Maternity colleagues will provide a report for the next meeting.

-       Members raised concerns about the fabric of the building at Basildon and water getting into building. Fiona Ryan confirmed there is a backlog with maintenance of the building. The patch and repair approach has not been the most cost effective. Fiona Ryan will liaise with Jonathan and provide an update.

-       The CDC at Pitsea should increase availability of diagnostic services and help residents to get diagnosed more quickly and hopefully bring some activity away from the Hospitals and into communities.

Fiona Ryan from the Mid and South Essex NHS Foundation Trust presented the briefing note included in the agenda. She confirmed that demand for phlebotomy had increased from 30,000 per month in 2020 to 45,000 per month in 2022. Thurrock clinic has one of the highest levels of patients who do not attend their appointments.

-       Members raised that some of the patients who did not attend their appointments may have in the interim whilst waiting for their appointment been admitted to Hospital

-       Members raised concerns regarding patients who require blood tests before treatment and if anything can be done to ensure they get access to a blood test in time

-       Members raised that you cannot get a same day blood test appointment in Thurrock on Swift Queue but you could get same day appointments in Kent, Southend, Basildon, Wickford and Billericay. Members noted that if you have a vehicle, can work flexibly and do not have dependants you may be able to get an appointment earlier at some distance away but that is not fair on those who do not have this option. It is also not fair on those using the walk-in option who have a long wait as some are not able to do this if they have dependants. The Chair noted that the walk-in services has become a race like getting GP appointments.

-       Fiona Ryan stated that she will take back to the team the points raised about the walk-in service.

-       The Vice-Chair raised concern that questions are not being answered in relation to the issues of blood test appointment issues from the Committee or in her capacity as a Governor. Members raised that those in the west of the Borough get offered Queens hospital as an option but there can be a delay in the test results getting back to their GP.

-       The Chair highlighted that it is not cost effective to Health for residents to be waiting 8 weeks for a blood test. 18 months ago the service was fairly responsive and is not now. The Chair urged the Trust to deal with this as a matter of urgency.

The Chair asked the Committee to agree to the next meeting on 11 January 2024 starting at 6.30pm. The Committee members agreed.

Councillor Speight requested a report on the LGBT Community services. He stated that it may fit under the EPUT update. Councillor Speight raised that lots of distressed families are concerned that support services for the LGBT Community are not being well-run. The Chair suggested this could be brought to the March meeting. The Executive Director of Adults, Housing and Health stated that someone from the NHS specialist provision team would probably be the right person to bring this back.

Councillor Polley raised that the waiting times for neurodivergent children diagnoses is two years plus. The Executive Director of Adults, Housing and Health suggested this may be for the Children’s Services Overview and Scrutiny Committee to look at and he suggested Councillor Polley discusses this with Councillor Carter.