Present for this item were:
Claire Hankey, Director of Communications
Tania Sitch, Integrated Care Director
Andy Vowles, Programme Director
James Wilson, Transformation Director
Dr Sarah Zaidi, GP and Ageing Well Lead
The following PowerPoint was presented to Members:
Councillor Ralph thanked officers for the presentation and stated he was fully supportive of the stroke side of this service and appreciated that the best care for some residents may mean having to go outside the borough. Councillor Ralph stated it would be a good idea to have all the specialists in one place. Councillor Ralph also raised his concern and objection to Joint HOSCs as not all size fitted all and Thurrock could easily be out-voted and power could be easily be given to other HOSCs.
Jo Broadbent referred to the stroke rehab beds and whether there was an early supportive discharge service within Mid and South Essex and whether the evidence based around stroke early supportive discharge had been taken into account in the calculation around the number of stroke rehabilitation beds. James Wilson stated that early thinking around volumes would need to be developed and embedded from views as part of the engagement process and ultimately be in the pre-consultation business case and confirmed there was an early supportive discharge service across Mid and South Essex and would be complimented to those requiring bed based rehabilitation. Dr Sarah Zaidi stated that the modelling being undertaken was aligning everything to best practice in terms of optimising outcomes and that early supportive discharge had been included as part of the modelling exercise.
Councillor Holloway thanked officers for the presentation and asked that the committee be informed of the specific impacts on Thurrock’s care and Thurrock’s residents. Andy Vowles stated that at this point in the process there was not any definitive set of options that could come to committee. The paper had come to committee to start exploring through engagement on what those potential options were and the criteria would be known once assessed. It would be at that point when a more definitive view on what would impact Thurrock’s residents. Councillor Holloway questioned what elements would be looked at when drawing all this together and making those final decisions to which James Wilson stated that the elements would be criteria, evidence based, patient experience and financial component. It was important to get the criteria right before moving from engagement of issues to the options.
Councillor Holloway stated the report was very general and hard to comment on but agreed that everyone wanted the best care for patients and was mindful that the best care could sometimes be configured outside of Thurrock but it was key that those stroke beds were kept in Thurrock.
Councillor Fish questioned what patients would be considered suitable for those beds and how the capacity would be worked out for those needing the beds. Dr Sarah Zaidi stated there were different service needs and this was standard practice and would recommend that this continued. It had been recognised that for older people it was to get them home as quickly as possible as this had been seen as good for them. It would be this cohort of patients that could be considered suitable and the decisions to be made were around the right model of care, were the outcomes being optimised, were they being benchmarked to national standard and where that bed configuration should be.
Kim James thanked officers for the report and looked forward to working with Claire Hankey but had concerns that these services may be too far away for relatives who did not have access to transport and that it had been fought to keep those stroke services at Basildon for that reason. That this was a concern for HealthWatch and for patients on how this would be managed and how residents would be discharged home.
Councillor Ralph had concerns that Basildon Hospital may lose all their experienced specialists as these services may be pushed further away and that patients would not be getting quality of care. James Wilson stated at this point in the process was to design the criteria and evaluate the best configuration and conclusions. Need to look at what was important for this engagement exercise in terms of criteria, options and engagement and to scope those to ensure the right outcomes were achieved.
Councillor Piccolo stated that if specialist treatment was required outside the borough, family members should be supported and that transport links should be available to them. James Wilson stated this would be taken into consideration as part of the options to support residents and patients.
Councillor Holloway and Councillor Fish both agreed that Joint HOSCs were not particularly helpful and not sure how a joint HOSC would work.
Councillor Ralph thanked officers for attending and noted that the presentation had provided members with updates on the work being undertaken to look at the possible future number and location of community beds across Mid and South Essex, had the opportunity to discuss the plans of engagement and that further updates would be provided as the project was developed and consult further on potential options.
Claire Hankey, Tania Sitch, Andy Vowles, James Wilson and Dr Sarah Zaidi left the meeting at 7.33pm.