Venue: Committee Room 1, County Hall, Morpeth, NE61 2EF
Contact: Lesley Bennett
APOLOGIES FOR ABSENCE
Apologies for absence were received from Councillor C. Humphrey.
Minutes of the meeting of the Health & Wellbeing Overview & Scrutiny Committee held on 15 June 2021, as circulated, to be confirmed as a true record and signed by the Chair.
RESOLVED that the minutes of Health and Wellbeing Overview and Scrutiny Committee meeting held on 15 June 2021, be approved as a correct record and signed by the Chair.
To note the latest Forward Plan of key decisions. Any further changes to the Forward Plan will be reported at the meeting.
A latest Forward Plan of key decisions (attached to the signed minutes) was received.
RESOLVED that the information be noted.
To receive a presentation from Birju Bartoli, Northumbria Healthcare NHS Foundation Trust, and David Lea, Northumberland CCG.
Members received presentations from David Lea, Northumberland CCG and Birju Bartoli, Northumbria Healthcare NHS Foundation Trust.
Points raised by David Lea included:-
· Urgent Care – Accident and Emergency
· Northumbria Healthcare figures compared with Newcastle Hospitals and England and showed a consistently strong local performance.
· Recovery performance improving despite increases in patient volume.
· Acuity of Accident and Emergency Patients
· The continued increase in the level of Type 1 patients (with life threatening conditions) month on month was concerning.
· Planned Care – Referral to Treatment Waiting Lists
· Patients should be seen within 18 weeks of referral but COVID had impacted waiting times due to social distancing and PPE requirements.
· Some planned routine procedures were suspended following a national directive with some specialties being impacted more. Other services had improved due to different pathways being used.
· Waiting List Profile
· Recovery of performance against waiting time threshold was now being seen although there had been a rise in the volume of patients on the waiting lists.
· Again, Northumberland patients, on average, waited less time than the overall England position.
· Maximum waiting time peaked in May 2020 but were now reducing.
· Figures shown for diagnostic tests with a peak in May 2020 followed by recovery. 99% of patients should be referred within six weeks.
· Mental Health Overview – Children and Young People’s Service (CYPS)
· Northumberland had a consistently strong performance with a slight deterioration from January 2021. Breaches were due to children not being available for appointment and a significant increase in the volume of the referrals.
· Most children waited no longer than 10 weeks and none longer than 14 weeks.
· Improving Access to Psychological Therapies
· A strong recovery rate was shown for those receiving treatment. There was a much lower volume of referrals being received into the service.
Points raised by Biriju Bartoli included:-
· Emergency Department
· Patients were expected to be seen, treated and admitted/discharged within four hours and this target had been consistently achieved other than in January 2021.
· Attendances decreased significantly between March-June 2020 but had steadily risen in the first quarter of 2021. Attendances were now back to pre-COVID levels.
· Referral to Treatment (RTT)
· 92% of referrals should be seen, treated or discharged within 18 weeks. Elective services resumed in August 2021 and it was aimed to meet the 92% standard by October 2021.
· Waiting list and health inequalities and clinical prioritisation lens to ensure no-one is waiting detriment to those measures.
· RTT – 52+ Week Waiters
· It was practice to ensure that patients were seen in chronological order where possible but clinical priorities had to take precedence.
· Cancer – 62 Day Standard
· Cancer performance had been maintained throughout COVID. It had been difficult to maintain that standard during June and July 2021 due to an increase in some types of referral, possibly due to people not presenting due to the COVID situation.
· Some referrals came from outside the normal catchment area, possibly because the Trust was meeting the standards.
· The standard was for 99% of patients referred for ... view the full minutes text for item 15.
To receive a presentation from Russell Patton, Deputy Chief Operating Officer, CNTW, and Kate O’Brien, Senior Head of Commissioning, Northumberland CCG.
To receive a presentation from Russell Patton, Deputy Chief Operating Officer, CNTW, Dr. Keda Kale, CNTW, and Kate O’Brien, Senior Head of Commissioning, Northumberland CCG.
Points raised included:-
· New additional funding (£750,000, £1.2 million then £2.25 million over the next three years) had been approved for the next three years for community mental health which would flow to local systems primary care and community hubs, to recruit new staff and to commission new VCSE services.
· Key Deliverables Long Term Planwere:-
· Core Model – community based offer redesigning community mental health services in and around Primary Care Network. A recovery college had been launched mental health voluntary care organisations would be together under one roof and be able to engage in courses and with opportunities in their own area.
· Dedicated Focus – Improving access and treatment for adults and older adults with ‘personality disorder’ diagnosis in need of mental health rehabilitation and eating disorders. These pathways accounted for most of the deaths in mental health services.
· Physical Health – increasing numbers of those with serious mental illness who received a physical health check.
· Individual Placement Support – help for those with mental health illness to stay at work or find employment.
· Early Intervention in Psychosis – identification of young people who were vulnerable to developing serious mental illness.
· The transformation plan looked at the area’s priorities, how to deliver them in partnership with the Council and local mental health providers and other providers around the mental health pathways. Joint Strategic Needs had been looked at along with local pathways, the understanding of CMHT, different ways of funding. Northumberland’s geographical differences to other partners were significant. Shared priorities had been agreed along with looking at different ways of doing things such as collaboration and integration.
· Bids for additional funding had been successfully made to improve community mental health and access pathways. Members were informed of a number of initiatives across the county..
· New Roles and Integrated Posts - Funding had been secured for allow the appointment of one post per year for each primary care network with under 100,000 population for the next three years. For CNTW this could equate to 110 posts, however, there was the challenge of where these staff could be found and encouraging them to move to the area.
· The CCG and County Council were working at ‘place’ and collaboration was at the heart of everything. Joint working and management was being discussed along with the possibility of formal partnerships. Secondment arrangements were being used where appropriate.
· Community Model Principles – Dr. Keda Kale explained that following the publication of the Long Term Plan, the Community Mental Health Framework for Adults and Older Adults had also been published outlining the key principles and what the Trust wanted to transform. The model of care used in Trieste, Italy, had been widely studied and its themes were the same or similar to those in CNTW’s framework
· Conclusion – the full impact of COVID was yet to be understood but ... view the full minutes text for item 16.
To receive a presentation from Lisa Quinn, Executive Director of Commissioning & Quality Assurance, CNTW and Paul Sams, Experience and Effectiveness Officer, CNTW.
Members received a presentation from Lisa Quinn, Executive Director of Commissioning & Quality Assurance, CNTW.
Points raised by Lisa Quinn included:-
· The Quality Accounts had been published on 30 June 2021.
· The quality priorities during 2020-21 would remain in the current year. These priorities were:-
· Keeping you safe and improving the inpatient experience. There had been increased emphasis on treating people locally. Whilst some services were asked to stand down during COVID, mental health services were asked to keep running.
· Working with you, your carers and your family to support your journey – Access standards had been maintained throughout the pandemic. The 18 week standard did not apply to mental health services, however, CNTW did apply it.
· Clinical effectiveness – training had taken place throughout the pandemic on equality, diversity, inclusion and human rights. Children and young people were increasingly accessing the service.
· Updating on points raised last year included
· An update on the CEDAR project in January 2021.
· Reduction in CYPS waiting times.
· Equality and Diversity masterclasses had been delivered and staff networks developed.
· There had been no out of area bed days since November 2020.
· In determining quality priorities for 2021-22, previous quality priorities had been reviewed, partnership with Tees, Esk & Wear Valleys NHS foundation Trust had been explored and two stakeholder events and an online survey had been held, both with high engagement levels.
· Quality Priorities for 2021/22 were:-
· Improving the inpatient experience – monitoring inappropriate out of area treatment days.
· Service user and carer experience – improving waiting times.
· Clinical effectiveness – equality, diversity and inclusion.
· Service user and carer experience – patient care, focusing on time staff were able to spend with service users and carers.
The following comments were made in response to queries and comments from Members:-
· During COVID there had been an increase in take up of the service by the 18-24 age group as there was more access to virtual and online and people engaged more. These options would remain available, however, face to face services were still available.
· Tees, Esk and Wear Valley was the closest large mental health organisation that CNTW worked with and some in patient services were shared such as the children’s in patient services at Prudhoe. The area being explored between the two Trusts was transitions for children and into adulthood and mainsteam local services into specialised services such as eating disorders. A provider collaboration had been formed. This had not been set as a priority to report on publicly.
· Previously, the in patient facility for young people with an eating disorder was provided at Middlesbrough. Through provider collaboration that care was now provided more locally at Prudhoe or in paediatrics in hospital.
The Chair thanked Lisa Quinn for her presentation and attendance at the meeting.
RESOLVED that the presentation be noted.
To consider the work programme/monitoring report for the Health and Wellbeing OSC for 2021/22.
Members considered the work programme/monitoring report for the Health and Wellbeing OSC for 2021/22.
It was requested that palliative care be added to the work programme for a future meeting.
RESOLVED that the work programme be noted.
DATE OF NEXT MEETING
The date of the next meeting is scheduled for Monday, 2 August 2021 at 1.00 p.m. venue to be confirmed.
The next meeting would take place on Monday, 2 August 2021 at 1:00 p.m. at the Holiday Inn, Seaton Burn.