Agenda and minutes

Members are asked to declare any interests in the items under consideration and in doing so state:

(1) the type of interest concerned either a

(a)   personal interest

(b)   prejudicial interest

(c)    disclosable pecuniary interest (DPI)

and

(2) the nature of the interest concerned

If any member requires advice on declarations of interests, they are advised to contact the Head of Democratic Governance in advance of the meeting.

There were no declarations of interest on this occasion.

To agree the minutes of the last meeting held on 31 March 2022 and the special meeting held on 11 May 2022 as a true and correct record.

The Committee agreed that the minutes of the last meeting held on 31 March 2022 and the special meeting held on 11 May 2022, be signed by the Chair as a true and correct record.

To consider any requests from members of the public to speak at the meeting.

There were no requests from members of the public to speak on this occasion.

The purpose of this report is to provide Blackpool Adult Social Care and Health Scrutiny Committee members a further update relating to the implementation of the Initial Response Service (IRS) and an update on Mental Health Transformation across the Fylde Coast, following the presentation given to the Committee in March 2022.

Ms Ursula Martin, Executive Director of Improvement and Compliance, Lancashire and South Cumbria NHS Foundation Trust presented an update on the development of the Initial Response Service and a summary of the other transformation work that had taken place since the previous report to Committee. She highlighted that a 28 bed unit had opened in Wesham which had originally been intended for both men and women, however, following new modelling it had been determined that the demand for such beds was predominantly men. The unit would therefore be utilised as a male unit, however, this could be reviewed should demand for services alter.

In response to questions from the Committee, Ms Martin confirmed that provision existed elsewhere for women and that no additional capacity was currently required at this time. She advised that should there be changes to demand, service provision would be reviewed and adapted as required.

With regards to the Initial Response Service, it was noted that it had been originally planned that the service would open in Blackpool in April 2022, however, there had been difficulties in acquiring an estate to site the service which had caused delays. She advised that whilst the search for suitable premises continued, recruitment had commenced and other preparation was ongoing so that when the service could commence it would be of high quality.

Members expressed concern regarding the length of time it was taking to acquire appropriate premises and therefore commence the service and requested that a new target date be provided. Ms Martin accepted the concern and advised that a meeting was being held on Tuesday 28 June 2022 to review the details of a recent appraisal and agreed that the findings could be shared with the Committee following the meeting. Ms Karen Smith, Director for Adult Services added that partners were working together in order to identify a potential shared location to ultimately provide a stronger presence and improved joint working through co-location. It was agreed that a full update would be provided at the following meeting of the Committee.

The Committee agreed:

1.      To receive a written update following the LSCFT management meeting to discuss the appraisal on the IRS on Tuesday 28 June 2022.

2.      To receive full update on the IRS at the following meeting of the Committee.

To provide an overview of the whole directorate including financial position. Members had also requested a special item on delayed discharges which is contained within this report.

Ms Karen Smith presented the Adult Services Overview Report to the Committee. She advised that there was pressure in all areas of service provision and that creative work patterns and solutions were being utilised to address pressure. She highlighted the importance of good partnership working with the NHS and being as flexible as possible in order to deal with challenges.

Ms Smith also noted the difficulties in the care at home and residential sectors and the significant financial pressure on providers. With regards to the Adult Services financial position, she noted that the budget in 2021/2022 had been balanced due to significant levels of grant funding through the pandemic and additional investment into services by the NHS. She added that the Service’s Medium Term Financial Sustainability Strategy was currently being revised.

The Committee referred to the current high levels of inflation and significant increases in the cost of living and queried whether Ms Smith felt confident that services would be maintained through the coming winter. Ms Smith noted the national challenges and the concern that care at home or residential companies could fail in the current financial climate. She noted that some providers had withdrawn from the market, but that others had entered and that the Council had retained the emergency staffing that had been established during the pandemic. The Council was working with providers in order to find creative solutions and support settings. The impact of the cost of petrol in particular was raised and Ms Smith advised that providers aimed to be innovative to reduce the burden and were considering how service provision could be amended to improve efficiency in travelling.

Members noted that the improvement in partnership working between the Council and the NHS was apparent and pleasing to see. In response, Ms Smith reported that due to the pandemic, improved joint working had been necessary and that now the relationships were in place they would continue. The work on the Transfers of Care Hub was an excellent example of this joint working.

The particular issue of the cost of insurance was noted by the Committee, with it questioned whether there was any solution to prevent other providers being unable to obtain insurance. Members noted the importance of stability for those in care homes and requested that this issue be kept on the agenda and raised with the Government.

The Committee went on to consider a presentation by Ms Christine Forsyth, Service Manager, Community Social Care in Health and Ms Charlotte Howard, Assistant Lead for Hospital Discharge Services, Blackpool Teaching Hospitals NHS Foundation Trust on the Transfer of Care Hub. It was noted that the hub was a single point of discharge, with approximately 200 patients moving through on a daily basis. The aims of the hub included to reduce length of stay, reduce triage times and identify from admission what needed to happen to allow a person to go home. The pressure points included staffing and the provision of an 8am to 8pm,  ...  view the full minutes text for item 5.

To consider the mid year performance of the Blackpool Clinical Commissioning Group (April 2021 – March 2022) and also the impact of the COVID-19 pandemic on current performance and ongoing recovery planning.

Mr Roy Fisher, Chair, Blackpool, Wyre and Fylde Clinical Commissioning Groups (CCG) introduced the end of year CCG performance report for 2021/2022 in Blackpool. He noted that the CCG would be replaced on 1 July 2022 with the Integrated Care Board and, on a more local level, the Place Based Partnership.

The Committee reviewed the performance data in detail and noted that a wide range were not meeting targets. It was queried whether CCG representatives could identify the areas of most concern and advise how those areas were being addressed. In response, Ms Lindsay O’Dea, Senior Programme Manager, Blackpool CCG advised that services were focussed on restoration and recovery and that the vast majority of indicators, although not meeting target, had improved. Ms Natalie Hudson, Chief Operating Officer, Blackpool Teaching Hospitals NHS Foundation Trust added that the national target to address all patients waiting longer than 104 weeks before the end of June 2022 had been met and that the number of patients waiting more than 52 weeks had been reduced from over 1,700 to approximately 740.

Other areas for concern were identified as the number of patients waiting over 12 hours, pressures on urgent and emergency services and ambulances. However, since the restrictions imposed due to the pandemic had been fully lifted in April 2022 improvements to performance had been made.

Dr Neil Hartley-Smith, Clinical Director, Blackpool CCG advised that an audit was being carried out regarding the number of face to face and virtual appointments offered to patients by GP surgeries in Blackpool. He advised that 77,000 appointments had been offered in April 2022 with 69,000 attended. Of these, 48,000 appointments had been held face to face with 32,000 held on the same day as the appointment had been made. It was agreed that telephone calls suited some situations and patients and not others and that the statistics demonstrated that both types of appointment were being offered.

Members raised concern regarding the number of appointments made and not attended, which totalled approximately 4,600 in April 2022 and there was a detailed discussion regarding how value could be given to appointments to ensure they were not wasted.

Reference was made to the extended access appointments and out of hours service, both of which continued. There had been concerns regarding the under utilisation of the extended access appointments previously, however, the Doctors appointments were now well used.

The Committee agreed that a report be requested from the Integrated Care Board/Place Based Partnership on the transition to the new structural arrangements to the next meeting of the Committee.

The purpose of this report is to update and outline actions that the Trust are undertaking to reduce the 52 week backlog, improve non-elective/emergency patient flow and address long COVID-19.

Ms Natalie Hudson, Chief Operating Officer, Blackpool Teaching Hospitals NHS Foundation Trust provided an update on the building work proposed on the Emergency Department at Blackpool Victoria Hospital. She advised that capital investment had been approved to refurbish the department to provide improved emergency care facilities. The refurbishment would also cover the ambulance drop off at the Emergency Department ensuring it was fit for purpose. As part of the redesign the number of cubicles in the department would be increased and each would be able to be isolated to allow for improved infection control. The work would be phased to ensure uninterrupted service provision.

In regards to the provision for patients with long covid, Ms Hudson noted that long term funding for the service provision had now been agreed. Ms Karen Smith, Director of Adult Services added that the service had a reasonably long wait time, however, service provision was person centred and wide ranging.

In response to a question, Ms Hudson advised that when a patient attended the emergency department they were triaged. If it was clear that the patient did not require treatment in the emergency department they would be directed to the on-site urgent care walk in centre.

To review the work of the Committee, the implementation of recommendations and identify any additional topics requiring scrutiny.

The Committee considered its revised workplan for the 2022/2023 Municipal Year.

The Committee agreed the workplan.

To note the date and time of the next meeting as 6 October 2022, commencing at 6pm.

The Committee agreed the date and time of the next meeting as Thursday, 6 October 2022, commencing at 6.00pm.