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 23 June 2022 as a true and correct record.

The minutes of the last meeting held on 23 June 2022 were signed by the Chair as a true and correct record.

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

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

To consider the Executive and Cabinet Member decisions within the portfolios of the Cabinet Member for Adult Social Care and Community Health and Wellbeing taken since the last meeting of the Committee.

The Committee noted the Cabinet Member decision taken since the previous meeting of the Committee.

To update the committee on the performance and activity of North West Ambulance Service.

Mr Gene Quinn, Interim Head of Service for Cumbria and Lancashire, North West Ambulance Service (NWAS) presented the NWAS performance report to the Committee. He highlighted that the service was not currently meeting the expected standards in regards to wait times for patients and that in order to address this a clinical incidence desk had been established in order to assess need and allocate resources in the most efficient way. The introduction of the desk had already had a positive impact on the response to high category calls.

He advised that there were a number of challenges locally and nationally that were leading to the performance issues such as discharge from hospital into social care and reported that the whole NHS and social care system was working together to address the concerns in order to improve the position. For its part, NWAS was ensuring that only those patients that needed to be admitted and assessed at a hospital were being transported there. If an alternative would better suit the needs of the patient, NWAS was ensuring they were signposted to the right place. He added that levels of staffing had been a concern and that the service was being proactive in recruiting from other countries and newly qualified paramedics.

Members spoke about the potential anxiety in the community in relation to the change of model for the ambulance service noting the hub and spoke sites to be utilised. It was suggested that NWAS consider how best to communicate with residents and concerns in relation to this. In response, Mr Quinn advised he would report back the concerns of the Committee centrally in order to consider how best to communicate the changes to residents. It was expected that the new hub would be open in January 2023 and at this time no open day was being considered.

In response to questions, Mr Quinn advised that it was expected that the new hub model would have a significant positive impact on the workforce, giving them more opportunity to interact with each other and support each other. He noted that being a paramedic was challenging and workers could be witness to terrible incidents. Having a place to come together and talk through experiences was expected to positively impact sickness rates and improve working conditions which would in turn lead to an increase in paramedics in work at any one time.

The Committee focussed on the challenges to the whole system and Mr Quinn advised that all partners including the hospital were focussed on reducing the number of breaches by 50% by March 2023. He added that system leaders had taken a leading role in hospital handovers and that everything possible was being done to address the problems. Mr Matt Cooper, Area Director, Cumbria and Lancashire added that work on clinical pathways was also a key focus such as falls prevention work and the use of the Psynergy vehicle continued, both of which would ensure people could be kept out of hospital when they  ...  view the full minutes text for item 5.

To receive an update from the Trust on Maternity Services at Blackpool Victoria Hospital following the recent Care Quality Commission inspection.

Mr Michael Chew, Divisional Director of Operations, Blackpool Teaching Hospitals NHS Foundation Trust introduced the report which focussed on the findings of the Ockenden report and the recent Care Quality Commission (CQC) inspection of Maternity Services at the Trust. He noted that there had also been a number of enquiries nationally into Maternity Services such as Shrewsbury and Telford from which there were lessons to be learned.

The Committee was informed that the Trust provided evidence of compliance with safety standards on a regular basis and had been part of the maternity incentive scheme meeting those standards for three years. It was explained therefore that a level of confidence could be assumed notwithstanding the CQC inspection outcome. Mr Chew advised that the Trust regularly reviewed the outcomes of patients in a number of areas such as Caesarean Sections, smoking and breastfeeding and that positive feedback was regularly received through the friends and family survey. He added that there were challenges with regards to recruitment and that the Trust was short by 20 midwives and that the level of health inequality and deprivation in Blackpool also provided additional challenge.

It was noted that the CQC visit had been carried out earlier in the year with the report published recently. Since the inspection, the Trust had received early communication from the CQC on the issues in need of addressing and had already acted upon those concerns, providing evidence to the CQC of the action taken. At the time of the inspection a Section 31 notice had been issued to the Trust which had already been removed based on the immediate action taken.

Ms Lisa Fitzgerald, Deputy Head of Midwifery, Blackpool Teaching Hospitals NHS Foundation Trust provided additional information in regards to the outcomes of the inspection and highlighted the five key areas requiring action to address as staffing, medicine management, operation of medical devices, infection control and incident management. She advised that a comprehensive action plan had been developed, with a large number of actions already completed and highlighted that a number of concerns raised by the CQC had been due to poor record keeping rather than action not taken and that this was something that had been addressed immediately. She also summarised the 15 essential actions arising from the Ockenden report and how these had been put into practice at the Trust.

The Committee discussed the inspection outcome in detail and noted their significant concerns in relation to cleanliness, infection control and hygiene. In response, Ms Fitzgerald advised that although accepting that some areas of improvement had been required, a number of the key issues related to the record keeping of cleaning and action undertaken rather than it not happening. She advised that a bespoke plan had been introduced for specific rooms and theatres and that procedures had been tightened to ensure the documenting of evidence. Issues raised such as the soft furnishings in the bereavement suite had been acted upon and addressed within 24 hours of the inspection.

In response  ...  view the full minutes text for item 6.

This report outlines the progress made by the Blackpool NHS Tobacco Addiction Service in mobilising the local community stop smoking service.

Mr Shane Faulkner, Operational Lead, Blackpool NHS Tobacco Addiction Service advised that the new service was launched during the pandemic and consisted of tobacco dependency treatment services in the community and for inpatients at Blackpool Victoria Hospital. He advised that despite the service launching in July 2021, it was only 11 quits short of its yearly target of 289 quits. It was therefore predicted that targets would be met in this first full year of the service.

In response to a question, Mr Faulkner advised that contact was maintained with patients following the 12 week programme with further contacts made at 16, 32 and 52 weeks to maintain progress. He advised that should a person relapse they could come back into the service to receive additional support.

Members noted that the service was aiming to target certain groups notably those with mental health conditions and queried what additional support would be provided to those patients. Mr Faulkner advised that the same approach would be taken to all service users and that continued social support would be provided to promote success.

It was queried how the targets for the service had been set and what the prevalence of smoking was in Blackpool. In response, Dr Arif Rajpura, Director of Public Health advised that in Blackpool prevalence of adults smoking was 20%, with the England average 12%. Of pregnant women, 21% smoked in Blackpool compared to 9% in England. The aim of the smoking cessation programme was to reduce the overall prevalence of smoking, however, other measures were also required to impact the statistics such as the targeting of illicit tobacco by trading standards. He added that smoking prevalence had reduced but not as quickly as in other areas of England which was why target groups had been identified.

The Committee also raised concerns related to the increasing use of vaping by young people, particularly those that had never smoked. The concern was shared by all and it was noted that Public Health was working closely with schools in order to try and reduce usage, however, many products were clearly targeted towards young people.

The Committee requested that a further report be received on smoking cessation in approximately 12 months to allow them to monitor the performance of the service and requested that future reporting include a breakdown of key demographics of the service users.

To update the committee regarding alcohol consumption, alcohol-specific hospital admissions and deaths and alcohol treatment and recovery support in Blackpool.

Ms Hannah Maiden, Public Health Registrar provided an overview of the report on alcohol consumption, health impacts and treatment in Blackpool. She highlighted that the impact of lockdowns on alcohol consumption was based on national data and indicated a 25% increase in home alcohol sales. She noted that this was driven by people already identified as heavy drinkers and that levels had stayed high for approximately one year before declining back to baseline levels. She added that levels of liver disease had remained high with the number of alcohol related deaths significantly rising in 2020.

In Blackpool, 23% of adults consumed more than the recommended 14 units per week which was at a similar level to England averages, however, this had increased from 14%. In contrast the number of alcohol related admissions to hospital and alcohol related deaths were double the England average in Blackpool indicating the potential impact of other factors such as poor diet, deprivation and overall health inequality. The vast majority of cases were linked to liver disease and partners were working together in order to try to address the levels through preventative measures including messaging in schools and lobbying for minimum unit pricing.

Representatives for the drug and alcohol treatment services commissioned by the Council were in attendance at the meeting to provide an overview of current service provision. Mr Tom High, Service Manager, Delphi advised that the drug and alcohol service provisions had been separated as it had been recognised that many people seeking help for alcohol consumption had been put off from approaching services that also catered for drug use. The service had also been opened as a drop in service which had resulted in increased engagement. He added that the service also proactively contacted service users following the conclusion of their time in treatment to offer continued support.

Members discussed the current challenges around alcohol reduction and noted the unhealthy promotions often offered by local pubs as well as the frequent offers at supermarkets. The stigma attached to seeking help for alcohol dependency was also noted as a challenge as were the additional causes of liver disease such as poor diet and viral hepatitis, with the impact of deprivation significant in Blackpool. It was difficult to identify an easy solution to any of these challenges.

The advancement of the sharing of data between Horizon and the NHS was commended. It would allow real time sharing of information and bring together systems once fully embedded.

The report outlines the current services, highlights the challenges and provide solutions and options to inform the future delivery model/s for the services.

Ms Nicky Dennison, Public Health Specialist reported that Public Health was seeking the Committee’s support in decommissioning the Family Nurse Partnership (FNP) in order to release funds to develop the 0-19 service, building on the work of the health visitors and strengthening the model. She advised that the rationale for the recommendation related to budget pressures but also that the FNP was a very niche service only available to few where the new proposal would support many.

It was reported that the released resource would enable the funding to be of benefit to more local families, and allow the Council to re-model in a way that allowed for proportionate universalism ensuring that the needs of vulnerable children, young people and families in Blackpool were better met through the existing health visiting service. 

In response to questions, Ms Dennison advised that it was expected that should the proposal be approved, the process to move to the new delivery model would be completed in approximately 12 months time. She added that she did not expect any groups to lose out following the model change and that the proposal would be more inclusive and flexible.

The Committee agreed to support the proposal to decommission the Family Nurse Partnership (FNP) to release funds to build a new 0-16/19 service, as per commissioning responsibilities.

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

The Committee noted its workplan for the remainder of the Municipal Year.

To note the date and time of the next meeting as 10 November 2022, commencing at 6.00pm.

The date and time of the next meeting was noted as 10 November 2022, commencing at 6.00pm.