There were no apologies for absence.

Members are reminded that they must not participate in the discussion or voting on any matter in which they have a Disclosable Pecuniary Interest and should leave the room prior to the commencement of the debate. 

Members were reminded that they must not participate in the discussion or voting on any matter in which they had a disclosable pecuniary interest and should leave the room prior to the commencement of the debate.

To confirm the minutes of the meeting held on 8 February 2016 as a correct record, attached marked:  3

The minutes of the meeting held on 8 February 2016 were agreed as a correct record.

To receive any public questions or petitions from the public, notice of which has been given in accordance with Procedure Rule 14.  The deadline for this meeting is 5.00 pm on Wednesday 16 March 2016.

An e-mail from Mrs George was circulated to Members of the Committee in relation to Future Fit and the intention to shift care out of acute hospital settings into community settings, the need for additional resources in the community to do this.  Mrs George had received correspondence to say that no money would be released for investment in community services and urgent care centres which meant that 30% of hospital activity would be transferred to the community, without any resources committed to covering the additional costs. She felt that the demand on the Sustainability and Transformation Fund would be high and might be that no money at all would be allocated to Shropshire.  GP services and community services were already stretched as was social care and it would not be possible to absorb the planned 30% transfer of activity away from hospitals.  She asked that the Health and Adult Social Care Scrutiny Committee make urgent representation to the CCG, to the Council and to local MPs on this issue. 

The Chairman reported that he had sought further information from the CCG on this matter and  had also raised the matter with the Joint HOSC Chair. 

To receive any questions from Members, deadline for notification is 5.00 pm on Wednesday 16 March. 

There were no questions from Members.

Representatives of West Midland Ambulance Service have been invited to attend the meeting to explain the contributing factors underlying the deteriorating trend in response times in Shropshire – especially rural areas – and discuss what is being done to address these concerns 

Michelle Brotherton - General Manager for West Mercia, Mark Docherty - Director of Clinical Commissioning and Service Development and Diane Scott - Deputy Chief Executive Officer, West Midlands Ambulance Service will be present at the meeting.

Dr Julie Davies - Director of Strategy and Service Redesign and Emma Pyrah - Commissioner Urgent Care, Shropshire CCG will also be present.

To follow:  WMAS Performance information for Shropshire February 2016, a report on comments received by Healthwatch regarding the Ambulance Service and a presentation provided by West Midlands Ambulance Service.   These will all be available in advance of the meeting.  

The Chairman welcomed the following representatives and thanked them for attending the meeting:  Mark Docherty – Director of Clinical Commissioning and Service Development (WMAS), Michelle Brotherton – General Manager for West Mercia and Executive Nurse (WMAS), Cliff Medlicott – Community Response Manager (WMAS), Murray MacGregor – Communications Director (WMAS), Julie Davies – Director of Strategy and Service Redesign (Shropshire CCG) and Emma Pyrah – Commissioner Urgent Care (Shropshire CCG).

The Director of Clinical Commissioning and Service Development introduced a presentation (copy attached to the signed minutes).  He acknowledged the challenge faced by the Ambulance Service in Shropshire and that meeting red targets in the county had been a struggle and continued to be so.  Activity was increasing and February 2016 had been 23% busier than February 2015.  Sometimes a day could be 30% busier than expected which caused major challenges.  If more resources were available then the service could respond to the increase in activity. 

He also stated that the change in clinical models at the hospitals had led to more ambulances travelling to Princess Royal Hospital relative to Royal Shrewsbury Hospital and this had led to an increase in job cycle time which had averaged 65 minutes, but in the last week had been 96 minutes.   Service reconfigurations could be challenging for ambulance services and must be properly resourced. A ‘vortex effect’ meant that resources could be sucked into the centre and an ambulance in Telford could end up in Wolverhampton or even further away.  This was partly why response times were challenged.

The Chairman asked if WMAS was involved in the Future Fit discussions and it was confirmed that this was the case.

The CCG Director of Strategy and Service Redesign said that the CCG did factor growth into the WMAS contract which was not done by all CCGs.  It had also done some modelling in relation to stroke and maternity and paediatric services moving to Telford and £500,000 had been added to the contract reflecting that reconfiguration.

The Committee were informed that ambulance turnaround delays at Royal Shrewsbury Hospital and Princess Royal Hospital.  It was clarified that paramedics had to stay with a patient until a clinical handover was made at the hospital.  Ambulances were often delayed by over an hour and some Ambulance Services classified this as a serious incident.  Although WMAS did not, it did measure these occurrences.  If it was possible to reduce the turnaround delays of over one hour, it would equate to having an extra ambulance on the road straight away.

The Committee was concerned to hear that Shropshire had recently experienced ‘zero status’ for a period of time when the county had run out of ambulances as a result of hospital delays.   This was not happening frequently but it was unacceptable that it had happened at all.  The help of the whole health economy was needed to deliver a better and safe ambulance service. 

The Director of Strategy and Service Redesign, Shropshire CCG, explained that the CCG was working closely with  ...  view the full minutes text for item 58.

To consider proposals for the Committee’s Work Programme, TO FOLLOW marked:  8

The Cabinet Forward Plan is available from:

http://shropshire.gov.uk/committee-services/mgListPlans.aspx?RPId=130&RD=0

The Chairman confirmed that dates of meetings to consider Quality Accounts would be circulated as soon as they were available. 

Members requested further information around the Adult Social Care budget.