Apologies were received from Councillors Peggy Mullock and Tracey Huffer.  Councillor Roger Evans substituted for Mrs Huffer.

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 have 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 6 June 2016 as a correct record – TO FOLLOW

The minutes of the meeting held on 6 June 2016 were confirmed 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.  Deadline for notification is 5.00 pm on Wednesday 20 June 2016.

There were no public questions.

To receive any questions of which Members of the Council have given notice.  Deadline for notification is 5.00 pm on Wednesday 20 July 2016.

There were no Member questions.

·       To receive an update on progress with the four strands of work to improve the service discussed at the 21 March 2016 meeting.

·       To receive the ambulance response times for Shropshire

The Chairman welcomed Barry McKinnon, Shropshire  -  West Midlands Ambulance Service, Julie Davies, Director of Strategy and Service Redesign - Shropshire CCG, and Sara Biffen, Deputy Chief Operating Officer - Shrewsbury and Telford Hospital Trust, to the meeting.

Mr McKinnon gave a presentation which covered:  WMAS Visions and Values; the Ambulance Response Programme Pilot; New Call Categories and comparing performance; Operational Performance to 8 June 2016; Ambulance Turnaround delays at hospitals and lost hours.

A copy of the presentation is attached to the signed minutes.

During the presentation he reported that from June, WMAS had been implementing the national pilot of the Ambulance Response Programme. The objective of the pilot was to increase operational efficiency whilst maintaining a clear focus on the clinical need of patients, particularly those with life threatening illness and injury.  He explained the new call categories and the reasons that these would not be comparable with previous categorisations.

With regard to hospital handover he referred to the charts in the presentation which highlighted the significant challenge presented by total time lost in hospital turn arounds and the number of handovers over 1 hour.  Work was underway with Shrewsbury and Telford Hospital Trust (SATH) to address this but the issue was demand.   

He also referred to issues around retention of staff as recently five paramedics had been recruited by the GP Out of Hours Service as urgent care practitioners.   

A Member referred to when he had been on the WMAS Board in 2006 at which point delays over 60 minutes would be very unusual.  He said that WMAS had then been able to claim from the Regional Health Authority to pay overtime to maintain services.  He asked what had happened over the past 10 years which had led to the current situation.  He also said it would be interesting to know how many emergency response vehicles there were in 2006 compared to now and the growth in demand over the last decade. 

Mr McKinnon reported that in 2006 there had been a fine system in place which meant Hospitals would have to pay £1000 for every delay over 1 hour.  This system had ceased.  He also referred to the high demand on A&E facilities that had limited capacity.  There were no set times that these problems occurred.  

The Deputy Chief Operating Officer, SATH, emphasised that there was no set pattern to demand, and spikes could happen at any time.  The Regional Capacity Management Team attempted to predict demand but what historically had been predictable was no longer so.

Diane Steiner, Acting Consultant in Public Health, reported on a productive meeting held recently with Mark Docherty, Director of Clinical Commissioning and Service Development, WMAS. She reported that it had been agreed that Public Health would do some analysis to understand more behind the nature of calls to WMAS.  This might help to identify how Public Health could help, for example, through targeted fall prevention work.  She referred to one area the Committee had asked WMAS to  ...  view the full minutes text for item 17.

To receive an update presentation from Director of Adult Services, this will include details of brokerage.    Presentation to follow, marked:  7

The Director of Adult Services explained that one of the key areas of development related to Integrated Community Services was the development of a Brokerage Function for the purchase of domiciliary care.  He introduced Charlotte Quinton, Development Officer, who had developed ‘Shropshire Choices’, the Adult Social Care hub for care provision and market development, interacting across three online platforms. 

The Development Officer made a presentation – copy attached to the signed minutes – which demonstrated how the system worked across the platforms and Members were very impressed that:

·         All domiciliary care packages were brokered in the same way regardless of who they were managed by

·         New requests into brokerage were published the same day – to a total of 80 providers

·         Alerts were sent directly to providers each day as and when new packages were published or changed

·         Rates offered through brokerage were monitored and renegotiated where needed

·         Package requests were mostly open to all providers which meant that opportunities for expansion and business development were at their finger tips

·         As the sourcing of care was managed through one route, development of reporting suite and digital options for the Council and providers would be possible. 

All the information needed was in place so that providers knew where to recruit and where to invest and some had even invested in ways to transport workers. 

The Director of Adult Services emphasised that this was a very significant development, was critical for business going forward and that the behaviour of the market had changed greatly. The system had been built entirely in house and was a significant achievement. 

The Healthwatch Representative reported that Healthwatch had conducted visits to community hospitals and two or three patients had been identified in each one who had had a package agreed but were still in hospital because no one was able to deliver it.  She asked if delays in fulfilling packages were monitored.

Officers confirmed that all hospital discharges were categorised as high priority, including community hospitals.  These were constantly monitored and being highlighted to providers.  The south west of the county was currently experiencing particular difficulties as the block provider had difficulties staffing.

Members asked what would happen if no one came forward to fulfil a package and heard that the team also managed the body for all pre-purchased beds across the county.  These would be drawn on if needed.  Members also asked what would happen if there was a choice of provider and heard that if multiple options were presented the social worker would discuss these with the user of the service.  The decision often came down to visiting times, rather than cost. 

The Committee were extremely impressed with the developments presented to them, Members congratulated all involved and thanked the Development Officer and Director of Adult Social Care for attending the meeting.

To appoint 3 Members (2 Conservatives and 1 Liberal Democrat) and 3 Co-opted Members to serve on the Joint Health Overview & Scrutiny Committee 2016 – 2017.

•           Cllrs Gerald Dakin, John Cadwallader and Heather Kidd.

•           Co-opted Members – David Beechey, Ian Hulme and Mandy Thorn.

It was agreed to appoint the following three Members of the Health and Overview Scrutiny Committee and three co-opted members to serve on the Joint Health Overview and Scrutiny Committee 2016 - 2017:

Cllrs Gerald Dakin, John Cadwallader and Heather Kidd

Co-opted Members – David Beechey, Ian Hulme and Mandy Thorn

To receive responses to NHS Trust Quality Accounts made by representatives of the Committee:

Shrewsbury and Telford Hospital NHS Trust and Shropshire Community Health NHS Trust

Responses to the Shrewsbury and Telford Hospital NHS Trust and Shropshire Community Health NHS Trust Quality Accounts were noted.

To consider proposals for the Committee’s Work Programme, attached marked:  10

The Cabinet Forward Plan is available from:

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

The Chairman referred to a report to Cabinet on 13 July 2016 Day Services for Adults with Learning  Disabilities – Award of contract for Innage Lane, Oak farm and the Meres.  He suggested visiting these locations before the changes, with a follow up visit in approximately 12 months time.  Cllrs Dakin, Shineton and Moseley expressed interest in attending the visits.

The proposed Work Programme was noted.