Councillors and committees

Agenda and minutes

Venue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN. View directions

Contact: Andrew Spragg 

Items
No. Item

1/17

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

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    Minutes:

    Apologies were received from Bob Gardner and Graham Ellwood.  There were no substitutions.

2/17

MINUTES OF THE PREVIOUS MEETING: 10 NOVEMBER 2016 pdf icon PDF 288 KB

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    To agree the minutes as a true record of the meeting.

    Minutes:

    The minutes were agreed as an accurate record of the meeting.

     

3/17

DECLARATIONS OF INTEREST

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    All Members present are required to declare, at this point in the meeting or as soon as possible thereafter

    (i)            Any disclosable pecuniary interests and / or

    (ii)           Other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting

    NOTES:

    • Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest
    • As well as an interest of the Member, this includes any interest, of which the Member is aware, that relates to the Member’s spouse or civil partner (or any person with whom the Member is living as a spouse or civil partner)
    • Members with a significant personal interest may participate in the discussion and vote on that matter unless that interest could be reasonably regarded as prejudicial.

     

    Minutes:

    There were no declarations of interest made.

4/17

QUESTIONS AND PETITIONS

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    To receive any questions or petitions.

     

    Notes:

    1. The deadline for Member’s questions is 12.00pm four working days before the meeting (Monday 13 February 2017).

    2. The deadline for public questions is seven days before the meeting (Friday 10 February 2017).

    3. The deadline for petitions was 14 days before the meeting, and no petitions have been received.

    Minutes:

    There were no questions or petitions submitted to the Board.

5/17

SURREY HEARTLANDS- THE DEVOLUTION OPPORTUNITY pdf icon PDF 121 KB

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    The presentation annexed to this paper provides the Board with an update on the opportunities and ambition, the devolution ‘asks’ and next steps.

     

    Additional documents:

    Minutes:

     

    Declarations of interest:

     

    None

     

    Witnesses:

     

    David McNulty, Chief Executive, Surrey County Council and Chair, Surrey Heartlands Transformation Board

    Matthew Parris, Evidence and Insight Manager, Healthwatch Surrey.

     

    Key points raised during the discussion:

     

    1.    The Chair of the Surrey Heartlands Transformation Board explained that the primary thinking about the devolution opportunity had emerged from conversations regarding the Sustainability and Transformation Plans (STPs) and how health and social care systems can be improved by working together.

     

    2.    Members were informed that the Surrey Heartlands STP had been developing devolution plans since last spring, and that key partners had visited Manchester to hear about how health devolution had assisted their work.

     

    3.    Members acknowledged that devolution was a vehicle which would enable change to be delivered at speed and scale.  The ambition of the STP was to reduce variation of care, quality and outcomes whilst delivering sustainable services within an ageing population with complex health needs.  Members were informed that care would still vary based on individual medical needs, but that variation of care due to process would be reduced. 

     

    4.    The Chair explained that given the complexities of the STP footprint, covering 11 organisations, effective partnership working with stakeholder groups, workforce and advocacy groups was key.  He stated that public engagement was also important throughout the devolution process.  

     

    5.    Members recognised that there were two approaches to devolution; namely the Cities and Local Government (CLG) Devolution Act and the NHS England (NHSE) Devolution Framework.  It was explained that the STP were not going to follow either of these routes, instead agreeing upon a more pragmatic way forward that would achieve the devolution required.

     

    6.    Members acknowledged that bringing decision making closer to operational levels would allow for local accountability and control, whilst collaboration would enable a variety of expertise.  The Chair explained that as part of the wider economic system, the devolution opportunity would allow for a closer fit between prosperity and health and wellbeing through the reduction of variations. 

     

    7.    The Chair explained that a list of initial devolution asks had been discussed with but not yet agreed by central Government, and that the next steps would be dependent upon the drafted Memorandum of Understanding being signed off centrally, with a view to going live in April 2019.

     

    8.    Members were informed that whilst STPs were not considered to be the solution to social care funding shortfalls, health devolution would ensure funding and resource was used as effectively as possible rather than shifting pressures.  It was explained that funding would be more accessible without the need to enter the bidding process, which would also have a positive impact on staff time. 

     

    9.    Members acknowledged that health devolution would provide a big opportunity for Surrey County Council (SCC)  with regard to improving services and sharing best practices.  The Chair expressed the view that the success of the Orbis partnership provided complementary skills, and informed the Board that two key SCC officers were leading the work-streams for shared services and asset strategy for  ...  view the full minutes text for item 5/17

6/17

IMPROVING STROKE CARE IN WEST SURREY - PUBLIC CONSULTATION pdf icon PDF 98 KB

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    This is the public consultation document describing the proposals being put forward to improve stroke care across West Surrey.

     

    Additional documents:

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Dominic Wright, Chief Executive, Guildford and Waverley CCG

    Giselle Rothwell, Head of Communications and Engagement, NW Surrey CCG

    Vanessa Harding, Stroke Services Programme Manager

    Matthew Parris, Evidence and Insight Manager, Healthwatch Surrey

    Nick Markwick, Co-chair, Surrey Coalition of Disabled People.

     

    Key points raised during the discussion:

     

    1.    The Head of Communications and Engagement began by informing Members that the public consultation had opened on 6 February 2017 and would be running for 12 weeks, with a closing date of 30 April 2017.  She stated that local stroke groups, voluntary groups, patients and their carers were all being consulted, and that road-shows at hospitals and shopping centres had also been arranged as a way of engaging the wider public.

     

    2.    A witness raised concern regarding the response times for ambulances, particularly in the Waverley area.  Members noted that whilst SECAmb were meeting the national target, response times in Waverley were below target.  The Chief Executive for Guildford and Waverley CCG agreed that response times were of concern, and confirmed that the CCG was taking action within the contract.  He also explained that given its rural location, the CCG was looking to help itself by utilising first responders from within the local community in recognition of the below-average response times.

     

    3.    Members expressed concern that the infrastructure in some areas meant that ambulances could get caught up at certain times of day.  Witnesses were unable to comment on the satellite navigation system, although it was explained that SECAmb had a system in place to plan routes to avoid traffic calming measures.

     

    4.    Members noted that under current plans, Waverley stroke/cardiac patients were directly transferred to Frimley Park’s hyper-acute stroke unit (HASU).  The Chief Executive explained that he was aware that it was not a perfect solution, however it was within the key two-hour treatment time as recommended by the South East Coast Senate of Clinicians.   

     

    5.    Members noted that service users and members of the public had stated that home visits for more than two months following a stroke were less important.  It was suggested that more emphasis on aftercare and additional support within the community was important so that patients did not feel abandoned by the health system.

     

    6.    The Stroke Service Programme Manager explained that the premise of the new model was to reduce the length of stay in hospital.  It had been recognised that community-based rehabilitation had led to faster recovery times.  Early Supported Discharge (ESD) was currently available to 25% of patients, and the ambition was to increase this to 50%.  There were plans in place to grow the team to enable the increased availability of ESD to be achieved. 

     

    7.    Members questioned whether the 350 people that had been consulted in 2014-15 was a statistical representation.  The Head of Communications and Engagement explained that getting responses to consultation had sometimes proved difficult.  She explained that the sample would be expanding to 1500 in order to test initial proposals, with all  ...  view the full minutes text for item 6/17

7/17

SURREY AND BORDERS PARTNERSHIP - WARD CHANGE PROPOSALS pdf icon PDF 308 KB

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    This report covers the activity of the Working Group, its findings and recommendations made to the Trust on behalf of the Board.

    Additional documents:

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Justin Wilson, Medical Director, Surrey and Borders Partnership NHS Foundation Trust

    Don Illman, Lead Governor, Surrey and Borders Partnership NHS Foundation Trust

    Bill Chapman, Tim Hall and Tony Axelrod, Members of the working group

    Matthew Parris, Evidence and Insight Manager, Healthwatch Surrey.

     

    Key points raised during the discussion:

     

    1.    The Medical Director began by explaining that the ward re-location had taken place at the beginning of February and that the move had been successful.  He explained that the new location provided a much improved environment for inpatients.  Furthermore, the vast majority of nurses had transferred across to the Abraham Cowley Unit (ACU) and medical staffing levels had been augmented in order to support junior doctors.  The Board was informed that the success of the move would be evaluated from a patient experience perspective and its impact on missing persons (MISPER) data would also be analysed.

     

    2.    The Lead Governor raised concerns that four nurses had left Surrey and Borders Partnership (SABP) as a result of the move, and a further four had found new jobs nearer to where they lived.  He went on to state that whilst the physical environment at the ACU was fresh and newly refurbished, the rooms were still dormitories and therefore lacked a degree of privacy.  The Medical Director pointed out that whilst the rooms were not individual en-suite rooms, the move had enabled wards to become single-sex rather than mixed-sex as they were at Epsom and that this was considered to be a significant improvement. 

     

    3.    The Lead Governor told the Board that a consultation carried out in 2009 supported the case for three mental health hospitals within Surrey.  The east of Surrey currently has no beds since the move to ACU was implemented.  The Medical Director acknowledged the lack of facilities in the east of the county but explained that the consolidation of services onto fewer sites allowed for improved care provision to inpatients and consolidated medical support.  Furthermore, he explained that SABP had a contract with Sussex to be able to use 14 beds at Langley Green if SABP reached their full capacity. 

     

    4.    A Member of the working group commented on the conditions observed during his visit to the Epsom based wards prior to the move to the ACU.  He told the Board that the doors to the entire unit, including the stroke unit above, had to be locked whilst staff moved inpatients to and from the servery area at mealtimes due to a shared public thoroughfare.  

     

    5.    The Lead Governor raised concern that there was no public consultation regarding the decision to move the two wards from Epsom to the ACU, and that if this was a stroke or maternity ward being moved, there would have been public outcry.  The Medical Director explained that the consultation carried out in 2009 supported the decision.  The security and safety arrangements at the Epsom wards were of concern to the Trust, despite mitigations being implemented.  Furthermore, patient experience  ...  view the full minutes text for item 7/17

8/17

CHAIRMAN'S ORAL REPORT pdf icon PDF 124 KB

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    The Chairman will provide the Board with an update on recent meetings he has attended and other matters affecting the Board.

    Additional documents:

    Minutes:

    The Chairman provided an update to the Board regarding business undertaken since the previous meeting.  A copy is attached as an annex to these minutes.  The Board noted and accepted the Chairman’s report. 

9/17

RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 201 KB

10/17

DATE OF NEXT MEETING

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    The next meeting of the Board will take place on 13 March 2017 at 10:30 am.

    Minutes:

    The Board noted that its next meeting would be held on Monday 13 March at 10:30am.