Apologies were received from Cllr Angela Goodwin, Cllr Robert
Evans,Borough
Councillor Victoria Wheeler,Sinead Mooney,
Cabinet Member for Adult Social Care, Graham Wareham, Chief
Executive, Surrey and Borders Partnership NHS Foundation Trust,
Helen Coombes, Outgoing Interim Executive Director of Adults,
Wellbeing and Health Partnerships (SCC), Helen Coe, Director of
Operations & Recovery, NHS Surrey Heartlands ICB and Stephen
Dunn, Director of System Flow and Delivery.
Purpose of the item:To agree the minutes of
the previous meeting of the Adults and Health Select Committee as a
true and accurate record of proceedings.
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.
The
Chairman declared he was a community representative to NHS Frimley.
Cllr Carla Morson declared that she had a relative that worked at
Frimley Park Hospital. The Chairman declared on behalf of Cllr
Victoria Wheeler that she worked for a company that provided
consultancy advice to the NHS generally.
These reports outline the backlogs for cancer and elective
(planned) care across Surrey Heartlands and Frimley ICS, the
progress made in addressing these and actions being taken to reduce
further. In addition, it outlines the work being undertaken to
increase diagnostic capacity.
Professor Andrew Rhodes, Professor of Critical Care at the
University of London and the Chief Medical Officer for Surrey
Heartlands Integrated Care Board (SHICB)
Lucy
Hetherington, Associate Director of Planned
Carefor Surrey
Heartlands Integrated Care Board
Alexander Stamp, Deputy Chief Operating Officer– Planned
Care Frimley Heath Foundation Trust (FHFT)
Orlagh
Flynn, ICS Programme Director Elective Care, deputising obo Stephen
Dunn, Director of System Flow and Delivery (Frimley NHS
Trust)
Key point raised during the
discussion:
The
Chief Medical Officer (SHICB) provided a brief introduction to the
report about the elective delivery of the waiting lists relating to
outpatient surgery, diagnostics, and cancer.
The
Chairman referred to the serious impact on those on the waiting
list for long periods, and that there were further challenges to
waiting lists over the past 12 months due to industrial action in
addition to the impact of Covid. The Chairman asked if Surrey
Heartlands Integrated Care Board (SHICB) had a system in place to
cope with this and asked what the outlook was. The Chairman also
asked whether SHICB expected to bring their waiting lists back to
the required standards and how confident they were that the data
available was accurate. The Chief Medical Officer explained that
waiting lists had not recovered since the Covid pandemic.
Industrial action further impacted waiting lists. SHICB’s
hospitals learnt to manage and mitigate industrial action over
time. Industrial action had since finished, and it was hoped it
would not continue. Waiting lists were expected to take several
years to return to required standards. This involved aligning
capacity against demand, ensuring the right staff, facilities and
infrastructure was in place.
A
Member asked if there were any outstanding patients waiting over
78-weeks that did not relate to patient choice or conflicting
medical needs. If this was the case, the Member asked how these
patients were being prioritised. The Chief Medical Officer (SHICB)
noted that a year prior, SHICB had patients waiting over two years,
but had been resolving some of these long waits. The current aim
was to see all patients within 65-weeks. The 78-week wait time had
broadly disappeared. There were still a few patients at this wait
time, usually due to the complexity of a patient’s caseload.
Patients were prioritised against clinical need, by treating the
most complex and high-risk patients first. The aim to get all
patients seen within 65-weeks by the end of September 2024 was
expected to be achieved by the end of 2024. The next focus would
then be to reduce the wait to 52-weeks by
mid2025.
The
Member referred to NHS Frimley Integrated Care Board’s (ICB)
increased waiting list and its increase post-EPIC system
implementation. The Member asked what actions were being taken by
NHS Frimley ICB to manage and reduce the waiting lists, and when
they would be under control and exceeding expected standards. The
Member asked how NHS Frimley ICB was supporting patients with long
waits to manage their conditions. The
Member also asked for consideration to be given ...
view the full minutes text for item 22/24
Right Care, Right Person (RCRP) is a national Police led
initiative thatis an operational model developed
by Humberside Police. A national
partnership agreement was signed by NHS England, The Department for
Health and Social Care and the National Police Chiefs
Council.
Right Care Right Person is
designed to change the way the emergency services respond to calls
involving concerns about mental health.
This paper sets out the
arrangements in place between the health and social care sectors
and Surrey Police in response to the roll out of RCRP in
Surrey.
Mark Nuti, Cabinet Member for Health and
Wellbeing, and Public Health
Liz Uliasz, Director for Mental Health, Emergency
Duty Team (EDT) and Prisons- Adults, Wellbeing and Health
Partnerships (AWHP)
Simon Brauner-Cave, Deputy Director of Mental
Health Commissioning- NHS Surrey Heartlands ICB
(SHICB)
Alexander Jones, Consultant Nurse Mental Health
crisis care, Surrey and Borders Partnership
(SaBP)
Helen Wilshaw-Roberts, Strategic Partnerships
Manager- South East Coast Ambulance Service
(SECAmb)
Maria
Millwood, Board Director, Healthwatch Surrey
Key points raised during the
discussion:
The
Chairman raised that it was World Mental Health Day and noted that
the theme was workplace mental health. The Director for Mental
Health, EDT and Prisons, and the Deputy Director of Mental Health
Commissioning (SHICB) provided a brief introduction to the Right
Care Right Person (RCRP) report. The Director for Mental Health,
EDT and Prisons stated that the police shared their policy
procedure. The police delayed the RCRP implementation on request
when Surrey County Council (SCC) were planning to involve the
Children, Families, Lifelong Learning and Culture directorate, and
that those under18 years old were not part of RCRP. If a child was
involved, the police would deploy as normal. The police delayed by
about 6-weeks to give groups time to ensure practice was
embedded.
A
Member asked how the monitoring of RCRP was being managed
collaboratively regarding staff training and how issues were dealt
with. The Director for Mental Health, EDT and Prisons explained
that all organisations did their own training based on information
shared by the police. Training was monitored by the bronze, silver
and gold groups that continued to meet since RCRP’s
implementation. Prior to RCRP’s implementation, the bronze
group, looking operationally, reviewed case studies and
people’s potential journeys. This escalated to the silver
group, where learning was reviewed tactically. Issues were quickly
raised with police and data was challenged where
necessary. The Director for Mental
Health, EDT and Prisons rolled out training and staff awareness
sessions to around 1000 SCC staff, which may be repeated. Prior to
RCRP’s implementation, each organisation undertook a Red,
Amber, and Green rating at the Silver Tactical group meeting on
their readiness for RCRP. The Adults, Wellbeing and Health
Partnerships directorate (AWHP) had a dedicated email where staff
could raise issues. Organisations created their own guidance for
staff, which included a Surrey system agreed escalation
process.
The
Consultant Nurse (SaBP) stated that SaBP socialised their staff and
reviewed training provided by the police. He took part in the
bronze and silver meetings, where case reviews and issues around
RCRP were assessed and corrected. Outside of these meetings, SaBP
had regular interfaces, where good practice was discussed to ensure
that things worked well and that people received the support
required from the right service. SaBP went back to their teams to
ensure awareness of the escalation procedure was clear, and issues
were raised in the Bronze group. Initial RCRP learning with the
police was around welfare checks, where people may be used to
online reporting for welfare checks. SaBP communicated with teams
...
view the full minutes text for item 23/24
1.This report has been prepared for the Adults and
Health Select Committee. It reviews the
number of people of working age in Surrey who are not working
because of mental health issues. It
will explore the issues that have led to this and how these issues
can be addressed to deliver improvements for Surrey residents,
especially those who experience the poorest health outcomes within
the 21 Health and
Wellbeing Strategy Key Neighbourhoods.
2.It reviews current data to ensure that the most
urgent mental health needs are identified and sets out what is
being delivered to support those who are some of the most
vulnerable people within the community.
This is to ensure a greater focus on reducing health inequalities,
so no-one is left behind.
Mark Nuti, Cabinet
Member for Health and Wellbeing, and Public Health
Liz Uliasz, Director
for Mental Health, Emergency Duty Team (EDT) and Prisons- Adults,
Wellbeing and Health Partnerships (AWHP), Surrey County Council
(SCC)
Lucy Gate, Public
Health Principal, Mental Health Surrey County Council
(SCC)
Rebecca Brooker,
Communities and Prevention Lead, (AWHP) Surrey County Council
(SCC)
Lorna Payne, Chief
Operating Officer, Surrey and Borders Partnership NHS Foundation
Trust (SaBP)
Georgina Foulds,
Associate Director for Community Transformation, leading Surrey
Heartlands Community Transformation Programme (SaBP)
Simon Brauner-Cave,
Deputy Director of Mental Health Commissioning- NHS Surrey
Heartlands ICB (SHICB)
Key points
raised during the discussion:
The Public Health
Principal provided a detailed introduction to the
report.
The Chairman asked
what the data explains about the number of people of working age in
Surrey who were not working because of mental health issues, what
are the gaps in the current provision and how these gaps could be
filled. The Public Health Principal explained that in Surrey there
were around 100,000 fit notes for people signed off from work due
to ill health, the majority of which were mental health or MSK
(musculoskeletal) related. It was not known how many of these get
repeat fit notes, but it showed a population level need. The
Communities and Prevention Lead, (AWHP) added that steps were being
taken to address gaps in understanding to provide a good service to
residents and help those most in need. Research had been done with
people living in work poverty, people furthest from the labour
market and with employers to understand what this meant to them.
Mental health emerged as a common theme in this work. Specific and
targeted work was being undertaken around impacts on employment,
looking both at the impact of sickness absence for
businesses’ economic productivity and resulting effects on
SCC’s system in terms of service demand and waiting lists,
and the impact on individuals and wellbeing as well as qualitative
and quantitative research on what experiences have been. Planned
ways to engage with people on this included connecting into things
such as Men’s Pitstops (mental health group). SCC would also look at their
own staffing and how they can understand sickness levels and
how that impacted on local productivity.
The Chairman raised
that careers and satisfying employment were key to dealing with
mental health issues, and asked what focus was on skills and career
development and what the thinking was on that direction. The
Communities and
Prevention Lead, (AWHP) explained SCC was working in a
person-centred way, recognising every individual was different and
wanted different things out of employment. There were two vanguard
programmes through Department of Work and Pensions funding (DWP),
which gave SCC £12m to support people into good quality work.
This was being delivered across the system in partnership with
health and voluntary sector colleagues, and district and boroughs.
Both programmes had a person-centred approach with residents and
included provision to work with employers to encourage workplaces
to have structures and support for staff’s ...
view the full minutes text for item 24/24
Purpose of the item: For the
Select Committee to review the attached recommendations tracker and
forward work programme, making suggestions for additions or
amendments as appropriate.
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