Agenda item

The Committee considered a report of the Better Care Together (BCT) Partnership which provided an update on plans and progress of the programme in relation to community health services, the engagement process in relation to the future of Hinckley Hospital, a summary of the East Leicestershire and Rutland strategy, and described the link between the University Hospitals Leicester’s (UHL) recent strategy and BCT community proposals. A copy of the report marked “Agenda Item 8” is filed with these minutes.

The Committee also noted that a representation had been received from Mrs Baker asking members to challenge a number of issues during the debate on this item.  A copy of the representation is filed with these minutes.

The Chairman welcomed Mary Barber, the Director of Better Care Together, Jane Chapman Chief Strategy and Planning Officer from East Leicestershire and Rutland CCG (ELRCCG), Caroline Trevithick Chief Nurse and Quality Lead from West Leicestershire CCG (WLCCG) and Andy Donoghue Property Services Regional Programme Manager from NHS Property Services, to the meeting for this item.

Arising from discussion the following points were raised:-

Community Services Offer

(i).          Plans were in place to increase provision in primary care through the creation of primary care hubs which would bring specialists together and be large enough to undertake some minor surgery procedures.

(ii).         The difficulties in measuring avoided admissions were acknowledged. However, there was evidence that, if there was a service that a frail elderly person could call in a crisis, this would avoid the crisis becoming extreme and resulting in the person being admitted to hospital. This was the aim of the new crisis response service, which had had some success to date, although not as much as expected. The service was currently being reviewed to see if it could be scaled up further.

(iii).     In order to provide specialised multi-disciplinary care, community hospitals would need to provide diagnostics facilities such as x-rays, specialist nurses and clinical oversight. In addition single site wards could be challenging in terms of inflexibility in staffing arrangements, and lack of specialist equipment which might be needed should a patient deteriorate, such as an x-ray machine, resulting in the need to transfer the patients to an alternative site.

(iv).     Treating Patients in their own home rather than a hospital meant that staff would need different skills. In particular, they would need to be comfortable with working alone in a one-to-one setting with the patient. Patients would also need to be comfortable with the arrangements. Quality of care would be measure robust, using the same metrics as the Intensive Community Support Services.

Hinckley Community Hospitals

(v).       Over last 18 months WLCCG had been engaging with patients, carers and staff to co-design the planned and urgent are for Hinckley. Consideration was particularly being given to Hinckley District Hospital and whether an alternative setting to deliver outpatient services was needed. The Committee was advised that a public meeting was to take place on 5 October to inform the consultation process further.

ELRCCG – St. Luke’s – Market Harborough

(vi).      East Leicestershire and Rutland CCG had worked well in Rutland to develop an integrated care model where nursing and social care staff worked with GPs to identify the holistic needs of patients. It was hoped to roll this out to Leicestershire as it linked well to the County Council’s model of locality working. The Committee welcomed the concept of care that was wrapped around the patient, but recognised the challenges involved in assessing patients and ensuring that they accessed the right service first time.

(vii).     The strategy formed part of a national recruitment to publish a two year plan. However, improvements would continue beyond 2016 and the strategy was seen by ELRCCG as a foundation for the future. It was not intended that the number of beds in community hospitals would be reduced but the strategy proposed a different model which would use the services more efficiently.

(viii).    With regards to St. Luke’s hospital in Market Harborough, it was noted that discussions regarding the legal basis of occupation had concluded and that the cost of indemnity insurance would be met by both the CCG and the tenants. NHS Property Services was now able to answer the contract and work would begin on site on 30 November.

The Committee was pleased to note the desire for change across the health and care services. However, it would be important to keep monitoring the changes to ensure that they did not destabilise the local health and care economy, and that services continued to be safe for patients. The timescales were challenging but officers were confident that change would happen and that lessons would be learnt on an ongoing basis.

RESOLVED:

That the report be noted.