Agenda and draft minutes

To be notified of the appointment of Substitute Members.

There were no substitute members.

You are invited to declare any registerable and/or non registerable interests in matters appearing on the agenda, and the nature of that interest.

You are also invited to disclose any dispensation in relation to any registerable and/or non-registerable interests that have been granted to you in respect of any matters appearing on the agenda.

Please complete the Declarations of Interests card available at the meeting and return it to the Democratic Services Officer before leaving the meeting.

There were no declarations of interest.

To Confirm the minutes of the meeting held on

Resolved:  that the minutes of the meeting held on 25 January 2023 be confirmed and signed by the Chair.

To consider the Annual Plan and Quality Account for 2023.

Jeremy Rushmer, Executive Medical Director, and Rachel Carter, Safety Director, of Northumbria Healthcare NHS Trust attended the meeting to present the Annual Plan and Quality Account.

It was highlighted that over the last year the Trust had been dealing with the aftermath of Covid which created new and different challenges.  This included one of the hardest December/January periods that been seen locally and across the region, with an unprecedented level of demand across all services, and particular pressure in emergency and elective services.  There has also been an increase in patients presenting with greater illness due to reduced access to healthcare during the pandemic.

It was noted that the 2022-23 safety and quality and improvement priorities had been:

1.     Ambulance handover

2.     Cancer pathway – urology

3.     Medical devices in maternity

4.     Medication errors in community

5.     Patient experience

6.     Staff experience

For 2023-24 there are 7 proposed priority areas.  These will be:

1.     Improving flow – reducing ambulance handover delays

2.     Medication errors – timeliness of critical medications (Parkinson’s Disease (PD)

3.     Improving cancer pathways

4.     Deteriorating patient – community NEWS (C-News)

5.     Improving delirium – assessment and management

6.     Involving people in the development and improvement of Trust services

7.     Developing a collaborative approach to improving staff experience

Members asked whether the situation during December and January could have been worse without the high take up of flu and Covid vaccines in the borough.  It was noted that the flu vaccine in particular had helped a difficult situation.  It was also noted that Covid had not been the main issue over the winter period in comparison with previous years.

There was some discussion about the instances of Strep A and the additional pressure this had caused.  It was noted that Strep A is an issue in winter with fluctuating levels.  There had been a surge in demand linked to parents who had concerns about their children, and this was part of the increased pressure in paediatrics.

There was some discussion about digital systems and the benefits this has brought to managing beds, ambulances etc.  There had also been improved communication systems with the ambulance service, including clinician to clinician calls, and this has helped to manage and improve the handover process.

It was noted that partnership working was important and relationships between organisations had been working better as a result of joint working across the pandemic.  There were aims to improve partnership working with primary care and mental health services and that the Trust is committed to partnership working.  It was also noted that partnership working with adult social care services was also important.

There was a specific question about the priority linked to ward medication systems and the role of ward medications assistants.  It was noted that medication assistants would not be administering drugs, but were involved in looking at which patients need medications and when they are needed.

The Chair thanked the representatives of Northumbria Healthcare Trust for the presentation to the Sub-committee.  It was  ...  view the full minutes text for item ASCH35/23

To consider an update on the Adult Social Care Workforce Strategy.

The Sub-committee received a presentation that provided an update on the adult social care workforce development strategy.

The sub-committee received detailed information about the internal and external social care workforce, including workforce profile information. 

A workforce development strategy has been developed to provide a 3 year plan, with progress reported to SMT on a quarterly basis.

The report outlined the future challenges facing the sector, including a projected increase in older people in the borough by 2030, both clients and carers, ongoing financial challenges, and ongoing difficulties with recruitment and retention due to increased competition for jobs from other sectors and also the NHS.  There will also be a new inspection framework introduced in the near future and legislative changes, including the adult social care reforms that have been pushed back to 2025.

It was noted that recruitment and retention issues were impacting on services.  For example, some nursing homes have been de-registering and becoming residential homes only due to a lack of nursing staff.  The Council is monitoring the situation with care homes across the borough.

The presentation outlined the introduction of the Care Academy, working with the market and external partners including the DWP to bring information and employers together in one place.  This would be developed going forward to include job adverts and recruitment information.

There was a wide-ranging discussion about the difficulties in the Care Sector.  It was highlighted that the differential between private and local authority rates was increasing, although these increased rates were not being passed on to care staff in terms of higher wages.

It was noted that the Council had recently carried out an analysis of care costs as part of the preparation work for the adult social care reforms and proposals that would allow private clients to commission services for residential care via the local authority at the local authority rate.  This ‘fair cost of care’ work had been sent to the Department of Health in the autumn, but the reforms were now on hold to 2025. 

The Sub-committee were of the view that they would like to look at adult social care in more detail next year.  It was noted that a study group had undertaken a review of Home Care during 2021-22 and made recommendations to the Cabinet. 

There was some discussion about other ways of addressing issues around adult social care including a possible motion to Council, in-depth scrutiny reviews or a spotlight review.  It was noted that the arrangements for scrutiny were due to change going forward but to note the request for this issue to be added to the work programme of the relevant scrutiny committee.

It was agreed that the Sub-committee would:

-        Suggest members explore putting together a Council motion requesting more government action in relation to Adult Social Care.

-        To include Adult Social Care as a key item on the work programme for next year, to include: 

-        the ‘fair cost of care’ analysis,

-        residential care in the borough;

-        the  ...  view the full minutes text for item ASCH36/23

Paul Jones, Healthwatch North Tyneside to provide an update.

Paul Jones, Healthwatch North Tyneside, presented the report which provided an update on key areas of work across the year and issues raised with Healthwatch by residents.

The following areas were highlighted:

·       Access to care across the system

·       Supporting the delivery of vaccine programmes

·       Breast screening

·       Health inequalities

·       Community Mental Health Transformation

·       NHS system change and service user voice

An issue was raised in relation to an increase in people accessing private services because they are unable to access timely services via the NHS.  Some councillors raised an issue about the lack of information about reputable private providers and whether this was something Healthwatch could assist with.  However, it was noted that this was not within the remit of Healthwatch.

Members noted that Healthwatch has been commissioned to support the Community Mental Health Transformation Programme to involve local people in the design and delivery of the programme.  This work is focussed on the creation of a ‘crisis café/safe haven’ as part of the out of hours crisis support service in the borough, and ongoing support for people with more complex mental health challenges, specifically working with a group of 10 residents.  The Sub-committee welcomed this programme of work, although stated that transformation funding will not make up for the money lost from mental health services over past years.

The Sub-committee thanked Paul for attending the meeting and for the update report.

The Sub-committee agreed that mental health transformation should be included as an item on the work programme for next year.