Agenda and minutes

Apologies for absence are listed above.

Members of Health Scrutiny Committee are asked to consider whether they have an interest in any of the matters on the agenda and if so, to formally declare that interest.

There were no declarations of interest.

The minutes from the meeting held on 20^th September 2022 are attached for approval.

The minutes of the meeting held on 20^th September 2022 were agreed as an accurate record.

Matters arising:

1.    The Task and Finish Groups for Carers and the Social Isolation and Loneliness have met and will be reported on later in the meeting.

Questions are invited from members of the public present at the meeting on any matters for which this Committee is responsible.

Notice had been received of 1 question. The Chair advised that copies of the questions had been circulated to all Councillors. The Chair also gave an undertaking to make these available on the Council Web Site.

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A period of up to 15 minutes will be allocated for questions and supplementary questions from members of the Council who are not members of the committee. This period may be varied at the discretion of the chair.

Notice had been received of 1 question. The Chair advised that copies of the questions had been circulated to all Councillors. The Chair also gave an undertaking to make these available on the Council Web Site.

Ian Mello, Director of Secondary Care Commissioningand Catherine Tickle, Commissioning Programme Manager.

Catherine Tickle, Commissioning Programme Manager presented an overview of Elective Care and Cancer Recovery and Reform Board Update.

Catherine Tickle advised the Committee that there is a specific focus on long waiters across all elective care specialties (72+ week waits) and cancer long waits (62+ day waits), as the key priority areas identified by Greater Manchester Integrated Care Board, for the next phase of recovery following the pandemic. Catherine Tickle also advised the range of initiatives in place to support recovery at a Northern Care Alliance Group level and Bury Locality level are outlined in the presentation slides.

A member acknowledged that waiting lists were not good prior to the pandemic, therefore for context can members be provided with an outline of pre-pandemic waiting times in comparison to now. In response Catherine Tickle advised she will provide a response to the committee on pre-pandemic waiting times.  Prior to the pandemic there were programmes of work to address the waiting duration however most of the increased demand is in Mental Health support.

In addition, Councillor Tariq, Cabinet Member for Health and Wellbeing stated that a number of elective operations are being cancelled.  In assurance to the Committee Catherine Tickle confirmed that the utilisation of surgical hubs are being considered and we need to keep appointments and procedures happening by ringfencing the site and time. A further way of reducing cancelations it though theatre utilisation.

A member questioned what contingency plans are in place for the workforce risk identified within the presentation. Catherine Tickle advised Committee Members that there are certain specialties where we have seen a reduction in the workforce, an example is in dermatology. There is a Greater Manchester workforce strategy which links to training programmes including developing staff along with considering how services can deliver care in different places at different times. Kath Wynne Jones advised there is a Strategic Workforce group that has been set up and bury is facing similar issues to those nationally. The Group is looking into what makes Bury attractive to work in, methods such as recruitment fairs in central bury venues and parts of the community have taken place to start to identify people.

Discussions took place regarding dermatology and the transformation programme. Catherine Tickle advised that at a locality level General Practitioners have been equipped to help provide some treatments and triaging. In addition, there is a pathway in place so people are triaged, and this is about to be piloted in Salford Royal by EDERMA and will mean there will be a clinician between primary and Secondary care. In addition, at a Greater Manchester Level there is a reduction in the number of referrals. It was requested the Councillor Grimshaw be sent the total number of beds at Salford and if dressings can be done in the unit.

In response to questions regarding pre-operation to surgery time waiting and cancelations members were informed there is improvement. Whilst Covid is still an issue effecting or posing risk to service delivery including still  ...  view the full minutes text for item HSC.7

Kath Wynne-Jones Chief Officer - Bury Integrated Delivery Collaborative and David Latham, Programme Manager to present. Report attached.

Kath Wynne-Jones Chief Officer, Bury Integrated Delivery Collaborative and David Latham, Programme Manager provided an overview of the presentation within the agenda pack. Members were informed Bury performs typically well compared to Greater Manchester. Work is currently being undertaken on resilience, community-based care, Fairfield General Hospital have an internal improvement plan, and the implementation of care which is part of the filiality model is all underway.

The Committee were informed about system meetings that are in place to discuss pressures and plans for the delivery of services. 

Councillor FitzGerald, Chair highlighted and asked for comment on the recent death of a patient in an ambulance at Fairfield General Hospital. In response Will Blandamer, Executive Director advised this was an incident that occurred on the 18^th October.  It is subject to a serious incident review being led by the Director of Nursing for the Bury Care Organisation which is part of the Northern Care alliance that runs Fairfield General Hospital and local community services.

The patient had been referred for ambulance transfer from a care home to Accident and Emergency at Fairfield General Hospital.  There was a queue of ambulances waiting to unload due to pressures in the department.  The patient however was regarded as clinically stable with close monitoring not only by the paramedics but a nurse, 2 A&E doctors, and a nursing Sister who provided IV antibiotics.  The patient then rapidly deteriorated and despite further attention from senior paramedics on site, and an A&E doctor, sadly passed away.

There will be a system learning event, including in particular colleagues from Rochdale as the deceased was a resident of Rochdale and was known to services in that locality. The event will seek to understand if there is anything that could have been done differently and what changes may be required. 

It is not clear whether the ambulance queue was a contributory factor in death of the patient although it is clear A&E nursing and medical staff, as well as pandemics were involved in the monitoring and pro-active care of the patient. Nevertheless, we recognise the circumstances of ambulances queuing to offload patients at the Hospital is not ideal.   Like other urgent care systems, the Bury system is under very significant pressure and this is manifest most obviously in the pressures at the front door of the Emergency Department. The report later in the meeting will describe the actions being taken to address these pressures.

On behalf of the health and care system in Bury we would like to extend our sympathy to the family of the deceased.  We would like to assure the Scrutiny Committee that colleagues at Fairfield General Hospital have maintained close contact with the family at this difficult time and we understand that the family were very appreciative of the care that delivered.

A member thanked officers for increased communication and another member complimented the rapid response team.

Discussions took place regarding the understanding officers had on re-admission rates. Members were informed  ...  view the full minutes text for item HSC.8

Adrian Crook, Director of Adult Social Care to present. Report attached.

Adrian Crook, Director of Community Commissioning provided an update on the Adult social care reforms. On 1st December 2021, a White Paper on the future of adult social care was published. The policy components of the reform reflect the transformation currently underway in Bury: improved housing options, assistive technology, a commitment to the workforce, sustainability of the care sector and greater choice and control for our residents.

Bury awaits further updates but will plan and prepare for what the paper sets out which is ambitions in technology, housing and adaptations. None of us want to be dependent on it.

Discussions took place regarding plans for more staff with the budget constraints, in response members were informed there is still modelling taking place regarding the number of staff required but the additional money should be able to fund the staff required.

Councillor FitzGerald, Chair asked for a further update to come back in July 2023.

Councillor FitzGerald to provide an overview of the recent establishment of the following two task and finish groups covering, Social Isolation and Loneliness and Carers.

EdenfieldThe Chair, Councillor FitzGerald thanked Andrea Tomlinson for the support she has provided to the task and finish groups.

The two groups have now had their first meeting which set the scope of the group. One of the groups is about Carers and following the first meeting it was felt young people were missing from the conversation therefore the plan is for the next session to invite the chair of Children and Young People Scrutiny and the Cabinet Member for Children and Young People. The meeting also covered discussions about the positive effects of Communities identifying support needs and how to engage with people who do not have a community network.

The second group covered Social Isolation and Loneliness and it was evident following discussion that young people are not considered much under this topic.  There is a current steering group that has Councillor involvement which is currently being reviewed. It was discussed how often, faith-based groups are better at spotting signs of social isolation and loneliness and it may be useful to invite some groups to meet with the task and finish group.

Councillor Tariq, Cabinet Member for Health and Wellbeing informed the Committee that recently a Greater Manchester Integrated Care Partnership took place in Bury and the discussion was loneliness and isolation. It reported that each locality needs to have a scoping exercise to pick up the signs of vulnerable residents. 

Councillor FitzGerald also updated members following the private briefing members received on Edenfield. Councillor FitzGerald did advise a further update will be organised as and when necessary. In addition, members were informed that Councillor FitzGerald did discuss this matter with the Chair of the GMCA Health Scrutiny and it was agreed that it won’t be reviewed on a GM level until there is a conclusion to the police enquiry.