Agenda and draft minutes

It was agreed:

That Councillor Linda Robinson be confirmed as Chair to the Joint Health Overview and Scrutiny Committee for the 2021/20222 Municipal Year.

Members of the Joint 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 made at the meeting.

Members of the public present at the meeting are invited to ask questions on any matter relating to the work or performance of Pennine Acute NHS Trust. A period of up to 30 minutes is set aside for public questions.

There were no members of the public present to ask questions at the meeting.

Patrick Crowley, Chief Executive will provided Members with a verbal update, presentation attached.

Patrick Crowley, Chief Executive, Pennine Acute Trust gave a presentation updating the Committee on the progress made in relation to the Formal Transaction of Pennine Acute Trust.

It was reported that phase 1 of the Transaction had been completed on 1 April 2021 when services had been disaggregated as planned and Manchester University NHS Foundation Trust (MFT) had acquired North Manchester General Hospital by commercial transfer.

Phase 2 of the transaction which was the legal aspect was due to be completed on 1 October 2021 with the transfer of Oldham, Rochdale and Bury Care Organisations to Salford Royal NHS Foundation Trust (known as the Northern Care Alliance).

Pennine Acute NHS Trust would be dissolved.

It was explained that the Transactions are being delivered in order to:

•      Help support and complement local integrated healthcare plans

•      To better meet the population health needs of local communities

•      Strengthen community support

•      Deliver more care closer to home

•      Maximise the use of estates on the PAT footprint

•      Support acute hospital services

•      Strengthen the delivery of both acute and community based services

This will see:

•      Improved population health

•      Improved patient experience

•      Improved quality of care

•      Improved finances

•      Improved staff experience

•      Improved education and training

•      Improved operational performance

The actions required to conclude the Transaction were reported as:-

•      Formal consideration by NHS Improvement on 14 September

•      Formal approval by Salford Royal Trust Board and Council of Governors

•      Formal approval by MFT Trust Board

•      Formal approval by Pennine Acute Trust Board

•      Signature of the Transfer and Dissolution Orders by the Secretary of State

•      Transfer letters issued to staff

It was explained that the Transaction was  being implemented on an “as is” basis – no changes to services on Day 1.

The transactions were undertaken because Pennine Acute was seen as unsustainable.  Therefore, it has always been understood that post transaction the successor Trusts (MFT and NCA) will seek to reconfigure some services, drawing on the strength of their wider organisations.

Existing service provision is currently being maintained through service level agreements between MFT and SRFT with plans to gradually exit from many of these service level agreements, which will require further disaggregation of former Pennine Acute services, are being developed by the end of September.

It was explained that in many cases, disaggregation will relate to each organisation providing the full existing service themselves rather than relying on support through an SLA from the other Trust.

In some cases there may be a change to patient flow to other sites for some procedures but any changes to patient flows will be the subject of discussion with commissioners.

Where wider stakeholder consultation and engagement is required, this will be undertaken, including with the Health Overview and Scrutiny Committee(s) and Healthwatch.

It was explained that this Joint Health O & S Committee was originally established to scrutinise “Heathy Futures” and “Making it Better” in the early 2000s.

The Committee originally covered  ...  view the full minutes text for item 4.

Penny Martin Director of Operations at Bury Care Organisation gave an update one the work being done in relation to the Elective Recovery Programme.

It was explained that there was a lot of work ongoing in relation to recovery.

It was explained that the terms Elective Recovery and Transformation were being used together and the service was in the process of recovering and transforming to ensure that it came back better.

It was aimed that the Constitutional standards would be delivered back to where they were by 2025 through redesign and co -production.

The following areas were highlighted:-

Redesign of Pathways – working with patients in this area in particular advice and guidance. Also  the establishment of the PIFU – Patient Initiated Follow Up

Green Sites/Hubs had been established which were to protect surgical services from Covid – supporting the recovery agenda for the whole of GM.

Community diagnostic hubs - Rapid Diagnostics Centres  for cancer recovery. These were well established.

The need to ensure that patients who are waiting are ‘waiting well’. This was explained as clinically prioritising patients and providing them with Waiting Well packages. These provided support around self help and what the patient could do to help themselves.

Being well – promoting good heath and living well which also included preparing well before procedure and recovering well following one.

Clinical services were being carried out over 6 and 7 days rather than the traditional 5 to help support recovery. This did come with challenges but these were being dealt with.

The Theatre Excellence Programme had been established to offer surgical theatres more support to help them work across the 7 days as efficiently as possible.

Work was being carried out in relation to Standardisation in relation to booking services becoming more user friendly and patient-led and by using digital technology to deliver this service in a different way.

Work to engage with patients, staff and partners was being carried out to make sure that services were transformed as they recovered. It was explained that services were provided differently, quickly when the Covid 19 pandemic first hit and there were ways of working that were established which could be utilised going forward and lessons that were learned.

It was agreed:

That an update presentation would be brought to a future meeting of the Committee.

Representatives from the Northern Care Alliance will report at the meeting – update to include current patient numbers, a staffing update as well as an update on the future of the Northern Care Alliance.

Penny Martin, Director of Performance presented a performance update from the Northern Care Alliance in relation to Covid 19.

The timelines in relation to COVID-19 were set out from March 2020 to date.

The Northern Care Alliance were designated as lead provider to run the GM Vaccination Centre at the Etihad Campus and across GM. The teams have vaccinated over 314,000 people to date and also vaccinated many thousands of people at the hospital vaccine hubs in Salford, Oldham, Bury and Rochdale.

In total they have provided over 500,000 vaccinations.

The Number of COVID-19 vaccinations we have given in total (led by the NCA) were reported as :-

• 491,772 • Salford Care Org –54,628

• Oldham Care Org –70,118

• Bury Care Org –18,971

• Rochdale Care Org –32,337

• Etihad GM vaccination Hub -314,210

The Covid19 data in relation to the Northern Care Alliance was reported as:-

Covid Patients: • Since March 2020 across NCA the NCA have successfully treated and discharged 5,942 COVID patients safely back to their homes, many of whom were severely ill

The total number of Covid patients discharged from the NCA hospitals was:-

• Salford -1,973

• Oldham -1,839

• Bury -1,272

• Rochdale -149

It was reported that the following number of urgent operations (non Covid patients) had been carried out:-

• Rochdale Infirmary remodelled in April 2020 as a COVID-19 green surgical site so patients across GM requiring urgent & cancer-related operations can receive life-saving treatment

• More than 8,000 urgent (P2) and cancer related operations safely carried out at Rochdale

Maternity Care –babies born

• Visiting partners within maternity has been reduced at Royal Oldham since March 2020

• 7,436 babies have been safely born in NCA hospitals since start of pandemic

Covid19 – current NCA data

• During pandemic the NCA have been able to continue to provide essential/urgent services

• Much of diagnostics and urgent care services have been maintained

• The pandemic has tested resilience, capacity and resolve and new ways of working have been adopted.

• There has been an increased use of technology such as virtual wards and online clinics

• The NCA continue to treat a significant number of patients with Covid19 across its hospitals

The numbers of COVID-19 patients currently have in NCA hospitals as of 02/09/21 was reported at 133

Total patients currently in NCA hospital beds  as of02/09/21 was reported as 1,333

Current average Length of Stay (LoS) for Emergency inpatients (Aug 21) = 5.91 days

Current average length of stay for inpatients following elective care = 0 days on

It was reported that the NCA focus is on supporting staff to ensure patients are safe and receive the highest standards of care across acute and community services, particularly during high demand

The SCARF programme launched last year continues to offer psychological and emotional support, however, staff sickness absence and staffing pressures continues to be a challenge.

Current staff sickness absence levels for August 2021 was reported as:

Covid  ...  view the full minutes text for item 6.

For discussion.

The Committee Members were asked whether they felt that the Joint Health O & S should continue to meet going forward and those present agreed that the JHOSC should remain as and established Committee across the Bury, Oldham and Rochdale footprint.

It was agreed:

1.   That Bury, Rochdale and Oldham Councils would continue to meet as a new Joint Committee.

2.   That the Terms of Refence for the new Committee would be established and agreed by all 3 Councils.