Minutes:
The Chair welcomed to the meeting the following from Hywel Dda University Health Board – Mrs Bernardine Rees (Chair), Mr Steve Moore (Chief Executive), Helen Annandale (Head of Physiotherapy and Carmarthenshire Therapies Lead), Bethan Lewis (Head of Nursing at Glangwili Hospital) and Lisa Davies (Principal Project Manager). They had been invited to the meeting to give a presentation on Transforming Clinical Services – Post Consultation and Next Steps.
The Committee thereupon received a presentation providing an overview of the Transforming Clinical Services Consultation Closing Report.
The report consolidated the work undertaken as part of the public consultation that took place from 19th April to 12th July, 2018. Key items presented included:-
· Programme background
· Summary of findings
· Key themes
· Conscientious consideration
· Recommendations to the Board
· Next Steps
The presentation was followed by a question and answer session during which the following questions / observations were raised:
· Asked what the anticipated timescales and cost would be for delivering the new facility, the Committee was advised that there is a sense of urgency to deliver the new facility as there are concerns about the current system, however, at this stage confirmation of cost and timescales could not be provided. The full business case may take a few years for completion and until this has been completed the funding could not be secured;
· Asked if the Trust had applied for Welsh Government funding for integration and transformation. Advised that the Trust is currently in the last stage of the bid and had been working closely with Social Care and 3rd sector organisations. The trust re-affirmed their commitment to working across the various public sector services and that they will focus on the need to be a ‘care organisation’. The trust is working closely with ABMU and gave assurance that negotiation will consider the best interests of patients;
· Asked if it would be practical to consider having a medical school attached to any new hospital, the Committee was advised that a lot of training is already undertaken at the existing facilities. Opportunities at the Wellness Village will significantly improve options in that regard;
· Asked about the location of the new facility and how this can be justified to the population. Advised that as the service is currently spread over several sites, the expertise is therefore spread out too and causes problems with staffing and rotas. By bringing all the services together at one location it should improve the work/life balance for staff and will also make it easier for patients to access specialist services such as neurology. The need for improved infrastructure to make the new facility accessible to all is recognised and is a challenge that will have to be addressed;
· Asked what plans are in place to address winter pressures. Advised that the Health Board will be meeting next week to discuss plans and make sure that they are prepared to face the pressures. Flu vaccination programme and social care/domiciliary care to help with the flow. £2m funding has been received from Welsh Government for winter planning;
· Reference was made to transport and travelling and to the presentation the Committee received earlier on Country Cars and the question was asked if the Board intended to using the 3rd sector more. Confirmed that they are working with the 3rd sector, however, trying to redesign things and placing the emphasis on trying to bring people into hospital less and only bring those people to hospital that really need to an focus on making sure that they have the care they need;
· Reference was made to the widespread problem people are experiencing in trying to get through to their surgery to make an appointment and it was pointed out that if people could be seen by their GP then perhaps less would go to the hospital. The Board was asked if there were any plans to address this problem. Advised that this is exactly what the Board is trying to do by creating a social model. Unfortunately, there will never be enough GPs and people more often than not don’t need to see a GP, they need to see a nurse or a physiotherapist. There are some great examples of this model which will be rolled out;
· Asked what the Board was doing to reduce the cost of agency staff. Advised that the Board had the highest cost in Wales but since introducing a cap for expenditure on agency staff it has seen the highest reduction across Wales;
· Asked about the possibility of integrating health and social care so that there is some sort of career progression for care. Advised that this is where modular training comes in “Grow Your Own” and the Wellness Village will have huge potential in this regard;
· Asked where the Board is with regards to IT infrastructure and what are they trying to achieve. Advised that there is a national debate with regards to IT and how to deliver. Need to look at the best use of digital technology. Need to spend time with clinicians and the public to find the best way forward. It is early days and there is a need for an all Wales debate but the aspiration would be for an electronic patient record.
The Chair thanked the representative from the Hywel Dda University Health Board for attending the meeting and for an informative presentation. The Chair acknowledged that there is a lot of work to achieve, however, integration is the way forward.
DURATION OF MEETING
At 1.00 p.m., during consideration of the above item, the Committee’s attention was drawn to Corporate Procedure Rule 9 “Duration of Meeting” and the fact that the meeting had been underway for three hours and it was
UNANIMOUSLY RESOLVED that Council Procedure Rules be suspended to allow the remaining items of business on the agenda to be considered.