Agenda and minutes

There were no declarations of interest.

a) The minutes of the meeting held on 25^th July, 2018 were signed as a true record.

b) The Chair brought to the Boards attention that the Cabinet Members had responded positively to the recommendations made at minute 3.

Report of Andy Hardy, Chief Executive, University Hospitals Coventry and Warwickshire (UHCW)

(i)   Report to be presented by Andy Hardy, UHCW

(ii)   Update from Andrea Green, Coventry and Rugby Clinical Commissioning Group (CCG) on the Latest Position for Improving Stroke Services in Coventry and Warwickshire

The Board received a presentation from Andy Hardy, Chief Executive of University Hospital Coventry and Warwickshire, and Andrea Green, Coventry and Rugby CCG on the progress made on the Better Care, Better Health, Better Value Programme.

Andy Hardy explained that the purpose of the programme is to integrate organisations better to make patient pathways smoother. He explained that four of the areas in the West Midlands had been through a 12-week programme funded by NHS England with the purpose to accelerate progress.

Progress has been made in renewing the concordat, in strategic commissioning and provider alliances.

He also informed the Board that the programme had advertised for an independent chair to see whether this would be better at bringing in stakeholders. The recruitment process is underway.

The Board were provided with a high level progress report on all work streams of the programme including:

·  Proactive and Preventative

·  Planned Care

·  Urgent and Emergency Care

·  Maternity and Paediatrics

·  Mental Health and Emotional Wellbeing

·  Productivity and Efficiency

·  Digital Health

·  Estates

·  Workforce

·  Stroke configuration

·  Out of Hospital Service

Members questioned representatives on the following subjects:

·  Whether the programme will make a difference, with a move away from the “STP” label

·  Clarification on integrated governance

·  Issues in mental health services – especially children and young people services. Members welcomed steps being taken to bring partners together to look at what was going wrong in the system and how these could be addressed

·  Nursing staff supply and reliance on agency staff, including the impact of Brexit

·  Efficiencies in back office services and shared finance systems

·  Capacity within the system to cope with increased demand from increase in population

·  Clarification on the estates programme

·  High ambitions and low benchmarks in terms of digital health aspirations

·  Openness to change of senior staff and managers within the system

Andrea Green updated the Board on progress made with the Pathway of Excellent Stroke Services. The programme has been partially assured but there is still work to do, specifically in terms of impact on provider colleagues. The process has taken longer as end to end services have been included, not just acute service.

RESOLVED that:

The Health and Social Care Scrutiny Board should be provided with the following:

(1)  A named lead for each of the workstreams

(2)  Narrative on the individual workstreams

(3)  Milestones for all of the programmes.

Report of Andy Hardy, Chief Executive, University Hospitals Coventry and Warwickshire (UHCW) who has been invited to the meeting for the consideration of this item

The Board considered a presentation by Andy Hardy, Chief Executive of University Hospitals Coventry and Warwickshire (UHCW) on the recent Care Quality Commission (CQC) inspection report and action plan.

Andy Hardy explained that of 58 ratings given, 48 are good or outstanding, or the 12 core services rated, 10 are rated good and 3 out of 5. They received overwhelmingly scored goods, but overall were rated as “required improvement”.

There were 4 “must do’s” in the report which need to have a response within a month with an action plan.

The two core areas that were scored “not good” were Emergency and Critical Care. As a result, these services will come together in governance terms to support the move to “good”.

Andy Hardy expressed that there was a lot to be proud of in the report with some significant improvements over the last three years.

Members asked questions on the following areas:

·  Triage, especially for stroke victims and the difference in audit scores for Coventry and Warwickshire

·  Whether services are responsive. In a national context of stretched budgets what can be done?

·  Whether some of the criticism in the report reflect that national picture, that UHCW is no different to any other hospital in the country.

·  The qualifications of the inspectors

·  The out of hours service and issues with records

·  Whether issues with waiting times are about quality of care or more about administrative issues.

·  Whether there is a well-trained and adaptive work force

RESOLVED that:

(1) The Health and Well-being Scrutiny Board should visit to see some of the outstanding areas of work.

All outstanding issues have been picked up in the work programme

The Board noted that all outstanding issues had been included in their work programme.

Report of the Scrutiny Co-ordinator

The Board noted their work programme for the current municipal year.

RESOLVED that:

(1) Specific workstreams from the Better Care, Better Health, Better Value Programme be added to the work programme.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

There were no additional items of public business.