Agenda and minutes

There were no declarations of interest.

The minutes of the meeting held on 3^rd February, 2016 were signed as a true record. There were no matters arising.

Briefing Note of Coventry and Rugby System Resilience Group

The following representatives have been invited to the meeting for the consideration of this item:

Sue Davies, Coventry and Rugby Clinical Commissioning Group

David Eltringham, University Hospitals Coventry and Warwickshire

Veronica Ford, Coventry and Warwickshire Partnership Trust

The Scrutiny Board considered a briefing note of the Coventry and Rugby System Resilience Group which provided an update on the current challenges faced within the health economy and the management of these issues. The Board also received a presentation from David Eltringham, University Hospitals Coventry and Warwickshire (UHCW). Sue Davies, Coventry and Rugby CCG, and Veronica Ford, Simon Gilby and Carol Peckham, Coventry and Warwickshire Partnership Trust attended the meeting for the consideration of this item.

The briefing note referred to the delivery of the winter resilience plan and available resources; the recent system challenges and the contribution of the plan to manage these including Delayed Transfers of Care; and the next steps in relation to the Emergency Care Improvement Partnership (ECIP) and transformation programme.

In light of the additional challenges faced during the winter period, an annual winter resilience plan was developed to ensure actions were taken to address these issues. The 2015/16 plan included the following areas of activity aimed at supporting improved performance:

·  Communication, education and engagement

·  Infection control

·  Primary care access, prevention and self-management

·  Providing alternatives to hospitals

·  Hospital flow

·  Supporting discharge.

The Plan also included a continuation of a range of existing initiatives where they were demonstrating success plus some additional new investments. The Board were informed that the total financial resource available for winter resilience for 2015/16 was £2.859m which was a reduction from £3.6m the previous year.

Reference was made to the significant increase in demand for services which meant during the week commencing 25^th January the Trust was unable to admit significant numbers of patients from the Emergency Department. Escalation activity facilitated the discharge of over 300 people over a two day period, with a proportion of the winter resilience fund being used to secure additional social care capacity. Further details were provided on the Delayed Transfers of Care at the hospital.

Further information was set out on how local health and social care was working to deliver sustainable improvement through the development of one improvement plan. The next steps to support improvement were:

·  Piloting an Ambulance Service Accredited Urgent Care Centre taking up to 25 ambulances per day away from UHCW

·  Creating a single point of access to community services for secondary care

·  Running Integrated Neighbourhood Teams at scale with alignment with Frailty and Urgent Primary Care Assessment Centre Pathways to ensure a more seamless step up/ crisis community intervention pathway

·  Developing frailty services across the system so that they work seamlessly and effectively.

The presentation described the system performance for winter 2015/16, provided comment on the success of the winter resilience plan and described improvement activity being progressed across the Health and Social Care system.

The Board questioned the officer and representatives on a number of issues and responses were provided. Matters raised included:

·  Further details about the reduction in Government funding and the funding invested by the Health and Social Care system

·  Learning and new ideas from the three perfect week exercises  ...  view the full minutes text for item 60.

Report of the Director of Public Health

The Scrutiny Board considered a report of the Director of Public Health which provided an overview of how Public Health were working in partnership with colleagues across the Place Directorate to reduce health inequalities linked to the environment in Coventry. Information was provided about the impact of the physical and socioeconomic environment on health inequalities; the way the sections had collectively worked to reduce inequalities; the projects and initiatives that aimed to make a difference; and the planned next steps.

Reducing health inequalities was a key priority in the Council Plan and statistics from Public Health England indicated that health inequalities were reducing in Coventry.

The report referred to the Local Plan which had been prepared to guide how the city would grow and develop to help meet the aspiration for Coventry becoming a top ten city. A public health practitioner now worked alongside the planning policy team leading on embedding health and wellbeing across all aspects of the planning process including input into the Local Plan. The Plan now contained specific policy guidance on health and wellbeing. It promoted active travel, access to healthy food, improved housing quality, and adequate provision of green spaces and improvements to air quality.

Reference was made to the Cycle Coventry project where the Council had improved facilities for cyclists and pedestrians focusing on areas of deprivation in the southwest and northeast of the city. Additional funding from Public Health had enabled over 1,100 children and adults to access cycle training and bike maintenance sessions.

The Public Health Department was also working with the Place Directorate on a range of initiatives to increase the use of open spaces by people experiencing greater deprivation including investing in outdoor gym equipment for Swanswell Park and working with Warwickshire Wildlife Trust to operate a series of green gyms along the city’s river corridor, a physical activity programme through outdoor environmental work.

Other areas of joint work included initiatives to promote physical activity; working with Coventry University to deliver a range of interventions to contribute to healthier eating; support to households in fuel poverty; and the establishment of the Coventry and Warwickshire Air Quality Alliance.

Attention was drawn to Licensing and to the recent addition of a public health practitioner to represent the Director of Public Health to act as the public health lead on all alcohol licensing matters. The Board were informed that a number of new paragraphs had been added to Coventry’s Statement of Licensing Policy acknowledging that the Director of Public Health was now a Responsible Authority strengthening the inclusion of public health principles in licensing decisions.

The members questioned the officers on a number of issues and responses were provided, matters raised included:

·  Further information about what was being done in areas where there was an abundance of fast food takeaways and best practice from other local authorities

·  Further information about what could be done to improve the nutritional content of food being sold at fast food takeaways and the current number of these  ...  view the full minutes text for item 61.

All outstanding issues have been picked up in the Work Programme

The Scrutiny Board noted that all outstanding issues had been included in the Board’s Work Programme for 2015-16, Minute 63 below refers.

Report of the Scrutiny Co-ordinator

The Scrutiny Board noted their Work Programme for the current year.

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.