Agenda and minutes

There were no declarations of interest.

The minutes of the meeting held on 13^th September, 2017 were signed as a true record. There were no matters arising.

Presentation by Brenda Howard, University Hospitals Coventry and Warwickshire (UHCW)

The board received a joint presentation which provided an update on progress with the Better Health, Better Care, Better Value Maternity and Paediatric Workstream. Meghana Pandit, University Hospitals Coventry and Warwickshire (UHCW), Jo Dillon, Coventry and Rugby Clinical Commissioning Group (CCG) and Brenda Howard, Programme Director for the Better Health, Better Care, Better Value programme attended the meeting for the consideration of this item. Councillor Abbott, Cabinet Member for Adult Services was also in attendance.

The presentation informed of the national vision for maternity services, to implement Better Births by 2020/21 which involved establishing a local maternity system (LMS) with the same scope as the Better Health, Better Care, Better Value programme. The requirement to establish the vision and plan to implement Better Births in the LMS in October 2017 was highlighted. Guidance was available in two key documents – The National Review, Better Births and the West Midlands Neonatal Service Review.

The key proposals for Better Births were personalised care; continuity of carer; safer care; better postnatal and perinatal mental health care; multi-professional working; working across boundaries; and a payment system. Further information was provided on each of these areas. The vision, metrics and examples of 5 high impact changes of the West Midlands Neonatal Review were detailed.

The presentation set out the vision for the Local Maternity System as follows:

‘Work together to improve the health and wellbeing of mothers, mothers to be, babies and families in our local population, and our staff who provide the care’. The objectives were to implement Better Births; delivery of Saving Babies Lives Care Bundle; improving maternity safety and wellbeing; and implementing the recommendations of the West Midlands Neonatal Review. The key responsibility was to provide assurance to the STP Board that the Maternity and Paediatrics work stream was progressing well and would deliver the expected benefits in a timely manner. Reference was made to the early engagement that the CCG had undertaken between December 2016 and April 2017 and attention was drawn to the summary of the key findings.     

The key challenges presented by the Local Maternity System were engagement from all stakeholders; the workforce implications as a result of the need to offer choice to mothers regarding place of birth and continuity of care; establishing community hubs and the financial implications; implementing the recommendations of the Neonatal Service Review; and digital platform development.

The presentation concluded with the next steps for the work stream which included further service user and stakeholder engagement; the submission of the Local Transformation Plan to NHS England by 30^th October 2017; and the CCGs working alongside the LMS and establishing a Strategic Commissioning Programme Board to identify critical success factors and desired outcomes to transform maternity and paediatric services by 2020/21.  

Members raised a number of issues in response to the presentation and responses were provided, matters raised included:

·  A significant concern that the information provided in the presentation did not include all the information requested by the Chair, Councillor  ...  view the full minutes text for item 17.

Joint report / presentation

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

Simon Gilby, Coventry and Warwickshire Partnership Trust (CWPT)

David Eltringham, University Hospitals Coventry and Warwickshire (UHCW)

Steven Jarman Davies, Coventry and Rugby Clinical Commissioning Group (CCG) 

The board considered a briefing note and received a joint presentation which provided an update on the preparations for winter 2017/18 in order to manage pressures against health and social care including details on the key issues likely to impact on the system. David Eltringham, University Hospitals Coventry and Warwickshire (UHCW), Steven Jarman Davies and Glynis Washington, Coventry and Warwickshire Clinical Commissioning Group (CCG) and Tracey Wrench, Coventry and Warwickshire Partnership Trust (CWPT) attended the meeting for the consideration of this item. Councillor Abbott, Cabinet Member for Adult Services was also in attendance.

The briefing note referred to the requirement for the Coventry and Warwickshire A and E Delivery Board to submit a winter plan to NHS England identifying how the system intended to remain stable and resilient through the winter period. The plan was currently in draft form and would be developed through the Board prior to submission by 1^st December, 2017.

The Board were informed that in many ways pressures experienced at winter continued to be felt beyond the winter period itself with parts of the system remaining under sustained pressure throughout the year, with over 1,000 attendances at A and Es across Coventry and Warwickshire each day and 270-300 patients admitted to hospital each day as emergency patients.

Key priorities to be addressed were:

·  Working to ensure that there was enough capacity across health and social care

·  Ensuring the system delivered care at the most appropriate level for the needs of patients and supporting more people within the community

·  Redesigning the wider Urgent and Emergency Care system

·  Ensuring the system was prepared for dealing with common expected winter illnesses and severe weather events

·  Having an operational resilience network that enacted action plans at peak times through a robust escalation reporting management process.

The briefing note set out the key areas of learning from the previous year.

Reference was made to the key winter plan developments. A set of existing plans were already in place to support resilience over the winter period and further information including existing and additional action plans with delivery dates were set out in an appendix to the briefing note. Key elements to ensure resilience concerned: profiling of elective work and reducing bed occupancy; primary care provision; ambulance response; local authority; UHCW; flu campaign; communication; and system escalation. The plans for each of these areas were detailed.

The Board were informed of the key issues which could have a detrimental impact on the ability to sustain a resilient system which included Christmas and bank holiday demand; workforce capacity; weather and transport; overall risk management; and the Better Care Fund.

The presentation detailed the key priorities to be addressed in winter planning, highlighted the key areas of learning from 2016/17, and detailed the demand for A and E services. The key actions detailed in the winter plan also were set out along with the priorities for UHCW.

Members raised a number of issues in response to the presentation  ...  view the full minutes text for item 18.

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 including the arrangements for the workshop and formal meeting to be held on 18^th October.

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.