To receive apologies for absence.

Apologies were received from Councillors David Minnery and Nick Bardsley.  Councillor Roy Aldcroft substituted for Councillor Bardsley.

Members are reminded that they must declare their disclosable pecuniary interests and other registrable or non-registrable interests in any matter being considered at the meeting as set out in Appendix B of the Members’ Code of Conduct and consider if they should leave the room prior to the item being considered. Further advice can be sought from the Monitoring Officer in advance of the meeting

None were declared.

To consider the minutes of the Health and Adult Social Care Overview and Scrutiny Committee meeting held on 16^th May 2022 (Attached).

The minutes of the meeting held on 15 May 2022 were confirmed as a correct record.

To receive any questions, statements or petitions from the public, notice of which has been given in accordance with Procedure Rule 14. The deadline for this meeting is 5pm on Tuesday 5^th July 2022.

A member of the public, Catriona Graham, had submitted a question on awareness around the proposals for a Health Hub in Shrewsbury and future consultation.

The full question submitted and response read out by the Chairman is attached to the web page for the meeting:  Public question 11 July 22

To receive any questions of which Members of the Council have given notice.  The deadline for notification for this meeting is 5.00 p.m. on Tuesday 5^th July 2022.

Councillor Bernie Bentick also asked a question about engagement to date around the proposed Shrewsbury Health and Wellbeing hub and the need for a robust public consultation if proposals were taken forward.  The full question and response provided is available from the webpage for the meeting:  responses to Qs HASOSC 11 July 22.pdf (shropshire.gov.uk)

Councillor Bentick also asked a question regarding future provision in each of the Shrewsbury locations which would be vacated by their GP practices moving into one hub site and the Chair said that the committee would be considering the Integrated Impact Assessment of any proposals and proposed mitigations

To include the work programme topics and an update from the 5 July 2022 meeting covering Urgent Care

Councillors Charmley, Halliday and Kidd reported on the JHOSC meeting held on 5 July 2022 which had considered the Winter Plan and Urgent and Emergency Care Improvement Plan.  The Director of Delivery and Transformation  of the Integrated Care System had attended and responded to questions from Committee members on matters including recruitment and retention, workforce and the 9% of patients who were discharged but returned to A&E within a week.  Members heard of plans to improve the discharge process and about virtual wards but no timescales had been provided. The minutes of the meeting are available from here: JHOSC mins 5 July 22

·       To learn about the Fuller Report on integrating primary care and how it could inform the shape of services in the future.

Presentation from Emma Pyrah, Associate Director Primary Care and Tracey Jones, Deputy Director Partnerships - NHS Shropshire Telford and Wrekin    

Tracey Jones, Deputy Director Partnerships and Emma Pyrah, Associate Director Primary Care  were welcomed to the meeting for this item.  They provided a presentation on the Fuller Report which had been commissioned to provide recommendations on how newly formed Integrated Care Boards could support integration of primary care. 

The presentation ( attached to the web page for the meeting: Fuller Report Presentation ) included information about the background and scope of the report; its vision; challenges around access and continuity; the four key areas of intervention to address these; and feedback on the report from the Royal College of GPs.  Simon Whitehouse, Shropshire and Telford & Wrekin Integrated Care Board, had contributed to the report and endorsed the recommendations presented to government.  A response was now awaited but the Board would be setting out local implementation plans to begin working towards the vision.

In response to the presentation, Members made comments and asked questions in relation a wide range of issues including: the current status of the report; definitions of Integrated Care Board and Integrated Care Partnership; what the ‘Core 20 plus five approach’ would mean for Shropshire; the digital issues in rural parts of county; workforce issues, including general practice and pharmacist recruitment; the BMA’s withdrawal of support for Primary Care Networks ; utilisation of available space, eg, at Bishop’s Castle Community Hospital; and the need for focus on obesity, a major factor in premature death; long waits to access GP surgeries by telephone and lengthy waits for appointments. 

In explaining what the ‘Core 20 plus five approach’ would mean for Shropshire, the Executive Director for Health and Wellbeing explained that the approach was designed to support integrated care systems to drive targeted action for health qualities improvement. In Shropshire rural population groups were experiencing poorer than average health outcomes and this approach meant they would benefit from a tailored approach for key clinical areas.  Committee Members said it was imperative that local Members and parish councils be involved in any neighbourhood work, in particular, identifying specific needs in very rural areas.

Members felt that the engagement with only 1,000 people was not likely to be a big enough or representative sample to base recommendations on and also expressed concerns about lack of reference to very rural areas in the report. 

Members also referred to the need to have easy access to dashboards of information that would mean progress or otherwise could be identified early on.

Tracey Jones thanked the Committee for the comments and questions and said she would feed these into the Integrated Care Board. 

·       To consider progress and plans with the Shrewsbury Health and Well-being Hub in Shrewsbury including outputs from focus group work, what has happened so far, and next steps along the project timeline.

Presentation from Emma Pyrah, Associate Director Primary Care and Tracey Jones, Deputy Director Partnerships - NHS Shropshire Telford and Wrekin    

Tracey Jones, Deputy Director Partnerships and Emma Pyrah, Associate Director Primary Care, NHS Shropshire and Telford and Wrekin, delivered a presentation providing an update on Shrewsbury Health and Wellbeing Hub on behalf of Edna Boamapong, Director of Communications and Engagement.  Members were reminded of the phases of the work as outlined at the May Committee meeting and updated on the engagement timeline so far. The presentation is attached to the web page for the meeting:  Health & Wellbeing Hub Presentation 

Members heard about the second phase of engagement including identification of key findings from six focus group meetings – the case for change was understood but there were concerns around travel, transport and traffic congestion issues; continuity of care; fears around impersonal experience; and the impact of the travel concerns on older people and people with disabilities.  The Groups had also contributed to identification of essential and desirable criteria.

Members also heard how the Equalities Impact Assessment would build into the iterative Integrated Impact Assessment (IIA) process and that proactive work was underway to engage with seldom heard groups. 

The continued process of engagement would be open, with additional focus groups targeted at harder to reach audiences, and local councillors.   A stakeholder reference group had been established, with membership including Healthwatch, Patient Participation Groups, Members, and practice representatives and would help to determine the weighting for evaluation criteria once feedback from focus groups was finalised.  This group would also feedback on communications and engagement activity.  A leaflet for practices would be developed to aid patient engagement and to outline why practices have decided to be a part of the programme - these include rent/maintenance/space/extra services.

Members noted that the presentation slide on ‘engagement roadmap 2022 – 2024’.  should also include an update on the July Health and Wellbeing Board meeting. 

The following acronyms used within the presentation were explained:

AIC Assurance Involvement Committee – constituted of members of public representing different aspects of patient groups, who receive reports on engagement and communications activity; PCC Primary Care Commissioning Committee,

IIA – Integrated Impact Assessment; PCBC – pre-consultation business case – the business case that will be consulted on; OBC – outline business case

It was intended to return to the Committee ahead of the next formal phase to share findings to date, ahead of consultation with the public which was planned to take place between October and December and was likely to last 8 – 12 weeks.

Following the presentation members of the Committee raised concerns around the following issues:

·         The real upset for people who were worrying about how they would travel to the hub and about losing regular contact with their GP and primary care staff;

·         The hub appeared to being presented as the only option available, an experiment being directed by NHSE, without a ‘plan B’, and it did not appear that other solutions had been considered.  For example, ideas put forward in the Fuller Report included the joining up of estates across health and social care, perhaps even  ...  view the full minutes text for item 17.

• To receive a report updating on the three co-optee roles on the Joint Health Overview and Scrutiny Committee with Telford and Wrekin Council, and opportunities to hear from people with lived experience in Health and Adult Social Care Overview and Scrutiny Committee work.

Report from Tom Dodds - Organisational Performance Manager (Report attached)

Contact: 01743 258518

Tom Dodds, Scrutiny Manager, explained the role of the three voting Shropshire co-optees on the Joint HOSC Healthwatch Shropshire, proposals for their focus and proposals to utilise non-voting co-optees to take part in the Committee’s work as required by the work programme.

RESOLVED

To confirm the focus of the three different co-optee roles for the Joint HOSC as Healthwatch Shropshire; Patient Groups representative and clinical professional experience

To ask that expressions of interest are sought for the three co-optee roles on the Joint HOSC.

To identify opportunities from the work programme for non-voting co-optees to take part in the work of the HASCOSC, and confirm this approach should be taken.

To confirm the topics for the committee’s work programme identified at the work programming session on Friday 24 June 2022, and the agenda for the next meeting(s). This will also include outlining how the committee would like to work.

Tom Dodds introduced the work programme which had been developed following an online discussion of proposals.  The need to be clear on objectives of the topic, what value scrutiny would add and who would be needed to attend had been identified and further work at a future workshop session was planned to address this.  Some items had been identified as suited to briefing sessions rather than formal meetings. 

The Committee noted proposals to date. 

To note that the next meeting of the Health and Adult Social Care Overview and Scrutiny Committee will take place at 10am on Monday 19^th September 2022.

The next meeting was planned for 19 September 2022.