Meeting documents

To consider a report by the Transformation Programme Lead for the Adult and Community Services Forward Together Programme (attached).

The Committee considered a report that included annual reports on behalf of the Committee and also that of Healthwatch Dorset.  The Committee's annual report represented a formal record of discussions during the past year that would be shared with the Health and Wellbeing Board.  It was usual practice to consider the work programme for 2019-20 at this stage, however, it had been felt necessary to postpone this discussion until after March 2019 when the new Dorset Council would come into being.

The Manager of Healthwatch Dorset informed the Committee of the following current areas of interest to Healthwatch:-

·    Transfers of Care and the "Home from Hospital" project:-

This project would follow the experiences of individual people on discharge from hospital, the aim being to track the ongoing support that needed to be met and offer the perspective of the person's journey rather than the care pathway.  Soon to be discharged people had already been recruited in Bournemouth with Dorset County Hospital and Poole Hospital to follow in the New Year.  Healthwatch had found that people were very keen to talk to them and visits would be offered to a person's home or by telephone.  It was hoped that this would provide a wider picture of whether the packages of care were in place as well as the enablers and barriers.

·    Access to primary care services for people in care homes

Access to NHS services was a right of every citizen and this did not change for a person living in a care home.  However, the reality was that there were greater problems in accessing services from a care home.  Starting with dental services, Healthwatch had been in touch with every care home in Dorset to ask about this.  The draft report had been sent to NHS England who commissioned dental services as well as local authorities, the Dorset Care Homes Association and Partners in Care.  Responses to the report were due by Christmas 2018 and would be published alongside the report in January 2019. 

·    Young people's emotional health and wellbeing

Although there was no separate project at the moment, Healthwatch was keeping a watching brief and actively wished to support carrying through the recommendations from the Inquiry Day. 

·    Involvement of local people in the shape of future health care services in Dorset, relating to changes to services resulting from the Clinical Services Review (CSR).

The primary interest of Healthwatch was in local people having accessible information about the proposals for change and opportunities for people to have their say and for their views to be incorporated into the decision making process.  Healthwatch had offered regular support to NHS organisations over the past 4 years in consulting with the public.  There was general support for the direction of travel behind the proposals and also significant anxiety of the potential effect of the changes in some parts of the County that had resulted in campaign groups.  Whilst making no judgement on the views expressed, Healthwatch applauded them for organising themselves and giving a voice to local people.

·    Access to GP services for people with learning disabilities

This project was currently In abeyance as Healthwatch was looking for a partner to work with them in visiting GP practices to assess whether there was equality of access.

Members asked whether people who had already been discharged from hospital could participate in the "Home from Hospital" project and it was confirmed that they could become involved by using the contact details on the Healthwatch leaflet and website. 

It was further noted that there was a lack of understanding that people remained under the care of the hospital following discharge from hospital and that GP services were being called upon under "hospital at home".  It was known that not all nursing duties took place within care homes due to a lack of staff or equipment and that it was often cheaper for the care home to call a district nurse rather than train its own staff, which a member felt was an abuse of the system.  The NHS should charge the home for the services provided by the district nurse in nursing homes, however, often this did not happen.

Members highlighted that individuals could be put off from engaging in the CSR process by campaign groups with a wider political agenda and that anything that Healthwatch could do to encourage individuals to keep involved in the conversation would be welcomed.

It was confirmed that Healthwatch was interested in how the CCG would

get the involvement of the general public as there was a tendency for the silent majority, who were open to new ideas, to not be heard.  It was Healthwatch's view that this had been lacking so far and was more of an issue of communication and having accessible information rather than engagement.

The Chairman thanked Healthwatch for the report and asked that the issue that had been raised in relation to the use of primary care services in care homes be investigated as part of the project for access to primary care services for people in care homes.

Resolved

1.    That the content of the Dorset Health Scrutiny Committee Annual Report be noted and agreed as a true record of the work of the Committee from 1 April 2017 to 31 March 2018;

2.    That the Healthwatch Dorset Annual Report 2017/18 and work priorities for 2019 be noted; and

3.     That detailed discussions regarding the Committee’s work programme for 2019 be deferred until the first meeting under the new Dorset Council.

Reason for Recommendation

a)   To maintain a record of the work of the Committee and to provide a summary for those who are interested in that work;

b)   To support the role of Healthwatch Dorset and to ensure that the Committee was aware of the priorities identified; and

c)    To enable the Committee to fulfil its duties under the new Dorset Council after 1 April 2019.