Agenda and draft minutes

To receive any apologies for absence.

An apology for absence was received from Cllr Andrew Kerby.

To confirm the minutes of the meeting held on 14 January 2020.

The minutes of the meeting held on 14 January 2020 were confirmed and signed.

The Chairman added that following the discussion on the budget at the last meeting two recommendations had been forwarded to the Cabinet for consideration. One of these related to the inclusion of a health line in all future Dorset Council reports.  Work at a recent workshop had highlighted the need to ask the Council how this could happen.  This was being progressed.

To receive any declarations of interest.

Cllr Jon Orrell declared a disclosable pecuniary interest as a GP and confirmed that a dispensation was now in place.

Cllr Nick Ireland declared that he was  a Governors of Dorset Healthcare University NHS Foundation Trust and that his partner worked had a senior role at Yeovil and District Hospital.

To receive questions or statements on the business of the committee from town and parish councils and members of the public.

The deadline for submission of the full text of a question or statement is 8.30am on Monday, 2 March 2020.

Details of the Council’s procedure rules can be found at: Public Participation at Committees.

The Chairman had received a letter from Swanage Town Council and this is attached in the Appendix to the minutes.

Public statements and questions from Mr Barry Tempest, Mr Philip Jordan, Ms Debby Monkhouse, and Mr Chris Bradey were made at the meeting and these are attached in the Appendix to the minutes.

Future Changes at Dorset County Hospital NHS Foundation Trust

Members agreed that they needed to know more about future plans for Dorset County Hospital NHS Foundation Trust (DCH).  They asked that the Chief Executives from the Hospital Trust and the Dorset Clinical Commissioning Group (CCG) be invited to the June 2020 meeting to respond to questions and asked that a joint report be provided by them.  The Cabinet Portfolio Holder for Customer, Community and Regulator Services stated that he was the Council's representative on DCH's Board of Governors and would be happy to find answers to the questions raised.

Withdrawal of the Swanage Ambulance Car

The Chairman confirmed that assurance had been given previously that the Swanage Ambulance Car would not be removed, that 6 new ambulances would be activated in Dorset and that there was no intention to remove cover from the Swanage area.  Members were concerned about the withdrawal of the promised level of cover in Swanage as timely treatment could be crucial.  One member referred to an email he had received from the South Western Ambulance Service NHS Foundation Trust (SWAST) Chief Executive who had confirmed that the reduction in cover at Swanage was due to CCG funding coming to an end on 1 April 2020.  However, the number of ambulances in Dorset was to rise from 36 to 45 and he had suggested that one be stationed in Wareham and one in Dorchester.  The Chief Executive had offered to ask his operations team to attend a future meeting.

The Chairman would formally write to the Chief Executive of SWAST to ask him to account for this change and copy this to the CCG Chief Executive.  She would circulate any response received.  If the response was not adequate, she would invite the Chief Officers to come to a future meeting.

Merger of Poole Hospital NHS Foundation Trust and Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

The Chairman suggested that this item be scrutinised as a joint exercise with Bournemouth, Christchurch and Poole Council (BCP) and she asked officers to progress this as a matter of urgency.  One member suggested that the merger would be more beneficial to BCP residents and for this reason any scrutiny should be carried out by Dorset alone.  The Chairman reminded members of the recent guidance from the Minister that only responses from joint committees would be accepted as a full Dorset response.

It was noted that the deadline for comments on the merger was 12 March 2020 and that the Committee did not have enough information to comment at this stage. It was highlighted that anyone could respond to this consultation and that there would be further consultation  ...  view the full minutes text for item 34.

To consider any items of business which the Chairman has had prior notification and considers to be urgent pursuant to section 100B (4) b) of the Local Government Act 1972. The reason for the urgency shall be recorded in the minutes.

There were no urgent items.

One member asked for further information about Bournemouth, Christchurch and Poole Council's decision to withdrawal support for the ambulance access road to Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust.  The Chairman would ask the appropriate Cabinet Portfolio Holder to provide a briefing to clarify the situation.

Decision

That the Chairman ask the appropriate Cabinet Portfolio Holder to provide a briefing to clarify the situation.

To consider a report by the Interim Executive Director for People - Adults.

The Committee considered a report by the Acting Executive Director People - Adults which provided an overview of the progress made to date with Delayed Transfers of Care (DTC) and continuing areas for improvement.

The Chairman apologised for the report being written from Dorset Council's point of view as neither Dorset County Hospital NHS Foundation Trust nor the Dorset Clinical Commissioning Group had been given the opportunity to contribute.

Members noted that there had been a significant reduction in DTCs for Dorset residents and that the overall trend was downward.  However, even though Dorset's performance had improved, so had other local authorities, and Dorset remained in the bottom quartile.

The report gave details of performance against the Better Care Fund (BCF), Dorset Integrated Care System delays, causes of delays, Integrated Care system improvements and opportunities for further improvement. 

The main cause of delay was waiting for care packages to be arranged for people in their own homes, particularly if they lived in rural locations.  One of the measures to reduce delays was to plan patient discharge from the time they entered hospital, giving them choice where possible.  Some of this had been achieved through the realignment of existing resources with the Better Care Fund (BCF) being used to enhance the support people were offered. 

Members thought it would be helpful to see how Dorset compared with other rural local authorities and what they were doing to be in a better position than Dorset in order to improve Dorset's position. Officers explained that any improvement would be based on developing locality and community groups who could respond to people's needs and support them at home and a move towards a discharge to assess model of working in hospitals.

Whilst members recognised the improvements made, they highlighted the need for improvement in the provision of care packages at home and asked what measures were being taken to address this. Officers explained that a fundamental rethink of the home care market was needed given the difficulties of providing care in rural areas, the distances care workers traveled and the time involved.  A more outcome-based approach was needed and care providers were being asked to work with individuals to meet their needs. There was also a need to make care a viable work option for people, including young people, to develop community resources, and provide affordable and key worker housing.

Somerset seemed to have solved DTCs and their performance had dramatically improved but there was no information as to how this had been achieved.  Members noted that officers were currently working on a "dashboard" and asked that this be produced on a six-monthly basis. 

It was suggested that as Dorset had one of the oldest populations, a question for the 16 June meeting when representatives from Dorset County Hospital and the Clinical Commissioning Group would be present, would be whether too many hospital beds had been cut and whether the trend for more people to live to be over a hundred had reduced over  ...  view the full minutes text for item 36.

The following information reports have been received since the last meeting:-

Healthwatch Dorset draft Workplan 2020/21

Healthwatch Dorset is the county’s independent health and care champion.  It exists to ensure that people are at the heart of care.

Our dedicated team of staff and volunteers listen to what people across Dorset like about local health and care services, and what they think could be improved.  These views are then used to create our Workplan for the year, so a real difference can be made.

The Healthwatch Dorset Staff Team and Steering Group have drafted a Workplan for 2020/21 based on what people have told us this year, while also giving consideration to national and local priorities in health and social care.

·      Cancer Support Services in West Dorset – Healthwatch Dorset has been commissioned to work on this engagement project, finding out what local people who are living with cancer think of the support they receive. Our findings will influence a local Macmillan pilot project to begin in April 2020 and we will also be gathering more feedback at the end of 2020 to find out if people’s experiences have improved. More info here: https://healthwatchdorset.co.uk/how-would-you-improve-local-cancer-support-services/
 

·      Children & Adolescent Mental Health Services – as part of the CAMHS review this year Healthwatch Dorset will be gathering feedback from marginalised young people eg. children excluded from school, young asylum seekers, young people who are homeless etc. Our findings will feed into the Dorset CCG CAMHS review by gathering feedback from young people who don’t always have the loudest voice.
 

·      Access to Primary Care – one of the most common themes local people speak to us about is their access to primary care. This is a long term project for the year which will need more research, with consideration being given to disabled access, learning disability health checks, carers & older people. This project will also help Healthwatch Dorset develop stronger working relationships with Patient Participation Groups and Primary Care Networks.
 

·      Accident & Emergency Care – in October/November 2019 we worked on a national project, together with 5 other local Healthwatch, talking to people in Poole A&E about their experience. Our findings have helped to inform the national review of A&E performance measures and our local report will be published in February 2020. This year we plan to look at ways of working with Dorset County Hospital and Royal Bournemouth Hospital on patient experience in A&E, to help inform the planned changes to local services following the Clinical Services Review.
 

·      Transport – this is a key theme that local people raise with Healthwatch Dorset. This is a long term project for the year which will need more research and will take into consideration the need for clear and accessible information, disabled access, older people and rural communities. We will aim to work together with Public Health, the local NHS, both local councils, the voluntary sector and Healthwatch England on this project.

As an important stakeholder, we welcome your thoughts on our draft Workplan. This  ...  view the full agenda text for item 37.

To receive the Committee's work programme.

The Committee considered its work programme and agreed the following:-

Items for meeting on 16 June 2020

Physiotherapy Services

Dorset County Hospital NHS Foundation Trust Future Plans

Continuing Health Care

Item for meeting on 17 September 2020

Primary Care Networks - how they help people at a local level, how prevention at scale is working and how this can be monitored going forward

Noted

To move the exclusion of the press and the public for the following item in view of the likely disclosure of exempt information within the meaning of paragraph 3 of schedule 12 A to the Local Government Act 1972 (as amended).

The public and the press will be asked to leave the meeting whilst the item of business is considered.

There were no exempt items of business.