Agenda and minutes

The evacuation procedure was noted.

There were no interests declared.

To approve the minutes of the last meeting held on 19 December 2023.

Consideration was given to the minutes from the Committee meeting held on 19 December 2023.

AGREED that the minutes of the meeting on 19 December 2023 be approved as a correct record and signed by the Chair.

To consider submissions on this scrutiny topic from representatives of the Borough’s four Primary Care Networks (PCNs).

The fourth evidence-gathering session for the Committee’s review of Access to GPs and Primary Medical Care focused on contributions from the Borough’s four Primary Care Networks (PCNs).  Clinical Directors and / or Operational Leads for each PCN were in attendance to discuss their responses to the following key lines of enquiry:

• Awareness of any access issues within your PCN area: Several elements were having an impact on GP access – these included a post-pandemic backlog (for both physical and mental health problems), long waits for secondary care which was resulting in patients contacting primary care providers for support in the interim, and the loss of experienced staff and the subsequent lag in training new staff to fill this void (who, in the short-term at least, were unable to work at the level of those older professionals who had left general practice).  That said, PCN representatives also acknowledged improvements to access, some of which had come as a result of COVID-19 and the need to work in different ways – innovation, particularly through the use of technology, had led to the emergence of alternative pathways regarding access to services, though this in turn further increased demand which was very challenging to meet given the lack of an uplift in resources.  As such, waiting times were further compromised.

Further to a Committee query, it was confirmed that all PCN areas used the OPEL system to monitor pressures which individual practices were under – this enabled any critical needs to be identified, something which the Hartlepool & Stockton Health (H&SH) GP Federation could assist with in terms of its digital staffing pool (it was noted that H&SH did not charge more for these staff to provide assistance).  Members subsequently noted the focus on shortages of nursing staff.

Reflecting on the various access options outlined within the combined PCN submission, Members welcomed the range of mechanisms available, though also drew attention to the challenges faced by those who were not as technologically minded when it came to online services.  Regarding waiting times, the Committee was reminded that this was a national issue, and efforts to mitigate the impact of delayed contact with health providers had resulted in the ‘Waiting Well’ initiative (a programme offering targeted support to certain groups of patients waiting for treatment).

Reference was made to a previous evidence session where Members were informed about the difficulties in attracting professionals to the Tees Valley area.  One of the PCN Clinical Directors present, who was also a GP trainer, spoke of the challenges of getting practitioners with the right qualities into the region and noted that the training scheme was not overly appealing / rewarding (as such, it was stated that there had been a period when training places were undersubscribed).  The Committee heard that those people who had qualified were not always staying in the area, hence the need to look further afield for the skills required – it was subsequently reported that there was a higher level of international  ...  view the full minutes text for item ASCH/45/23

Consideration was given to the SBC Director of Public Health Annual Report 2022.  Introduced by the SBC Director of Public Health, the report contained the following:

•           Foreword (SBC Cabinet Member for Health, Leisure and Culture)

•           Introduction (SBC Director of Public Health)

•           Covid-19 in Stockton-on-Tees

•           Supporting our residents

•           Living with Covid-19

•           Looking Ahead

•           Progress in 2022/23

The Committee was informed that, under the Health and Social Care Act (2012), the Director of Public Health had a duty to prepare an independent annual report.  As a consequence of COVID-19, production of this yearly requirement had been interrupted as the Council sought to manage the impact of the pandemic.  This 2022 report aimed to capture an overview of key activity from a public health perspective since COVID-19 emerged.  It also sought to summarise the learning from this period from a public health perspective and describe some of the activity since (in response to this learning).

Members commended the structure and content of the report, though felt it would have been useful to include a specific section detailing the impact of COVID on young adults with a learning disability and acknowledging the support provided to help these individuals during this time.

Mindful that this latest version was marked ‘2022’, the Committee looked forward to considering the next annual account in the early part of the next (2024-2025) municipal year.

AGREED that the SBC Director of Public Health Annual Report 2022 be noted.

Consideration was given to the latest Regional Health Scrutiny Update report summarising developments regarding the Tees Valley Joint Health Scrutiny Committee, the Sustainability and Transformation Plan (STP) / Integrated Care System (ICS) Joint Health Scrutiny Committee, and the North East Regional Health Scrutiny Committee.  Attention was drawn to the following:

• Tees Valley Joint Health Scrutiny Committee: The last meeting was held on 15 December 2023 (note: the meeting was not quorate for some of the items considered) and included a presentation on community water fluoridation plans, a NHS dentistry update, non-surgical oncology outpatient transformation proposals, and a Tees Valley winter planning update.

During consideration of the work programme for the remainder of the 2023-2024 municipal year, the Committee requested an informal briefing on Tees, Esk and Wear Valleys NHS Foundation Trust’s (TEWV) use of restraint, a source of previous Member concern – this was likely to be arranged for late-February / early-March 2024.

The emergence of details of a proposed ‘Partnership Agreement’ as part of the ongoing development of the ‘Group’ model between North Tees and Hartlepool NHS Foundation Trust (NTHFT) and South Tees Hospitals NHS Foundation Trust (STHFT) led to an informal (remote) Committee meeting being hastily arranged.  This took place on 2 November 2023 to allow Members to consider and comment on these developments / proposals – a statement on behalf of the Committee was then submitted back to the ‘Group’ for consideration by the Joint Partnership Board as part of its final ratification of the ‘Partnership Agreement’ (which was due to be agreed on 15 November 2023).

• Sustainability and Transformation Plan (STP) / Integrated Care System (ICS) Joint Health Scrutiny Committee: No further developments regarding this Joint Committee since the previous update in October 2023.  In related matters, North East and North Cumbria Integrated Care Board (NENC ICB) guidance on staying well and assisting services during the current cold season, information on a festive safe sleeping for babies campaign, and details regarding NTHFT leading an initiative to promote careers in health and social care were relayed.

• Changes to Health Scrutiny Arrangements: Attention was drawn to the impending introduction of new health scrutiny arrangements would come into force from 31 January 2024.  The main focus of the changes was the removal of the power of health overview and scrutiny committees (HOSCs) to formally refer matters of concern relating to major service reconfiguration to the Secretary of State.  Instead, the Secretary of State may act proactively, further to a request that he or she may receive from anyone – although such action would be subject to consultation with the HOSC, amongst others.  Guidance had been produced summarising these changes and was included within the papers for this meeting.

AGREED that the Regional Health Scrutiny Update report be noted.

Chair’s Update

The Chair reminded Members about the need to familiarise themselves with the forthcoming changes to health scrutiny arrangements (as outlined within the previous Regional Health Scrutiny Update item).

Work Programme 2023-2024

Consideration was given to the Committee’s current work programme.  The next meeting was due to take place on 20 February 2024 and was scheduled to feature the Teeswide Safeguarding Adults Board (TSAB) Annual Report 2022-2023, a related SBC safeguarding report, the latest CQC / PAMMS quarterly update (Q3 2023-2024), and the next evidence-gathering session for the ongoing Access to GPs and Primary Medical Care review.

Reference was made to the recent request for suggestions for Committee visits to frontline services – Members were encouraged to forward any proposals by the end of the week (26 January 2024).

AGREED that the Chair’s Update and Adult Social Care and Health Select Committee Work Programme 2023-2024 be noted.