Agenda and draft minutes

The evacuation procedure was noted.

There were no interests declared.

To approve the minutes of the last meeting held on 22 April 2025.

Consideration was given to the minutes from the Committee meeting held on 22 April 2025.

AGREED that the minutes of the meeting on 22 April 2025 be approved as a correct record and signed by the Chair.

Representatives of NTHFT will be in attendance in order to outline performance against the Trust’s quality priorities for 2024-2025 and inform the Committee of the emerging priorities for the next year.

Representatives of North Tees and Hartlepool NHS Foundation Trust (NTHFT), supported by University Hospitals Tees personnel, were in attendance to provide their annual presentation to the Committee on the organisation’s Quality Account, a document which NHS Trusts had a duty to produce each year.  The draft NTHFT Quality Account document had also been shared prior to this meeting and was included within the papers.

The initial section of the presentation focused on the formation and development of the ‘Group’ model (a formalised partnership approach between NTHFT and neighbouring South Tees Hospitals NHS Foundation Trust (STHFT) which had culminated in the establishment of the ‘University Hospitals Tees’ framework).  Group ambitions for patients and staff were outlined, as were nine Group quality priorities for 2024-2025 which covered the three key headings of ‘Patient Safety’, ‘Clinical Effectiveness’, and ‘Patient Experience’.

NTHFT performance during the 2024-2025 period was then reflected upon, features of which included:

·       Infection Rates: Hospital-onset healthcare-associated cases for MSSA (36), Klebsiella species (22), MRSA (3), and C Difficile (60) had all increased compared to the previous year (2023-2024).  Community-onset healthcare-associated cases and community-onset community-associated cases had all decreased for these same four infections (aside from community-onset healthcare-association cases of MRSA which had remained the same (2)).  Like all Trusts across the country, NTHFT was focusing on infection control measures to reduce these rates.

·       Summary of Improvements: A range of improvements in relation to events (safety-associated; cardiac arrest reviews), patient experience (complaints; compliments; claims), Medical Examiner feedback (an area which had significantly expanded since 2021), and surveys (national inpatient, cancer and Friends and Family Test results) were highlighted.  It was noted that the Trust had a responsibility to respond / react to the feedback it received (both good and bad).

·       Urgent and Emergency Care: A chart illustrating A&E flow demonstrated a very positive picture across each stage of the urgent and emergency care pathway.  NTHFT had performed better than regional and national averages for several measures including lower conveyance rates, shorter handover times, lower mean waiting times, front-door streaming (reducing crowding), fewer 12-hour waits, and lower ‘no criteria to reside’ rates and shorter 1+ non-elective lengths of stay (increasing bed availability).  The Trust recognised that all its departments (not just A&E) played a significant role in these achievements, with performance against the 4-hour standard wait target ranking NTHFT as the third best Trust in the UK.

Despite these successes, the Trust had identified a number of action points to further enhance patient flow – these included the recruitment of GP registrar trainees, a review of staff-to-patient ratios across urgent treatment centre sites, and a focus on streaming (ensuring the patient was in the right place first time).  The issue of security was also noted, with the Trust experiencing a further increase in the number of cases of abuse towards its staff, something it had a zero-tolerance to.

·       Summary Hospital-level Mortality Indicator (SHMI): NTHFT continued to perform well on this indicator, with the Trust remaining in a  ...  view the full minutes text for item ASCH/12/25

Following a recent Committee request, representatives of Norton Medical Centre were in attendance to provide a response to the latest Care Quality Commission (CQC) inspection of its services.  NHS North East and North Cumbria Integrated Care Board (NENC ICB) personnel were also present and made the following initial statement:

‘In the context of the NHS in England, the Integrated Care Board (ICB) oversees the commissioning of health services, while the Care Quality Commission (CQC) regulates the quality of those services, including general practices.

The ICB has duties to ensure that commissioned services meet the CQCs standards and to respond to CQC assessments and concerns.

When any practice receives an adverse rating from the CQC, the ICB is notified and asked to carry out its own investigation under the terms of the GP contract.  The ICB is required to issue either a Quality Improvement Plan or a contract Remedial Notice to any practice that receives ‘requires improvement’ or ‘inadequate’ ratings.  The practice must demonstrate and provide evidence of improvement where concerns have been identified, therefore the ICB work with both the practice and CQC closely to ensure actions are taken to address any areas identified.’

Led by a GP Partner from Norton Medical Centre and supported by the Practice Manager, a presentation (circulated in advance and included within the meeting papers) was given covering the following:

·       Practice profile

·       Pre-inspection preparation

·       Post-CQC inspection outcome

·       Key themes identified in CQC report

·       Support received

·       Next steps

·       Supplementary information: CQC inspection ratings and areas of positive practice identified

The practice had been inspected routinely over several years, with its previous overall rating being ‘Good’.  It was advised ahead of the CQCs latest visit that an inspection was planned to look at two domain areas: ‘Responsive’ and ‘Effective’.

The inspection took place on 12 July 2024, after which the CQC requested further documentation and evidence.  Following the inspection, the practice was advised that the CQC would be issuing a notice of decision on 15 October 2024 in relation to Regulation 12 (Safe care and treatment), as well as a warning notice on 8 November 2024 in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance).  The regulator was not assured that there was a safe system in place to triage service-users safely and found the practice lacked oversight of significant event monitoring.  The practice was disappointed by the findings which it felt did not reflect the hard work of practice staff, and it was noted that the practice had been living with this for some time even though the CQCs report was only published in March 2025.

An Action Plan in response to the inspection findings was agreed in conjunction with the CQC and the ICB and was included in the presentation for information – this demonstrated the issues identified by the regulator across each of its key domains, the action taken to date, and planned actions for the future.  Specific achievements highlighted included the introduction of a new care  ...  view the full minutes text for item ASCH/13/25

Consideration was given to the Health and Wellbeing Board forward plan and the minutes of previous meetings which took place in January and February 2025.  Attention was drawn to the following:

·       29 January 2025: Item 3 of these minutes recorded a presentation and discussion points in relation to a Pharmaceutical Needs Assessment update (this topic was subsequently considered by the Committee in February 2025).  The January 2025 meeting also included items on the Joint Strategic Needs Assessment (JSNA) and the Joint Stockton-on-Tees Health and Wellbeing Strategy (the final refreshed version covering the 2025-2030 period was approved by Cabinet in February 2025, though this was yet to be uploaded to the SBC website under ‘Our Plans’).

AGREED that the forward plan and the minutes of Health and Wellbeing Board meetings which took place in January and February 2025 be noted.

CHAIR’S UPDATE

The Chair had no further updates.

WORK PROGRAMME 2024-2025

Consideration was given to the Committee’s current work programme.  The next meeting was due to take place on 17 June 2025 where the next CQC / PAMMS quarterly report (Q4 2024-2025) would be presented.  It was also confirmed that the PAMMS Annual Report (Care Homes) for 2024-2025 was currently being prepared for consideration at the June 2025 meeting.

In other work programme matters, the recent in-depth Reablement Service review remained paused following the Committee’s agreement to defer its final report at the last meeting in April 2025 (the outstanding information requested by the Committee would be circulated once received).  Initial planning meetings regarding the Committee’s next in-depth review of Carers Support would commence in June 2025 with a view to presenting a draft scope and plan to the Members in July 2025.

The Committee was reminded about a number of email correspondences which had recently been shared, including:

·       Arrival Medical Practice and Riverside Medical Practice: Merger Outcome

·       Tees, Esk and Wear Valleys NHS Foundation Trust: (Draft) Quality Account 2024-2025 (any comments required by 23 May 2025)

·       North East Ambulance Service NHS Foundation Trust:(Draft) Quality Account 2024-2025 (any comments required by 23 May 2025)

·       Pharmaceutical Needs Assessment 2025: Live Consultation (responses by 22 June 2025)

Finally, it was noted that some communication issues had surfaced in the last six months in relation to the ongoing dialogue between North Tees and Hartlepool NHS Foundation Trust and the local health scrutiny function.  These were recently raised with the Trust’s Chief Executive who had since responded positively.

AGREED that the Chair’s Update and Adult Social Care and Health Select Committee Work Programme 2025-2026 be noted.