Agenda and minutes

Members are asked to declare the existence and nature of any Disclosable Pecuniary Interests in respect of any item of business to be considered at the meeting.

No declarations of interest were made by councillors regarding items on the Agenda.

Daniel Elkeles, Chief Executive, Epsom and St. Helier University Hospitals NHS Trust, will be in attendance and will provide an update on the Trust’s latest performance and position.

Daniel Elkeles, Chief Executive, Epsom & St Helier University Hospitals NHS Trust was in attendance and provided an update on the Trust’s latest performance and financial position.

The Panel was reminded of the context of the Trust’s activities: one District General Hospital on two sites with a catchment of 490,000. The Trust served two health economies with two host clinical commissioning groups and comprised almost 5,000 staff and 600 volunteers. It was the fifth largest renal provider in the country and the very successful South West London Elective Orthopaedic Centre (SWELOC) was based on the Epsom Site.

Looking back at 2016/17, Mr. Elkeles highlighted the reduction in expenditure on agency staff which was currently the lowest in London and, in terms of performance, that the Trust was consistently delivering the four hour A&E target, regularly being number one in London and 7^th nationally.

Mr. Elkeles reported that, financially, the Trust ended the year in a better position than planned for.  The slightly lower than predicted deficit meant more to spend on patient care.

The Trust was also working hard to address the CQC rating of “Requires Improvement”. The Trust was originally committed to 300 actions, 40 of which were outstanding as of March 2017: Of these still outstanding actions, a number were connected with the Trust’s estate and would be extremely challenging to address.  It was anticipated that a re-inspection would take place in Q3 of this financial year.  In terms of providing consistently high quality care – accelerated by the CQC findings, a restructure of the leadership team had taken place with an emphasis on clinical leadership (from “Board to Ward”).  10% of consultants were now in leadership roles. The Critical Care Faculty set up in conjunction with St. George’s Hospital had proved a huge success and had resulted in the appointment of two new consultants.  Mr .Elkeles also highlighted the Vanguard “Red Bag Initiative” which was the equivalent of the Epsom and Ewell Health Care Alliance in the London Borough of Sutton. The initiative was having a huge impact on the quality of care of those admitted to hospital from care homes in that area.

Mr. Elkeles went on to highlight the previous fifteen years’ of strategic uncertainty that had faced the Trust and indicated that there would be announcement made shortly regarding the future beyond 2020.

In regard to the Trust’s estate, Mr. Elkeles was pleased to confirm that the Trust had been permitted to reinvest the proceeds from the sale of the Sutton site into a 72 week programme of backlog maintenance and improvements at St. Helier. Whilst this was good news, the disruption to patients was acknowledged.

In terms of improving services, it was highlighted that St. Helier was now home to a new Assisted Conception Unit, £500,000 had been set aside to improve cancer diagnosis and a new state-of-the- art contact centre had been installed.

Whilst the Panel welcomed the investment being made in the Trust, members were concerned that the  ...  view the full minutes text for item 2.

Representatives from Epsom Health and Care Alliance will be in attendance and will provide an update on the work of the Alliance.

The Panel received a presentation from Sonya Sellar, Mid Surrey Area Director of Adult Social Care, Surrey County Council, Dr. Hilary Floyd, Medical Director, GP Health Partners Ltd, Stephen Cass, Chief Executive Officer CSH Surrey and Daniel Elkeles on the work of the Epsom Health and Care Alliance.  The presentation set out to explain who made up the Alliance, what it had achieved in the last eighteen months and what it hoped to achieve in the coming year.

The partner organisations which made up the Alliance consisted of GP Health Partners Ltd, Epsom and St. Helier University Hospitals NHS Trust, CSH Surrey and Surrey County Council.  It had been established as a legal joint venture (or equal partnership) based on shared interests and vision to provide coordinated and integrated care to the 200,000 people registered at the 20 GP practices which together comprised GP Health Partners Ltd. It was considered important that the Alliance’s Vision and Values had been developed in conjunction with local residents and staff from across the partnership – there were no organisational silos.  In terms of governance arrangements, lay members were key; Surrey and Borders Partnership NHS Foundation Trust and the Borough Council also had places on the Board.

The work of the Alliance currently focussed on the frail and elderly over 65 and integration of care was at the heart of what the Alliance was working to achieve.  This saw a shift towards more preventive working, listening and responding to the needs of patients. The service was one of the first of its kind in the country.

There were several elements to the @home service pioneered by the Alliance.  Firstly, GPs had an opportunity to refer patients to the Community Assessment and Diagnostic Unit (CADU) for a multi-disciplinary approach to their needs. This team would thoroughly review an individual’s situation and needs and then arrange the required services, for example, for equipment to be delivered at home or for visits from nurses, physiotherapists, occupational therapists, community matrons or social care re-enablement assistants.  Secondly, an enhanced @home team could arrange rapid additional short-term support at home for people who ran the risk of becoming acutely unwell or who needed extra support after being discharged from hospital.  Finally, early discharge team on the wards assessed who could be assisted at home with the correct support negating the need for an unnecessarily prolonged stay in hospital.

It was considered that this approach had made a real difference with more people receiving better care, at home, people receiving care in the right setting and new ways of working as demonstrated by the following statistics:

·                     On average 3 patients remained at home and 3 brought home sooner each day;

·                     Equivalent 1 ward patient being actively looked after at home;

·                     Emergency admissions below 2015/16 (national increase 3-4%);

·                     People staying half a day less in hospital;

·                     Epsom Hospital achieved 4 hour Accident and Emergency target;

Staff felt part of one team and the challenge was now to grow the service.  It  ...  view the full minutes text for item 3.

The Panel is asked to confirm as a true record the Minutes of the meeting of the Health Liaison Panel held on 23 March 2017 and to authorise the Chairman to sign them.

The Minutes of the meeting of the Health Liaison Panel held on 23 March 2017 were agreed as a true record and signed by the Chairman.

The Panel to discuss a draft work programme (to follow).

The Chairman stated that he considered the mission or the purpose of the Panel was to influence work undertaken within the Borough Council to support the preventative healthcare strategy and the drive towards cutting hospital admissions, particularly amongst the frail and elderly.  He wished to position the Panel as an adjunct to the Community and Wellbeing Committee.

He informed the Panel that a Health Strategy paper was being prepared for the Panel’s November meeting prior to submission to the Community and Wellbeing Committee and that he would be looking at the Panel’s Terms of Reference to make sure that they were relevant and up-to-date, in particular the role of partner authorities.

The following work programme was intended to set out the scope of the Panel’s work.  It would help direct and maximise the Panel’s output and would be reviewed at each meeting.

There was some discussion about the appropriate time to put mental health services on the Agenda but it was considered that March 2018 would be appropriate based on current understanding of developments in this area.  It was requested that any consideration of mental health issues should also specifically encompass “Safe Havens” and suggested that mental health provision might be a suitable topic for a public meeting.  It was agreed that the Head of Housing and Community, in consultation with the Chairman, would review the work programme and re-circulate it to members of the Panel.