To receive an update from the Council’s representative on matters considered at the last meeting. 

23.1          Members received an update from the Council’s representative on the Gloucestershire Health and Care Overview and Scrutiny Committee on matters discussed at the last meeting held on 10 July 2018.

23.2           The Council’s representative advised that it had been confirmed that Gloucestershire would become one of only 14 Integrated Care Systems (ICS) in the country; the county had been given a huge vote of confidence and was praised by the NHS England Chief Executive for providing strong leadership and effective partnership working.  An ICS for Gloucestershire would mean: an even greater focus on supporting people to stay healthy and independent; local people with long term conditions should see more joined-up care and support in their own homes; greater freedom to make local decisions about services; and, the ability to attract additional money. 

23.3           The Committee had been pleased to welcome the Chief Operating Officer from the Gloucestershire Care Services NHS Trust (GCS), the Clinical Lead Therapist from the Gloucestershire Clinical Commissioning Group (GCCG) and the Consultant Physician in Stroke and General and Old Age Medicine at Gloucestershire Hospitals NHS Foundation Trust to discuss the clinical case for change for bed-based stroke rehabilitation.  The Committee had been concerned about performance against stroke targets for some time and the clinical evidence supporting the change was clear that creating a centre of excellence for stroke patients in Gloucestershire was the best way forward for patients.  It would deliver benefits to patients’ health and reduce social care needs and would be staffed in line with national guidance from the Royal College of Physicians and the Stroke Association.  The options appraisal that had been undertaken had identified the Vale Community Hospital in Dursley as the preferred location.  The question was posed as to whether the service development would adversely affect the number of beds available across the county and the Chief Operating Officer from the Gloucestershire Care Services NHS Trust had discussed the bed modelling that had been undertaken which demonstrated that there would be no adverse impact.  The GCCG and GCS had not identified the proposal as a substantial variation and therefore the Committee did not have a statutory role, instead it had a significant role as a critical friend.  All Members of the Committee had been fully supportive of this proposal as it was clear that moving to a community setting was significantly better than trying to deliver a comprehensive stroke rehabilitation regime in an acute hospital setting. 

23.4           The Director of Adult Social Services had informed the Committee that overall performance was good; however, performance relating to carers and self-directed support was not where it needed to be.  A report was being taken to Gloucestershire County Council’s Cabinet on 18 July 2018 with regard to the procurement of a new carers’ contract and, within this context, consideration had been given as to how this funding could be made more widely available.  Some Members had expressed disappointment that not all of the data in this report – or the public health report which was discussed later in the meeting - was up-to-date;  it had also been stated that the structure of both reports made it difficult to understand the overall performance picture. 

23.5           With regard to the public health report, the Committee had been advised that there continued to be a positive trend against performance targets in the Healthy Lifestyle Service.  Performance relating to NHS Health Checks had fallen in quarter three, although it was still above the regional and national average based on the latest available data.  Some Members had indicated that it would be helpful to receive a wider range of public health indicators e.g. immunisation data.

23.6           The GCCG report had shown significant use of Emergency Departments by people with minor conditions over the last month – this was disappointing given the increase in the primary care offer, including availability of appointments both during the week and at weekends.  It was agreed that it would be more informative for the Committee to receive a breakdown of the Accident and Emergency data between sites, as opposed to performance for the Trust as a whole.  It was also noted that performance against cancer targets remained a concern, particularly the two week wait.

23.7           The Chair thanked the Council’s representative for her report and it was

RESOLVED          That the Gloucestershire Health and Care Overview and Scrutiny Committee update be NOTED.