Agenda and minutes

To consider and approve the minutes of the previous meeting held on 03 February 2022, as a true and correct record of the proceedings.

Resolved:-

1.    That the minutes of the meeting held on 03 February 2022 be approved as a true and correct record of the proceedings.

To receive declarations of interest from Members in respect of items listed on the agenda.

Cllr Miro declared a disclosable pecuniary interest in respect of items 7 and 8 as an employee of Rotherham NHS Foundation Trust.

Cllr A Carter declared a personal interest in respect of item 7, as a close family member was a current service user.

To receive questions relating to items of business on the agenda from members of the public or press who are present at the meeting.

The Chair confirmed there were no questions from members of the public or press in respect of any items of business on the agenda.

To consider whether the press and public should be excluded from the meeting during consideration of any part of the agenda.

The Chair confirmed there was no reason to exclude members of the public or press from observing any matters of business on the agenda.

To consider a verbal update from Rotherham Healthwatch

Consideration was given to a verbal update presented by the Manager of Healthwatch in respect of recent trends and inquiries from members of the public.

Resolved:-

1.    That the update be noted.

To consider a presentation in respect of delivery of maternity services in Rotherham

Consideration was given to an update in respect of maternity services presented by the Deputy COO and the Head of Nursing and Midwifery of The Rotherham NHS Foundation Trust (TRFT). The update explained the recent journey and new approaches undertaken by the service in respect of continuity of care, as well a challenges, risks, and future goals for the service.

In discussion, Members requested clarification of the difference between numbers of women who book into the service versus those who give birth with the service. The response from the Head of Nursing and Midwifery was that many women book in because of the neighbouring catchments, and roughly one tenth may lose an early pregnancy. It was noted that efforts were made to market the success of the maternity unit to be able to make women feel more comfortable birthing in Rotherham. If births do go up at the unit, midwives will need to increase as well.

Further details were requested in respect of the six actions recommended by the CQC upon the recent inspection. The response described each of the recommended actions, indicating which were “must do” and which were “should do.” Timescales and progress in respect of each were described as well as which had been completed and signed off. Comparison with other similar units suggests these were not bad results at all.

Clarification around benchmarking of continuity of care operations as also requested. Targets and what would be required as far as midwife resource were described. It is estimated that in the region 100 midwives are needed, which is a lot of midwives. The model could not be run if maternity units were not safely staffed.

Further clarification was also requested around “complexity” of cases. It was acknowledged that it is known to practitioners which cases needed to be referred elsewhere, but many ambitions and workstreams had to be placed on hold during the pandemic, which was responsible for the percentages reflected in the report.

Assurances were requested around instances of particular conditions and risks associated with childbirth, as well as vital scores for babies immediately after birth. Details were provided in respect of how the unite performs in respect of each type of condition and assurances were given that the unit is not an outlier for infant brain injury.

Further assurances were requested around the wellbeing and retention of staff.

Details were given in regard to the Professional Midwifery Advocates and leads in each area who provide support for staff and safeguarding supervision. The continuity of care model would allow flexibility of scheduling for midwives which was believed to be attractive to the workforce in terms of fatigue. Working patterns were being examined with a view to getting the two models working well together.

Members requested further information around recruitment strategies.  Student placements had been increased, and the model whereby trainee nurses are paid is returning. This is not an immediate solution for the workforce. A big impact had been felt as a result of staff sickness.  ...  view the full minutes text for item 67.

To consider the response of Rotherham as a Place in respect of hospital discharge planning

Consideration was given to a presentation in respect of the response of Place Partners to discharge planning. The Deputy COO of The Rotherham NHS Foundation Trust (TRFT) and the Acting Strategic Director of Adult Care, Housing, and Public Health presented information around discharge policy and practice during the pandemic, entering the recovery phase and up to the time of reporting. The presentation described recent decision-making, milestones, challenges, risks and goals.

In discussion, Members expressed hopes that refinements could be made to the policy around To Take Out (TTO) prescriptions which have created delays at times for discharged patients who would otherwise be ready to leave the hospital. The response from the TRFT noted the current options and noted the potential for further refinement. This is an area that can be challenging for Trusts nationally. Various models had been considered and implemented to try to expedite TTOs. Future scrutiny on this topic was invited.

Members also expressed interest in efforts to prevent deconditioning of patients whilst in hospital, with a view to enabling them to go back to their own homes without requiring a higher level of care. The response from the TRFT representative described the work that had been done in this area and cited specialist innovations in reablement. The response was supplemented by the Acting Strategic Director, who described the approach to prioritisation of patients and the combined wraparound approach which has yielded improvements despite a challenging period in the last two years. The work with specialists had added considerable value within care homes.

Members requested further information around the availability of beds. The clarification was offered by the Acting Strategic Director, who illustrated that the beds were already in existence and the capacity that had always been there – the question to be established regarding capacity is who pays.

Members requested assurances that care could be delivered to patients without land lines in their homes. The response noted the analog to digital switchover had meant that there were not barriers associated with having or not having land lines.

Members further inquired around the provision for elective patients to help reduce their time in hospital. The response from presenters identified initiatives in place and offered further detail outside the meeting.

Members also expressed interest in the planning for when the time-limited funding stops. The response noted that the funding eased the pressures associated with the pandemic but the pressure would now return to baseline.

Resolved:-

1.    That the report be noted.

To consider and approve the updated scrutiny schedule of work

Resolved:-

1.    That the updated work programme be approved.

2.    That authority be delegated to the Governance Advisor in consultation with the Chair and Vice-chair to make changes to the schedule of work as appropriate between meetings, reporting any changes back to the next meeting for endorsement.

To consider any item(s) which the Chair is of the opinion should be considered as a matter of urgency.

The Chair confirmed there were no urgent matters requiring a decision at the meeting.

The next scheduled meeting of the Health Select Commission will be held on 7 April 2022, commencing at 5pm in Rotherham Town Hall

The Chair announced that the next scheduled meeting of Health Select Commission would take place on 7 April 2022, commencing at 5.00 pm in Rotherham Town Hall.