For the Committee to note the appointment of Councillor Mrs Aspinall as Chair, and Councillor Deacon as Vice Chair for the forthcoming municipal year.

The appointment of Councillor Mrs Aspinall as Chair and Councillor Mark Deacon as Vice-Chair was noted.

The Committee will be asked to make any declarations of interest in respect of items on this agenda.

The Committee will be asked to confirm if the minutes of 09/03/2022 are correct for the record.

The minutes of the meeting held on the 9 March 2022 were confirmed as a correct record, subject to the correction of a grammatical error.

To receive reports on business which, in the opinion of the Chair, should be brought forward for urgent consideration.

There were no items of Chair’s urgent business.

The committee’s terms of reference were noted.

Members of the Committee considered the Health and Adult Social Care Policy Brief.

Sarah Gooding (Policy & Intelligence Advisor). 

Members raised questions concerning-

a)    Better mental health support for people in crisis;

b)    Grant fund to support women's reproductive wellbeing in the workplace;

c)    Increased funding for nursing support in care homes.

In response to questions from members further information would be provided outside of the meeting. 

The Committee noted the report.

Tony Gravett MBE introduced the Healthwatch Annual Report to the Committee and highlighted the following key points-

a)    Citizens’ primary concerns regarded access to services such as NHS Dentistry, GPs, Mental Health services, Children’s services, & Urgent and Emergency Care, leading to low patient confidence;

b)    Healthwatch had undertaken numerous work-projects throughout the year to gather public experiences including face-face visits to the Emergency Department (ED), NHS 111 campaign effectiveness surveys, 111 non-emergency patient surveys, and mystery shopping work for Pathfields.

In response to questions from the Committee, it was reported that-

a)    The Covid-19 pandemic had caused a reduction in the diversity and quantity of Healthwatch volunteer staff. It was recognised that a recruitment campaign was needed;

b)    Patient surveys were being considered through a variety of media formats such as SMS, email, and social media, as well as a regular newsletter. A GP patient survey was currently being finalised with Healthwatch, Livewell Comms, and the Mayflower Group;

c)    While Healthwatch’s in Devon, Plymouth and Torbay did not have an active role in the patient complaint process, they offered sign-posting to numerous advocacy services.

The Chair thanked Mr Gravett for the report, and praised the efforts of Healthwatch volunteers.

The Committee agreed to recommend that the CCG/ HNS Devon recommission Healthwatch to repeat their survey of ED attendance, at a future date.

1)    111 and Out of Hours Primary Care

2)    Ambulance Handovers

3)    Admission Avoidance

4)    Same Day Emergency Care + Emergency Department

5)    Hospital Discharge

Dr Dafydd Jones (GP) & Jo Turl (Director of commissioning for NHS Devon) delivered a presentation on Integrated Urgent Care, 111, and Out of Hours General Practise, and highlighted the following points to the Committee-

1.    The Integrated Urgent Care Services (IUCS) currently provided by Devon Doctors were underperforming however, there were both short-term and long-term plans in place to resolve many issues;

2.    The 111 service suffered from a low call answering capacity due to unplanned absence, insufficient weekend establishment, high attrition rates and recruitment difficulties;

3.    The 111 service was however, effective at signposting and triaging to reduce unnecessary demand on 999 and the Emergency Department;

4.    There were contingency plans to enable national flexibility when regional call handlers reached capacity. This was now being used on a planned basis due to demand pressures;

5.    Plymouth had a comprehensive procurement plan in place for a long-term solution: From 1 October 2022, ‘Practise Plus Urgent Care Group’ (PPU) would be taking over the contract from Devon Doctors, bringing greater national capacity, flexibility, experience, and a rating of ‘outstanding’ for 111 call handling. 

The Committee welcomed the various measures enacted to improve Integrated Urgent Care Services. In response to questions raised by the committee, it was reported that-

1.    Devon Doctors were in ‘special measures’, with demand outstripping capacity however, the new provider (PPU) had enhanced capacity and flexibility in times of peak demand;

2.    Workforce and staffing issues were an ongoing national issue that did not solely impact on Plymouth;

3.    Temporary creative solutions were currently in place to bolster staffing including; flexible hours, incentive schemes, and the return of retired staff.

The Committee agreed it would prove beneficial to invite Dr Dafydd Jones & Jo Turl back once PPU had taken over from Devon Doctors in October 2022.

David Harper (County Commander SW Devon- SWAST), James Glanville (Head of Urgent and Emergency Care- NHS Devon), James Wenman (Associate director for Urgent Care), & Jo Beer (Chief operating officer- Derriford Hospital) gave a presentation to the Committee on ‘Ambulance Handovers’, and highlighted the following key points-

a)    Ambulance demand had reached unprecedented levels last summer, with over 400+ incidents per day, compared to 335 per day in April 2022, and 333 per day in May 2022. This had now returned to more expected levels;

b)    There were now significant delays in ambulance response times for category 1 and 2 calls, which correlated with increased hospital handover times. These handovers now regularly exceeded 3hrs and caused a significant reduction in the amount of patients seen by the ambulance service each day;

c)    Increased activity was not seen as a major factor driving increased response times in SW Devon, with 65% of patients managed without admittance to the ED.

Following questions from the Committee, it was reported that-

a)    There were specialist teams investigating patient safety incidents where unnecessary harm may have been caused by handover/ response delays.

The committee requested this data be brought to the next meeting;

b)    While there was currently  ...  view the full minutes text for item 8.

The committee noted that all tracking decisions had been actioned.

The Chair and Vice-Chair will lead a discussion of items on the work programme for the municipal year 2022/23

The Committee agreed that Primary Care, including pharmacy and dentistry, would brought to the next meeting on 07 September 2022.

The Committee agreed to add the following items to the work programme-

a)    Colin Campbell Court Wellbeing Hub Update

The Committee also requested that future reports use full terms for acronyms and initialisms, or alternatively, provide a key.