Agenda and minutes

An apology for absence was received from Mr F Cassidy.

There were no changes to membership to note.

Members are invited to disclose any disclosable pecuniary interest they have in any item on the agenda which comprises

1          Details of any employment, office, trade, profession or vocation carried on for profit or gain.

2          Details of any payment or provision of any other financial benefit (other than from the authority) made or provided within the relevant period in respect of any expenses incurred by you in carrying out duties as a member, or towards your election expenses.  (This includes any payment or financial benefit from a trade union within the meaning of the Trade Union and Labour Relations (Consolidation) Act 1992.

3          Details of any contract which is made between you (or a body in which you have a beneficial interest) and the authority

            (a)     Under which goods or services are to be provided or works are to be executed; and

            (b)     Which has not been fully discharged.

4          Details of any beneficial interest in land which is within the area of the authority. 

5          Details of any licence (alone or jointly with others) to occupy land in the area of the authority for a month or longer. 

6          Details of any tenancy where (to your knowledge)

            (a)     The landlord is the authority; and

            (b)     The tenant is a body in which you have a beneficial interest.

7          Details of any beneficial interest in securities of a body where

            (a)     That body (to your knowledge) has a place of business or land in the area of the authority; and

            (b)       Either –

(i)        The total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body; or

(ii)       If that share capital of that body is of more than one class, the total nominal value of the shares of any one class in which the relevant person has a beneficial interest exceeds one hundredth of the total issued share capital of that class.

In addition, you must also disclose other non-pecuniary interests set out in the Code of Conduct where these have not already been registered.

Note

A “disclosable pecuniary interest” is an interest of a councillor or their partner (which means spouse or civil partner, a person with whom they are living as husband or wife, or a person with whom they are living as if they are civil partners).

There were no disclosures of interest made for this meeting.

RESOLVED,that the press and public be not excluded from the meeting during consideration of any items on the agenda.

To consider the minutes of the previous meeting held on 15 March 2022 (copy enclosed).

RESOLVED,that the minutes of the meeting held on 15 March 2022 be agreed as a true record and signed by the Chair.

To consider a report by the University Hospitals of Morecambe Bay NHS Foundation Trust (copy enclosed).

Members received update a report that summarised the current position and progress of the improvement plans to address the following:-

o CQC Must Do and Should Do recommendations

o NICHE Report recommendations

o Royal College of Surgeons Report recommendations

The report combined all three reviews into one report which had been designed to meet the reporting requirements of the Trust Assurance Committees, Trust Board and the Service Improvement to aid efficiency, support visibility and to increase understanding of cross-cutting themes.  A summary of the key issues were listed in the report.

The Director of Governance outlined the robust governance that had been put in place and agreed to provide monthly progress reports, submitted to the UHMBT Board, to members when available.  Members received an explanation of the Niche Investigation Assurance Framework (NIAF) in terms of levels 0-5 and were informed the Trust was working towards achieving level 3 compliance.  It was noted that Niche would undertake a return visit in October, with the expectation of their report being published in January 2023.  It was suggested that the Joint Committee be convened when appropriate to consider the NICHE report.

In answer to members’ questions, the Director of Governance acknowledged a slippage in the progression of CQC’s must and should dos, but outlined actions and processes that had been put in place to ensure the Trust remained on target and most importantly have a sustainable patient centred service.   The Director of Governance agreed to provide members with the percentage of “must dos” which were beyond the control of UHMBT to deliver, along with details of type of actions required and who had responsibility for these.

The discussion then centred around staff vacancy figures and the impact of these on services.  It was agreed that members be provided with current vacancy rates across nursing and midwifery together with any specialism where the levels were of a concern (above 15%) for the Trust.  Seasonal pressures and the ability to cope was discussed.

Further to a member’s question on another level of process, the Director of Governance agreed to provide information on the rationale for the proposal by the People Committee for the Trust to introduce a mechanism of escalation, separate to the existing grievance and Freedom to Speak Up processes.

Recording of ethnicity and health inequalities were discussed.  Work was being undertaken at Lancashire County Council on Health Inequalities and it was agreed that this work be shared with the Joint Committee members when available.

The Director of Governance was thanked for the report.

RESOLVED, that the report be noted.

To consider a report by the University Hospitals of Morecambe Bay NHS Foundation Trust (copy enclosed).

The Chief Operating Officer presented reports and gave a presentation on the approach the Trust, and system partners, were taking to prepare for the forthcoming winter period and when responding to escalating service pressures.  The presentation outlined the Trust’s Managing Patient Flow, Surge and Escalation Plan.

The Officer informed members of hospital admission and “not meeting the criteria to reside” (NMCR) figures, adult social care pressures and the pressures of these on the hospitals.  It was reported that this year’s winter was expected to be particularly challenging given already stretched health and social care services, with an expected increase of illnesses. Members noted improvement projects that had been designed to mitigate winter pressures, focussing on increasing capacity outside hospital and ensuring timely discharges.   The introduction of virtual wards was discussed and  the officer outlined safeguarding measures put in place for these. 

In discussion of adult social care pressures, the Chief Operating Officer outlined work that was taking place with Cumbria County Council to provide additional alternative provision, freeing up headroom within the Trust.  It was agreed that members be provided with details of the provider in receipt of the contract, which was currently out to tender, to provide alternative domiciliary care provision to reduce NMCR over the winter.

The Chief Operating Officer informed members that the Trust was not considering opening additional ward capacity for NMCR.  A member asked the Trust to give consideration over undertaking a Quality Impact Assessment of not opening additional ward capacity for NMCR.

To conclude, the officer gave a presentation on the Managing Patient Flow, Surge and Escalation Plan and outlined Opel 4 Escalation.  Members suggested circulating the presentation to the full Health Scrutiny Committee members.

Members thanked the Chief Operating Officer for the reports.

RESOLVED,that the report be noted.

To be confirmed.

The date of the next meeting was to be confirmed.