Agenda and minutes

Apologies for absence were received from Mr D Blacklock, Mr J Bland, Mr F Cassidy and Mr A Semple.

There were no changes to the membership of the Committee on this occasion.

Mr C Whiteside declared a personal interest in agenda item 7(b) – Update on Digital Strategies – North Cumbria (Minute 40(b) refers) as his wife was employed at the West Cumberland Hospital.

RESOLVED,     that the press and public be not excluded from the meeting for any items of business.

To confirm the minutes of the meeting held on 3 October 2022 (copy enclosed).

RESOLVED,     that the minutes of the meeting held on 3 October 2022 be agreed as a correct record and signed by the Chair.

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

The Committee received a report and presentation which provided an update on the University Hospitals of Morecambe Bay Digital Strategy and detailed the governance in place to support the Strategy and progress made in each area.

Members were informed that the current Digital Strategy had been in place for two years, applied to the Place Based Partnership and deliberately aligned to the same five key themes of the regional Digital Strategy.

The Committee was informed there had been a significant delivery in empowering the citizen with the in-house development of a patient engagement portal to deliver letters electronically to those patients who were happy to receive them in this way and patient self-service for booking outpatient appointments. 

The Committee noted that the Trust had a programme to pilot the South Cumbria and Lancashire patient portal, “WellPRES”, with Pain Management which was yet to be made live due to issues with the software.  It was explained, however, that approximately 5,000 cancer patients across the wider area used WellPRES to support their care.

Members were informed that a new maternity system across the four hospital providers of South Cumbria and Lancashire was fully live and allowed the expectant mother to share her records, in an emergency, with any care provider in the world providing they had IT access.

The Committee was informed of similar progress being made in primary care with a ‘Digital Front Door’ which had been nationally mandated with the general aim of increasing access to primary care.  It was explained that the principles behind the online consultation element of the digital front door was to enable patients to request and receive support at a time and place that was convenient for them.  Members noted that this was also designed to support clinical scenarios including clinical consultations, direct care advice, reporting of symptoms and the ability to review a known problem/condition as well as enabling access to administrative services such as fit notes and test results.

The South Cumbria and Lancashire region recently procured a framework contract for practices to choose one of three suppliers, each with varying degrees of functionality.

A discussion took place regarding the ‘NHS App’ another ‘Digital Front Door’, which was relatively easy to use and had a very secure process to register patients.  Members were informed of an increased use of the NHS App within Morecambe Bay since 2018, in response to the Covid-19 Pandemic noting that patients could use this to view results, make repeat prescriptions and from 20 November 2022 view the details of GP consultations.

Whilst members welcomed the introduction of an NHS App highlighted the need to consider the differing ranges of IT skills in the community and drew attention to the possible danger of exacerbating other inequalities.  A discussion took place regarding the size of information which would be displayed on the screen of a mobile telephone.  Officers acknowledged the concerns raised and explained that the information could also be accessed via laptops and iPads where the information  ...  view the full minutes text for item 40a

To consider a report and presentation by North Cumbria Integrated Care NHS Foundation Trust (copies enclosed).

Members considered a report which provided an update on progress against the delivery of the North Cumbria Integrated Care NHS FT Digital Strategy.

The Committee was informed that the Trust Board approved a new Digital Strategy in October 2020 with a vision to digitally enable the workforce to support the delivery of high quality clinical care for patients and communities.

Members were advised that the Strategy was being delivered through five key areas which included enabling the workforce, digital infrastructure, digital systems, data analytics and data protection by design.  Officers explained that significant progress had been made in each of those areas, particular in the ‘high volume’ areas of digital infrastructure and digital systems/applications, with a large number of initiatives completed and currently underway.

The Committee noted the completed highlights from the initiatives and the priority digital projects for 2022/23 whilst acknowledging ongoing investment in the digital healthcare services was critical, both in terms of technology and resources.  Officers highlighted that without this the Trust would be unable to address the historical under-investment and prepare for the future.

Members acknowledged the progress which had been made to date and asked when all records would be fully digitised.  It was explained that whilst progress had been made there was still a significant amount of paper with the intention to scan in historic records. 

The Committee was informed that the priority digital projects included continuing with the development of the business case for the future Electronic Patient Record solution, digitising paper medical records, continuing the roll?out of Electronic Prescribing and Medicines Administration, further improvements to data centres, upgrading and expanding the use of Emergency Department Information Systems and wireless network improvements.  Members were informed that the Trust had under?invested in IT, therefore, there was a significant amount of ‘catch?up’ to be undertaken.

Members drew attention the cyber security and it was confirmed that the Trust had a dedicated Team for this.

A discussion took place regarding missed appointments and it was suggested that a reminder text be sent to patients regarding their appointments and clarity ascertained for any missed appointments.

A question was asked regarding the meaning of ‘remove digital friction’ and it was confirmed they were annoyances which hindered progress such as the need to log into multiple systems or information held in a number of different places.

Members noted the RIO upgrade and server migration and asked why the system was still in use.  It was confirmed this was only used for Children’s Services.

The Committee requested further information on the ‘Solar Winds Configuration’ and it was agreed this would be sent direct to members.

During the course of discussion attention was drawn to the implementation of the first phase of the Great North Care Record which was a regional project led at ICB level.

Members asked how the Communications Team were dealing with the impact of the postal strikes with regards to notification of appointments and it was agreed this would be investigated with the appropriate  ...  view the full minutes text for item 40b

To receive a presentation by Lancashire and South Cumbria Integrated Care (copy enclosed).

The Committee received a presentation from Lancashire and South Cumbria Integrated Stroke and Neurorehabilitation Delivery Network (ISNDN) which detailed a reminder of the whole system network approach, the drivers for change and the proposed model of care together with an update on the progress made to date.

Members were informed that it was felt having an Enhanced Network Model would allow more equitable access to important life-saving care seven days a week and an increased availability of treatments reduction in long?term disability, deaths and costs to the health and social care economy.

The Committee noted the progress to date which included the recruitment and improvement work taking place to increase access to the region’s thrombectomy service, collaborative work being undertaken with UCLAN to provide appropriate courses to grow a workforce and improvements which had been made in the rehabilitation element through investment.

Members raised concerns about the thrombolysis rates in Lancashire and South Cumbria being below the national average.  Officers explained that in?depth investigations into this was being undertaken but initial findings suggested this was because of late presenters to the Service.

The Committee highlighted the different models in north and south Cumbria and asked whether best practice and lessons learnt would be considered from other neighbouring areas.  Officers confirmed the Trust was well connected with other areas and assured members communication did take place.

A discussion took place regarding the distance patients may have to travel to receive appropriate care.  Officers emphasised that safe care was a priority and the refreshed Business Case would take this matter into consideration.

Members noted that there were stroke triage nursing and ambulatory care pathways in all hospital sites providing urgent stroke care to better manage or refer stroke mimic presentations and protect stroke beds.  A discussion took place regarding the number of mimic presentations and members were informed 75% of people were stroke mimics with 25% true strokes.  Officers explained that the front door was much more sensitive and assessed patients quickly.

A discussion took place regarding the effects of the New Hospitals Programme on the Service and it was explained it was felt this would provide support for a sustainable service in the future.

Members were informed that innovative ways were being looked at to deliver services in the future.  Officers explained that on?line rehabilitation courses had been successful with fantastic patient satisfaction.  The Committee was informed that a network of staff were working collaboratively together which gave them the ability to reach more patients.

Whilst members welcomed the work being under with UCLAN asked if any measures were in place to ensure retention of staff.  Officers confirmed that a Workforce Strategy would be implemented which would include retention of resources.

Members were informed that the Acute Business Case was signed off in Summer 2021 and implementation was part way through.  Officers explained this would be refreshed to reflect changes and the implementation plan updated with new timescales.

The Committee asked if financial and other resources were available  ...  view the full minutes text for item 41.

To note the minutes of the meeting of the Cumbria and Lancashire Joint Health Scrutiny Committee meeting held on 27 September 2022 (copy enclosed).

The Committee received and noted the minutes of a meeting of the Cumbria and Lancashire Joint Health Scrutiny Committee held on 27 September 2022.

Members were informed that a further meeting had been requested to ensure progress was being made on the Care Quality Commission.

RESOLVED,   that the minutes be noted.

To consider a report by the Strategic Policy and Scrutiny Adviser (copy enclosed).

The Committee received a report which updated members on developments in health scrutiny, the Committee’s Work Programme and monitoring of actions not covered elsewhere on the Committee’s agenda.

Members suggested that Integrated Care Boards should be involved in future Cumbria Health Scrutiny Committee meetings.

RESOLVED,   that

                          (1)          the update on the implementation of the Health and Care Act be received;

                          (2)          the existing Work Programme be noted and the following items be added for consideration at the February meeting:-

                                        (i)      update on Hyper Acute Stroke Unit in North Cumbria;

                                        (ii)     incorporate recruitment and retention of GPs.

To note that the next meeting of the Committee will be held on Tuesday 21 February 2023 at 10.30 am in the Council Chamber, County Offices, Kendal, LA9 4RQ.

It was noted that the next meeting of the Committee would be held on Tuesday 21 February 2023 at 10.30 am at County Offices, Kendal.