Agenda item

To receive a presentation by representatives from Betsi Cadwaladr University Health Board on Area Structure and thereafter questions on health services provision.

(AN INVITATION HAS BEEN EXTENDED TO ALL MEMBERS OF THE COUNCIL IN RESPECT OF THIS ITEM)

The Chair welcomed Mrs. Ffion Johnstone, Mr. Andrew Jones, Mr. Geoff Lang, Ms. Alison Cowell, Mr. Wyn Thomas as representatives from the Betsi Cadwaladr University Health Board (BCUHB) to the meeting.  It was noted that Mr. Simon Dean, Interim Chief Executive was unable to attend the meeting as he had been called to a Public Accounts Committee at the Welsh Government.

The Chair further noted that all Members of the County Council had been invited to attend the meeting in respect of this item and were afforded the opportunity to present questions in advance of the meeting to the Betsi Cadwaladr University Health Board.  A response to the questions presented had been forward to the Members of the County Council.

A presentation was received by the representatives of the Betsi Cadwaladr University Health Board to the meeting which highlighted :-

Operating Principles

·           Public and staff engagement;

·           North Wales Vision – Local Delivery;

·           Population needs analysis and patient, ‘what matters’;

·           Prevention of ill health and reduced dependency;

·           Primary care informed Commissioning;

·           Area wide culture of Partnership Working;

·           Community led pathways – home is the first assumption;

·           Workforce development – skill mix analysis, generic and enhanced roles;

·           Succession Planning;

·           Safeguarding embedded – Children’s and Adults;

·           Patient safety, risk management and service quality;

·           Robust operational and business planning, financial control, accountability and performance management;

Vision of the Health Board

·           Patients and communities less dependent;

·           Clusters influencing the system;

·           Trusting relationships at a local level;

·           Robust core community services and integrated teams;

·           Local service vision, with ownership by partners and staff, and understanding by local communities, joint planning;

·           Motivated and appropriately skilled workforce;

·           Modernised services through technology and innovation;

·           Improved reputation for Betsi Cadwaladr University Health Board;

·           Decision making at a local level and influencing strategic direction.

A question and answer session was afforded and the following comments and concerns were presented :-

·           Temporary Changes to Women’s and Maternity Services in North Wales were undertaken by the BCUHB.  Concerns on Anglesey that a specialist maternity service at Ysbyty Gwynedd is in jeopardy.  BCUHB responded they are currently working through the responses to the consultation on maternity services in North Wales and a report will thereafter be afforded on the quality and health impact assessment to the Health Board in early December.    The Health Board has invited the Royal College of Obstetrics and Gynaecology to work alongside the Board Clinical Team across North Wales to look at the Health Boards current services in respect of Women’s and Maternity Service.  There are no plans to change the Obstetrics services in North Wales at present.  Members of the Committee considered that the Women’s Services and Maternity Services needs to stay at Ysbyty Gwynedd in Bangor;

·           The County Council, through its Transformation Programme for Adult Services Social Care, is committed to developing Extra Care provision across Anglesey supporting the Authority’s vision of a fundamental shift away from traditional residential care in favour of alternative care models.  Questions were raised regarding if BCUHB were consulted regarding the recent consultation regarding the Haulfre Residential Home in Llangoed.  BCUHB responded that the Haulre Residential Home was discussed at an Integrated Board with representatives from the BCUHB, County Council and the Third Sector. Mrs. Ffion Johnston, Area Director (West) further stated that she meets regularly with Chief Officers of the County Council and discussion with regard to Extra Care provisions on Anglesey has been undertaken;

·           The frequency of cervical screening for women over the age of fifty has been changed from 3 years to 5 years recently.  Questions raised whether this change was due to clinical evidence or the need to save money.  BCUHB responded that the screening is very much driven by clinical evidence and recommendations from the UK National Screening Committee.  Studies have shown that in the 50-64 age group five yearly screening offers similar protection as 3 yearly screening as cervical cancer incidence decreases with age.  The percentage of women attending cervical screening on Anglesey is 78%;

·           In respect of breast care and cancer diagnosis, questions raised regarding the current waiting time for referral to see consultants.  BCUHB responded that they would have to report back with data of current waiting times for breast care and cancer diagnosis;

·           Hergest Psychiatric Unit at Ysbyty Gwynedd -

·        Questions raised regarding how many complaints concerning violence by other patients or inappropriate behaviour towards patients by staff have been received in respect of the Hergest Psychiatric Unit in 2015.  BCUHB responded that 16 complaints had been received by patients in 2015.  Safety incidents and incidents involving patients and staff will need to be reported back to Members of the Committee;

·        Questions raised regarding how many incidents of whistle blowing received from staff in 2015, and does historical data reflect any trend.  BCUHB responded that there have been no incidents of whistle blowing at the Hergest Unit in 2015.  There has been programme of work undertaken with staff and outside support to improve the quality of care in the Hergest Unit.  The view of the Board Commission of Psychiatric has been sought in respect of the quality of the service at the Hergest Unit;

·        The interior condition of the Hergest Unit had been allowed to deteriorate over the years. BCUHB responded that the quality of the environment at the Hergest Unit will be incorporated into the Mental Health Strategy which currently taking place. 

·           Ysbyty Penrhos Stanley, Holyhead and Ysbyty Cefni, Llangefni – questions raised regarding BCUHB intentions for both hospitals in the future. BCUHB responded that there is an empty ward at Ysbyty Penrhos Stanley and investigations are currently been undertaken to locate an IVI therapy(intravenous of medications) and assessment unit in Anglesey.  A frailty assessment unit is also considered at Ysbyty Penrhos Stanley.  A Mental Health ward exists at present at Ysbyty Cefni and BCUHB are investigating to locate a mental health unit for all ages in the future.  However it was emphasised that no decisions as yet has been made for the future of the facility.  The Area Director (West) and Officers from the Local Authority will need to discuss the possible use of the facilities in due course;

·           Patients trying to get GP appointment are having to make numerous phone calls before getting through to make an appointment.  Many attend the Accident and Emergency Unit or Out-of-hours doctors at Ysbyty Gwynedd as they are having difficulties making an appointment with their GP.  BCUHB responded many GP surgeries on the Island are investigating new telephone/appointments systems and the health board may need to support them financially with training of other staff within GP surgeries;

·           Recruitment issues with regard nursing staff.  BCUHB responded that over the last 3 years a significant change in expectation about the number of nurses on wards to reflect the changing nature of the needs of people that are cared for.  The whole of the UK are trying to recruit staff following the Francis Report into the Mid Staffordshire NHS.  Training programme are lacking behind;

·           Questions raised regarding the ratio of managerial/administrative post to medical staff at Ysbyty Gwynedd.  Questions were further raised whether BCUHB were considering voluntary redundancy of administrative posts.  BCUHB responded that the medical staff ratio at Ysbyty Gwynedd is much higher than any other health board in Wales.  It was stated that the administrative posts are part of a good clinical teams at Ysbyty Gwynedd and there is no plan to offer voluntary redundancies as administrative posts have been reduced over the years.  Management costs will be forwarded to Members in due course;

·           Drug/alcohol abuse is having a serious effect on children, families and the elderly.  The Head of Children’s Services stated that she totally agreed with the statement that drug/alcohol abuse has dire effect on children and families.  The County Council is a lead authority for the Gwynedd and Môn Integrated Family Support Service (on behalf of both Gwynedd and Anglesey and the Health Board) which works with families where drugs and alcohol problems are endangering the children’s safety within their homes.  The service received 20 referrals last year and during the last 6 months 20 other referrals have been received.  The Corporate Director – Community stated that a ‘Model Môn’ Board for adults has been incorporated within the Social Services Department for a number of years and it is intended to incorporate a new ‘Model Môn’ Board for children services; an invitation has been extended to the Head of Learning to be part of this Board.

The Chair thanked the representatives from Betsi Cadwaladr University Health Board for attending the meeting and to all Members and Officers of the County Council for their contribution to this item.

RESOLVED to accept the report and to await the response of BCUHB to those issues regarding which information was not available at the meeting. 

ACTION : As noted above.