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AGREED – That the Work Programme, as attached as Appendix 1 to report COGC/67/23S, be agreed.
AGREED – That the Committee wish to thank Jason Killens for attending today’s Meeting, and that he be asked to thank all staff within the Welsh Ambulance Service for their passion and commitment.
AGREED – That the Committee wish to thank Rachael Page, John Harris and Lyndsey Bloor for attending today’s Meeting and for their presentations. Members look forward to undertaking a performance benchmarking exercise to review GP Practices across the County Borough, and also welcome a more detailed response to questions submitted by Councillor Becca Martin at today’s Meeting.
An apology for absence was submitted on behalf of Councillor Beryl Blackmore.
AGREED – That the Minutes of the Meeting held on 14 June 2023 be signed as a correct record.
Members were reminded of their responsibility, under Paragraph 11 of the Members’ Code of Conduct, to declare any interests in relation to any of the business to be transacted at this meeting. The following declarations were made: Agenda Item 6 – G.P. Practices and G.P. Recruitment Councillor Claire Lovett – Personal – Registered patient with a Surgery which is part of the Hill Crest Group. The Councillor remained in the meeting taking part in the discussion and voting thereon. Councillor Becca Martin – Personal – Registered patient at Hill Crest Surgery. The Councillor remained in the meeting taking part in the discussion thereon.
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AGREED – That the Work Programme, as attached as Appendix 1 to report COGC/67/23S, be agreed.
The Chief Officer Governance & Customer submitted a report (COGC/67/23S) asking Members to consider the Committee’s work programme. The Scrutiny Facilitator presented the report and highlighted the main points within it. He advised that in September, the Committee would be considering two items, namely the PSB Wellbeing Plan, and the Adult Social Care Contract. In addition, Members would also be considering the Committee Work Programme for 2023/24. The Chair advised that the Labour Group were currently in the process of preparing a Topic Selection Form for submission to the Committee, asking them to urgently consider the budget challenge within Social Care, with a focus on Children’s Services. The Chair agreed that a discussion would take place at the Chair’s Planning Meeting at the end of August with regards to whether the September Meeting should be set aside to discuss the budget issue as a single Agenda item only. AGREED – That the Work Programme, as attached as Appendix 1 to report COGC/67/23S, be agreed.
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AGREED – That the Committee wish to thank Jason Killens for attending today’s Meeting, and that he be asked to thank all staff within the Welsh Ambulance Service for their passion and commitment.
The Chair of the Safeguarding, Communities and Wellbeing Scrutiny Committee submitted a report (COGC/47/23S) asking Members to discuss and consider an update regarding the measures to reduce the current operational pressures, demand and response times of the Welsh Ambulance Service NHS Trust (WAST) across the Wrexham County Borough. The Chair welcomed Jason Killens, Chief Executive of the Welsh Ambulance Service to the Meeting. He gave a presentation to the Committee and highlighted the following points: · Emergency Medical Services - BCU Red Performance. Confirmation that performance for 8, 9 and 10 minute responses had increased since December last year which Members were pleased to note. · Emergency Medical Services - BCU Amber Performance. Suggestion that performance in this area had also improved, and this was mainly due to an improvement in hospital handover times. · Emergency Medical Services - BCU Production. Confirmation that performance for this area was above target and that ambulance production had been consistently strong. It was also noted that the changes to roster arrangements had resulted in the actual availability of response vehicles being above target. · BCU – Hospital Handover Lost Hours. Confirmation that the Service lost approximately a third of the entire fleet nationally due to issues with hospital handovers. On a positive note, whilst it still remained high compared to other Welsh Health Boards, improvements were being sustained. · Emergency Medical Services - Abstractions. Confirmation that sickness absence was closely monitored. In recent months, there had been improvements in overall sickness nationally, and the Welsh Ambulance Trust had exceeded those targets. · Emergency Medical Services - Patient Safety Report. Confirmation that there were no concerns in this area. Following the presentation, a discussion ensued and the following points were noted: · Clarification sought with regards to the definition of an amber call. Members were advised that a series of questions were asked of the 999 caller to identify what was going on at the scene to help prioritise and allocate the most appropriate resource to deal with the emergency. A medical dispatch system was used which generated a code and a priority of either red, amber or green based on the seriousness of the problem. Amber 1 categories included patients suffering from things such as a stroke, cardiac chest pain, difficulty breathing and some fitting. Amber 2 included patients involved in road traffic accidents, and other non-life threatening symptoms. · Concern that a target of 6% for sickness absence by 2024 seemed high. It was noted that the ambulance sector within the NHS historically had higher sickness rates largely due to the physical nature of the role. A lot of absences were related to muscular skeletal illnesses as a result of lifting patients. Other absences were stress related. 6% was the target that would place the Service mid-range across the UK. · Clarification sought with regards to whether ambulance drivers had a maximum number of hours in which they were allowed to work. Members were advised that the Service worked within the European Working Directive and this was monitored through the rostering software which tracked core and overtime hours. · Confirmation that staff had worked overtime in order to cover abstractions and also to provide additional capacity over the winter period. It was noted that overtime was variable as flexibility was needed in order to provide additional capacity either nationally or in a different Health Board area to cover things such as sporting events. · Confirmation that the workforce had increased over recent years by over 400 full time equivalents. Some part time staff who previously worked overtime had had their contracts changed to full time. · Importance of ensuring that first aid, including mental health, was introduced as part of the Welsh curriculum. Confirmation that the Ambulance Service would be happy to support and encourage the teaching of first aid training as part of the school curriculum. · Confirmation that six Mental Health specialists had been recruited to respond to 999 calls. AGREED – That the Committee wish to thank Jason Killens for attending today’s Meeting, and that he be asked to thank all staff within the Welsh Ambulance Service for their passion and commitment.
Y penderfyniad fel y'i cofnodwyd
AGREED – That the Committee wish to thank Rachael Page, John Harris and Lyndsey Bloor for attending today’s Meeting and for their presentations. Members look forward to undertaking a performance benchmarking exercise to review GP Practices across the County Borough, and also welcome a more detailed response to questions submitted by Councillor Becca Martin at today’s Meeting.
(Members declarations of interest in relation to this item are set out in Minute 7 above) The Chair of the Safeguarding, Communities and Wellbeing Scrutiny Committee submitted a report (COGC/48/23S) asking Members to consider an update on the measures put in place to address the problems being experienced when trying to access General Practitioner (GP) & Emergency services across areas of the Wrexham County Borough. The Chair welcomed Rachael Page, Associate Director for Primary Care at Betsi Cadwaladr University Health Board to the Meeting. A presentation was given to Members and the following points were raised: · Primary Care Update – Acknowledgement that the demand on primary care had continued to face significant challenges especially for same day appointment requests in GP practices. · Key updates from GP Practices in the area. · Concern nationally that there was a risk that GPs may reduce their hours or resign. · Confirmation that the Health Board had progressed the roll out of the national Accelerated Cluster Development programme and would be working closely with the Local Authority and third sector partners. · Recruitment across Primary Care. · Health Board managed practices. · Recruitment in managed practices. Following the presentation, a discussion ensued and the following points were noted: · Concern expressed regarding the difficulties in recruiting GPs. Members noted that the Health Board had recruited 13 salaried GPs who would all be in post by September. · Clarification sought regarding the plans to retain medical students within the Wrexham area. It was noted that the increase in the number of trainees coming to the area was positive, but schemes such as financial incentives to move into the area were being looked at. · Confirmation that the workforce needed looking at as a whole in terms of how other Clinicians, such as Advance Practitioners and Paramedics could complement GPs. · Whilst acknowledging that there was still work to be done, it was welcome news that there had been a drop in complaints, following an improvement in the times taken to answer phone calls. · Suggestion by some Members that patients and residents were still not satisfied with the service they were receiving. Health Board representatives confirmed that they would like to meet with Councillors in order to establish whether it would be possible to introduce open surgeries which would allow patients to speak to them about their concerns. · Confirmation that the Health Board worked closely with community pharmacy teams. · Concern expressed by Members that not all patients were aware of the econsult app. · Request by the Chair that Members email their concerns, and any information relating to individual cases within their Wards, to the Health Board, and if a satisfactory response wasn’t received, then he would write to the Health Minister. · Importance of ensuring that consideration was given to the large housing developments that would be built in the County Borough, and the requirement to provide additional GP provision. · Clarification sought regarding whether there was a difference in pay for GPs in Wales and England. · Confirmation that the Healthcare Inspectorate Wales inspection reports were available on the HIW website, approximately 8 weeks after the inspection. The Chair welcomed John Harris, Clinical Director for Emergency Care in Wrexham at the Maelor and Lindsey Bloor, Director and General Manager of Emergency Care to the Meeting. A presentation was given to Members and the following points were raised: · Progress in the last 18 months. It was noted that historically there had been difficulties recruiting permanent consultant staff in the Emergency Department, together with staff who worked below consultant grade. However, the consultant workforce had been increased by 8, and staff below that grade, with significant experience within emergency medicine, had also been recruited. It was also confirmed that there had been a change to rotas which ensured that there was always a consultant present between the hours of 8am and 12 midnight. · Service improvements – improvements had been made to the infrastructure which enabled the introduction of an urgent treatment centre which provided additional rooms to treat patients with minor injuries and illnesses in a more streamlined manner. · Challenges – The Emergency Department remained a challenging place to work with overcrowding and huge volumes of patients being an issue experienced regularly. It was unfortunate that a lack of alternatives for some patients attending hospital due to social reasons, and not managing in their home environment, meant that the Emergency Department was sometimes the only option for them. · What we are doing to address the challenges – Update on the 6 Goals Programme which involved reviewing areas for improvement to provide safe alternatives to treatment including community provisions and same day emergency care within the hospital. · ED Performance – Overcrowding continued to be the biggest factor in meeting targets but it was hoped that the use of the urgent treatment centre would see an improvement in performance. · Average Time to Triage and Clinician – Confirmation that the expected time for a patient to be seen was 15 minutes but this target was actively monitored throughout the day. Again, one of the challenges faced by the Department was physical space, but it was hoped that the changes made to directly streamline patients to specialists would help to ensure patients were seen more quickly. Following the presentation, a discussion ensued and the following points were noted: · Clarification sought regarding whether some pressures at the hospital were due to patients not being able to see their GP and therefore were choosing to visit the Emergency Department instead. It was possible to identify which GP practice patients were registered with, and this helped to identify whether there were some practices that were not performing as well as expected. · Reassurances given that the Social Care Department worked with colleagues at the Health Board in supporting patient discharge, and to ensure patients received the correct response in community care. AGREED – That the Committee wish to thank Rachael Page, John Harris and Lyndsey Bloor for attending today’s Meeting and for their presentations. Members look forward to undertaking a performance benchmarking exercise to review GP Practices across the County Borough, and also welcome a more detailed response to questions submitted by Councillor Becca Martin at today’s Meeting.
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