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The decisions as the council's minutes record them. A plain-language summary follows once it has been written.
RESOLVED – That Agenda Item 12 - Welsh Ambulance Service National Health Service Trust (WAST) and Item 13 - GP Practices and GP Recruitment be brought forward for consideration at this time.
AGREED – (i) That the Committee thank Jason Killens and Estelle Hitchon for attending today’s meeting and for the presentation. The Committee appreciate the openness with which it was delivered. (ii) That the topic be placed on the Work Programme for 2024/25 with an aim to assist WAST in managing transformation from a Council services perspective. (iii) The Committee requested an update on the usage and efficacy of Defibrillators with the intention of publicising this across local communities. All public access Defibrillators require registration on The Circuit register. (iv) The Committee recognises the difficult circumstances in which WAST operate given the level of resources (38%) which are subverted from the frontline.
AGREED – (i) That the Committee thank BCUHB for their attendance at the meeting and for the informative presentation. (ii) That this topic form part of the Work Programme for 2024/25 to enable the Committee to monitor progress and improvement.
AGREED: - That the Committee considered and agreed the proposed changes to the work programme attached at Appendix 1.
Apologies for absence were submitted on behalf of Councillors Beryl Blackmore and Alison Tynan.
The Minutes of the Meeting held on 12 June, 2024 were submitted. Amendment to Minutes - Attendance Councillor Claire Lovett was in attendance at the June Meeting which wasn’t reflected in the Minutes. Minute Number 7 - Child Poverty in Wrexham During the ensuing debate, a number of Members spoke in support of the recommendations which had been tabled at the June Meeting by Councillor Derek Wright, which were namely: Suggested recommendations: (i) Child Poverty is believed to be one of the main reasons for children being taken into care costing WCBC Social Services department, most of their overspend for the last several years of millions of pounds with £11m+ in the past financial year. A task and finish group should be formed include Heads of Service from both Social Services Alwyn Jones and Education Karen Evans, the Lead Member for Children Services and members of the SCWSC – The aim of the T&F is to review leadership of anti-poverty strategy & review Integrated Impact Assessment& Consult with the appropriate WG Minister, WLGA and relevant best practice exemplars. Emphasise actions to prevent entry into care & poverty. (ii) The T&F should Target the areas with the highest poverty, where more children are going into care such as in the most deprived areas of the borough, with resource both financially and physically with Officer time. (iii) As this subject appears to greatly affect the overall WCBC budget we request the T&F returns to the SCWSC with report back within eight months and give clarification of any unanswered questions. (iv) As we heard at last month’s SCWSC meeting play is vital for all children but particularly poorer children, therefore we implore WCBC to do everything possible to keep the Gwenfro Valley Adventure Playground Scheme open as recorded in the previous recommendations minutes attached to this report, specifically looking into the lease agreement & consequences of not having a long term lease? The Minutes of the June Meeting reflected recommendations which had been put forward as an amendment by the Chair, which were namely: (i) That the Safeguarding, Communities & Well-being Scrutiny Committee thank the Officers and the Lead Member for the report. (ii) The Committee suggest the item be added to the agenda next month for further consideration of the general principles and to explore the setting up of a task and finish group. In order to provide clarity on the recommendations today, a vote was taken on the amendment put forward at the last Meeting by Councillor Marc Jones. The amendment was carried and this therefore became the substantive motion which was duly voted upon and carried. AGREED – (i) That the resolution as detailed in Minute Number 7 – Child Poverty in Wrexham (12 June 2024) remain as previously agreed. (ii) That, subject to the amendments above, the Minutes of the Meeting held on 12 June, 2024 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:- Item 2 – Minutes Councillor Krista Childs – Personal- The Councillor was a Trustee for the Wrexham and Play Partnership. The Councillor remained in the meeting taking part in the discussion and voting thereon. Item 5 – Welsh Ambulance Service National Health Service Trust (WAST) Current Pressures and Response and Item 6 – GP Practices and GP Recruitment. Councillor Krista Childs – Personal – The Councillor had family members employed by BCUHB. The Councillor remained in the meeting taking part in the discussion and voting thereon. Item 5 – Welsh Ambulance Service National Health Service Trust (WAST) Current Pressures and Response. Councillor Marc Jones – Personal - The Councillor had a family member employed by BCUHB. The Councillor remained in the meeting taking part in the discussion and voting thereon. Item 6 – GP Practices and GP Recruitment. Councillor Jeremy Kent – Personal-The Councillor was contracted as Bank employee at BCHUB. The Councillor remained in the meeting taking part in the discussion and voting thereon. Item 6 – GP Practices and GP Recruitment. Councillor Claire Lovett – Personal – The Councillor was a patient at Forge Road Surgery. The Councillor remained in the meeting taking part in the discussion and voting thereon. Item 6 – GP Practices and GP Recruitment. Councillor Becca Martin – Person – The Councillor was a patient at Hill Crest Medical Centre. The Councillor remained in the meeting taking part in the discussion and voting thereon.
Decision as recorded
RESOLVED – That Agenda Item 12 - Welsh Ambulance Service National Health Service Trust (WAST) and Item 13 - GP Practices and GP Recruitment be brought forward for consideration at this time.
RESOLVED – That Agenda Item 12 - Welsh Ambulance Service National Health Service Trust (WAST) and Item 13 - GP Practices and GP Recruitment be brought forward for consideration at this time.
Decision as recorded
AGREED – (i) That the Committee thank Jason Killens and Estelle Hitchon for attending today’s meeting and for the presentation. The Committee appreciate the openness with which it was delivered. (ii) That the topic be placed on the Work Programme for 2024/25 with an aim to assist WAST in managing transformation from a Council services perspective. (iii) The Committee requested an update on the usage and efficacy of Defibrillators with the intention of publicising this across local communities. All public access Defibrillators require registration on The Circuit register. (iv) The Committee recognises the difficult circumstances in which WAST operate given the level of resources (38%) which are subverted from the frontline.
(Members declarations of interest in relation to this item are set out in Minute 10 above) The Chair of the Safeguarding, Communities and Wellbeing Scrutiny Committee submitted a report (COGC57/24) 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, Welsh Ambulance Service Trust to the Meeting and Estelle Hitchon, Director of Partnerships and Engagement, Welsh Ambulance Service Trust, he gave a presentation and highlighted the following points: • Emergency Medical Services BCU - The bulk of patient demand was in the Amber performance category. Suggestion that performance in this area had improved • Acknowledgement that they were off target (43%) in the Red performance category however performance was largely stable · Recognition that in many cases the Trust had been unable to meet some of its basic targets as a total of 38% of its capacity was being taken up by delayed hospital admissions · Recognition that targets not met in relation to response times had not been good for patient experience · Confirmation that WAST’s ambulance production had been consistently above benchmark and that they had increased capacity in the number of ambulance hours available this year compared to last year · 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 · WAST had a good track record of delivering improvements however acknowledgement was given that during the present challenging environment more needed to be done · Emergency Medical Services - Patient Safety Report. Awareness that sadly there had been adverse incidents and avoidable harm caused to patients as a result of the pressures, particularly at handover delay issues. · Emergency Medical Services - Abstractions. Confirmation that sickness absence was closely monitored as it has a significant impact on staff on duty and the hours they work · The Trust, alongside their partners, aim to establish change to reduce the need for ambulance service. They had been specifically focussing on interventions that could be put in place in the home / community thereby reducing the increasing dependency with high cost interventions. · Confirmation that six mental health specialists had been recruited to respond to 999 calls · The presentation would be made available to members following the meeting. Following the presentation, a discussion ensued and the following points were noted: · Members requested an update on the impact of the six mental health specialists that had been recruited to respond to 999 emergency calls relating to mental health patients · Confirmation given that the six mental health specialists had achieved good results for patients who had required their support. In addition there was a response vehicle on the streets to offer a targeted response to patients who required access a mental health specialist · Clarification sought with regards to response times and whether the 20 mph speed limit had impacted on the non-critical/none blue light calls. · Confirmation that this had been analysed and whilst there hadn’t been a significant impact there had been a small impact on the non-emergency fleet such as planned journeys to outpatient departments · Confirmation that changes were in place to reduce Police Officer time spent attending to Mental Health Incidents, as other agencies would attend. WAST are monitoring the impact of this new way of responding · Clarification sought regarding the implementation of public access defibrillators in local communities · Confirmation given that the defibrillators had proved invaluable. The installation of them and the training provided to operate them had a positive impact. All public access defibrillators require registration on The Circuit, the national electronic database · Hospital admissions - recognition that it is preferable to retain people safely, for as long as possible, in their own homes in the community with admission to hospital a last resort, as patients can begin to decondition during a hospital admission AGREED – (i) That the Committee thank Jason Killens and Estelle Hitchon for attending today’s meeting and for the presentation. The Committee appreciate the openness with which it was delivered. (ii) That the topic be placed on the Work Programme for 2024/25 with an aim to assist WAST in managing transformation from a Council services perspective. (iii) The Committee requested an update on the usage and efficacy of Defibrillators with the intention of publicising this across local communities. All public access Defibrillators require registration on The Circuit register. (iv) The Committee recognises the difficult circumstances in which WAST operate given the level of resources (38%) which are subverted from the frontline.
Decision as recorded
AGREED – (i) That the Committee thank BCUHB for their attendance at the meeting and for the informative presentation. (ii) That this topic form part of the Work Programme for 2024/25 to enable the Committee to monitor progress and improvement.
(Members declarations of interest in relation to this item are set out in Minute 10 above) The Chair of the Safeguarding, Communities and Wellbeing Scrutiny Committee submitted a report (COGC/58/24) 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 Shaun Taylor, Primary Care Manager 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 · The Health board had fully implemented its new operating structure, with the Primary Care team now embedded within the wider East Integrated Health Community (IHC) · Demands on Primary Care continued to be significantly above pre Covid levels especially for same day appointment requests in GP practices. · Recruitment across all staff groups continued to be a challenge for both GMS and managed practices, work was ongoing in this area · Options had been pursued by the Trust to aim to reduce dependency on agency workers. · Key update from the East Area – 19 GP practices across Wrexham. Ongoing risk that partners will reduce their hours or resign from practice resulting in an increase in both single handed practices and practice handbacks · Future proofing Primary Care – confirmation had been received to confirm that a BCU wide group would be set up, this would lead to more consistency and more consideration of data. Following the presentation, a discussion ensued and the following points were noted: · Concern expressed regarding the difficulties in the recruitment and retention of GPs. · Since 2023 the Health Board had recruited 28 salaried G.P.’s at three managed practices · Assurances given that G.P.’s were offered a clear pathway in their careers · Clarification sought relating to patients being encouraged to seek medical advice/support in places other than at G.P. surgeries, such as medical pharmacist · Clarification sought regarding the consistency at GP practices, preference for patients to see regular staff and G.P.’s at their practice · Recognition that there had been improved accessibility at Borras and Hillcrest Practices, however patients continued to experience difficulty obtaining a same day appointment · Assurances sought that steps had been taken to improve staff morale for those employed at G.P. Practices · Assurances given that steps had been taken to improve staff morale including Managers regularly speaking to their teams and the Annual Staff Survey · Recognition of the lack of engagement by the Health Board in relation to major Planning Applications AGREED – (i) That the Committee thank BCUHB for their attendance at the meeting and for the informative presentation. (ii) That this topic form part of the Work Programme for 2024/25 to enable the Committee to monitor progress and improvement.
Decision as recorded
AGREED: - That the Committee considered and agreed the proposed changes to the work programme attached at Appendix 1.
The Chief Officer Governance & Customer submitted a report (COGC/54/25) asking Members to consider the Committee’s work programme. The Scrutiny Facilitator presented the report referring in particular to the proposed changes as follows which were highlighted in the work programme (as attached at Appendix 1 to the report). In introducing the report he advised that we were now at the end of the Work Programme for 2023/24. A new Work Programme would be presented to the Committee in September for discussion & finalisation. He also informed Committee of the following: At the September Committee members would be consider two items, namely The Social Care Budget and the Work Programme for 2024/25. The Update on Grants Report would be taken alongside the Early Help Partnership item at the October Meeting The item on Child Poverty carried over from last meeting was discussed further and ultimately a way forward was considered by the committee. Child poverty is believed to be one of the contributory factors for children being taken into care, costing WCBC Social Services department millions of pounds over the last several years. To that end, Safeguarding and Well-being Scrutiny Committee discussed and resolved that WCBC will organise a workshop for all members to explore more fully the detail of the Child Poverty report as presented at the June 2024 SWSC. The workshop would allow members to engage with the key issues contained within the report and be made aware of some of the approaches to alleviating the symptoms locally. Furthermore, an outcome of the Workshop will be to consider the merits of a short Task & Finish group to consider and research best practice models of prevention and mitigation of poverty nationally and internationally to understand how these models could be implemented locally. AGREED: - That the Committee considered and agreed the proposed changes to the work programme attached at Appendix 1.
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