Agenda and minutes

County Councillor Nikki Hennessy replaced County Councillor Lorraine Beavers for this meeting.

The following speakers were welcomed to the Health Scrutiny Committee meeting:

• Professor Mark Pugh, Medical Director from the Lancashire Teaching Hospitals Foundation Trust;
• The former Chair of the Health scrutiny Committee, County Councillor Steve Holgate;
• Heather Tierney-Moore, Chief Executive of Lancashire Care Foundation Trust (LCFT); and
• Damian Gallagher, LCFT.

Apologies for absence were presented on behalf of County Councillor Jenny Purcell and District Councillor Colin Hartley (Lancaster City Council) and Julie Robinson (Wyre Borough Council).

The Committee was presented with a report setting out the constitution, membership, chair and deputy chair and terms of reference of the Health Scrutiny Committee for the municipal year 2017/18.

Resolved: That;

  i.  The appointment of County Councillors Peter Britcliffe and Jenny Purcell as Chair and Deputy Chair of the Committee for the remainder of the 2017/18 municipal year be noted;

  ii.  The new Membership of the Committee following the County Council's Annual Meeting on 25 May 2017 be noted; and

  iii.  The Terms of Reference of the Committee.

Members are asked to consider any Pecuniary and Non-Pecuniary Interests they may have to disclose to the meeting in relation to matters under consideration on the Agenda.

County Councillor Lizzi Collinge declared a non-pecuniary interest for Item 5 as her employment was funded by Lancashire Care NHS Foundation Trust.

Resolved: That the minutes from the meeting held on 28 February 2017 be confirmed as an accurate record and signed by the Chair.

The Chair welcomed Professor Mark Pugh, Medical Director from the Lancashire Teaching Hospitals Foundation Trust, to the meeting. Professor Pugh provided the Committee with an update on the mobilisation of Chorley and South Ribble Hospital's Emergency Department and Urgent Care Centre and the issues faced with recruitment and retention. A copy of the presentation is set out in the minutes.

The presentation provided the background to the circumstances, key findings of an independent review, the current situation, recruitment issues, use of locums and key messages.

The Committee expressed concerned with recruitment figures and policies. It was reported that there was no delay between an interview being conducted and a job offer being made. The majority of delays involved visa applications and the English language tests. It was noted there was capacity within the system to allow individual Trusts to undertake their own individual English language assessments. On the use of locums it was reported that the Trust was limited to paying £120 per hour and the Trust was not allowed to break this cap in accordance with the regulator, NHS Improvement.

Resolved: That:

  i.  The update on the mobilisation of Chorley and South Ribble Hospital's Emergency Department and Urgent Care Centre be noted; and

  ii.  Further updates on the mobilisation of Chorley and South Ribble Hospital's Emergency Department and Urgent Care Centre be assigned to the Health Scrutiny Committee Steering Group.

The former Chair of the Health scrutiny Committee, County Councillor Steve Holgate presented the report of the Scrutiny Inquiry Event – "STP Workforce", which was held on 9 March 2017.

The aim of the Workforce Scrutiny Inquiry Event was to enhance elected members knowledge and understanding of the current and future challenges, explore options and identify where they could add value to the solution design. The challenges of the geography of Lancashire and South Cumbria combined with the diverse population and a myriad of organisations who either delivered or signposted health and social care services within the public, private and third sector required an innovative approach.

Resolved: That; the Scrutiny Inquiry Event report be;

  i.  Received and noted;

  ii.  Formally handed to the Local Workforce Action Board (LWAB); and

  iii.  Circulated to all organisations who attended the event.

The Chair welcomed Heather Tierney-Moore, Chief Executive and Damian Gallagher from Lancashire Care Foundation Trust (LCFT) who were both Senior Responsible Officers (SROs) within the Sustainability and Transformation Partnership (STP) Governance Structure. They provided the Committee with an update on the work of the Local Workforce Action Board (LWAB) highlighting progress that had been made since the Scrutiny Inquiry Event.

It was reported that there was a significant difference in the funding that Lancashire and South Cumbria received particularly for medical under-graduate and post-graduate training compared with other parts of the North West and the south of the country. Officers were having discussions at a national level to address the disparity in funding. Lancashire and South Cumbria was under funded by approximately £27m.

The LWAB was also working with Health Education England nationally around the potential for Lancashire and South Cumbria in becoming an exemplar in global health utilising the "earn, learn and return" initiative to provide additional and sustainable method for recruitment. However, the importance of promoting the benefits of working in Lancashire from an academic, training and development perspective and to attract people to live and work in Lancashire was also vital and required a joint approach.

It was noted that considerable work was already happening across NHS organisations on recruitment and retention. Some of the work undertaken by the LWAB included:

• The creation of non-traditional contracts of employment to enable people with the flexibility to work across the whole of Lancashire and South Cumbria and not just employed by one Hospital Trust in one area;
• Funding additional medical places at the private medical school at the University of Central Lancashire (UCLAN). A small but important commitment to enable local recruitment in the knowledge that people tended to stay where they learned;
• Increased use of Physician Associates;
• Portfolio Career options as well as single specialities;
• Scaling up advanced practitioner nurses;
• Utilising Pharmacists in new ways;
• Minimising the use of agency staff and utilising Trusts' own 'Bank Staff' provisions;
• Sharing staff resources and systems such as payroll systems;
• Changing providers for Occupational Health; and
• Population-centric workforce planning.

Resolved: That;

1. The work of the Local Workforce Action Board (LWAB) be noted; and
2. The Committee write to the Secretary of State for Health and the Chairs of Health Education England and Health Education North West to formally invite appropriate representatives to attend a future meeting of the Committee to address the inequity of funding for medical under-graduate and post-graduate training in Lancashire and South Cumbria.

The first meeting of the Health Scrutiny Committee Steering Group was held on Tuesday 4 July 2017. Details of matters considered at that meeting were provided in the report.

Resolved: That the report of the Health Scrutiny Steering Group be received and noted.

The work plan for both the Health Scrutiny Committee and its Steering Group was presented to the Committee for information. The topics included were identified at a work planning workshop held on 20 June 2017.

Resolved: That;

1. The report and comments be noted;
2. The topic for the next scheduled meeting be confirmed; and
3. The information required for the topic to be considered at the next scheduled meeting be identified.

An item of urgent business may only be considered under this heading where, by reason of special circumstances to be recorded in the Minutes, the Chair of the meeting is of the opinion that the item should be considered at the meeting as a matter of urgency.  Wherever possible, the Chief Executive should be given advance warning of any Member’s intention to raise a matter under this heading.

There were no items of Urgent Business

The next meeting of the Health Scrutiny Committee will be held on Tuesday 19 September 2017 at 10.30am at County Hall, Preston.

Future meetings of the Committee for 2017/18 municipal year are as follows:

·  31 October

·  12 December

·  23 January 2018

·  5 March

·  17 April

All meetings will commence at 10:30am.

The next meeting of the Health Scrutiny Committee will take place on Tuesday 19 September at 10.30am in Cabinet Room C (The Duke of Lancaster Room) at the County Hall, Preston. Future meeting dates were noted.