Agenda item

The Clinical Chair of Slough Clinical Commissioning Group (CCG), Dr Jim O’Donnell, gave Members a presentation on the CCG Operating Plan 2017-19 and an update on current issues.

Members noted that the plans to bring delegated commissioning of primary care to Slough were progressing and likely to come into effect in April 2017, subject to NHS England approval.  The CCG had nine ‘must dos’ for 2017-19 that included priority areas of cancer, mental health and improvement to referral to treatment times.  The Operating Plan was closely aligned to local priorities including those set out the Slough Joint Wellbeing Strategy - mental health and wellbeing, increasing life expectancy and protecting vulnerable people, and was focused on improving outcomes in priority areas of unwarranted variation in spend on neurological conditions, cancer and circulatory disease.  Dr O’Donnell set out the examples of future developments that would address these priority areas including continued improvements in access to mental health services for children and young people, increased emphasis on prevention, and improved cancer diagnosis treatment times.  More integrated care planning and social care would also be an important feature in the future to try to reduce the time people spent in hospital.

(Colin Pill joined the meeting)

During the course of the discussion, Members raised a wide range of issues which are summarised as follows:

·  Life expectancy – Members asked what further action was planned to continue the rapid improvement in levels of life expectancy that had brought Slough much closer to national averages.  It was responded that all plans should contribute to reducing such inequality and prevention and self-care were highlighted as being particularly important.  Members commented on the key role that GPs played in influencing patients not only to treat any immediate conditions but to promote healthier lifestyles and other preventative activities.  Dr O’Donnell recognised this but also highlighted the role of other partners to engage people effectively in such work.

·  Clinical priorities – a Member asked what conditions should be prioritised to have the biggest overall impact on the local population.  Dr O’Donnell explained that addressing the most common conditions would have the biggest statistical impact in terms of health outcomes.  However, he highlighted the importance of improving services for people least well served by current provision such those with learning disabilities and neurological conditions.

·  Cancer – Dr O’Donnell highlighted that early diagnosis was the key to improving outcomes for patients and more needed to be done to raise awareness in the population to identify symptoms early and visit their GP if they had concerns.  Preventative work such as diet and lifestyle factors was also important.

·  Mental health – the Panel welcomed the positive progress that had been made in improving local Child and Adolescent Mental Health Services (CAMHS) recently and Dr O’Donnell highlighted the investment required at an earlier stage to further improve services.  Family circumstances and the role of parents was also discussed in finding a solution that met the wider needs of children experiencing mental health conditions.

·  Workforce – the possible impact of Brexit on the workforce in the health sector was raised given the reliance on imported labour and skills.  The CCG recognised the important contribution that immigrants made to the healthcare system.  It did not currently have any specific plans in place, however, providers would need to take their own decisions in relation to workforce planning.

·  Engagement – the Panel discussed engagement at some length given the importance of communicating with people about how best to prevent health conditions, self-care and access appropriate health services.  More generally, the current Channel 5 documentary on ‘GPs: Behind Closed Doors’, filmed at Dr O’Donnell’s Farnham Road practice, helped improve understanding of the issues and challenges faced by the primary care sector.

·  Children’s Health - Members felt that it was crucial to communicate with schools and young people and offered their support to any practical steps that could be taken.  Health professionals needed to work closely in a coordinated way with schools and children’s services providers to promote healthy diets, exercise and awareness.  The Director of Adult Social Care highlighted that issues particularly effecting children had been flagged up in the Frimley Sustainability & Transformation Plan but that more detailed work needed to be undertaken.  It was requested that the Interim Director of Children’s Services, Director of Public Health and Chief Executive of Slough Children’s Services Trust be involved in co-ordinating this work.  The Panel encouraged the CCG to work proactively with these partners to promote healthy lifestyles in schools and that the Panel be updated on progress.

·  Transport access – asked about the role of the CCG in bus services for disabled patients to health services, Dr O’Donnell commented on the provision of home based services for patients if their disability prevented them visiting a surgery.  Concern was raised about the lacked of anchors for wheelchair users on some bus services to Wexham Park Hospital.  The Overview & Scrutiny Committee had raised this issue directly with First Buses at a recent meeting, however, Members were not satisfied with the response provided and commented that it could be a matter for further scrutiny.  In view of the Panel’s concerns it was suggested that the matter be looked into in further detail by Healthwatch and the CCG and that the concern be raised with the Council’s transport team.

At the conclusion of the discussion the Chair thanked Dr O’Donnell for his presentation and the Panel noted the report.

Resolved –

(a)  That the presentation and the CCG Operational Plan be noted.

(b)  That the CCG and Healthwatch have further discussions on the issue of disabled facilities on buses providing access to Wexham Park Hospital and that the concerns of the Panel be passed to the Council’s transport department.

(c)  That the Panel encourage the CCG to work proactively with the Council’s education and public health teams and Slough Children’s Services Trust to promote healthy and active lifestyles to children in local schools with an update to be provided at a future meeting.