Agenda item

Betsi Cadwaladr University Health Board

Presentation from Betsi Cadwaladr University Health Board:

Healthcare in North Wales is Changing – update on service reviews
Locality Developments
Public Health – Tobacco and Alcohol update
Members’ Questions

Decision:

That the presentations be noted.

Minutes:

The Chairman welcomed Jill Galvani, Executive Director of Nursing, Midwifery & Patient Services; Andrew Jones, Executive Director of Public Health; John Darlington, Assistant Director – Planning; Jackie James, Principal Health Development Specialist and Janet Ellis, Primary and Community Services Programme Manager to the meeting who were in attendance to provide presentations on the following areas:-

Healthcare in North Wales is Changing – update on service reviews
Locality Developments
Public Health – Tobacco and Alcohol update

Update on service reviews

The Executive Director of Nursing, Midwifery & Patient Services gave a presentation which covered the following areas:-

The Triple Aim
Case for change – the main messages
Bringing the threads together
What questions need to be answered?
Localities and Community Services
Paediatric Services
Maternity, Gynaecology & Neonatal Services
Non-elective General Surgery
Trauma and Orthopaedics
BCU Board position
Next steps – key areas

In response to a question on junior doctors, Executive Director of Nursing, Midwifery & Patient Services said that there was a need to address the high level of funding spent on locum doctors. Significant work was being undertaken to provide training opportunities to ensure junior doctors were being drawn to employment opportunities in North Wales. Executive Director of Public Health said that a significant review on junior doctors had been undertaken over the last 18 months.

Councillor H.G. McGuill asked whether there was flexibility to enable nurses to move around departments depending on the needs of the service areas. Executive Director of Nursing, Midwifery & Patient Services said that there was flexibility to move staff depending on their confidence in a specific service area. The Unions were largely supportive of this.

In response to questions on future funding and the efficiency programme, Executive Director of Nursing, Midwifery & Patient Services explained that the capital funding was well utilised. There was a need for the Health Service in Wales to save £70M in 2012/13 and increased drug costs and staff costs together with ringfenced budgets were adding to the financial pressures. An efficiency programme had been produced to enable savings to be met whilst maintaining a high level of service. The Assistant Director – Planning said that in line with the Medium Term Financial Strategy 6% of the budget since 2010 to 2015 had to be identified as savings.

The Chief Executive said that he and others had recently met with the Chair and Acting Chief Executive of the Local Health Board and recognised that there were significant challenges ahead. High level political engagement was key together with collaborative working across North Wales.

The Executive Member for Social Services asked whether the reduction in senior managers had been considered to meet the level of savings required. Executive Director of Nursing, Midwifery & Patient Services said that there was a voluntary release scheme for employees but this continued to be a major challenge across the National Health Service.

In responding to questions on changes to the National Health Service, Executive Director of Nursing, Midwifery & Patient Services explained that the presentation given to the Committee was a bold statement outlining the significant changes which needed to be made to meet the high level of savings required. The Chief Executive was confident that his health service colleagues would achieve the funding pressures placed upon them through their efficiency programme.

Councillor D. MacFarlane asked if a copy of recommendation of the recent Wales Audit Office (WAO) report could be provided to the Committee. Executive Director of Nursing, Midwifery & Patient Services explained that the WAO was a separate report to that of the Welsh Royal College report which provided recommendations on the Health Service. This report was published in the public domain and could be made available to the Committee.

Councillor M. Bateman asked whether there was a need to consider continuing with free prescriptions in Wales. Executive Director of Nursing, Midwifery & Patient Services explained that the Health Service, where possible, used local suppliers to ensure best value. The Chief Executive said that there was a need for a review as the cost for free prescriptions was significant.

Locality Developments

The Director of Community Services and Primary and Community Services Programme Manager gave a presentation which covered the following areas:-

What are localities
Locality working
Model of Care
North Wales Localities
Flintshire Localities
Locality Leadership Team
Where are Local Services Now
Where are we up to?
Key deliverables 2011/12
Work in progress
Work to date
Links with TSSA
Future work
Engagement and Inclusion

Councillor H.T. Howorth raised concern around the speed in which some opportunities for co-located health services were progressing. The Chief Executive commented on the development of co-located health and social care teams in Connah’s Quay and said that consultation was being carried out with the primary health service to co-locate health and social care teams in Flint as part of the regeneration programme. The Committee would be given the opportunity to consider the future shape of the service.

In response to concerns around meeting the needs of patients once they have been discharged, the Executive Director of Nursing, Midwifery & Patient Services reported that an annual survey was carried out to review how the care of out-patients was being met. Copies of that survey could be provided to the Committee.

Councillor E.W. Owen commented on cross border issues and raised concern on patients from Wales having to be treated at the Countess of Chester Hospital. The Executive Director of Nursing, Midwifery & Patient Services explained that there was a need for cross border working with hospitals treating specialist conditions based in England. In response to specific cases she said that she would look into these matters following the meeting.

Public Health – Tobacco and Alcohol update

The Executive Director of Public Health provided a presentation which covered the following areas:-

· Our healthy future

· Tobacco and Alcohol

· BCUHB Approach

· Local Authority

· Summary

· Director of Public Health Annual Report

In response to a question on Council employees smoking outside Council buildings, the Chief Executive said that banning smoking on the Council campus would be difficult to enforce. There would need to be a progressive approach and this would have to be considered with Unions but was not a change the Council was looking to make in the immediate future.

The Director of Public Health reported that initiatives to stop smoking on hospital campuses had been carried out in conjunction with the Unions and support was provided to employees seeking to stop smoking. The change was introduced following complaints from patients having to walk into the hospital with people smoking near the entrances. Feedback following the introduction of the changes had been positive.

Questions from Members

All Members had been given the opportunity to submit questions to Betsi Cadwaladr University Health Board prior to the meeting. A copy of the questions and the responses given are attached at Appendix 1 of the minutes.

The Chairman thanked Jill Galvani, Executive Director of Nursing, Midwifery & Patient Services; Andrew Jones, Executive Director of Public Health; John Darlington, Assistant Director – Planning; Jackie James, Principal Health Development Specialist and Janet Ellis, Primary and Community Services Programme Manager for the presentations and for answering the questions from Members.

RESOLVED:

That the presentations be noted.