Representatives from the following will be in attendance to give an overview on their area of expertise:
· Clinical Commissioning Group (CCG)
· Great Western Hospital
· Public Health
· Healthwatch Wiltshire
This will be followed by presentations on the following:
· Healthy Community Network
· Understanding Autism
Following the presentations there will be an opportunity for questions.
Minutes:
The Chairman welcomed the Health and Wellbeing panel members to the meeting and clarified that attendees would be given the opportunity to ask questions following the presentations which were as follows:
James Slater, Clinical Commissioning Group (CCG)
From April 2012 the CCG had taken over responsibility from the PCT for the commissioning of services for the people of Wiltshire. However, unlike the PCT, the CCG was clinically led.
Its governing body included 7 GPs and 2 lay members, with 57 practices represented across Wiltshire. In order to reflect the size of the locality 3 local groups had been established beneath, namely:
· NEW (North and East Wiltshire)
· Sarum (South of the County)
· WYKD (West, Yatton Keynell and Devizes)
The CCG was driven by the need to provide care in the home and not in the hospital wherever possible, in line with the wishes of the community.
Planning work undertaken by local GPs had identified 7 key priorities:
· Staying healthy and preventing ill health
· Planned care
· Unplanned care and caring for the frail elderly
· Mental health
· Long term conditions
· End of life care
· Community services and integrated care
Although the CCG had been in place for a relatively short period, some key changes had already taken placed including:
· Waiting times for dementia assessments had been reduced from 12 months to approximately 4 weeks.
· Extra A&E Consultants had been funded in Bath RUH and GWH Swindon.
· Additional funding to the Surgical Assessment Unit
· Improved discharge planning to ensure patients were back in their community as quickly as possible.
New Care Coordinator positions had been funded by the CCG to work within general practices to help provide a coordinated approach to health and social care that allowed people to stay at home where possible.
Kevin McNamara, Great Western Hospital (GWH), Swindon
As well as being one of 3 main acute hospitals covering Wiltshire, GWH was also responsible for providing maternity and community hospital services.
GWH were also working in partnership with a local charity and the local authority to provide a mobile chemotherapy unit for less complicated cases. This allowed for treatment to be undertaken in a more local setting.
Noting a desire for services to be provided at a more local community level, the GWH continued to work with the CCG and local authority to find ways in which this could be achieved.
GWH had worked with the CCG and local authority to develop the Care Coordinator roles as mentioned within the previous presentation. Their role included identifying those at greatest risk of ill health with an aim to keep people well, living independently and at home.
Approximately 5,000 people from within the area required out patient appointments from GWH.
A new Children’s Emergency Department was expected to be opened at GWH in December which would ensure the most appropriate care was provided.
There had been a significant increase in patients being admitted to hospital which provides challenges to the hospital as a provider. Additional staffing had been arranged to ensure the right nurses were in the right area at the right time.
In noting that by 2016 the NHS were expected to show a shortfall of nurses, additional investment in staff of approx £1.8m had been made by GWH and staff were being prepared to work extra shifts over the winter period.
GWH had missed out on the opportunity to receive additional winter preparedness funding of £4m which would put an extra strain on the available resources.
Maggie Rae, Corporate Director, Wiltshire Council
Public Health had now fully transferred into the local authority who had placed public health at the heart of its recent business plan.
Work would continue in prevention, promoting healthy lifestyles, reducing disease and tackling health inequalities. Work being undertaken was beginning to show effects with males in Wiltshire now living to 80 years of age for the first time.
The Public Health vision was to improve health and wellbeing through set priorities that were evidence based, all of which would start with the Joint Strategic Assessment (JSA).
There were 35 full time equivalent officers within the Public Health team and there was therefore a high reliance on partnership working.
A number of programmes had been identified, all of which aimed to promote better health.
As well as men’s life expectancy figures increasing to 80 for the first time, there had also been improvements in reduced fatality figures in relation to cardiovascular disease, heart attacks and strokes.
Work continued in helping to address smoking with every GP practice in Wiltshire now running ‘stop smoking’ programmes.
Abdominal Aortic Aneurism (AAA) screening programmes had also been established for men in the county. Letters would be sent to males upon reaching the age of 65 and it was hoped that this would reduce related deaths by approx 50%.
Awareness campaigns relating to road traffic accidents had resulted in a reduction of 10% from 2011 to 2012.
Childhood obesity figures had for the first time stayed level. Although not ideal this was the first time an increase had not been reported.
Every GP practice in Wiltshire had been commissioned to undertake health checks for those reaching 40 years of age with patients called back every 5 years thereafter. These would include dementia checks to help identify any early signs, noting that dementia figures were expected to continue to rise.
With specific reference to the expected increase in dementia cases, Wiltshire Council aspired for the community to be dementia friendly and it was therefore likely that a campaign would be launched in the future.
Paul Lefever, Healthwatch Wiltshire
Healthwatch arose from legislation introduced by the Health and Social Care Act 2012 to give communities a bigger say on how health services were provided.
Healthwatch Wiltshire was a community interest company and was totally independent. For those wishing to join the company application forms were available on the tables.
The purpose of Healthwatch Wiltshire was to:
· Promote the voice of the consumer in the development of health and social care strategies (children and adults);
· Provide and promote effective signposting and information systems;
· Promote, monitor and inspect the quality of services commissioned to meet health and social care needs
· Be able to demonstrate where Wiltshire was in terms of its health and social care services
Healthwatch Wiltshire was represented on the Health Select Committee, Health and Wellbeing Board (statutory requirement) and Commissioning Board.
They also worked with SWAN advocacy who were contracted to provide an independent voice for vulnerable adults in the community.
To help it undertake its role a volunteer network had been established with specialist volunteers trained to undertake specific projects, generalists to carry out key tasks and associates to support the aims and objectives of Healthwatch Wiltshire.
Emma Townsend and Patty Harrison on Understanding Autism
A year long campaign to raise awareness of autism had been undertaken which revealed that there were an estimated 4,500 people in Wiltshire with autism.
Autism was often called the hidden disability and it was therefore difficult to evaluate the type of support needed.
A DVD giving an insight into the world of autism was shown, a copy of which could be found via the following link:
http://www.youtube.com/watch?v=qNWwnL3KUsw
The autism lead, who was also a mother with 2 autistic sons, explained that those with autism showed a different approach to the world, with the following identified as key differences:
• Sensory differences
• Vulnerability
• Anxiety and fears
• Obsessions and rituals
• Inflexible thinking
• Keeping things the same
• Not generalising experiences
• Difficulties ‘mind reading’
Those with autism often had to be taught social communication and interaction and had a different cognitive style and approach to learning.
Following the presentations questions were received from the floor where the following information was provided.
The CCG was working on ways in which care for minor injuries could be delivered, noting that it was not cost effective for some minor injuries units to remain open. GPs were leading on this work and the CCG would be working with local communities to find a solution.
In noting the concerns raised with regards to the Out of Hours service provided within the Pewsey community area the CCG confirmed that they were working closely with Wiltshire Medical Services (WMS) (who provided the service) and that an additional £500k had been invested to support WMS and to ensure a better service was provided.
The NHS employed approximately 1.3million staff with a network of small to medium practices providing localised care. It was acknowledged that the existing system had not been designed to meet the needs of the population today but that the CCG was now looking to develop a strategy on how healthcare would be provided in the future and a consultation exercise would therefore be taking place to seek the views of stakeholders and the public.
GWH confirmed that to address the significant increase in A&E visits, the hospital had introduced an ‘alternative front door’ approach with those entering the department signposted to an alternative clinic for non emergency care.
Missed appointments were noted as a cause for expense and ways in which these could be minimised were discussed. This included the extension of text reminders as an example.
The Chairman thanked the panel members for their time and for providing further clarity on health and wellbeing across the county.