To receive apologies for absence.

All committee members were present.

Apologies were noted from: Hilary Hall, Corporate Director Community Wellbeing, Herefordshire Council; Robert Mackie, Director of Finance and Interim Chief Executive, Herefordshire and Worcestershire Health and Care NHS Trust; and Christine Price, Chief Officer, Healthwatch Herefordshire.

To receive details of any councillor nominated to attend the meeting in place of a member of the committee.

There were no named substitutes.

To receive declarations of interest in respect of items on the agenda.

No declarations of interest were made.

To receive the minutes of the meeting held on 29 January 2024.

The minutes of the previous meeting were received.

Resolved:

That the minutes of the meeting held on 29 January 2024 be confirmed as a correct record and be signed by the Chairperson.

To receive any written questions from members of the public.

No questions had been received from members of the public.

To receive any written questions from members of the council.

No questions had been received from councillors.

This report provides the Health, Care and Wellbeing Scrutiny Committee with the background and findings of the Care Quality Commission’s (CQC) inspection of Herefordshire and Worcestershire Health and Care NHS Trust (the Trust).  It also outlines the actions taken following the “Well Led” inspection.

The Chairperson invited representatives from the Herefordshire and Worcestershire Health and Care NHS Trust (the trust) to update the committee on the outcomes of the Care Quality Commission (CQC) inspection report of the trust.

The committee received the presentation ‘Herefordshire and Worcestershire Health and Care NHS Trust Improvement Plan’ (link to the presentation).  The Director of Strategy and Partnerships presented the slides: Background; Trust services in Herefordshire; Our communities and patients.  The Director of Nursing presented the slides:- Overview of our Improvement Plan; CQC inspection; Rating for mental health services; Overall rating; Areas for improvement; Current actions; and Six key elements of the Improvement Plan.

The principal points of the discussion included:

1.           The Chairperson noted that aspects of the inspection report on mental health services were relevant to Herefordshire and welcomed the Improvement Plan; the report also covered a broader range of services which were delivered by the Trust in Worcestershire.

2.           In response to a comment from a committee member about the ratio of ‘leaders’ to other staff, the Director of Nursing explained that leaders included anyone with line management responsibility.

3.           The Director of Strategy and Partnerships commented on the interdependencies within mental health and on the regulated activity delivered by the trust.

4.           The Vice-Chairperson questioned the level of awareness about the issues inherited through the transfer of the mental health and learning disability service to the trust in 2018. 

The Director of Strategy and Partnerships commented that due diligence had not identified any performance ‘red flags’ and outlined subsequent challenges which had arisen from the community mental health transformation process and from the COVID-19 pandemic.  It was noted that recruitment and retention was a significant issue for the trust, and for the NHS generally.

The Associate Director, Primary Care and Community Mental Health Services commented that there had been high vacancy rates in some community teams but this was now returning to typical levels, in the context of the characteristics of the health service nationally; the vacancy rate for adult mental health community services was around 12%.

5.           Attention was drawn to the slide Rating for mental health services which showed the position for ‘Acute wards for adults of working age and psychiatric intensive care units’ as ‘Inadequate’ for Safe, and there was decline to ‘Requires Improvement’ for Effective, Caring, and Responsive.

The Director of Nursing confirmed that the trust was looking at all areas.  An overview was provided of the challenges, exacerbated by the pandemic and workforce difficulties, in adult inpatient mental health services.

6.           In response to a question about the effects of the pandemic, the Director of Nursing explained that demand went down initially, as people avoided health settings, but many individuals’ mental health had deteriorated during that period which had resulted in increased demand for mental health services subsequently. 

The Director of Strategy and Partnerships added that this was particularly apparent for children and young people.  The Vice-Chairperson commented on the consequential challenges for learning providers.

7.  ...  view the full minutes text for item 34.

To consider the draft work programme for the Health, Care and Wellbeing Scrutiny Committee for the municipal year 2024/25.

The Statutory Scrutiny Officer introduced the draft work programme for the committee for the municipal year 2024/25. 

It was noted that there had been movement in the work programme since the last meeting to accommodate the Care Quality Commission inspection reports on Herefordshire and Worcestershire Health and Care NHS Trust at this meeting, and on Wye Valley NHS Trust: The County Hospital at the next scheduled meeting.

Resolved: 

That the draft work programme be agreed, subject to periodical reviews, as the basis for the primary focus for the committee for the municipal year 2024/25.

Monday 20 May 2024 2.00 pm

Monday 29 July 2024 2.00 pm

Monday 30 September 2024 2.00 pm

Monday 25 November 2024 2.00 pm

Monday 27 January 2025 2.00 pm

Monday 31 March 2025 2.00 pm

The date of the next scheduled meeting was identified as Monday 20 May 2024.*  Proposed dates for the municipal year 2024/25 were noted.

[*Note: this meeting was rescheduled to Tuesday 28 May 2024, 12.30 pm, but was subsequently postponed]