To receive an interim update from the Trust on Stroke Services and consider the Committee’s role in commenting on the Trust’s Quality Account.

The Committee received an interim update from the Trust.

Integrated Care Organisation

Mr Tim Tomlinson, Director of Nursing and Operations added to the published update by reporting on progress in establishing the Integrated Care Organisation (ICO).  Further to the report to the Committee in January the Hospitals Trust Board and the NHS Herefordshire Board and considered the business case and a formal agreement was being prepared to establish the ICO with effect from 1 April 2011.  The ICO would be known as the Wye Valley NHS Trust (provider of health and social care).

Members emphasised the need to ensure that the Trust’s roles as a provider of health and social care services was made explicit in any correspondence and documentation.

Stroke Services

In relation to the report on stroke care, produced in response to the Committee’s request for more detail on this issue at its last meeting, Mr Tomlinson reported demonstrable improvements.  However, further work remained to be done. He remarked that recruitment of a second stroke specialist was proceeding but there was a shortage of such specialists nationally.

Members proposed that preventative measures to guard against strokes should be the subject of further reporting

The report stated that work to develop the Hillside Intermediate Care Centre as a Stroke Rehabilitation Unit was continuing.  In January the Committee had sought assurance that the needs of those who previously would have received intermediate care at the Centre would be appropriately met.  Mr Tomlinson reported that the intention was that 12 of the 22 beds at Hillside would be allocated for intensive stroke rehabilitation delivered by a specialist team.  This approach would enable people to return to their homes as soon as possible.   The Committee needed to bear in mind the changes to care to be introduced by the Integrated Care Organisation which were based on the principle of locality teams providing intermediate care closer to home.

Members remained concerned that there appeared to be an uneven provision of care across the County with Cottage Hospital beds available in Bromyard (14), Leominster (29) and Ross on Wye (25).  People from Hereford City were being accommodated in these beds placing strain on patients and relatives who had to travel to visit them.

Mr Tomlinson commented that changes to care would be likely to free up some bed capacity in the County Hospital.

The Director of Quality and Clinical Leadership emphasised the need to distinguish between the specialised intermediate care that Hillside was designed to provide and the need to use that facility appropriately and the type of care that was provided in a Community Hospital.  She reinforced the point that the new care pathways were designed to move away from a bed based model of care, focussing instead on providing support to patients in their own homes.

Members continued to have reservations about provision in Hereford.   It was proposed that this issue should continue to be reviewed as part of the Scrutiny work.

RESOLVED:

That    (a)     it be recommended that provision of beds for care for patients not in need of acute care, in particular for residents of Hereford City, should be kept under review as part of the future scrutiny work programme; and

            (b)    it be recommended that preventative measures for Stroke, should be kept under review as part of the future scrutiny work programme.

Quality Accounts

The Chairman informed the Committee that the process for the Committee’s contribution to the production of Quality Accounts required further consideration in consultation with officers.  The forthcoming elections complicated the submission of comments within the required timescale.

However, the Trust had also invited the Committee to suggest matters for inclusion in the improvement programme for the Integrated Care Organisation. 

It was suggested that the improvement programme should include a focus on complex discharges of patients with continuing health and social care needs.

RESOLVED:   That the Trust be recommended to include a focus on complex discharges of patients with continuing health and social care needs in the improvement programme for the Integrated Care Organisation.