NORTH YORKSHIRE COUNTY COUNCIL

16 February 2022

STATEMENT OF CHAIRMAN OF THE SCRUTINY OF HEALTH COMMITTEE

The Scrutiny of Health Committee has a responsibility to review any matter relating to the planning, provision and operation of health services in the County.  A key part of that responsibility is requiring NHS bodies to consult health scrutiny on proposals for substantial developments or variations of local health service provision.

Committee meeting on 17 December 2021

The committee last met on 17 December 2021, using Microsoft Teams for a live broadcast meeting.  At that meeting, committee members received detailed presentations on: ‘unavoidably small hospitals’; the plans for the re-opening of the Esk Ward, Cross Lane Hospital, Scarborough; progress with the Care Quality Commission (CQC) inspection improvement plans that have been put in place by Tees Esk and Wear Valleys NHS Foundation Trust (TEWV); stroke services in North Yorkshire; the NHS response to and recovery from the pandemic locally; and data on the vaccination programme, infection rates and the number of people hospitalised with Covid-19.

There were no public questions/statements at the committee meeting.

Outlined below are some of the areas that the committee has been looking at in-depth.

‘Unavoidably small hospitals’

Stephen Eames CBE, Designate Integrated Care System (ICS) Chief Executive, Humber, Coast and Vale Health and Care Partnership gave a presentation to the committee on ‘’unavoidably small hospitals’.  This followed on from a number of pieces of scrutiny over the past five years on smaller hospitals in the county and how they have adapted to a smaller workforce, lower levels of demand for services and financial constraints.  The key messages from the presentation were: small hospitals in the UK are not that small when compared to other developed countries and health systems; centralisation of services is not always a viable option; hospitals are part of a wider integrated system and key to the provision of a broad range of services locally; they are able to meet 99% of need but not the rare 1%, for which access to centralised specialist treatment is required; the development of new workforce strategies is important; the greater use of technology will enable more services to be delivered locally in smaller hospitals; and with a super ageing population, smaller hospitals are likely to take on a greater role.  The emerging ICS architecture of the NHS is part designed to facilitate a dynamic new role for smaller hospitals.  This different perspective on smaller hospitals and the key role that they have to play in the local community helps change the dialogue from a focus upon what is missing or lost to one of what is retained, what can be developed and the specific niche that such a hospital can fill in the local community.

Mental health services

The performance of the Tees Esk and Wear Valleys NHS Foundation Trust and the mental health services that it provides has been a subject for scrutiny by this committee for a number of years.  The committee has continued to review progress that is being made by TEWV with the delivery of improvement plans following a number of challenging inspections by the CQC.  More recently, the committee has sought assurance that the temporary closure of the Esk ward at Cross Lane Hospital, Scarborough due to staffing pressures would not become permanent and that efforts were underway to ensure its prompt re-opening.  Despite these issues, it is recognised that TEWV has been able to develop new mental health services in the county and modernise its in-patient facilities and community hubs.  The workforce pressures faced by TEWV across a number of services is understood and in the coastal areas of the county unsurprising.  It is of concern, however, that workforce shortages in key public services in North Yorkshire, particularly health, remain an issue despite years of effort to address them.   

Stroke services for the North Yorkshire population

The committee has carefully scrutinised the changes to the provision of hyper acute stroke services in Harrogate and Scarborough since July 2018.  This is an example of a specialist service (the 1% that was referred to in the earlier summary of discussions on ‘unavoidably small hospitals’) where centralisation makes sense clinically, financially and in terms of workforce management and patient outcomes.  The committee will review the patient outcomes data on an ongoing basis, to ensure that the services provided in Leeds, York and Hull continue to meet the level that was stated at the outset of the changes made to the services.

The committee heard that the North Yorkshire Clinical Commissioning Group (CCG) had embarked on further engagement with groups on the east coast who had previously expressed concerns about the changes to stroke services at Scarborough Hospital.  They had also undertaken a survey with patients who had been treated through the new stroke pathway over the past 18 months.  The feedback from both the survey and the wider engagement was positive.  It was also accepted by the CCG that more work still needed to be done to share the vision for health services in Scarborough and the future of the hospital.  Members will be aware that Scarborough hospital is due £47 million of capital investment for the development of new urgent, emergency and critical care facilities.

Mid Cycle Briefing on 28 January 2022

At the Mid Cycle Briefing on 28 January 2022, the focus was upon the development of the committee work programme, with a view to being able to handover a robust work programme for the committee members post the May elections.  The agenda for the March meeting of the committee was also finalised. 

Committee meeting on 11 March 2022

The next meeting of the committee will be at 10am on 11 March 2022.  At this time, the items for consideration at that meeting are as follows:

· The NHS response to and recovery from the pandemic

· An update on Covid-19 prevalence in North Yorkshire

· An update on the performance of the newly redeveloped Whitby Hospital

· Capital investment in Scarborough Hospital and the development of new urgent, emergency and critical care facilities.

· A review of urgent care pathway in the Vale of York CCG area.

This will be the last meeting of the committee in this Council.  I would like to take the opportunity to thank the committee members and supporting officers from the Council and the NHS locally for all that they have done to enable effective health scrutiny over the past 5 years, under my chairmanship and that of my predecessor County Councillor Jim Clark.

COUNTY COUNCILLOR JOHN ENNIS

Chairman of the Scrutiny of Health Committee

28 January 2022