Agenda and minutes

Joint Health Overview and Scrutiny Committee - Tuesday 9th March 2021 6.00 pm

Venue: Online via Youtube

Contact: Joe Suffield  Democratic Services

No. Item




No apologies were received.


Declarations of Interests

To receive declarations of interest from Members.


There were no declarations of interest.


Questions and Deputations

To answer any questions, if any asked by any resident of the Borough pursuant to Standing Orders.


No questions or deputations were received.


Minutes pdf icon PDF 258 KB

To receive the minutes of the previous meeting held on 16th December 2020.


The minutes of the meeting held on 16th December 2020 were presented to the Board.


Member requested that an item on Long COVID was included at a future meeting.



The minutes of the meeting held on 16th December 2020 were approved.


Urgent Care Update and NHS 111 First pdf icon PDF 831 KB


The Acting Chief Officer for West Midlands Integrated Urgent and Emergency Care Service introduced the item and drew Members attention to:

·  The NHS 111 offer continues to be delivered by West Midlands Ambulance Service (WMAS) in Dudley. It has developed into a frontline patient service, with a number of clinicians to support the calls.

·  It was noted that 999 and 111 call handlers within the West Midlands would soon be integrated seamlessly. This would enable 999 calls to benefit from the expertise of 111 clinicians and reduce ambulance conveyance.

·  Since the COVID-19 pandemic, there had been increased demand on the service, as the public had been encouraged to use the 111 service. This had not significantly impacted on regional performance against KPIs. Other factors which increased demand included:

o  The introduction of NHS 111 First in December 2020.

o  Staff sickness and absence rates.

o  National contingency support to other 111 providers in England.


The Integrated Emergency and Urgent Care Director, WMAS highlighted the following points to Members:

·  WMAS took over as the NHS 111 provider for the Greater West Midlands region in November 2019. A considerable amount of work had been undertaken to improve the service. From March 2020, there were significant changes in the activity of the service and how users accessed the health service. This was unlikely to ease in the immediate future.

·  There appeared to be less of a reliance to contact GP surgeries and instead residents would choose to contact NHS 111.

·  They continued to try to reduce the number of people who unnecessarily contacted 999 or attended Emergency Departments. This was part of a shift to support patients in their own home, and for them to access the most appropriate local service.

·  They aimed to completely integrate the 999 and 111 service into a single call queue. This would improve outcomes for patients as they would be able to seamlessly access alternative pathways when appropriate.


Members made comments and asked the following questions:

·  A Member asked about which services NHS 111 users attended instead of Emergency Departments. The Integrated Emergency and Urgent Care Director confirmed that the information was available and this highlighted that patients would primarily be directed to Primary Care services, local pharmacies and other similar provision. In response, the Member sought clarity whether this created an additional burden on Primary Care services, and whether there was additional funding to support this. It was stated that the data would not support this, and less patients were sent through to their own GPs.

·  A Member queried whether there was information to show that fewer people would attend Emergency Departments if they contacted NHS 111. The Integrated Emergency and Urgent Care Director explained there were not larger numbers of patients referred to Emergency Departments after they contacted NHS 111. They worked closely with partners to make sure referrals were followed up; as they were able to book appointments.

·  A Member asked whether there had been any significant events as a result of residents who  ...  view the full minutes text for item 5.


Briefing on Birmingham and Solihull STP Wave 2 Update pdf icon PDF 1 MB


The Director of Planning and Delivery, Birmingham and Solihull CCG, introduced the item and provided the following update on the Birmingham and Solihull service response to COVID-19:

·  Since the last update, there had been significant changes in the previously reported position, as a result of the latest COVID-19 wave. The rate of COVID-19 had dropped a lot, however remained high. Similarly, hospital admissions remained high, and patients had been transferred out of Birmingham and Solihull Hospitals to manage demand.

·  They were due to re-enter the restoration and recovery phase, and plans were being drawn up to prepare for this. Primarily this would focus on maximising capacity within the system for priority 2 and 3 patients. This would be a system wide approach, with a single waiting list across Birmingham and Solihull providers, which would mean that resources would be pooled.

·  An elective coordination hub would be led by University Hospitals Birmingham (UHB). Decision making would take place at Chief Executive level in relation to the order that critical services would be restored. Where service changes would be made permanent, due process would be followed.

·  The 2021/22 planning round had been deferred by NHS England and Improvement to Quarter 1 of 2021/22. They still awaited the national planning guidance and financial allocation for 2021/22. There was steps to identify the baseline financial position for the next financial year.


Members made comments and asked the following questions:

·  A Member asked in what order services would be stood back up.  The Director of Planning and Delivery explained that it would be decided on clinical priority, which was a process undertaken by clinicians.

·  A Member queried how many staff were absent from work because of mental health problems and what support was available and accessed. Other Members flagged similar concerns. The Deputy Chief Executive, Birmingham and Solihull CCG, highlighted that there was a health and wellbeing programme of work and a “peoples” Board. Sickness and absence was monitored through this forum and information on this would be shared with the Board. The offer had been promoted to support staff mental health; it was recognised that this would need to be in place for a prolonged period of time.

·  Members requested clarity about whether Solihull Hospital still had COVID-19 patients. The Director of Planning and Delivery confirmed that it no longer had COVID-19 patients, these were restricted to the Queen Elizabeth, Good Hope and Heartlands Hospitals. Strict measures to prevent cross infection remained in place.

·  A Member questioned how people with degenerative diseases were prioritised. The Director of Planning and Delivery explained that all patients would be included and considered on the single waiting list.

·  A Member sought clarification on the backlog of patients for the priority groups, how long it would take to work through this list and the process for this. The Director of Planning and Delivery noted that the figures for the priority lists shifted frequently, and information would be shared with the Board. There was detailed modelling work which would consider  ...  view the full minutes text for item 6.


Birmingham and Solihull STP Finance Update 2020/21 pdf icon PDF 526 KB


The Associate Director of Finance for Sustainability and Transformation provided the following update:

·  The system had an agreed system trajectory of £19.2m deficit. The current forecast at month 10 was a £31.7m deficit, which included a £22.3m increase in annual leave accrual. There were indications that there would be additional funding to cover some of this. The balance without the annual leave accrual was a £9.4m deficit.

·  There were some risks in the financial position in relation to the elective incentive scheme which had specific targets that had not been met. There would have been a charged levied for this, but national indications suggested that they would not be applied.

·  Guidance continued to be circulated on how to treat COVID-19 related costs at the end of the financial year. As this was released, forecasts would be reviewed and updated.

·  The system has a capital envelope which had to be operated within. If one partner had some slippages on their capital programme, this would be managed across the system.

·  The cash position was better than planned, due to a national system whereby block payments to providers were paid a month in advance and therefore they had the benefit of an additional month’s cash within the system.

·  The planning round had been paused and it was likely that financial arrangements for the latter half of 2020/21 were due to roll over into the first quarter of the 2021/22 financial year. The funding envelope available for health was still to be confirmed.

·  Nationally there had been £1.5bn set aside for recovery and restoration work. There would be guidance on what these additional funds would look to cover. They had made some high level estimates about the costs of restoration and recovery, which would total around £50m. This continued to be assessed and may be reduced. Upon a fair shares basis it would be likely that the allocation would amount to £20m. The allocation was expected to be circulated around the end of March.


Members made comments and asked the following questions:

·  A Member raised concerns that to clear the backlog would potentially cost £50m, while there was likely to only be £20m of funding available. They asked how long it would take to clear the backlog based on the £20m figure and how the money would be used. The Associate Director responded that it would be determined by the funds available and would be a collaborative effort to pool resources to decide it would be most effectively used. The discussions on allocations remained ongoing and would form part of the planning round. It was requested that an update on this would be included at the next meeting.

·  A Member asked how the additional allocations were split between trusts. In response, the Associate Director confirmed that the allocations were given to systems to manage across partnerships to enable the allocations to be clinically prioritised.

·  A Member queried whether the current deficit included the CRES savings. It was confirmed that this did include any efficiency  ...  view the full minutes text for item 7.


Goodrest Croft Surgery


Councillor Pocock raised the issue of the closure of Goodrest Croft Surgery. It was requested that the information received by Birmingham Councillors was shared with Solihull Members, as the GP surgery may have Solihull residents.



Members asked that a report was bought to the next meeting which covered the procedure for the closure of the GP surgery, and the consultation that took place prior to the decision.