Agenda item

The Committee received a report of the Director of Transformation and Partnerships and presentation from representatives of the County Durham Clinical Commissioning Groups (CCGs) and County Durham and Darlington NHS Foundation Trust (CDDFT) that provided an update in respect of the Review of Stroke Rehabilitation Services in County Durham (for copy see file of Minutes).

The Principal Overview and Scrutiny Officer highlighted background details from the report.

The Director of Commissioning, DDES CCG gave a detailed presentation that highlighted the following:-

·         Scope of Improvement

·         Vision and commitment

·         Patient, public and carer engagement

o   methodology

o   emerging themes

·         What does it look like

o   Best practice

o   Patient engagement feedback

·         Gaps with the current provision

·         The way forward

The Chairman thanked the Director of Commissioning for her presentation and commended the service provided at Easington and suggested that this was rolled out across the County.  In relation to the bed reduction at Bishop Auckland he asked if this report had an effect on ward six.  The Director of Commissioning explained that Stroke Rehabilitation was delivered on ward three at Bishop Auckland Hospital and was independent of ward six.  She confirmed that the two issues were separate and that Bishop Auckland Hospital was an important part of health care and structure and that this report was not questioning the viability of the hospital.

In response to a question from Councillor Darkes about the ‘magic hour’ in relation to strokes he was advised that the one hour was the golden hour to scan the patient and carry our diagnostics.  The timeframe for clot busting therapy if required was within four hours.

Referring to the presentation to Committee in July with the attendance of Dr Py stating that the therapies were diluted and that there were longer intensities in Bishop Auckland Hospital, Councillor Smith was concerned that there was an underlying agenda.  She went on to recall that staff at Bishop Auckland were to be freed up and available to work in the community as it had been identified that there was a lack of community services.  She asked for re-assurance about the future of Bishop Auckland Hospital.  The Director of Commissioning said that the views of clinicians was that therapies were diluted across the two sites and therefore the options were to move therapists into the community or to employ more therapists.  She confirmed that patients did stay longer in Bishop Auckland Hospital and the service would want to see patients discharged as soon as was appropriate for them.  She assured Members that there was not a plot to close the hospital but that they had to ensure that they commissioned the right services by gathering evidence and feedback.

Councillor Zair was also concerned that there was a bigger agenda for Bishop Auckland Hospital.  He said that the fear was exacerbated by the ward six announcement.

Councillor Allen also believed that there was a correlation between the two issues of the implications for ward six and the acute beds at UHND.

The Director of Commissioning informed the Committee that there was further work to be undertaken with regards to ward six and a lot of factors would be taken into account, one being having services closer to home and that the national guidelines must be taken into account.  She added that recovery was better outside of the acute setting and that the service would be aspiring to that.  She added that this did not mean that beds would not be required for stroke rehabilitation in Bishop Auckland Hospital.  They would deliver the best care with the staff available to them.

With regards to the survey Councillor Temple asked for clarification about acute services as it only referred to UHND.  It was confirmed that this was a typographical error and did in fact relate to both sites. 

The Chairman asked if the east of the county had been considered.  The Commissioning and Development Manager confirmed that the period of engagement had been extended and would focus on the population of Easington.

Resolved:

(i)         That the report be received and information within the presentation be noted;

(ii)        That a further report be brought back to the Adults Wellbeing and Health OSC on 18 January 2019.