Agenda item

The Chairman introduced Sarah Burns, Director of Commissioning, DDES CCG, Rachel Rooney, Commissioning and Development Manager, North Durham CCG and Gillian Curry, Head of Communications and Charity CDDFT.

The Commissioning and Development Manager outlined some of the key areas of feedback that was received as part of a targeted engagement exercise in relation to stroke rehabilitation services that was undertaken over an eight week period (for copy see file of minutes).

Gaps and key points were highlighted which would be addressed during the ongoing review in relation to:

·         communication challenges;

·         emotional wellbeing and support;

·         inconsistency of community rehabilitation provision;

·         people who appreciate a longer period of therapy once discharged from a hospital setting.

The Commissioning and Development Manager advised that the exercise would include representation from community and hospital based clinicians, primary care, regional clinical network and the Stroke Association. A business case would be developed and presented to Adults, Wellbeing and Health Overview and Scrutiny Committee in April 2019.

The Chairman referred to the County Durham and Darlington Stroke Rehab Improvement Group membership and asked if none health organisations were involved. He also questioned where the money was coming from to fund the community service and would it affect hospital beds in University Hospital North Durham, Bishop Auckland and Darlington. The Commissioning and Development Manager replied that the group had representations from the Stroke Associations, CCGs and the clinical network to focus on clinical best practice. She confirmed that there would be investment in community services as stroke rehabilitation was a priority and they were currently identifying which areas to target with further detail to be included in the business case. She added that the aim was not to reduce beds and they were focusing on the outcomes that could be improved.

Councillor R Bell suggested that there were parallels between the Stroke Rehabilitation service review and the ward six issue in terms of the reliance on community services to pick up on service demand under revised service models and the need for appropriate resource investment to enable that to happen. He also noted the positive experience of stroke rehabilitation services expressed by patients as part of the engagement process.

Councillor Darkes referred to improvement health outcomes for those that had suffered a stroke and asked if there would be engagement and integration with the ambulance service to respond within the magic hour. The Commissioning and Development Manager advised of work carried out to move to a single site model and information was available on improvements made regarding response times which would be shared with the Committee.

Mr Taylor Gooby referred to concerns regarding public health cuts and questioned if it was the NHS Trust, CCG or the Local Authority who was ultimately responsible for providing provision in the community. The Director of Commissioning advised that the CCG was responsible for ensuring appropriate resources to meet the needs of patients. She explained they were engaging patients and carers to better understand the gaps and needs of the population and were working collectively with partners to address those issues.  There was an obligation to the Adults, Wellbeing and Health Overview and Scrutiny Committee, County Durham and Darlington NHS FT’s governing body and NHS England to ensure that any proposed changes to clinical pathways were based upon robust clinical evidence and subject to the statutory consultation and engagement processes.

The Chairman reiterated the Council’s concerns regarding the threat of losing £19 million in Public Health Care Funding.

Councillor Hopgood commented on the importance of engaging families, as patient’s responses can be very different from the families’ perspective. The Commissioning and Development Manager agreed that family involvement was crucial and clarified that the term ‘carer’ also incorporates family engagement.

Councillor Patterson reiterated her concerns about the reliance of community based services and also the difficulties of accessing services in such a large geographical area as County Durham. It was important that community service provision and stroke rehabilitation services were delivered in a timely manner to assist in recovery.

The Principal Overview and Scrutiny Officer advised that members had previously raised issues around transportation and the involvement of NEAS. The NEAS representative was unable to attend the meeting, however advised that the review of stroke rehabilitation was in the early stages of development and that NEAS would be fully engaged in the review process through the Local Area Development Board.

Resolved:

That the key themes from feedback and the process for further development of the stroke rehabilitation services across County Durham and Darlington be noted.