Agenda item

To consider a report from Leeds City Council’s Head of Governance and Scrutiny Support that introduces a report from the West Yorkshire and Harrogate Health and Care Partnership that provides a further update on the Partnership’s Specialist Stroke Care Programme.

Further to minute 8 of the meeting held 30th July 2018, the Joint Committee considered the report of Leeds City Council’s Head of Governance and Scrutiny presenting the requested update on the Specialist Stroke Care Programme and the work undertaken across West Yorkshire and Harrogate to improve Specialist Stroke Services.

The following were in attendance and contributed to the discussion:

·  Jo Webster – Chief Officer NHS Wakefield CCG and SRO West Yorkshire and Harrogate Stroke Programme

·  Andy Withers – Clinical Chair Bradford Districts CCG and West Yorkshire and Harrogate Stroke Programme Chair

·  Graham Venables – Clinical networks clinical director – Northern Region

·  Stacey Hunter – Chief Operating Officer, Airedale NHS Foundation Trust – representing the West Yorkshire Association of Acute Trusts

·  Jacqui Crossley, Head of Clinical Effectiveness and Governance, Yorkshire

·  Karen Coleman – West Yorkshire and Harrogate Health and Care Partnership Communication and Engagement Lead

Jo Webster – Senior Responsible Officer (SRO) for the Stroke Programme – provided the Joint Committee with highlights from the report and overall aims of the programme, which included:

·  Providing seamless and consistent care across the care pathway

·  A focus on prevention with the aim to reduce the number of strokes by 46 annually.

·  Further reduction of up 620 strokes per year, through best practice interventions with identified high risk patient groups.

·  Enabling a swift recovery for people suffering a stroke and having an agreed set of standards around rehabilitation.

·  Public engagement had provided 2,500 responses.

·  The SRO went on to add that the November meeting of the Joint Clinical Commissioning Group (scheduled for 6 November 2018) was expected to recommend future Specialist Hyper-Acute Stroke Services to be provided from 4 of the existing sites, with the other existing unit at Harrogate to provide rehabilitation services only. Members received assurance there would not be any further reconfiguration of services.

·  Further communication would be undertaken to ensure patients are aware of the new care pathway.

The Joint Committee considered the details presented at the meeting and highlighted a range of matters during its discussions, including:

Ø  The findings of the public consultation.

Ø  The optimum annual patient flow for Specialist Hyper-Acute Stroke Services, which could highlight the need for a review of service provision, as follows:

o  Less than 600 per annum

o  Between 1200-1500 being high for a single team within an individual unit

Ø  The current annual patient flow / numbers at the current Specialist Hyper-Acute Stroke Units.  The Joint Committee was provided with the following summary of current patient flows/ numbers:

o  Mid Yorkshire 900 p/a

o  Leeds Teaching Hospital Trust 1200 p/a

o  Bradford 800 p/a

o  Calderdale 750-800 p/a

o  Harrogate 300 p/a

Ø  The possible impact on safe provision once the Harrogate Hyper-Acute Stroke Unit was decommissioned (as proposed).

Ø  Members received assurance that LTHT would manage the additional patient numbers as it was anticipated that approximately 100 patients (i.e. a third of current Harrogate patients) would divert to York Teaching Hospital NHS Foundation Trust

Ø  The capacity and role of the Ambulance Service to deliver the new emergency care pathway.

Ø  Recognition that patient flow within the West Yorkshire and Harrogate area necessitated a standard pathway to ensure consistent service delivery.

Ø  Whether service users/consultation respondents had been formally made aware of the final proposals. (Officers from the Partnership agreed to ensure further engagement would be undertaken.)

Ø  The need to ensure former Harrogate patients have access to the standard rehabilitation pathway following emergency treatment. 

In conclusion, the Chair noted there had been public engagement with the population of Harrogate around the proposed closure of the Harrogate unit (as a hyper acute stroke unit); and this had also been the subject of discussion with North Yorkshire County Council’s Scrutiny of Health Committee/ Chair.  However, the proposals and the associated impact on services in Leeds had not been presented when the Leeds Scrutiny Board previously considered the review of Specialist Stroke Services in July 2018. As such, noting that Leeds Teaching Hospitals NHS Trust – through the West Yorkshire Association of Acute Trusts (WYATT) had considered the proposals, the Chair requested that, as the local operational plan was prepared and ready to be in place by the end of 2018, that

Ø  The Joint Committee be given the opportunity to review the overall plan;

Ø  The Leeds Scrutiny Board also be given the opportunity to consider the specific implications and any associated mitigating actions for services in Leeds, and

Ø  Kirklees Health and Adult Social Care Scrutiny Panel receive an update and assurance on patient flows, as appropriate.

RESOLVED –

a)  To note the ‘optimal’ service delivery model for hyper acute stroke care presented.

b)  To note the view of the West Yorkshire & Harrogate Health & Care Partnership that there is no requirement or plan to further engage or consult across the whole of West Yorkshire on the optimal service delivery model

c)  To request further formal engagement with service users on the proposed ‘optimal’ service delivery model for hyper acute stroke care.

d)  To support the recommendation to commission a standard hyper acute stroke service pathway and service specification across WY&H.

e)  To support the recommendation to re-establish a stroke clinical network across WY&H

f)  To note the work underway to further improve quality and outcomes across the whole of the stroke pathway for the people of WY&H; and

g)  To acknowledge that plans for Harrogate will be led locally and not via the WY&H Partnership, while noting that as the operational plan was prepared and ready to be in place by the end of 2018:

• The Joint Committee be given the opportunity to review the overall plan;
• The Leeds Scrutiny Board be given the opportunity to consider the specific implications and any associated mitigating actions for Leeds, and
• That Kirklees Health and Adult Social Care Scrutiny Panel receive an update and assurance on patient flows, as appropriate.

NB Councillor Clark left the meeting at 3:40 pm during consideration of this item