Questions for Calderdale and Kirklees Joint Health Scrutiny Committee about shifting hospital services into the “community”

These are the questions I have sent to the Kirklees Scrutiny Officer for the virtual meeting of Calderdale and Kirklees Joint Health Scrutiny Committee on 25th Sept, 1.30pm.

Dear Richard
Sorry I missed the 10am deadline, but I have questions for the Scrutiny Meeting:

1) Re the update on primary and community services – Please will the Calderdale and Kirklees Joint Health Scrutiny Committee affirm that it is its business to scrutinise the Care Closer to Home/Primary Care Network/Integrated Care plans for the whole CHFT footprint? And make sure that it does this thoroughly?

2) Why does the Calderdale and Huddersfield Service Reconfiguration Update Report for the Calderdale and Kirklees Joint Health Scrutiny Meeting make the misleading statement that

“These changes to the delivery of Community Services are subject to separate place-based Scrutiny in both Calderdale and Kirklees”

– when there was a clear challenge to this arrangement in the last CK JHSC meeting in October 2019, by Cllr Colin Hutchinson?

He reminded the Committee that at some stage, they have to tell the Health Secretary whether or not they are satisfied that the revised plans meet his 3 requirements:

  • Further work focussing on out of hospital care
  • Hospital capacity
  • Availability of capital

He pointed out that the Scrutiny Committee needed further information about progress to increase care in community settings, that would allow the hospitals trust to work within the planned bed base.

The NHS organisations provided  little information in that meeting about progress to increase care in community settings – moreover, Matt Walsh seemed to try and divert this scrutiny by responding to Cllr Hutchinson’s statement with:

“We need to think about the relationship between place and this committee.”

Translated, that seems to mean he wanted the “place” – ie individual Council – health scrutiny committees to scrutinise their area’s Clinical Commissioning Group’s care closer to home plans – rather than the Calderdale and Kirklees Joint Health Scrutiny Committee scrutinising both the Greater Huddersfield and Calderdale care closer to home plans.

It was not the first time in this Scrutiny Committee that he had made the same point.

Cllr Hutchinson replied,

“This committee has to respond to the Secretary of State. And we have no interest in duplicating work that’s going on in Councils’ scrutiny committees, but we do need to be able to respond to Secretary of State in due course.”

3) It is very worrying that there is so little information about Care Closer to Home/ the shift of services out of the hospitals, in the current document for scrutiny. And what there is is a skimpy affirmation that

“The experience from the Pandemic is that the continued integration of services is able to be implemented at pace across Primary, Community and Social care.”

The fact that this is possible doesn’t mean it’s desirable. And we know from the West Yorkshire and Harrogate Integrated Care System – and from members of the public – that there are serious issues about restoring elective care in the Covid-19 “reset”.

We also know that in Calderdale at least, GPs are inundated and are finding it very difficult to balance their on-day response to patients’ needs with other needs for GP services.

Please will the Committee make sure that these issues are properly scrutinised in this meeting and they don’t just note the update, as it recommends?

4. Relatedly, ONS data shows a big rise in deaths at home over past months. Please will the Scrutiny Committee find out what the End Of Life Care in the community services have been able to do, to provide appropriate good quality care to people dying at home in Calderdale and Kirklees since the last Scrutiny meeting 11 months ago? And whether and how the need for their services has risen in line with data about increased numbers of people dying at home?

5. Finally, we know that many Care Home residents died of Covid 19 after NHS England ordered the mass discharge of patients at the end of March, in order to prepare for an influx of Covid-19 patients. Please will the Committee find out what arrangements are now in place for the safe discharge of hospital patients to care homes, and their care after discharge?

Best wishes,

Jenny Shepherd

(Each person is only allowed to ask 4 questions, but I forgot that and asked 5. That and missing the deadline is a bit rubbish, sorry.)

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