To receive any declarations of interest.

There were no declarations of interest received at this point in the meeting.

The minutes of the Adult Social Care and Services Scrutiny Panel meeting held on 11 November 2020 were submitted and approved as a correct record.

Craig Blair, Director of Commissioning Strategy and Delivery, NHS Tees Valley Clinical Commissioning Group (CCG) will be in attendance to provide the Panel with information in respect Palliative / End of Life.

The Chair welcomed the Panel and members of the Health Scrutiny Panel to the meeting. He advised that this was a setting the scene meeting in response to Palliative and End of Life Care. With this in mind, he welcomed Craig Blair, Director of Commissioning Strategy and Delivery from NHS Tees Valley Clinical Commissioning Group (CCG).

The Director firstly provided some context, outlining that the Tess Valley CCG was now coterminous with the Tees Valley Integrated Health and Care Partnership (ICP). The ICP working spans three secondary care providers, five hospices, five local authorities and parent carer forums along with numerous third sector organisations. It is a complex and a diverse system that they work in.

The Panel were advised that there had been an organisational change and a recent merger of three diverse CCGs, Hartlepool and Stockton-on-Tees CCG, Darlington CCG and South Tees CCG to become Tees Valley CCG . The merge highlighted inequalities and variation in funding and contracting methods across hospice services and palliative care services and emphasised the need for one strategy co-produced with partners.

The aim of the CCG was to explore the use of new contracting methods and national service specifications for similar services provided by hospices and specialist services adapted to meet the needs of individual providers. Many of the CCGs palliative and end of life care services have outdated service specifications which require review.

In terms of Covid, it has been challenging for all sectors, however the Director advised that as a system they have responded in a coordinated, flexible and effective way. However the pandemic has had wider system impacts with Hospices especially in light of reduced charitable income. The Director outlined that there is a need to continue the excellent working relationships with the Hospices to ensure vital services are maintained. Covid and the organisational changes have driven an added impetus to review services and explore the development of a system wide approach to delivering integrated services.

The Panel were advised that once the need is established across the CCG and the current service analysis completed, then the delivery model and the most appropriate payment and contracting methods to deliver the model will be determined.

The CCG are willing to look at innovative contracting solutions to deliver true integrated care that draws on the emerging ‘Future Vision’ work NHSE/I are currently supporting Hospice UK to produce, with the aim of re-imagining a more sustainable future for palliative and end of life care. The CCG are also focussed on collaborative working to develop and deliver new and innovative pathway development and contracting solutions to deliver true integrated care that draws on the emerging ‘Future Vision’ work NHSE/I are currently supporting Hospice UK to produce, with the aim of re-imagining a more sustainable future for palliative and end of life care.

The aim from a commissioning service:

To make the last stage of people’s lives as good as possible by aligning systems and processes so that everyone works together confidently, honestly  ...  view the full minutes text for item 20/26

David Smith, Chief Executive will be in attendance to provide information on the work and support Teesside Hospice provide in respect to Palliative/ End of Life Care.

The Chair welcomed David Smith, Chief Executive of Teesside Hospice to the meeting.  Prior to the meeting, the Chief Executive had shared a briefing document, however briefly went through key aspects.

He advised the Panel that Teesside Hospice was established in 1982, and is a charity working in partnership with the NHS and wider system delivering specialist palliative care, end of life care, wellbeing activities, lymphoedema care and grief and trauma counselling services for adults and children across Teesside and parts of North Yorkshire. As others have developed their skill in delivering generalist care, their priority is to look after people, their families and carers who have complex or multiple needs and to provide Specialist Palliative Care and support and expertise in end of life care. In addition, they provide specialist advice and support to other professionals on palliative and end of life care, offer specialised education and training and undertake research across our areas of work.

Teesside Hospice employ 148 people in a variety of different roles and have over 300 volunteers in our hospice, retail and fundraising departments.

The services are available free of charge to the people who need them. In 2020-21, the clinical services will cost just over £3M to deliver. About 43% of this comes from the local NHS with the remainder coming primarily from fundraising activities across Teesside and local residents via retail sales in the shops.

Teesside Hospice and Mission statement

Our Vision is that we are there for everybody who needs us. We want to change the way our society and healthcare systems care for people with a life limiting illness and ensure that local people get the very best care at the end of their life.

Our Mission is to complement other services by leading the development of new ways of working and delivering hospice care that meets the needs of those at the end of their life today and those in the future, whatever their needs might be.

The Panel heard that there is a skilled multidisciplinary team at the hospice, which offers patients holistic care, ensuring that their physical, emotional, social and spiritual needs are met. The team includes: a Consultant in Palliative Medicine, Hospice Medical Team, Specialist Nurses, Occupational Therapists, Dietician, Social Worker, Physiotherapist, Complementary Therapist, Chaplaincy and Counselling Services.

The Hospice also provides a 10 bedded Inpatient Unit, which is the only specialist inpatient beds for people requiring palliative or end of life care in the locality. The Chief Executive advised that it is useful to consider the facility at Teesside Hospice as a High Dependency Unit for people with Palliative and End of Life Care needs.

With a target occupancy rate of 85% and average length of stay around 14 days, the Inpatient Unit focusses its work in the general areas:

·         End Stage Care: Some patients choose to spend their last days in the unit, being admitted during the very late stages of their illness

·         Pain and Symptom Management: for people experiencing pain and  ...  view the full minutes text for item 20/27

The Chair will provide a verbal update from the Overview and Scrutiny Board help on 3 December 2020.

The Chair provided a verbal update from the Overview and Scrutiny Board held on 3 December 2020.

Agreed-

That the update be noted.