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BRECKNOCK AND RADNOR COMMUNITY HEALTH COUNCIL Minutes of a meeting held on Friday 29th November 2013 in Bishop Meadow Motel, Brecon at 10.30 am. Present: CHC Members: Cllr Mrs D G Thomas – Chairman Mrs H Barrow – Vice Chairman Mrs A Mathias Cllr H Williams Cllr I Williams Co-opted Members: Mr G Davies Mrs J Eason Mr G Greaves Mrs M Morris Mr J Steadman Mrs B Whitticase In Attendance : J David Adams, Chief Officer, CHC Jayne Thornhill, Deputy Chief Officer, CHC Gill Coles, Office Manager, CHC Dr Brendan Lloyd, Medical Director, Powys THealth Board Mr Andrew Evans, Local General Manager, South Powys Mr Bruce Whitear, Director of Planning Three members of the public were present. Action FC/91/13 There were no apologies for absence. FC/92/13 Declarations of Interest: There were no Declarations of Interest. FC/93/13 Chairman’s announcements: There were no specific announcements by the Chairman. th FC/94/13 Minutes of the Meeting held on 16 September 2013 th The minutes of the meeting held on 16 September 2013 were AGREED as a correct record. FC/95/13 Matters Arising and Not Listed on the Agenda a) Ystradgynlais Community Hospital Minor Injuries Service Locality General Manager, Andrew Evans reported that the appointment of a nurse practitioner for the Minor Injury Unit at Ystradgynlais Hospital had been made. The successful candidate was currently employed at Morriston Hospital and a release date was being negotiated. 1 Mrs Heather Barrow stressed the need to advertise the minor injury service to the public once the person had taken up the post. b) Proposal to transfer the mental health resource centre from “The Larches” to the hospital The Chief Officer reported that a brief on the current situation for the transfer of the mental health resource centre from “The Larches” to Ystradgynlais Community Hospital had been received at a recent meeting of the Ystradgynlais Health Focus Group. The information had been welcomed by those present. It was noted that the service would move into the hospital in March/April 2014. c) The Chief Officer informed the meeting that the questionnaire to monitor the Virtual Ward service operated at the Ystradgynlais, Crickhowell, Brecon, Hay and Talgarth GP Practices had been finalised. Distribution of the questionnaires had commenced at the beginning of November. No completed surveys forms had been received at the CHC office to date. It was noted that prepaid addressed envelopes were being issued with the questionnaires and the CHC office number was being included should anyone need assistance with completing the questionnaire. Ann Mathias suggested publicising the survey with a report and photograph in the local press. d) Implementation of the Recommendations from the Review of Community Health Councils. The Chief Officer reported that there was no certainty concerning the date for joining the two CHCs in Powys to form a single CHC. Progress was being made by the two CHCs to work more closely together. In the meantime, a Joint Executive Group of the two CHCs had been formed and would be meeting on 10th December. e) Pain Management Clinic It was noted that the Manager of the Pain Management Clinic, Bronllys Hospital would be invited to give a presentation to the full CHC meeting in January 2014 on the current developments for long term conditions. At the AGM of Powys THealth Board members had been advised that the residential aspect of the Pain Management Clinic had been closed temporarily following a fire safety audit. The CHC had not been advised of the future arrangements for the service. Locality General Manager, Andrew Evans informed the meeting that the residential facility had been closed temporarily due to compliance with fire regulations. Patients who were undergoing treatment had been moved to local 2 Bed Breakfast accommodation. Residential pain management treatment would be postponed during December and January. The situation would be addressed in January. FC/96/13 Ministerial Appointments to Brecknock and Radnor Community Health Council The Chief Officer confirmed the Ministerial appointments to Brecknock and Radnor CHC as indicated in his letter to CHC members dated 21st November 2013: From 1st December 2013 to 30th November 2017 Mrs Barbara Whitticase Mrs Jane Eason Mr Geoffrey Davies st st From 1 April 2014 to 31 March 2016 Mrs Jacqueline Wilding A number of other candidates interviewed for the ministerial appointments had been invited to have their names added to a waiting list pending a vacancy arising within the CHC membership. Two Ministerial appointments had been made for st Montgomeryshire CHC – one member appointed from 1 st December 2013 and one from 1 July 2014. Induction training would be organised for new members of both Powys CHCs at a venue in Llandrindod Wells and all existing members would also be invited to attend. The Chairman encouraged all members to attend the induction training to meet the new members. The Chief Officer reported that revised guidance on annual appraisal arrangements had been received. He also advised that a recruitment process would take place in conjunction with Powys Association of Voluntary Organisations to fill the existing vacancies for voluntary organisation members. FC/97/13 Response from Powys Teaching Health Board concerning the transfer of the Stroke Rehabilitation Service from Bronllys Hospital to Breconshire War Memorial Hospital The Chief Officer presented his report updating members on the arrangements the Health Board had and was making to respond to the caveats imposed by the Community Health 3 Council in relation to the transfer of the stroke rehabilitation service. The report set out the position and findings of the CHC’s Monitoring Group in respect of each of the caveats imposed by the CHC. The CHC was particularly concerned over the clinical leadership for the stroke rehabilitation service. The Health Board’s response to the concerns raised by the CHC on this issue was outlined in the Chief Officer’s report. The Chairman invited the Health Board representatives to report on the action taken and being taken by the Health Board to address the issue of clinical leadership for the service. Director of Medical Services Dr Brendan Lloyd explained that currently Consultant Physician: Age Care, Dr Dunn was the consultant lead for the stroke rehabilitation service. He advised that Dr Dunn would be retiring in the next 12 to18 months. He reported that there was a major shortage of specialists in care of the elderly nationally and it was necessary to build a more sustainable model for the stroke rehabilitation service in Powys. It was intended that Consultant Physician: Age Care, Dr Pinhorn would extend her remit while Dr Dunn was still in post to take on the lead role in rehabilitation care. The Health Board had looked at the possibility of recruiting a specialist for Mid Powys with sessions from Wye Valley NHS Trust. However the Trust had also experienced difficulties in recruiting to two Consultant posts at Hereford for stroke services. Consequently support to Powys could not be offered by Wye Valley NHS Trust. Geoffrey Greaves stressed the importance of involving the Local Authority Social Services Department to improve care in patients’ homes when discharged from hospital. Multi- disciplinary teams were essential. Locality General Manager, Andrew Evans assured the CHC that the Health Board worked closely with Social Services to enable patients to return to their own homes as soon as possible after suffering a stroke. Ann Mathias asked if the Health Board had been aware of the difficulties with clinical leadership prior to the consultation exercise. She commented robustly that members were very disappointed to be informed at this time that this situation had arisen. Dr Lloyd replied that sustainability of the service would always be dependent on recruitment of a consultant in that specialty. There had been numerous discussions with Dr Dunn and Dr Pinhorn. He said the Health Board had 4 consulted on the provision of the service not on consultant cover arrangements. The Locality General Manager informed members that at the time of the consultation the Health Board was not aware that Hereford would be unable to provide a service because of recruitment difficulties. Neither did the Health Board know that the Consultant Physician would be retiring. The Health Board’s proposals would create a more sustainable model for rehabilitation service. Geoffrey Davies commented on the high regard for the service at Bronllys and reminded of the CHC’s proviso that the high standard of service currently at Bronllys Hospital must be maintained and replicated at Breconshire War Memorial Hospital. In response to this observation, Dr Lloyd informed members that Dr Pinhorn had worked in Powys for a number of years and with the support of the multi-disciplinary team, he assured CHC members that the quality of the service would be maintained and improved. Jane Eason reminded that stroke rehabilitation was not an acute service. She said there was already a robust rehabilitation service at Breconshire War Memorial Hospital. Members needed an assurance that the service would continue. Dr Lloyd responded that whilst it was not possible to give guarantees of continuity, the health board was implementing a more sustainable model for Consultant provision. Cllr Huw Williams commented that in 18 months’ time it appeared that the service would go from two to one consultant. Dr Lloyd confirmed the service would rely on one consultant physician and it would be difficult if the health board was unable to recruit. Dr Lloyd gave an assurance that the Consultant Physician at Breconshire War Memorial Hospital had a broad experience of knowledge in rehabilitation. She would be provided with a package of training to extend her knowledge in stroke rehabilitation.

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