Health and Social Care Committee

HSC(4)-05-12 paper 1

Forward work programme – Further discussion on 'one-off' evidence sessions

To: Health and Social Care Committee

From: Committee Service

Meeting date: 8 February 2012

Purpose

1. To discuss and agree how to use the fourth day available to the Health and Social Care Committee between now and the summer recess for a one-off evidence session.

Background

2. At its meeting on 2 February, the Committee discussed topics for four ‘one-off’ evidence sessions for the spring and summer terms.

3. The Committee agreed to pursue one-day inquiries in relation to the following topics:

- wheelchair waiting times in Wales: follow-up work on the recommendations made by the Third Assembly’s Health, Wellbeing and Local Government Committee’s Report on Wheelchair Services in Wales;

- venous thrombo-embolism prevention; and

- reduced fetal movements and still births in Wales.

4. The Committee also agreed:

- to re-visit the topic for their fourth session at a later date, deciding between co-responder services, access to medicines or orthopaedic waiting times;

- to await the report of the House of Commons Welsh Affairs Committee’s on-going inquiry into post-traumatic stress disorder before undertaking work on this topic; and

- that the subject of health inequalities would require longer than one day for consideration and, as such, should be placed on the list of possible future inquiry topics.

Options

5. The Committee may wish to select one of the following three topics for its fourth available day:

- co-responder services;

- access to medicines;

- orthopaedic waiting times.

Information on each of these is attached at Annex A to this paper.

6. Alternatively, the Committee may wish to retain a gap in the programme to allow sufficient flexibility to respond to any emerging issues and / or future legislation.

Action

7. The Committee is invited to consider and agree how it wishes to use the fourth day available in its forward work programme between now and the summer recess.

Committee Remit

The Health and Social Care Committee’s role is to consider expenditure, administration, policy and legislative matters within its remit. The main areas of ministerial responsibility falling within the Committee’s remit are listed below.

National Health Service

Social care

Mental health services

Public health and health protection

Health improvement

Carers

Social services activities of local authorities

Aids, adaptations and support at home

Independent living

Care in the community

The Older People’s Commissioner for Wales

Food safety

Prison Service health service

Regulation of residential, domiciliary, adult placements

Research and development in health and social care

Relevant EU policy matters

So far this term, the Committee has undertaken the following pieces of work:

Inquiries

Inquiry focused on the provision of stroke risk reduction services and the effectiveness of Welsh Government policies in addressing any weaknesses in these services – completed December 2011

One-off evidence session on the public health implications of inadequate public toilet facilities - ongoing

Inquiry into the effectiveness of the Community Pharmacy contract in enhancing the contribution of community pharmacy to health and wellbeing services - ongoing

Inquiry the provision of residential care in Wales and the ways in which it can meet the current and future needs of older people - ongoing

Legislation

Members will be aware of the following legislative developments:

The Food Hygiene Rating (Wales) Bill: the draft Bill and consultation paper were published by the Welsh Government on 14 December 2011. The consultation period ends on 7 March 2012.

The Organ Donation (Wales) Bill: the White paper was published by the Welsh Government on 8 November 2011. The consultation period ends on 31 January 2012.

The Social Services (Wales) Bill: a public consultation will be launched in March 2012, with a view to introducing the Bill into the National Assembly for Wales in October 2012. Regulations and a Code of Practice for Social Services will be developed once the Bill has received Royal Assent.

The Public Health (Wales) Bill: a consultation is due to be published in 2012.

Potential inquiries: any of the following subjects could provide a timely inquiry for the Committee.

Title	Subject
Health inequalities	In March 2011 the Equality and Human Rights Commission published the report *How fair is Wales?* which called for a reduction in health inequalities between socio-economic groups, especially those affecting older and younger men. The *Programme for Government 2011-2016* states the Welsh Government will implement the actions contained within its technical working paper *Fairer Health Outcomes for All* in order to prevent poor health and reduce health inequalities. The Committee may wish to consider the progress being made on implementing the actions contained within the health strategic action plans and how this is reducing health inequalities between socio-economic groups in Wales.
Wheelchair waiting times in Wales	In May 2010 the former Health, Wellbeing and Local Government Committee published a *Report on Wheelchair Services in Wales. The inquiry was undertaken as a result of criticism of the effectiveness of these services to meet service users’ needs, with waiting times for assessment and provision of particular concern. The Welsh Government’s All Wales Posture and Mobility Review - Phase 2* was published in October 2010 and following this an additional £2.2m of recurrent funding was allocated in the draft budget to help implement the Review’s findings and recommendations, and in particular to ensure waiting times standards contained within the Children and Young People’s National Service Framework are delivered by March 2012.^{^[1]} In March 2011 the All Wales Posture and Mobility Service Partnership Board, as an Advisory Group to the Welsh Health Specialised Services Committee (WHSSC), was established to implement the Review’s recommendations. The Committee may wish to review the progress being made on implementing the recommendations contained within the former Health, Wellbeing and Local Government Committee report in relation to wheelchair waiting times, recommendations contained within the All Wales Posture and Mobility Review - Phase 2 report, and progress being made on delivering the waiting times standard by March 2012.
Co-responder	Concerns have been raised that co-responders are not being utilised effectively. The Committee may wish to investigate the use of co-responder services across Wales; the type of call-outs currently being dealt with by co-responders; clinical efficacy; potential cost savings; and response target times.
Venous Thrombo-embolism prevention	Pulmonary embolism following deep vein thrombosis in hospitalised patients causes between 25,000 and 32,000 deaths in the UK every year.^{^[2]} In February 2005 the House of Commons Health Committee published a report on *The Prevention of Venous Thromboembolism in Hospitalised Patients. In January 2010 the National Institute for Health and Clinical Excellence (NICE) published clinical guidelines on CG92 - Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital*. The guidance offers best practice advice on reducing the risk of venous thromboembolism (VTE) in patients admitted to hospital. The Committee may wish to explore the implementation of the NICE guidance across Wales and the work of 1000 Lives Plus in preventing VTE.
Reduced fetal movements	In March 2008 NICE published clinical guidance on *Antenatal care: routine care for the healthy pregnant woman. In February 2011 the Royal College of Obstetricians and Gynaecologists (RCOG) published new advice for clinicians on the management of women with Reduced Fetal Movements* (RFM) during pregnancy, providing recommendations as to how women presenting RFM in both the community and hospital settings should be managed. The Committee may wish to investigate the implementation of the NICE and RCOG guidance across Wales and the services pregnant women are receiving with regard to RFM in both the community and hospital settings.
Post-Traumatic Stress Disorder (PTSD)	In February 2011 the former Health, Wellbeing and Local Government Committee published its *Report on Post-Traumatic Stress Disorder Treatment for Services Veterans.* In 2010 the Welsh Government had begun to roll out a specialist mental health and wellbeing service for veterans following a pilot scheme in Cardiff and the Vale. The report made recommendations on improving data collection on the incidence of PTSD; raising awareness of PTSD among veterans and their families; improving access to substance misuse services for veterans with PTSD; and the transfer of medical history from the armed services to GP practices. Healthcare Inspectorate Wales (HIW) is conducting a review of the adequacy, availability and accessibility of NHS provision for Armed Forces personnel, their families and veterans in Wales. The Review started on Friday 9 December 2011 and will run until 20 February 2012. A report of the findings will be made to Welsh Ministers in April 2012. The Welsh Affairs Committee (WAC) has announced they are undertaking an inquiry into the Support for Armed Forces Veterans in Wales, which will examine cross-border co-ordination as it affects veterans, and the level of co-ordination between the Ministry of Defence, the Wales Office and the Welsh Government. The deadline for written evidence submissions was 18 November 2011 and it is likely the oral evidence gathering sessions will begin in February 2012. The Committee may wish to examine the progress being made on implementing the recommendations contained within the former Health, Wellbeing and Local Government Committee report on PTSD and, once completed, the reports and recommendations made by HIW and WAC in relation to PTSD.
Orthopaedic waiting times	In December 2010, the then Minister for Health and Social Services, Edwina Hart AM, issued a statement on waiting times in relation to orthopaedic services. The Minister stated that work would commence on developing plans to increase orthopaedic capacity, and in March 2011 the Welsh Government announced the investment of an additional £65 million over the next three years to drive down waiting times for orthopaedic services in Wales. In July 2011 the Minister for Health and Social Services, Lesley Griffiths AM, stated the additional funding is being used to develop sustainable solutions to increase capacity and reduce demand for orthopaedic services and that, by March 2012, no-one should be waiting longer than 36 weeks. Plans are in place to increase capacity, including the building of two modular theatres in North Wales, employing additional consultants. Across South Wales, LHBs are exploring innovative ways to reduce demand across the Region. The Committee may wish to review LHBs’ achievement of the waiting time targets; the utilisation of the additional funding provided by the Welsh Government; and the effectiveness of the plans for increasing capacity and reducing demand.

[1] Welsh Health Specialised Services Committee, Joint Committee, All Wales Posture and Mobility Service, Agenda Item 15, 29 November 2011 [accessed 23 January 2012]

[2] House of Commons, Health Committee, HC99, The Prevention of Venous Thromboembolism in Hospitalised Patients, February 2005 [accessed 23 January 2012]

Annex A
Health and Social Care Committee

Forward work programme



Date of session:	2 February 2012