Liz Davenport (Chief Executive) and Chris Knights (Programme Director) of Torbay and South Devon NHS Foundation Trust gave the submitted presentation on the proposed approach to developing a strategic outline business case for the Building a Brighter Future Programme at Torbay Hospital.  They responded to questions in relation to:

·                the new digital offer and if it would replace all the stand-alone digital platforms which currently did not link – the aim was to ensure that all the systems for primary and secondary care and adult social care would be integrated across the peninsula.  Progress had been made via the national care records approach. The best options for our health and social care services were necessary to enable sharing of information in real time to make good decisions on clinical care with an end-to-end pathway;

·                how the proposed reprovision of medical and emergency services related to the current number of beds available – there were currently 550 beds available in Torbay within Torbay Hospital and other community provision.  Without implementing changes modelling based on age profile would result in an increase in demand by 150 beds.  The overall plans proposed building 408 new beds excluding same day emergency beds within the Emergency Department.  The Programme included enhancing digital options and supporting people to monitor their own health and wellbeing at home with a focus around prevention and early intervention to reduce the need for hospital admission;

·                how climate change and carbon offsetting would be achieved – they were required to deliver the build at net carbon zero and have already been in discussions with the Council on potential use of solar energy.  This was difficult to achieve due to the age of some of the older buildings but options such as triple glazing, heat pump technology, building a facility for staff to cycle to work and demonstrating a commitment to support the health and wellbeing of staff were all being explored;

·                the level of disruption to the Emergency Department – discussions were ongoing in respect of the phasing of the Programme and there would be some disruption to existing services. However, this was being delivered by an experienced team and there was likely to be three or four significant phases with the element affecting the Emergency Department being undertaken at the end of the programme.  There would be ongoing improvement and work has already started on a new medical receiving unit;

·                how achievable was the programme and what was being done to address health inequalities and wider place shaping to work together to regenerate Torbay – collaboration had already started to be developed and innovations were already changing the shape of how people access services to enable them to be supported at home.  There was a commitment to work together to improve health outcomes for people through prevention and early intervention, help with housing and supporting people to improve their own health.  Recruitment and retention of staff was important to create a highly skilled and committed workforce, the proposal would realise benefits through providing the right environment for clinicians which would help with this.  They were working with the community to develop new roles and routes into care and support through education and the Programme would create new opportunities for people currently in education for new jobs and provide wider economic benefits to Torbay;

·                residents had to have virtual appointments during the pandemic but with an aging population how would you ensure that people can receive the services they need – it was acknowledged that there would not be a single solution.  They would ensure that digital technology was not a barrier to accessing care and that options were developed to help people monitor their own health and wellbeing and manage and access health and care successfully;

·                would the proposals lead to a single GP surgery covering the whole of Torbay and would residents need to develop a wider understanding of human biology to receive telephone consultations – no GPs work as part of organisations to manage primary and secondary care, longer term plans were to ensure that primary care networks were coterminous with the areas they cover to ensure better joining up of services.  One of the benefits of the integrated care organisation was working in communities for residents to access support including good quality information, not leaving people on their own and ensuring they were supported as close to home as possible.  The proposals would enable GPs to refer patients to diagnostic services to enable them to maintain their conditions for as long as possible, help reduce the risk of delay of surgery when needed and protect elected procedures better than the current model.

The Board acknowledged the great work of the Torbay and South Devon NHS Foundation Trust, particularly during the Covid-19 pandemic and welcomed the significant investment being made through the Building a Brighter Future Programme to help improve health and social care services, along with the wider economic benefits for the residents of Torbay.

Resolved:

That the Overview and Scrutiny Board supports the proposed approach to developing the strategic outline business case as outlined at the meeting for the Building a Brighter Future Programme (unanimous).