Wednesday 22 May 2024
General Update
Thank you, Sir,
I would like to start by updating the Assembly on the progress of our 'big ticket' programmes as part of the Committee forHealth & Social Care's ongoing commitment to the transformation of health and care. Although I don't always make noise about strategies or visions it does not mean we have not got a plan ... we do... and it's built around the ideals of the Partnership of Purpose. The Partnership of purpose and all the work done on it in the previous term needs to move from concept and ideals to reality and substance. The team has a very clear vision of where we want to get to but its equally important to make progress with an actual plan, do actual things that are the actual building blocks of the future. And be very mindful that we are working is an area where staff are in demand virtually worldwide so before you make radical changes on paper or set hares running or break what we have... be very sure you have a better workable plan in your pocket and the cheque book.
There is much to be admired about our health and social care system... we have good care provided by a range of qualified, skilled and committed professionals, good doctors, good facilities - albeit under pressure, and we should appreciate the quality of services we have and the cost envelope we work within.
Of course, we will always keep an eye on other jurisdictions both near and far, to understand what works well, what not so well and what is best to shape our health and social care system for the future.
So to some of our building blocks... Phase1 of the "Our Hospital Modernisation" Programme. The team are working incredibly hard to ensure that service-users will be able to access the new facilities this autumn, the main components being:
· The expansion of the Critical Care Unit from 7 beds to 12 beds, with scope for further expansion in the future. This extra space is a response to the growing ageing demographic of our population and gives increased capacity for patients who need to undergo very major surgery. It will also provide increased resilience in the event of a future pandemic or major incident, and
· The expansion of the Post Anaesthetic Care Unit from 7 spaces to 10 spaces. This will free up space and then give the support facilities for the increased operating theatres that will be developed in Phase 2.
Phase 1 will provide some of the extra capacity to meet demand and facilitate safe delivery of services and will pave the way for the more extensive work to be undertaken in Phase 2.
As regards to the progress of Phase 2, HSC is currently out to tender for an independent facilitator to lead the value engineering exercise for the next stage of the Programme and this is an important next step in providing us with the information needed to move forward. Despite there being an indication that Phase 2 may cost more than indicated previously, HSC is resolute of the need to press ahead with this investment, which remains essential if we are to have any chance of meeting the long-term care needs of our community, with demands on health and social care services ever-increasing. While we now need time to focus on this work, I reiterate my commitment to keep States Members updated.
The Committee has appointed Deputy Marc Leadbeater, supported by Deputy Gavin St Pier, to the Hospital Programme; Deputy Aidan Matthews to the Electronic Patient Record (EPR) Programme; and Dr George Oswald, HSC's Non-voting Member, to the 'Our Community Services' Programme.
These arrangements will be reviewed in the light of the commissioned work by the Head of the Public Service in terms of whether politicians are best placed on Programme or Project Boards, or not, and we await the findings of this governance review.
Another building block for the future again supporting the Partnership of purpose and a significant piece of work is the part of HSC Transformation Programme... is the work on our Electronic Patient Record, or "EPR", A key enabler for the future is the replacement of our records to a new platform which can enable new working... better data and efficiencies with teams able to work with a modern digital system which will have the facilities in the future to link all our health care together with Doctors and Ambulances Hospital specialists if we wish it to.
As we have already advised, there has been a need to extend the October 'go live' date for the first implementation stage of the EPR into 2025. It is critical to patient safety to ensure that the transfer of old records to the new system is implemented seamlessly, and with a high-level attention to testing and new working practices. The EPR Team has identified that there would be too much risk to these essential aspects of the Programme to go live in October.
The Committee will update States Members as this moves forward.
I'm also pleased to be able to update the Assembly on positive progress being made in relation to the 'Our Community Services' projects. Another building block for the future.
Works have commenced by the Guernsey Housing Association and their construction partners to develop 'La Vieille Plage', a 14 unit Specialist Residential Home at L'Islet that will be replacing the outdated facilities at Sunnybrook on the Duchess of Kent site.
This exciting development has been designed to meet the needs of service users with varying degrees of learning and physical disabilities, supporting mobility, accessibility and activities of daily living and to enhance the quality of life of residents. The HSC Project Team are working with the Adult Disability Service to finalise the details and specifications for the home, and it is due to be completed and ready for occupation in the summer of 2025.
I'm confident to say that the new accommodation at La Vieille Plage will be life changing for its new residents and that it will also provide a much improved working environment for members of staff too. We must pass on our thanks to the Committee forEmployment & Social Security for its support with this important development.
Also in that area, progress is being made on the Children & Families Hub, with seed funding granted to explore options for co-locating services which support children and their families at the Raymond Falla House site. This will deliver significant benefits, help to improve outcomes for children and their families through enhanced access to and coordination of services, and offer improved working environments for staff, which we hope will aid recruitment and retention. The co-location of services in this way will also allow HSC to vacate and return buildings currently being used to the States Property Unit for sale or repurposing.
Overall, the Hub will provide an exciting opportunity to transform our ways of working and to improve experiences for children and their families.
I will sound like one of Deputy Queripel's broken records and I know that I have spoken about this topic on many occasions before the Assembly, but I wish to reiterate that one of the key enablers for all of the services provided by HSC is accommodation. HSC is fortunate to have a great number of dedicated, hardworking individuals committed to delivering valuable health and social care on our islands. We - the States - needs to ensure that staff, both locally resident or being recruited from off Island, are able to secure suitable and affordable accommodation. I will say it again... we need to ensure that staff, both locally resident or being recruited from off Island, are able to secure suitable and affordable accommodation. It is a challenge which affects permanent staff and agency staff alike, and it is especially frustrating when we have permanent staff willing to come and work here who cannot, simply because they cannot find suitable accommodation.
It is a challenge brought to the Committee by our Corporate Management Team on a regular basis as it very much impedes service delivery across the organisation. We have narrowed in previously on the financial effects of staffing challenges on our ability to remain within the annual revenue budget allocation, which continues to be strained by accommodation pressures, but I cannot emphasise strongly enough that the absence of suitable accommodation and its impact for HSC remains one of our greatest strategic challenges. It impacts on our ability to offer core, essential services that our community relies on; it adversely affects the quality and continuity of care we are able to provide; it means we cannot work as efficiently and effectively as we would like, and it also affects the morale of staff, how they feel about their work and the Island. It also means we put more pressure on the local market than we need to in providing that care to locals.
Please continue to support the provision of additional key worker housing units and to expedite where possible the development of sites already identified. This will be crucial in ensuring that our essential services can be delivered safely, effectively and efficiently And provide accommodation to residents.
I would now like to move on to focus on some of our key pieces of policy work.
Last week, States Members were welcomed to a presentation on an evaluation on the funding of drugs and treatments... or NICE drugs and also from Public Health Services as to ideas to support healthier lives.
"Solutions for Public Health" shared the findings of its work with States Members, which reviewed the implementation of additional drugs and treatments and presenting possible options for the future. CareWatch also presented feedback on service-user experience. This is a complex topic, and I won't be able to do justice to this during my update Statement today. However, the Committee will be further discussing the findings of the review and the potential policy options before reporting back to the States. At this stage, I expect the Committee will bring a range of options for debate.
However, just as important and goes hand in hand with extending any drug provision is to consider the potential of investment and activities that would support people to live healthier lives for longer, which we know will ease pressures 'down the line'. By helping to mitigate future expenditure which is coming like it or not [there is a question of how you fund care] but the demand is coming, in fact it's arrived on my watch. So work is underway, with the support of Public Health and the Health Improvement Commission, to identify further ways that we can enhance and further protect health before it reaches our hospital. I hope that those States Members who were able to attend this presentation left with a greater recognition of the role that we each play, as Deputies and within our Committee mandates, in fostering an "environment for health". This is a matter for all of us.
With this in mind, the Committee is pleased to be bringing recommendations to ban smoking in vehicles carrying children and the commercial growing of tobacco, and to create a regulatory framework for vapes through a new enabling law, which we will discuss shortly. Again, all part of the plan and another building block and embodied in the Partnership of Purpose.
Thank you, Sir.