The Joint Health Overview and Scrutiny Committee met to discuss winter preparedness, the hospital transformation project, and other topics. The meeting was scheduled to include an update from the co-chairs of the committee, a review of the winter plan for Shropshire, Telford and Wrekin, and an update on the Hospital Transformation Project. The committee was also scheduled to confirm the minutes of their previous meeting.

Hospital Transformation Project

The committee was scheduled to receive an update on the Hospital Transformation Project. The report pack does not contain any further information about this topic.

STW Winter Preparedness

The committee was scheduled to review the Winter Plan for Shropshire, Telford & Wrekin. The report pack does not contain any further information about this topic.

Co-Chairs' Update

The committee was scheduled to receive an update from the co-chairs. The report pack includes the minutes of the Joint Health Overview and Scrutiny Committee meeting held on 10 February 2025, which includes a co-chairs' update.

In that meeting, the co-chairs referred to a letter that they had sent to the Secretary of State on behalf of the Committee, asking for a meeting concerning the performance of the Shrewsbury and Telford Hospital NHS Trust (SATH), the issues raised in the Care Quality Commission (CQC) report and Channel 4 Dispatches programme and reports of inadequate care, poor outcomes and distressing patient experiences. The letter had been shared widely and sought assistance in addressing the challenges of the local care system and reiterated the need for better funding and support. Members were told that they would be updated when a reply was received.

The co-chairs also addressed concerns that had been raised following the Integrated Care Board's (ICB's) notice of intent to award the out of hours GP contract to a company called Medvivo¹. Concerns had been raised that the preferred provider appeared to have misrepresented itself as it appeared to be part of a multi national company, and would not understand the geography of Shropshire and rural issues.

Lorna Clarson, Chief Medical Officer, NHS Shropshire Telford & Wrekin, reported that the process had been transparent, fair and proportionate, the service specification had remained the same and the decision was not about cost-cutting but quality of care. She explained that she was not able to discuss contract details until the end of the 'standstill' period allowing bidders to challenge the decision. There was a commitment to work closely with the public and address their questions with evidence from the provider when this was possible.

Minutes of the Previous Meeting

The committee was scheduled to confirm the minutes of the previous meeting held on 10 February 2025.

The minutes record that the committee received an update on the CQC Action Plan for Medicine. Following the presentation, members asked questions about:

• progress and compliance with the action plan
• how improvements were evidenced, monitored and audited
• tools to improve discharge efficiency and patient outcomes
• recruitment and retention
• training programs for staff
• how patient and relative feedback was measured and influenced care practices
• the discharge planning process
• the long term issues around mental health care
• dementia care and the need for specialised training and dementia-friendly environments
• whether there had been a recruitment freeze for certain posts and if so what were the impacts of that.

The minutes also record that the committee discussed the Shropshire Community Trust – Virtual Wards[^3]. The committee were told that the virtual ward initiative began in 2019 and had since evolved to include a rapid response offer, initially launched in Telford and Wrekin and then rolled out in Shropshire. The rapid response service aimed to stabilise and treat patients within the first 72 hours to avoid hospital admissions, after which patients could be admitted to the virtual ward for longer-term care.

The virtual ward served both as an admission avoidance measure and as a step-down option for patients discharged from hospitals like SATH. The service benefited from strong community support and included various pathways such as respiratory and diabetes support.

The virtual ward team comprised around 90 staff members, including GPs, advanced clinical practitioners, pharmacy technicians, and others. The caseload demographics showed that about 54% of the activity was focused on admission avoidance, while 46% was on step-down care.

The virtual ward had admitted 6,184 patients, and occupancy rates were discussed. The team was working to understand and meet targets, despite the lack of a specific virtual ward acuity tool. The average was about 68% across the year, there were more medically unwell patients compared to other virtual wards and greater levels of frailty.

The discussion also touched on the importance of raising awareness about the virtual ward among GPs, chemists, and the general public, and the importance of publicity showing it to be a safe and effective service. The virtual ward has shown positive outcomes in preventing patient deterioration and has had a significant social and economic impact.