1. Purpose

2. Recommendations

2.1 Agree that the proposal to vary the provision of paediatric speech and language therapy services do not constitute a substantial variation of services.

2.2 Consider whether Portsmouth City Teaching PCT has complied with Section 11 of the Health and Social Care Act in developing and implementing the above proposals.

3. Background

3.1 The Committee is aware that the Health and Social Care Act 2001 places a duty on strategic health authorities, primary care trusts and NHS trusts to make arrangements to consult patients and the public about on-going service planning, on proposals for service development and change and on decisions that may affect how services operate. The Acts also places a statutory duty on NHS bodies to consult all affected overview and scrutiny committees (OSC) on any proposal for the development or variation of local health services. If an overview and scrutiny committee considers the proposal to be substantial it will be subject to formal scrutiny by the committee.

3.2 Guidance published by the Department of Health recommends that proposals for service change are discussed with all affected overview and scrutiny committees at an early stage in order to agree whether or not a proposal is considered by the committee to be substantial. In addition, a local framework for assessing whether a service development is substantial was jointly agreed by this Committee in March 2005.

3.3 When dealing with proposals for a substantial development or variation by an NHS body, where more than one OSC is consulted, a joint OSC committee covering all the local authorities affected by the proposals must be formed for the purposes of responding to the NHS.

3.4 OSCs also have a statutory role to play in considering whether an NHS body has satisfactorily complied with its responsibility under Section 11 of the Health and Social Care Act to consult with patients and the public about any proposal to vary a service. An OSC may give consideration to this aspect of a NHS proposal whether the proposal is considered by the OSC to be substantial or not.

4. Proposals Received to Vary or Develop Local Health Services

Changes to paediatric speech and language therapy

4.1 Speech and Language Therapy Services in Portsmouth and South East Hampshire are currently provided in schools across the district by Portsmouth City Teaching Primary Care Trust (PCT). The Committee has been notified by Portsmouth City Teaching PCT that, in order to comply with the recently published Children's National Service Framework there is a need to refocus the provision of these services.

4.2 To assist with Members' decision about whether this service change constitutes a substantial variation of services, Portsmouth City PCT has completed an assessment framework for this proposal and this is attached as Appendix 1. A background paper has also been prepared by the PCT and this is attached to the Framework. Following receipt of the framework the Scrutiny Support Manager at Portsmouth City Council, in consultation with the Health Review Manager at Hampshire County Council, made some additional enquiries on behalf of both authorities about the proposal. Details of these enquiries are included on the letter attached as Appendix 2 and the PCTs response to these is attached as Appendix 3.

4.3 The Patient and Public Involvement Forums (PPIF) and Local Education Authorities affected by the proposals have been contacted to ask for their comments. If any are received these will be circulated at the meeting. In addition, Portsmouth City Council's Department for Children and Families and Portsmouth PCT have developed a Joint Strategy for responding to the needs of children with speech language and communication needs, a copy of which is attached as Appendix 4.

4.4 As the proposed change appears to be an improvement to the provision of existing services it is suggested that this it not substantial and therefore does not need to be subject to formal scrutiny by the Committee. However, the Committee may still wish to consider whether the PCT has complied with its duties under Section 11 of the Health and Social Care Act in developing and implementing these proposals. A Briefing Paper outlining the stakeholder consultation carried-out by the PCT is attached as Appendix 5, and further information that was supplied by the PCT about the consultation process is included in Appendix 3.