PROPOSALS TO DEVELOP OR VARY NHS SERVICES

1. The Committee is continuing to monitor proposals from the NHS to substantially vary health services, including:

Maternity Services:

Maternity Services in Southeast Hampshire

The Hampshire Primary Care Trust has completed its consultation on maternity services in Southeast Hampshire. The Committee has agreed The Primary Care Trust's preferred option of the provision of three 24 hour midwife led birth centres at The Grange, Petersfield (8beds), Black, Gosport (11 beds) and a co-located service in Portsmouth (currently at St. Mary's Hospital (12 beds), moving to the new Queen Alexandra Hospital, Cosham in 2009(9 beds)) and that the Primary Care Trust regularly reviews birth rates and demands for services in the light of changes locally and in neighbouring areas to ensure that the configuration of birth centres is best placed to meet local needs. If there are significant changes in birth rates or demand the Primary Care Trust reconsiders the development of a birth centre within phase 2 of Fareham Community Hospital taking account the experience of local women accessing other birth place choices.

Maternity Services in Southwest Hampshire

Following delays with the removal of rehabilitation services from the Ashurst the opening of the new birthing centre has been delayed. Reconstruction work has not yet commenced and Southampton University Hospitals Trust has been required to provide clear information about the timeline for the opening of the birth centre and the way in which this has been communicated to local people

Southeast Specialist Palliative Care Team - Withdrawal of Portsmouth Primary Care Trust

Hampshire Primary Care Trust has alerted the Committee to a formal notification from Portsmouth City Primary Care Trust of its intention to withdraw from existing arrangements for commissioning specialist palliative care services in southeast Hampshire. The Committee requested The Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee to consider the proposals and the anticipated impact on services delivered to residents in Southeast Hampshire and Portsmouth which has requested the completion of a framework assessment on its proposals for palliative care services.

West Sussex Primary Care Trust - Acute Service Reconfiguration

The West Sussex Health Overview and Scrutiny Joint Committee is continuing, on a bi-weekly basis, to scrutinise West Sussex Primary Care Trust's proposals for the reconfiguration of Health acute health services in West Sussex. Formal consultation by West Sussex Primary Care Trust ceased on 14 November 2007 and 38 alternative options had been received. Hampshire and Portsmouth members of the Joint Committee had requested the Chairman to convey a number of concerns to the West Sussex Primary Care Trust. The West Sussex Primary Care Trust had appointed Sir Graham Cato to investigate the alternative proposals who had indicated that he would favour the retention of Accident and Emergency Services at each hospital, his report to the Primary Care Trust was awaited.

Surrey Primary Care Trust - Fit for the Future Commissioning Intentions

Surrey Primary Care Trust has given notification that it intends to go

out to consultation on its commissioning intentions for speciality services. With the exception of renal services it is not considered substantial for Hampshire residents. Full details on proposals to vary renal services have been sought.

Surrey and Hampshire Borders Partnership NHS Trust - A New Design for Day Services: Improving Adult Mental Health Day Services in Surrey Heath and Northeast Hampshire

Surrey and Hampshire Borders Partnership NHS Trust are proposing improvements to Adult Mental Health Services in Surrey Heath and Northeast Hampshire. It is not anticipated that the proposals would have an impact on Hampshire residents, however the Committee has sought further information on proposals for occupational therapy and acute depression services for Hampshire residents.

2. The responses made by the Committee influence and improve the delivery of Health Services in Hampshire and, in doing so, support the delivery of the Corporate Strategy aim of maximising well being.

INQUIRIES RECEIVED AND ACTION TAKEN

1. The Committee continues to receive inquiries from partner organisations and County Councillors. At the last meeting Members were alerted to inquiries about :

Incidence of Deaths from Clostridium Difficile at Winchester and Eastleigh healthcare NHS Trust and Southampton University Hospitals Trust

The Committee received a presentation from representatives of the Trusts giving details on how Clostridium Difficile is spread, the severity of illness, the scale of the problem , the challenges of control and actions being taken to reduce incidences.

Fareham Community Hospital

The business case for the new Fareham Community hospital has now been approved by Hampshire Primary Care Trust.

Fordingbridge Hospital

Following the closure of Fordingbridge Hospital to inpatient admissions on the grounds of patient safety clarification has been sought on the process being followed and investigations into the quality of patient care and assurances sought that patients were being treated as locally as possible. Members highlighted the problem of travelling to and from alternative hospitals and sought confirmation that Fordingbridge Hospital would reopen to inpatients as soon as possible.

Oak Park Hospital, Havant

The Committee received the business case for the new Oak Park Hospital and Hampshire Primary Care Trust reported that space at Oak Park Hospital and the proposed new Fareham Community Hospital was being reserved for possible expansion in the future. St. Mary's Hospital, Portsmouth would, if required, accommodate any overspill.

Milford on Sea War Memorial Hospital

At a meeting with key stakeholders on 23 October 2007 broad support was given to the way forward proposed by Hampshire Primary Care Trust. This included a model of care focussed on supporting local people with long term conditions, providing extended community rehabilitation, day rehabilitation and extended outpatient clinics.

Andover War Memorial Hospital

The Committee received details on the progress with the

implementation and outcome of the consultation on Andover War Memorial Hospital which was agreed in 2006.

Continence Services

The Hampshire Primary Care Trust had confirmed that people were limited to 4 pads per 24 hours and that new patients were limited to 3 pads within 24 hours. Further inquiries about the impact of the policy have been raised with Adult Services particularly in the context of needs of residential and nursing home clients.

The Primary Care Trust has reflected on the concerns expressed by service users and the current variation in service provision and recognises the need to ensure a consistent continent service and policy is in place across Hampshire for 2008/2009. The Primary Care Trust will achieve this by developing a service specification, in line with best practice guidelines, based on assessed need. The cost implications of moving to a Hampshire Primary Care Trust wide single service will be determined and incorporated into the operating plan for 2008/09.

On a short term basis, the Primary Care Trust has issued an instruction to all service providers that they should ensure that all clients receive the number of pads that are sufficient to meet their assessed needs. This will remove the variation in policy across Hampshire and ensure that individuals receive an adequate daily supply of pads. Referrals to specialist continence services will need to continue, but community nurses will be able to supply an adequate number of pads pending such a referral.

Ambulance Service and Road Closures

The Committee raised concerns about the awareness of road closures by the Ambulance Service and the effect that closures have on transporting patients and meeting required timescales. Investigations were made into the problems and the Committee was advised how the Ambulance Service was made aware of road closures and how they affected the service.

DR. R.J. ELLIS

Chairman.

4IR340108