Archived decisions

AT A MEETING of the HEALTH REVIEW COMMITTEE of the COUNTY COUNCIL held at The Castle, Winchester on Tuesday, 30 March 2004

PRESENT

Dr. R.J. Ellis (Chairman); Mrs. A.M. McNair-Scott (Vice-Chairman); Mrs. P.G. Banks;

B. Bayford; I.F.E. Beagley; C. Connor; Mrs. P. Dickens; A. Dowden; Mrs. K. Heron;

Mrs. P.G.E. Holden-Brown; P.K. Mason; R.C. McIntosh; A. Mitchell; Mrs. E.M.F. Randall; K.P.J. Searle; Mrs. P.A. West; D.F. Wright.

Also in attendance: Councillor B. Parnell (Southampton City Council).

59. DECLARATION OF INTEREST

Members were mindful that where they believed that they had a personal or personal prejudicial interest in any matter to be considered at the meeting, they should normally, at the time of debate, declare their interest and, having regard to the circumstances described in paragraphs 9, 10, 11 and 12 of the County Council's code of Conduct, consider whether to leave the meeting whilst the matter is discussed.

Councillor Mrs. P. Dickens declared a non-pecuniary interest in that she is employed by the NHS; Councillor P.K. Mason declared a non-pecuniary interest in that he is employed by the Ambulance Service and Councillor D.F. Wright declared a non-pecuniary interest in that his wife is a General Practice Manager.

60. MINUTES

The Minutes of the meeting of the Committee held on 27 January 2004 were confirmed as a correct record and signed by the Chairman.

61. CHAIRMAN'S COMMUNICATIONS

(a) Strategic Health Authority (SHA)

The Chairman had continued to attend SHA Board Meetings on the Committee's behalf. Peter Bingham, the Board Chairman, had resigned with effect from 1 May 2004 and to date there was no replacement for him. Arrangements had been made for the SHA to meet with the Chairman of the overview and scrutiny committees and NHS and PC Trusts on 4 May 2004.

(b) Health Web

The Chairman reported that a skeleton Health Web site would be available to members early April, 2004 and that the site would be fully operational shortly.

(c) Visits to Health Trusts and District Councils

The Chairman reported that he and the Health Review Manager had now visited all Health Trusts and District Councils in the County to discuss health scrutiny. Links had been established with District Councils to deal with local issues including the possible delegation of health overview and scrutiny powers.

(d) Haslar Hospital

The Chairman reported that he had written to the Chairman of the House of Commons Select Committee on Health stating the concerns about proposals for the future of Haslar Hospital. A reply had now been received stating that there were no immediate plans to investigate the matter but that the letter had been circulated to all members of the Health Select Committee. Peter Viggers MP had also requested a meeting with the Chairman on this issue.

(e) Public and Patient Involvement Forums (PPIF)

The Chairman reported that there had been a distinct lack of information about PPIF's including a refusal to give details of memberships. He had written to the Commission for Public and Patient Involvement expressing his concerns.

(f) Joint Committees

The Chairman reported on the meeting of the Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee which had taken place on 24 March. He also reported on the Joint Meeting with Surrey County Council, in Select Committee mode, on the question of Mental Health and Learning Disability Services in north east Hampshire/Surrey. The findings and supporting recommendations had been presented to the NHS but to date no reply had been received.

(g) Excellent Council

The Chairman reported as the County Council was one of the ten excellent councils it had been requested of the Deputy Prime Minister's Office to participate in the "Innovation" project. Various topics had been highlighted and the County Council had chosen the theme of joint working with nurses and social workers to facilitate keeping older people at home longer. "Innovation" was launched at Ashford with the Minister of Health in attendance.

(h) Conferences/Seminars

The Chairman gave details of conferences/seminars he had attended since the last meeting of the Committee.

(i) Emergency Care Briefing

The Chairman reminded members about the Emergency Care briefing which was to be held in The Conference Room, Ashburton Court on Thursday 8 April, 2004. He encouraged all members to attend.

(j) Annual Report

The Chairman reported that the Annual Report of the Committee was in the process of being prepared and would be formally presented to the next meeting of the Committee.

(k) Penny Velander

The Chairman reported the recent appointment of Penny Velander as Health Review Officer, her duties would be mainly concerned with thematic reviews.

62. DEPUTATIONS

There were no deputations to this meeting.

63. CO-OPTION OF DISTRICT MEMBERS

The Chief Executive reported that the Association of Hampshire and Isle of Wight Local Authorities had nominated Councillors C. Connor and A. Mitchell to fill the vacancies on the Committee for District Members.

RESOLVED:

That Councillors C. Connor and A. Mitchell be appointed as co-opted Members of this Committee.

64. LOOKING AHEAD - REVIEWING EMERGING ISSUES FOR MANAGEMENT AND DEVELOPMENT OF NHS SERVICES IN HAMPSHIRE AND THE ISLE OF WIGHT

The Chief Executive of Hampshire and Isle of Wight Health Authority presented a report (Item 6 in the Minute Book). He gave details of six emerging issues.

(a) Lymington Community Hospital

Plans had been drawn up for the new Lymington Community Hospital and the full business case for the hospital would be presented to the Health Authority in either April or May 2004.

(b) Future of Renal and Transplant Services

Following a review of progress with the improvement plan it was confirmed that the renal and transplant service would continue to be provided at Portsmouth Hospitals NHS Trust.

(c) Public and Patient Involvement Forums (PPFI's)

The Health Authority were also having problems with contacts for PPFI's and agreed to advise the Committee of any information about them that it managed to gain.

(d) Patient Choice

Members were advised of the policy and guidance on patient choice which should enable patients a choice about where and when they receive elective surgery and other NHS services, which should, in turn, assist in reducing hospital waiting lists.

(e) Future of Integrated Working with Southampton and Winchester

The provision of surgical services in Southampton and Winchester was being investigated with a view to providing the best service for patients. Any substantial changes in the services would be discussed with the Committee at the earliest opportunity and be the subject of formal consultation.

(f) HealthFit

Discussions on the HealthFit proposals had now been completed. There had been a good response from stakeholders but not so good from patients, ways were being investigated to encourage a better response. The move forward for HealthFit was under discussion and it was hoped that an indication on the next steps would be presented to the next meeting of the committee.

RESOLVED:

That the report be received and noted.

65. REVIEW OF THE HEALTH OF OUR CHILDREN AND YOUNG PERSONS

The Chief Executive presented a report on the findings and recommendations of the first two reviews, the Health of Children Looked After and The Health of School Age Children in Hampshire (Item 7 in the Minute Book). Councillors Mrs. Banks and Mrs. McNair Scott reported on the responses from the agencies cited for taking responsibility in each review and presented an update on each respectively.

RESOLVED:

(a) Health of Children Looked After in Hampshire

That:-

(i) A top-level multi-agency group accepts responsibility for the co-ordination and monitoring of the review findings and recommendations to improve all care and support arrangements for children who are looked after in Hampshire.

(ii) A health information scheme be established which will enable children who are looked after to maximise their health and care choices.

(iii) A comprehensive responsive and supportive multi-agency network of services to support children looked after be provided.

(iv) Key professionals who are responsible for collating and transferring information should design, establish and monitor a transferral system that meets the needs of children, carers and professionals.

(v) Clear guidance and procedures for health assessments and GP practices be developed.

(vi) A training and support network to enable continual professional development and improve communication be established.

(vii) An overall involvement and responsibility for review recommendations be maintained.

(viii) A progress report be presented to the Committee in November 2004 and an annual report in May 2005.

(b) The Health of School Age Children

(i) A top level multi-agency group accepts responsibility for the co-ordination and monitoring of the review findings and recommendations to improve eating habits and physical activity levels for all children and young people across Hampshire

(ii) Baseline information on the health and well being of children and young people across Hampshire be established.

(iii) A county wide health promotion strategy for healthy eating be developed.

(iv) A county wide health promotion strategy for physical activity be developed.

(v) An overall involvement and responsibility for review recommendations be maintained.

(vi) A progress report be presented to the Committee in November 2004 and an annual report in May 2005.

66. INQUIRIES RECEIVED AND ACTION TAKEN

The Chief Executive presented a report on inquiries received, the source of each inquiry and the action taken (Item 8 in the Minute Book). He gave details about Chiropody Services - specifically access for people with diabetes; Diagnostic and Treatment Centres. Arrangements for Patient and Public Involvement in health; Redevelopment of Queen Alexandra Hospital/Services in southeast Hampshire; Delayed Transfers of Care; Visit to NHS Direct; Access to NHS Dentists; Change in Service Provision; Future of Pharmacy Services and Making Public Health Effective.

RESOLVED:

That the report be received and the actions outlined in the report be endorsed.

67. PROPOSALS TO DEVELOP OR VARY NHS SERVICES

The Chief Executive presented a report on proposals from the NHS to vary or develop health services in the area of the Committee (Item 9 in the Minute Book). He gave details of proposals on:-

Consultation by Eastleigh and Test Valley South and Mid Hants PCTs - Provision of In-Patient Services for Older People with Mental Health Problems in Eastleigh and Winchester

The PCT's had responded to comments from the Committee and confirmed that at Moorgreen Hospital, Willow Ward will be transferred to the Tom Rudd Unit and the plans for Linden Ward had been revised to include improved toilet and washing facilities.

Eastleigh and Test Valley South PCT Consultation - The Mount Hospital.

Further to initial work with patients, carers and key stakeholders the PCT had launched the next phase of the consultation process. This was intended to get feedback from local people about the way in which services configured to provide the more effective care to people requiring rehabilitation in the area.

The working group had written to the PCT indicating the range of services that would be expected in any reprovision of services provided at The Mount.

The working group had visited the Mount Hospital site on 17 March. The report of the visit was tabled.

HealthFit

A response had been sent to the Strategic Health Authority on the HealthFit discussion document setting out the concerns of the committee about the level and consistency of community, public and patient engagement that took place at Stages 3 and 4 of the HealthFit development process; the need for each of the localities to be engaging with local people in developing proposals and the need for the Committee to be appraised of any service change that may be substantial at the earliest opportunity.

Mental Health Services in North East Hampshire

A joint Hampshire/Surrey meeting was convened on 18 February 2004 to consider the case for a single Trust from the NHS and to secure feedback from staff, voluntary organisations, carers and service users that would be affected by the NHS decisions. The Committees interests were represented by the Chairman and Councillors Williams and Mrs. Leversha. The Joint Committee made a series of recommendations for action by the NHS and reserved its option to refer the consultation process to the Secretary of State should the NHS not modify the current proposals.

Blackwater Valley and Hart PCT - Changes to Service Provision at Fleet Hospital

In response to a number of issues raised through the local district council the PCT extended the consultation period.

Maternity Services in South East Hampshire

Confirmation of the timing of the formal consultation process was still awaited.

Foundation Hospitals

Three hospitals in Hampshire were seeking Foundation status from 1 October 2004 - Southampton University Hospitals Trust; Winchester and Eastleigh Health Care Trust and North Hampshire Hospitals Trust. In addition two hospitals over the county boundary were also consulting on Foundation status - Royal Bournemouth and Christchurch Hospitals Trust and Frimley Park Hospital Trust. The consultation documents did not include any proposals to substantially change the services and it was not, therefore, necessary for joint committee arrangements. A response to the formal consultation exercise would re-affirm the Committee's expectations to Section 11 of the Health and Social Care Act; the need for early involvement of the relevant OSC's in considering proposals to substantially vary or develop NHS services and highlight the need for robust governance arrangements.

Reforming the NHS Complaints Procedure - National Consultation

The Department of Health had launched a national consultation on the proposed reform of the NHS complaints procedure. A draft response had been prepared by the Chief Executive in discussion with the Chairman and Cllr. Mrs. Dickens.

"Choosing Health" : National Consultation on Public Health

The Department of Health had launched a major consultation exercise which invited consultees views on the role that individuals, the government - both central and local - the NHS, the public sector more broadly, the voluntary sector and industry, the media and others could play in improving peoples health.

RESOLVED:

That:-

(a) Eastleigh and Test Valley South PCT: Consultation on the future of The Mount Hospital

(i) The consultation process be noted and plans for involving local people, patients and key stakeholders in determining the options for the future of services currently provided at the Mount Hospital.

(ii) The working group responds to the consultation in accordance with the key issues identified by local people and the interests of the health service in the area.

(iii) The working group continues to keep the Committee briefed on any actions taken.

(iv) Members are sent details of the formal consultation document when it is published.

(b) `HealthFit' Implementation

(i) The Committee be informed of the response of the Health Authority to the comments made on the HealthFit framework.

(ii) The Committee continues to press for information on the engagement of local people across localities.

(c) Mental Health Services in North East Hampshire

The Committee be advised of the response of the lead PCT and any subsequent action taken by the joint Surrey/Hampshire Committee.

(d) Blackwater Valley and Hart PCT: Changes to Fleet Hospital

(i) The Committee be advised of any changes resulting from the extended consultation period.

(ii) Feedback from the PCT on the response to consultation be reported to the Committee.

(e) Maternity Services in South East Hampshire

(i) The Committee informed of any action taken by the joint committee.

(ii) The criteria for responding to consultation previously agreed by the Committee are drawn to the attention of the joint committee.

(f) Foundation Hospitals

(i) That there are no substantial variations in service arising out of the consultation on the constitution of each of the proposed Foundation Hospitals be noted.

(ii) The Committee reaffirms its expectation that any proposals to substantially vary or develop NHS services are brought to the Committee at the earliest opportunity.

(iii) The Committee restates its expectation that local people will be fully involved in planning services in accordance with section 11.

(iv) The Committee highlights the responsibilities of the NHS to advise all overview and scrutiny committees of any changes that may affect their populations.

(g) Reforming the NHS Complaints Procedure

The response proposed as set out in appendix 6 of the report be endorsed.

(h) `Choosing Health': National Consultation

(i) The Committee responds to the consultation highlighting the need for joint working across health and social care service providers.

(ii) The development of evidence based practice be endorsed.

(iii) Feedback from Districts and Boroughs on the key issues relating to improving public health be invited.

(iv) These comments be included in the response of the Committee.

68. SETTING THE REVIEW PROGRAMME FOR 2004/05

The Chief Executive presented a report setting out the key areas for the work programme of the Committee for 2004/05 (Item 10 in the Minute Book). It was proposed that there would be thematic reviews on access to therapy in schools; and access to footcare for people with diabetes. The proposed review in the mental health of children and young people be deferred whilst work takes place across health and social care relating to the Children Bill. A number of issues that had been raised with the Committee were the subject of local or national performance monitoring arrangements and it was proposed that the committee would continue to be briefed on these issues. Issues raised that were likely to be the subject of formal consultation by the NHS included maternity services; services for children; services for older people; emergency services and cancer services. Lead members had been identified for all but cancer services.

RESOLVED:

That:-

(a) Approval be given to the proposed programme of work as set out in Section 3 of the report.

(b) Members with an interest in contributing to the planned reviews contact the Health Review Manager by 14 April 2004.

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