Archived decisions

ITEM 2(b)

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

PRESENT

Councillors: Dr R J Ellis (Chairman); Mrs A M McNair Scott (Vice-Chairman);

Mrs P G Banks; K G Chapman; C Connor; Mrs P Dickens; A Dowden; K Evans;

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

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

Felicity Hindson, MBE - Executive Member for Social Care.

98 DECLARATIONS 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 personal interest in that she is employed by the NHS; Councillor P.K. Mason declared a personal interest in that he is employed by the Ambulance Service; Councillor Mrs. P.A. West declared a personal interest in that her daughter-in-law is employed by the Ambulance Service and Councillor D.F. Wright declared a personal interest in that his wife is a General Practice Manager.

99 MINUTES

The Minutes of the Meeting of the Committee held on 21 September 2004 were confirmed as a correct record and signed by the Chairman.

100 CHAIRMAN'S COMMUNICATIONS

(a) Meetings

The Chairman reported that he had attended the Strategic Health Authority Meeting on 10 November 2004.

(b) Conferences

The Chairman reported that he would be attending conferences on Political Landscapes in Health on 2 December and the Public Health Agenda on 13 and 14 December. The Vice Chairman and Health Review Manager would be attending a conference on the Reconfiguration of Surgical Services on 2 December.

The Chairman reported that discussions were in progress for the setting up of a Trust to combine Health and Social Services in the Isle of Wight.

(d) White Paper on Public Health

The Chairman reported that the Government had announced that a White Paper on Public Health would be published shortly.

101 DEPUTATIONS

There were no deputations to the Meeting.

102 INQUIRIES RECEIVED AND ACTION TAKEN

The Chief Executive presented a report on inquiries received, the source of each inquiry and the action taken (Item 5 in the Minute Book). He gave details about arrangements for Patient and Public Involvement in health and the interrelationships; Beyond HealthFit and GP out of hours cover.

RESOLVED:

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

103 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 6 in the Minute Book). He presented the report in two parts which comprised of items for information which alerted the Committee to forthcoming proposals from the NHS to vary or change services and items for action which set out the actions required by the Committee to respond to proposals from the NHS to substantially change or vary NHS services.

Under items for information he gave details on:

Hampshire Ambulance Trust

The Hampshire Ambulance Trust had taken steps to ensure that patients who had experienced falls were dealt with appropriately.

Mid and South West Hants Cluster: Surgical Services Reconfiguration

Jane Hayward, Project Manager gave a presentation to the Committee on the intention to review the options for reconfiguring surgical services across Southampton University Hospital Trust; Winchester and Eastleigh Healthcare NHS Trust; Lymington Hospital and Andover Hospital. She said that Mark Hackett, Chief Executive of Southampton University Hospital Trust was to take the lead in this work. Single surgical services was part of the plans developed and set out in Beyond HealthFit for all organisations working together across South West Hampshire. The work would be phased and would consider surgical services at Andover, Lymington, Southampton and Winchester. She outlined the project aims and structure, the proposed timetable and gave details of the membership of the project board.

Winchester and Eastleigh Healthcare NHS Trust: Temporary Closure of Endoscopy Services at Andover Hospital

As a result of the identification of a contaminant in the endoscopy suite at Andover Hospital, the Winchester and Eastleigh Healthcare NHS Trust had advised of the temporary closure of the Endoscopy Services at Andover Hospital and that action was being taken to provide alternative services.

Members were concerned about the possibility of contamination happening elsewhere and requested to know what monitoring procedures were in place.

Under items requiring action he gave details on:

Blackwater Valley and Hart Primary Care Trust: Modernising Health Services at Fleet Hospital

Following consultations with local people in early 2004 Blackwater Valley and Hart Primary Care Trust had been working with local stakeholders to identify affordable options for developing Fleet Hospital. Public consultation on the options had been adjusted to run from 1 January 2005 to 31 March 2005. Details of the options were shown in Appendix 3 to the report.

Planning Future Health Services in Fareham and Gosport

Following the meeting of the Committee on 26 November 2004 to consider the Fareham and Gosport Primary Care Trust's proposals for the future of health services in Fareham and Gosport the Chief Executive presented a report summarising the outcomes of the meeting and the recommended response to the Trust, shown in Appendix 6 to the report. Comment was made about the detrimental effect the closure of The Cambridge Military Hospital at Aldershot had had on the population of the area.

Department of Health: Future Arrangements for the Support of Patient and Public Involvement in Health

The Department of Health had launched a consultation on the arrangements for the future of the Patient and Public Involvement in health. The consultation period would end on 30 January 2005. The points to be considered were shown in Appendix 5 to the report.

RESOLVED:

That:-

(i) Mid and South West Hants Cluster - Surgical Services Reconfiguration

(a) The Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee be advised of the proposed changes.

(b) The Health Review Committee be advised on the joint arrangements established.

(ii) Winchester and Eastleigh Healthcare NHS Trust - Temporary Closure of Endoscopy Services at Andover Hospital.

(a) The Committee be advised of any decisions taken with regards the endoscopy service at Andover Hospital at its meeting in March 2005.

(b) The Committee be advised of the monitoring procedures that were in place to prevent contamination.

(iii) Blackwater Valley and Hart Primary Care Trust - Modernising Health Services at Fleet Hospital.

(a) Any comments Members wish to make on the Primary Care Trust's proposals be sent to the Chairman by 7 March 2005.

(iv) Maternity Services in South East Hampshire

(a) Clarification on the date for commencing formal consultation be sought.

(v) Planning Future Health Services in Fareham and Gosport

(a) It be recommended to Fareham and Gosport Primary Care Trust (PCT) that:

(i) The additional health needs information referred to by the PCT be made available to the Committee which should include the way in which primary care and community services across Fareham and Gosport will be developed to complement the service provided at Queen Alexandra Hospital and take account of the need to keep as many services as local as possible. In particular people living in Gosport need to have a better understanding of how the commitment made to them in 2000 would be delivered, with as many services as possible being provided in the community.

(ii) The PCT re-examine the population projections provided to take account of planning assumptions and the policy of the Office of the Deputy Prime Minister with regard to new housing.

(iii) Additional information, based on postcodes, about the way in which people living in Fareham and Gosport used the Royal Haslar Hospital Accident and Treatment Centre and NHS Trust Accident and Emergency Departments be provided to the Committee.

(iv) Additional information on the health needs of local people, differentiating between the communities of Fareham and Gosport and further information about the way in which the health needs of those identified as being vulnerable or disadvantaged would be met be provide to the Committee.

(v) Agreement be reached between the PCT and Gosport Borough Council on an appropriate methodology for assessing the impact of changes proposed on traffic transport consideration.

(vi) The PCT Board provides the Committee with a fuller account of the financial implications of the options presented, including a more detailed breakdown of the costs associated with redeveloping the Royal Haslar Hospital and further information on the income to be generated from the sale of assets.

(vii) The PCT Board provides the Committee with unequivocal assurance that the financial risks identified were being managed to ensure that the acute and community health services planned were affordable and sustainable.

(viii) The feasibility of reducing or waiving the transfer of assets of the Royal Haslar Hospital be explored as a matter of urgency.

(b) Assurances be sought from the Ministry of Defence that, should a decision be made to proceed with the closure of the Royal Haslar Hospital it was able to demonstrate that the only viable option that represented value for taxpayers money was for assets to be transferred on payment of the valuation.

(i) To the Secretaries of State of Health and Defence, copied to the Defence Select Committee, requesting additional information with regard to the Defence Medical Services Review and the impact these decisions would have and the impact they would have on local NHS provision, taking account of commitments made in 2001. Also seeking assurances that the Defence Medical Review had been evaluated to ensure that it was able to meet the existing and new challenges facing the armed forces in Hampshire.

(ii) To the Secretary of State for Defence stating the Committee's view that it would not be in the interests of the Health Service in the area for the Royal Haslar Hospital to close before the redevelopment of Queen Alexandra Hospital was complete. Should this happen the Committee would wish to consider further action in the interests of the health service in the area.

(d) Denise Holden be thanked for her hard work on the scrutiny process.

(vi) Department of Health - Future Arrangements for the Support of Patient and Public Involvement in Health

(a) The Chairman be advised of any views on the proposals by 10 January 2005.

(b) The Chief Executive, in consultation with the Chairman drafts a response to the consultations on behalf of the Committee.

104 HEALTH REVIEW - PROGRESS REPORT

The Chief Executive presented a report on the progress made by the Children and Young People Strategic Partnership on the reviews of The Health of Children Looked After and the Health of School Age Children and on the draft report of the working groups on Therapy Services for Children in School and Pre School and Access to Podiatry Services for People with Diabetes (Item 7 in the Minute Book).

(i) The Health of Children Looked After and the Health of School Age Children.

The Director of Social Services outlined the work that had been carried out by the Children and Young People Strategic Partnership on these reviews since being requested to do so by the Committee.

RESOLVED

That:-

(a) The Children and Young People Strategic Partnership be thanked for their work on the review to date.

(b) A further report be presented to the Committee in March 2005.

(ii) Therapy Services for Children in School and Pre School

Councillor Mrs McNair Scott, Chairman of the Working Group, outlined the scope of the review and the procedures undertaken. She gave details of the various therapy services and the national guidance on them. The findings showed that the availability of therapy sessions to children in school and pre-school across Hampshire were inconsistent, lacking in strategic leadership and carried unacceptable waiting times. No one organisation or partnership maintained an overview and many children received no service at all.

RESOLVED:

That the Chief Executives of Hampshire Primary Care Trusts; the County Education Officer; Hampshire and Isle of Wight Strategic Health Authority; Hampshire County Council's Children's Services Board and Hampshire and Isle of Wight Child Health Network be invited to respond to the findings and conclusions of the review within 28 days and they be asked to address strategic direction; equity of services; waiting times; partnership working; criteria for assessment; staffing levels; increased community bases; communication; pre-school partnership and training and professional development in their replies.

(iii) Access to Podiatry Services for People with Diabetes

Councillor Dowden, Chairman of the Working Group outlined the scope of the review and the procedures undertaken. He gave details of the types of diabetes, national guidance and the questionnaires used for the review. The findings showed that there was a huge variation in services across Hampshire with no agency or partnership taking overall lead for developing strategic direction.

RESOLVED:

That:-

(a) The Hampshire and Isle of Wight Strategic Health Authority be recommended to take strategic responsibility for ensuring equity of foot care services for people with diabetes across Hampshire and comply with recommendations from the diabetes National Service Framework and National Institute for Clinical Excellence guidelines.

(b) The leads for diabetes from each Primary Care Trust be recommended to join together to form a Diabetic Health Network to action the recommendations in the National Service Framework and National Institute for Clinical Excellence guidelines on foot care for people with diabetes.

(c) Key agencies be recommended to join together to introduce a training and development programme for staff involved in the foot care of patients with diabetes.

(d) The relevant authorities be requested to comment on the recommendations within 28 days.

105 FRAMEWORK FOR ASSESSING SUBSTANTIAL CHANGES TO NHS PROVISION

The Chief Executive presented a report providing a context to the dialogue that was needed to be taking place between Overview and Scrutiny Committees and NHS Organisations to establish if a proposal to vary or develop NHS provision for people living in the area was substantial in nature (Item 8 in the Minute Book). He outlined the rationale behind the proposals and the guiding principles that would be undertaken in assessing proposals.

RESOLVED:

That:-

(a) Support be given to the approach for assessing proposals from NHS organisations as set out in the report.

(b) The approach be presented to the Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee with a view to agreeing a common framework for assessment.

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PRESENT