Contact : Penny Velander, Health Review Officer, Ext 7479, [email protected]

1. Summary

1.1. At the 30 November 2004 meeting the Committee received and approved the draft reports for the following two health reviews

· Access to Therapy Services for Children in School and Pre-school

· Access to Podiatry Services for People with Diabetes

It was agreed that the draft reports would be sent out with a deadline for response set for 7 January 2005

1.2. Despite several written and electronic reminders many of the agencies did not respond within the deadline therefore necessitating a delay in the final report being presented to Committee.

1.4 Responses have now been received and this report presents the final review findings, conclusions and recommendations for Committee to consider

2 Access to Therapy Services for Children in School and Pre-school.

2.1 Responses to the review report and conclusions were mixed. There was some criticism that the report didn't contain any recommendations to comment on. However the intention was to consult with service providers to get their ideas on the best way to overcome the obstacles identified in the report.

2.2 Most respondents agreed that strategic direction is needed to overcome the disparities that exist in different localities. The Strategic Health Authority has recently appointed a new Children's Lead and it is hoped that this person will play an instrumental role in facilitating the review findings both within the Health Authority and the PCTs.

2.3 If the review recommendations are to achieve significant improvements all agencies must have a positive attitude to change and fully explore how successful outcomes can be delivered.

3 Access to Podiatry Services for People with Diabetes

3.1 Overall the responses were supportive to the review findings especially from Social Services and the Workforce Development Confederation which show great potential to work together on training and development. Programmes to skill carers of adults with learning disabilities and elderly in basic foot care will provide a better service for clients and reduce the burden on podiatrists

3.2 Responses from the Strategic Health Authority and the PCTs were more cautious with the Strategic Health Authority admitting that this area of work would not be a priority for them in the near future but stated that their lead officer will work with the Networks. PCTs are very focused of local service provision but appear to have difficulty in seeing that local disparities hinder the progress of joined up planning and strategic thinking. This is an important obstacle to overcome and needs real commitment to change from all PCT Chief Executives with support from the Strategic Health Authority

3.3 It is hoped that the positive responses from Social Services and the Workforce Development Confederation will spur the PCTs and Strategic Health Authority to explore how they can build on and support training and development initiatives across Hampshire.

3.4 Both the Strategic Health Authority and the PCTs must face the serious consequences that lack of investment in this service will lead to. Only the SHA can lead on the development of a regional network, but this has to require the willingness of Primary and Acute Trusts. Podiatry services will not be able to manage any increase in demand without additional investment. This is an opportunity to work differently and provide structure to a very important area of health care, which is responsible for millions of pounds of NHS resources when things go wrong.

3.5 The latest figures show that diabetes is set to double in the next ten years. It is essential that the infrastructure is created to support diabetics and their carers to manage their symptoms in the best way. The National Service Framework and NICE guidelines provide the backbone for this infrastructure. The health economy in Hampshire must provide the will to put it into practice.

4 Recommendations

· The Health Review Committee agrees the recommendations as outlined for the Access to Therapy Services for Children in School and Pre-school review report

· The Health Review Committee agrees the recommendations as outlined for the Access to Podiatry Services for People with Diabetes review report

· The Health Review Committee writes to all Chief Executives and Directors cited for each review requesting details on how they will be supporting the development and progression of review recommendations

· The Health Review Committee shares the review findings with other relevant Policy and Resource Committees, Cabinet and full Council

N.B. The list excludes:

1. Published works

Documents which disclose exempt or confidential information as defined in the Act.