AT A MEETING of the HEALTH OVERVIEW AND SCRUTINY COMMITTEE of the COUNTY COUNCIL held at The Castle Winchester on Tuesday, 31 January 2006

PRESENT

Chairman:

p Councillor Dr. R.J. Ellis

Vice-Chairman

a Councillor Mrs. A.M. McNair Scott

Councillors:

Co-opted Members:

Councillors:

p C. Connor

p Mrs. M. Kerley

A. Mitchell

p D. Welch

Also in attendance: Councillor Mrs. E. Baker (Portsmouth City Council)

Apologies were received from: Councillor Mrs. P. Dickens as she was representing the County Council at a meeting in Birmingham.

31. DECLARATIONS OF INTEREST

Members were mindful that, where they believed they had a personal or personal prejudicial interest in any matter to be considered at the meeting, they should normally at the time of the 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 was discussed.

The following members declared a personal interest:

Councillor P. Edgar - does work for NHS.
Councillor D. Harrison - employed by NHS.
Councillor D. Wright - wife a General Practice Manager.
Councillor Mrs. P. West - a member of Andover Reconfiguration Board and daughter-in-law a paramedic.

32. MINUTES

The Minutes of the meeting of the Health Overview and Scrutiny Committee held on 29 November 2005 were confirmed as a correct record and signed by the Chairman.

33. CHAIRMAN'S COMMUNICATIONS

(a) Martin Combs

The Chairman welcomed Martin who joined the support team on 1 December 2005.


(b) Conference

The Chairman reported that he and the Health Scrutiny Manager had attended a conference in London which was to explore the implications of the, then imminent, White Paper on the Health Outside Hospital. The conference had been helpful in highlighting some of the changes that would be seen in the NHS in the coming months.


(c) Commissioning a Patient Led NHS

The Chairman outlined the County Council's reply on this issue. Nick Relph had been appointed "Transition Director" for the proposed Strategic Health Authority in which Hampshire would be situated and links would be made with him to ensure that there would be continuity as the changes rolled forward. Sir Ian Carruthers had confirmed that he would continue his role of Chief Executive, in addition to leading national work on the development of commissioning.


(d) Southeast Region Health Overview and Scrutiny Committees

The Chairman reported on a recent meeting of Chairmen and officers of the Southeast Region Health Overview and Scrutiny Committees. All supported call for NHS funding to be revisited. He circulated a letter which had recently been sent to the Chairman of the Public Accounts Committee.


(e) White Paper - Healthcare Outside Hospital

The Chairman reported that the White Paper had now been published. The Health Scrutiny Manager had e-mailed a copy to all members and he urged members to read it.


(f) Solent Mind

The Chairman reported that Solent Mind had announced that Solent Mind would be providing several new vocational projects across Hampshire. The work would be central to the second inclusion agenda and helping get people back to work.


(g) Health and Wellbeing Meeting

The Chairman reported that he had attended an internal seminar on health and wellbeing which had identified many problems but not the way forward. He said that health and wellbeing should be tackled corporately and involve a high degree of co-ordination from all sectors.


(h) Health Debts

The Chairman reported that the health debts across the Strategic Health Authority area were now approximately £24m, but underlying overall deficits were considerably higher.

34. DEPUTATIONS

There were no deputations to this meeting.

35. PROPOSALS TO DEVELOP OR VARY NHS SERVICES

The Chief Executive presented a report on proposals to develop or vary health services in the area of the Committee (Item 5 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:-

(a) Southwest Primary Care Trust/Southampton University Hospital Trust : Closure of Maternity Beds and Review of Maternity Services in Southwest Hampshire

The Southampton University Hospital Trust had confirmed that the Romsey Birth Centre would reopen on 20 March 2006. In response to the Committee's comments on the review of maternity services the Southwest Primary Care Trust Alliance had confirmed that:


· All local NHS organisations will be involved in informing the review


· The women from across the area would have the choice in where they gave birth


· There would be closer partnership working with services for children and families


· The time frame for taking this work forward had been extended


RESOLVED:

That:-

(i) Romsey Birth Centre re-opening on 20 March 2006 be noted.


(ii) The Committee be advised of the next steps on the review of maternity services in southwest Hampshire when these were available.


(b) Mid and Southwest Hampshire Primary Care Trusts : Surgical Service Reconfiguration

Work was in progress with regard to activity and case mix and a business case was being developed for spinal care.

RESOLVED:

That the Committee be updated on progress with the surgical service reconfiguration at the next meeting.


(c) The Future of Services in Fareham and Gosport/Southeast Capacity Plan

The Strategic Health Authority had been appraised of the concerns of the Committee about the development of community services in southeast Hampshire. The Private Finance Initiative for Queen Alexander Hospital had been signed in December. The revised capacity plan for southeast Hampshire had got to be considered by the Strategic Health Authority.

RESOLVED:

That the Committee be advised of the response of the NHS and its partners to the review and the way in which this would be taken forward.


(d) Strategic Health Authority : Acute Paediatric Services Review

The Strategic Health Authority had sought the views of the NHS family on the review and recommendations by 31 January 2006.



RESOLVED:

That the Committee be advised of the response of the NHS and its partners and the way in which this would be taken forward.


(e) Mid Hampshire Primary Care Trust : Mental Health Accommodation

An outline of the next steps planned was presented to Members. The Primary Care Trust had indicated that there had been extensive engagement with individuals, their families, staff and Adult Services. Confirmation had been requested that other stakeholders, including Patient and Public Involvement Forums were satisfied that with the Section 11 involvement that had taken place.

RESOLVED:

That, subject to confirmation that adequate Section 11 engagement had taken place, it be agreed that this was not a substantial service change.


(f) East Hampshire/Fareham and Gosport Primary Care Trusts : Elderly Mental Health Services

Following queries raised by Members at the last meeting of the Committee about the services the Primary Care Trusts had confirmed their intention that management of these services would transfer to the Hampshire Partnership Trust on 1 April 2006. There would be no service changes associated with the transfer and no additional issues had been raised with the Committee by the Public and Patient Involvement Forum.

RESOLVED:

That the change in management arrangements be noted.


(g) Blackwater Valley and Hart Primary Care Trust : Rainbow Assessment and Treatment Group

No additional information had been provided about the proposal. Surrey Health Overview and Scrutiny Committee and the Patient and Public Involvement Forum had been alerted to the changes put forward. The Primary Care Trust had been appraised of the expectations of the Committee with regard to Section 11 engagement.

RESOLVED:

That:


(i) The Primary Care Trust be requested to confirm the feedback from all stakeholders, including the Patient and Public Involvement Forums whose populations were affected in line with Section 11 requirements.


(ii) The information provided and the views of Surrey County Council Overview and Scrutiny Committee inform the future recommendation of the Committee about the future of the change.


(h) Southeast Primary Care Trust Cluster : Maternity Services in Southeast Hampshire

The Chairman had written to the Trust requesting clarification following press reports that a decision about the future of the birth centres was imminent. Assurances had been given that a date for the reopening of the units would be given in the New Year. The Committee had been advised that the grounds of any temporary closure should include a date for the reopening of the services in question.

RESOLVED:

That:-


(i) The Primary Care Trust be requested to inform the Committee of the re-opening of the birth centres and if this is not provided consideration be given to any possible closure of the birth units being referred to the Secretary of State.


(ii) The Committee be advised of any further action relating to the review of maternity services at its next meeting.


(i) East Hampshire Primary Care Trust, Transfer of Learning Disability Services

The East Hampshire Primary Care Trust had indicated that learning disability services would transfer to Hampshire Partnership NHS Trust with effect from 1 April 2006. There would be no change in the services provided to the population of East Hampshire and Fareham and Gosport.

RESOLVED:

That the change in management arrangements be noted.


(j) East Hampshire Primary Care Trust : Transfer of Older Persons Medicine Services

Following East Hampshire Primary Care Trust's indication to transfer Older People's Medicine Services to Portsmouth Hospitals Trust in April 2006 the committee had requested the delay be deferred and had given its reasons for requesting the deferral of the transfer. Portsmouth City Health Overview and Scrutiny Committee had also shared these concerns.

RESOLVED:

That East Hampshire Primary Care Trust be requested to delay the transfer of Older persons Medicine Services to Portsmouth Hospitals Trust until such time as a satisfactory resolution of the issues highlighted had been resolved to the satisfaction of the Committee and the views of Adult Services be formally invited.


(k) North Hampshire Primary Care : Reprovision of Older Persons Mental Health Services Provided at Homefield House, Basingstoke

The Primary Care Trust had reviewed usage of Homefield House which provided a mix of residential and respite care to older adults with dementia. The assessment conducted by the Trust concluded that of the 20 residents only 7 met the continuing care criteria. It was proposed that patients with challenging behaviour be transferred to Parklands Hospital where additional staff resources were available with patients receiving GP led care remaining at Homefield House. It was intended to implement the proposed reprovision in December 2006. An initial feedback from Adult Services had requested further clarity on the proposals.

RESOLVED:

That:-


(i) The views of Adult Services on the proposals be requested.


(ii) The Primary Care Trust be requested to provide detailed information about Section 11 engagement including the views of the relevant Patient and Public Involvement Forums.


(iii) An update on the proposals be presented to the next meeting of the Committee.


Under items requiring action he gave details on:


(l) Hampshire Partnership NHS Trust : Improving Mental Health Services for Older People of Working Age

Martin Berkley, Chief Executive of Hampshire Partnership NHS Trust gave a presentation on the steps to be taken to improve local services outlined in the consultation document "Moving Ahead" following feedback from local people. He gave details about the Trust, which had provided specialist mental health and learning disabilities services since 2001 across the seven Primary Care Trusts in the area. The Moving Ahead proposals would enable a £5m investment to modernise, promote inclusion and prevention, develop community teams, enable more choice, and give more support for people in their community setting. He outlined the process of consultation and the key comments made, and the implications that the services provided, service users and financial. It was agreed that the consultation process had been satisfactory. Members noted the issues of concern that had been raised by key stakeholders including the proposed changes to services in the Lee-on-Solent area and he confirmed that the Trust was responding to this feedback and that appropriate alternative provisions would be made available for service users.






RESOLVED:

That the consultation process was adequate and that the proposals were in the interests of the health services in the area.


(m) Winchester and Eastleigh Healthcare NHS Trust : changes to the Configuration of Services at Andover War Memorial Hospital

Following the presentation to the last meeting of the Committee the Trust Board had now considered the detailed report of the consultation process and the preferred option for the reconfiguration of services at Andover War Memorial Hospital. The Trust had confirmed that the report of Article 13, the external consultancy commissioned to analyse the consultation feedback, setting out the outcome Of the consultation process, would be made available to Members of the Committee on request.

Concern was expressed as to the whereabouts of funding donated to the Save the Hospital campaign following the recent death of its Chairman. It was agreed that the most appropriate way forward was to request the police to look into the situation.

RESOLVED:

That:-


(i) The detailed consultation and engagement process, which included input from the relevant Patient and Public Involvement Forums, District Councils and other key stakeholders be noted.


(ii) Confirmation be given that the consultation process had been adequate and that the preferred option identified was in the interests of the community affected.


(n) North Hampshire Primary Care Trust : Changes to the Configuration of Services at Alton Community Hospital

No further action had been received about the proposal.

RESOLVED:

The Committee be advised of the progress with developing the consultation at its next meeting.


(o) Department of Health : Commissioning a Patient Led NHS

Arrangements for consulting key stakeholders about the configuration of Primary Care Trusts, strategic Health Authorities, and Ambulance Services had been published on 14 December 2005 with consultation completing on 22 March 2006. The Committee had been circulated with an electronic copy of the document.

RESOLVED:

That the views of members be re-affirmed as follows:-

- the need for robust local arrangements to ensure that local commissioning arrangements were able to reflect the different health needs of the population of Hampshire with particular importance to Ambulance Services and Public Health and that future arrangements would include adequate representation from elected members.

- Public Based Commissioning areas be aligned with District Boundaries.

- Improved partnership working across the County Council, District Council and the NHS.

and members wishing to have additional points included in the response to the consultation should direct these to the Health Scrutiny Manager by 17 March 2006.


(p) Healthcare Commission ; Engaging with Patients and Public

The Healthcare Commission had published a consultation document on engaging with patients and public on 15 December 2005, the closing date for comments being 9 March 2006.

RESOLVED:

That the following comments be made on the consultation process:

- Recognition of the problems of going out to consultation over a holiday period.

- The need to recognise local partners in assessing health services, this included Patient and Public Involvement Forums and Health Overview and Scrutiny Committees. The role of Health Overview and Scrutiny Committees being particularly important as this was the only body in the scrutiny network which included democratically elected Members.

- The need for improved working relationships with stakeholders and a two way exchange of information.

- The need to use local intelligence to inform the assessment process, underpinned by clear and objective evaluation procedures.

Any additional comments from members be directed to the Health Scrutiny Manager by 7 March 2006.

36. INQUIRIES RECEIVED AND ACTION TAKEN

The Chief Executive presented a report on queries received, the cause of each inquiry and the action taken (Item 6 in the Minute Book). He gave details Of the temporary closure of The Grange and Blackbrook Birth Centres, Compliance with National Institute of Clinical Excellence guidelines, Ambulance Services Estates Strategy; return of routine neurology referrals, transfer of upper gastro intestinal cancer surgery from Frimley Park Hospital to Royal Surrey County Hospital; progress with Aldershot Health Centre, closure of New Street Practice, Andover and Independent Sector Procurement Diagnostics. Members were concerned at proposals for the reconfiguration of the Ambulance Services estate and requested that the Chairman and Chief Executive of Hampshire Service be requested to attend the next meeting of the Committee to explain proposals. The Chief Executive also reported that West Sussex County Council was experiencing similar problems with regard to transfer of gastro intestinal cancer services.

RESOLVED:

That:

(a) The report be received and the actions outlined in the report be endorsed subject to West Sussex Health Overview and Scrutiny Committee being included with joint meeting with Surrey Health Overview and Scrutiny Committee on the transfer of gastro intestinal cancer services.


(b) The Chairman and Chief Executive of Hampshire Ambulance be requested to attend the next meeting of the Committee to explain proposals for the reconfiguration of the Ambulance Services Estates.

37. REVIEW OF PUBLIC HEALTH AND WELLBEING

The Chief Executive presented a report giving an update on progress being made with the review of public health and wellbeing (Item 7 in the Minute Book). The report was a first attempt to look at health improvement and public health/wellbeing across Hampshire and recognised the need for further work to be carried out to build on accurate practice. Further work would be required with colleagues in Local Government and the local NHS to achieve this.

RESOLVED:

That:-

(a) The report be shared with the Adult Services Restructuring Board Working Group that was taking forward joint working with the public health network. This to include:

- a more detailed mapping of public health plans and programmes across Hampshire, including opportunities to share best practice and identify gaps in delivery.

- the development of Local Strategic Partnerships and Local Area Agreements.

- identification of the health improvements to be delivered by local people.


(b) Lead officers from Adult services and the Public Health Network report back to the Committee on 28 November 2006 detailing the outcome of the review.

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