AT A MEETING of the HEALTH OVERVIEW AND SCRUTINY COMMITTEE of the COUNTY COUNCIL held at The Castle Winchester on Tuesday, 25 July 2006

PRESENT

Chairman:

p Councillor Dr. R.J. Ellis

Vice-Chairman

p Councillor Mrs. A.M. McNair Scott

Councillors:

Co-opted Members:

Councillors:

a Mrs. M. Kerley

p D. Welch

Also in attendance: Councillor David Stephen Butler (Portsmouth City Council) Councillor Mrs. E. Oulton (Isle of Wight Council) and Councillor B.D. Dash at the invitation of the Chairman.

Apologies were received from: Councillor Mrs. P. West as she was carrying out duties as Chairman of the County Council.

53. DECLARATION 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 Mrs. P. Dickens - employed by NHS.
Councillor P. Edgar - does work for NHS.
Councillor D. Harrison - employed by NHS.
Councillor D. Wright - wife a General Practice Manager

54. MINUTES

The Minutes of the meeting of the Health Overview and Scrutiny Committee held on 30 May 2006 were confirmed as a correct record and signed by the Chairman subject to Minute No. 50 being amended to read the Future of the Lawns Day Hospital, Havant.

55. CHAIRMAN'S COMMUNICATIONS

(a) NHS Conference

The Chairman reported that he and the Health Scrutiny Manager had recently attended the NHS Conference. It had been useful for networking and identifying key issues facing health.


(b) South Central Strategic Health Authority

The Chairman reported that Simon Tanner had been appointed Director of Public Health for the new Strategic Health Authority. The Chairman was to meet with Mark Bitnell the Chief Executive of the Strategic Health Authority on 16 August 2006 and would be raising a number of issues relating to working with local government.


(c) Hampshire Primary Care Trust

The Chairman reported that the Chairman of the new Hampshire Primary would be Jonathan Montgomery and that the name of the Chief Executive would be announced shortly.


(d) Healthcare Commission

The Chairman reported that he had had a useful meeting with Anna Walker, the Chief Executive of the Healthcare Commission. They had discussed ways in which the Commission and the Committee could work more effectively. It was anticipated that the Local Government Association would be directly approached with a view to formalising the working relationship between the Healthcare Commission and Health Overview and Scrutiny Committees and what could be done locally to promote closer working.


(e) Portsmouth Hospitals NHS Trust

The Chairman reported that the Portsmouth Hospitals NHS Trust was intending to seek foundation status. (Copies of the proposals were available at the meeting). The Trust was continuing to make a significant contribution to improving financial challenges facing the local health economy but it was not anticipated that this would have any impact on service provision.

56. DEPUTATIONS

The Committee received a deputation from Mr. C. Curry; Mr. T. Lowes and Mr. K. Jannaway on the changes to service configuration at Havant and Emsworth and The Future Services in Fareham and Gosport/Southeast Capacity Plan. They were concerned at the closure of Victoria Cottage Hospital, Emsworth prior to the provision of the new community hospital at Oak Park, Havant, which was to replace both Victoria Cottage Hospital and Havant War Memorial Hospital, and that it was now proposed that there would only be 25 beds in the new Oak Park Community Hospital. This was at variance with previous proposals.

57. INQUIRIES RECEIVED AND ACTION TAKEN

The Chief Executive presented a report on enquiries received, the source of each enquiry and the action taken (Item 5 in the Minute Book). The enquiries related to:-

Transfer of Upper Gastro Intestinal Cancer Surgery from Frimley Park to Surrey County Hospital.

The Future of Lawns Day Hospital, Havant.

Changes to Neurology Rehabilitation Services.

Changes to School Nursing Provision.

Changes to Community Services for Children with Terminal and Life Threatening Illness.

Incidence and Cause of Delays in Discharge from Winchester and Eastleigh Healthcare NHS Trust.

Partnership Working with the Healthcare Commission.

Compliance with National Institute of Clinical Excellence Guidance.

HIV Counselling Services.

Care at the End of Life.

Southampton University Hospital Trust Challenges.

Changes to Service Configuration at Havant and Emsworth.

St. Mary's Hospital, Portsmouth - Closure of Kingsclere and Exton 4 Wards.

A representative from Surrey, West Sussex and Hampshire Cancer Network gave a presentation on the transfer of Upper Gastro Intestinal Cancer Surgery from Frimley Park to Surrey County Hospital. He outlined the proposals, which were to focus the surgical element at Surrey County Hospital, and the actions being taken to achieve this. The focus was on providing the best possible options for all patients. Members requested an update on progress in early 2007.

Councillor Mrs. Buckley gave an update on the action being taken on the future of the Lawns Day Hospital at Havant.

Members were concerned at the proposed number of beds in the new Oak Park Community Hospital at Havant and at the representation on the steering group for the hospital.

The Chief Executive reported that at a joint meeting with representatives of Portsmouth Health Overview and Scrutiny Committee, held on 19 July 2006, consideration was given to the closure of Kingsclere and Exton 4 Elderly Care wards at St. Mary's Hospital and it had been resolved that the closure of these wards did not constitute a substantial change. However, there were wider issues relating to the reducing in lengths of stay in hospital, which, although would be beneficial to patients, could have an impact on other service providers - concern was expressed at the interface between Adult Services and the NHS when looking at provision and the apparent impasse that had been reached about the way in which the model of care set out should be delivered. The Joint Committee requested a further meeting in 9 months to hear how this was being progressed as it was essential that current funding pressures did not create barriers to people working together to find solutions in a difficult financial climate.

RESOLVED:

That:-


(a) The report be received and the actions outlined in the report be endorsed.


(b) The Committee be updated on progress with the transfer of Upper Gastro Intestinal Cancer Surgery from Frimley Park to Surrey County Hospital in early 2007.


(c) East Hampshire and Fareham and Gosport Primary Care Trusts be requested to give further consideration to the proposed number of beds at the new Oak Park Community Hospital and to the representation on the Steering Group.

58. 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 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 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) Hampshire Child Health and Maternity Services Discussion Board

The Primary Care Trust had responded to the Committee's comments made on the discussion paper and arrangements had been made for three workshops across Hampshire to involve and inform all staff who work in child health and maternity services.

RESOLVED:

That the Committee be updated on progress at its meeting in November 2006.


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

Representatives of Southampton University Hospital Trust circulated the draft public consultation document on Modernising Maternity Services and gave a presentation on the proposals, why changes to the service were necessary and the progress made to date.

RESOLVED:

That the Committee be kept updated on the consultation process.


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

Portsmouth Hospitals NHS Trust had indicated that it may be possible to re-open the Grange Birthing Centre, Petersfield in October or November 2006. The proposal not to invest further funding in Blackbrook Birthing Centre, Fareham had been supported by the Maternity Services Liaison Committee, Blackbrook Support Group and the Fareham and Gosport Patient and Public Involvement Forum. The Chairman had written to the Trust expressing concerns about the closure of Blackbrook in the context of the delays to the Fareham Community Hospital and requested that alternative arrangements for maternity services in the area be agreed with the stakeholder prior to any further action being taken.

RESOLVED:

That the Chairman's actions be endorsed and the Committee be kept up-to-date on the progress of the Joint Committee on maternity services.


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

The Committee's comments on the capacity plan had been sent to the Strategic Health Authority but no response had been received. Members were concerned that proposals for an additional 80,000 homes in the area had not been taken account of in the capacity plan.

RESOLVED:

That the Committee be advised of the response from the Strategic Health Authority at its next meeting.


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

The Primary Care Trust had produced a paper, seeking to address concerns raised by the Committee, outlining how it wished to proceed with the transfer of older persons medicine services. A Joint Committee with Portsmouth City Council had been established with Hampshire being represented by the Chairman and Vice-Chairman of the Committee and Councillors Mrs. Dickens and Wright. The Joint Committee had met on 19 July and resolved that transfer of the Older Persons Medicine Services did not constitute a substantial change. The Joint Committee stressed the need for clarity about the way in which the integrity of Older Persons Medicine Services will be maintained following the transfer to Portsmouth Hospitals NHS Trust. In the absence of other mechanisms to allow democratic impact into the development of commissioning arrangements for these services the Joint Committee requested a further meeting in six months to allow members to determine how its recommendation had been taken forward.

RESOLVED:

That:-


(i) The appointment of the Chairman, Vice-Chairman and Councillors Mrs. Dickens and Wright to be Joint Committee with Portsmouth City Council to consider the transfer of Older Persons Medicine Services be approved.


(ii) The Committee be updated on the work of the Joint Committee.

Under items requiring action he gave details on:


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

Lord Warner had responded declining the request for the configuration of the Ambulance services to be referred to the Independent Reconfiguration Panel and Warwickshire County Council had concluded that it was not possible to proceed with a judicial review on the reconfiguration.

RESOLVED:

That the Committee's concerns on the Ambulance Service be raised with management team of the Ambulance Trust for a detailed response.


(g) Southwest Alliance Primary Care Trusts : Neurology Rehabilitation Services

Formal Consultation on changes to the Neurology Rehabilitation Services commenced on 11 July 2006 and the consultation document was attached as Appendix 3 of the Chief Executive's report.

RESOLVED:

That:


(i) Members advise the Health Scrutiny Manager of any issues they wish flagged to the Primary Care Trusts in response to the consultation by 15 August 2006.


(ii) A presentation on the outcome of the consultation be made to the next meeting of the Committee.


(h) Department of Health : A Stronger Voice : A Framework for Creating a Stronger Local Voice in the Development of Health and Social Care Services

The Department of Health's document had been published on 13 July 2006 and circulated electronically to members. It outlined changes to the way Patient and Public Involvement in health would be supported in the future as well as the integration of this requirement with social care commissioning and provision.

RESOLVED:

That Members advise the Health Scrutiny Manager of any views they had on the proposals by 15 August 2006 for inclusion in the response of the Committee to the Department of Health.

59. THEMATIC REVIEW PROGRAMME

The Chief Executive presented a report giving an update on progress with thematic reviews (Item 7 in the Minute Book). He gave details of the progress being made with Public Health and Wellbeing and Out of Hours Services. The Executive Member for Adult Social Care had requested the Committee to review the issue of Care at the End of Life. Following discussions a working group had been established to review the services and care provided for patients/clients aged 65 or more who have been diagnosed as being near the end of their lives. The proposed terms of reference for the working group were shown as Annex 1 Appendix 3 of the Chief Executive's report.

RESOLVED:

That:-

(a) The progress made with the Health and Wellbeing and Out of Hours reviews be noted.


(b) A working group for the Care at the End of Life Review consisting of members and stakeholder representatives and advisors be established. The membership be as follows:-

Councillors: D. R. Ellis (Chairman)
R. McIntosh (Vice-Chairman)
Mrs. A. Buckley
K. Chapman
Mrs. P. Dickens
Mrs. J. Frankum
Mrs. A. McNair Scott
D. Wright.

NHS Chairman of the Hampshire Primary Care Trust
Professor M. Severs

and independent expert advice to cover Primary Care, Secondary Care, Palliative Care and other issues as appropriate to support the working group.


(c) The terms of reference for the Care at the End of Life Review be as set out in Annex 1 Appendix 3 of the Chief Executive's report.


(d) The Committee delegates its powers to the Care at the End of Life Review Working Group for the purposes of the exercise.


(e) The Care at the End of Life Working Group reports finally back to the Committee in January 2007.

60. APPOINTMENT OF CO-OPTED MEMBER TO PORTSMOUTH CITY HEALTH OVERVIEW AND SCRUTINY COMMITTEE

RESOLVED:

That the Chairman of the Committee be appointed as the Committee's co-opted member on Portsmouth City Health Overview and Scrutiny Committee.

61. FORWARD PLAN

The Chief Executive presented the Committee's Forward Plan (Item 9 in the Minute Book). Members requested that the outcomes of previous reviews be included in the forward plan.

RESOLVED:

That, subject to the inclusion of the outcomes of previous reviews, the forward plan be approved.

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