Contact: Denise Holden ext. 7338

e-mail: [email protected]

1. Summary and Purpose

1.1. This report provides Members with information about the issues brought to the attention of the Committee and the response to these referrals. It sets out the inquiries received, the source of this inquiry and any action taken. Where appropriate comments have been included and copies of briefings or other information attached.

1.2. The approach adopted provides the route through which Patient and Public Involvement Forums (P&PIFs) and other partner organisations (Hampshire district councils, NHS organisations, voluntary and independent sector providers and organisations that are representative of social care service users and carers) can raise issues with the Committee.

1.3. Where inquiries raised with the Committee are already subject to monitoring or other performance management activities the action taken will be focused on the local resolution of inquiries through appropriate sign-posting to the agency best placed to respond.

1.4. Where an issue cannot be satisfactorily resolved between the parties concerned then the Committee can consider options for further action.

1.5. New issues raised with the Committee, and those that are subject to on-going reporting are set out in Table One of this report.

1.6. The recommendations included in this report support the Corporate Strategy aim of maximising wellbeing through the overview and scrutiny of health services in the Hampshire County Council area.

Table One: Inquiries Received and Action Taken

Section 100 D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

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

Appendix One

UPDATE ON ALDERSHOT CENTRE FOR HEALTH AUGUST 2006

Construction of the new Centre for Health began on 12^th December 2005 with a build programme set at 78 weeks. Progress on the enabling works as part of the construction phase went to plan due to dry winter conditions and by April 2006 1,300 lorry loads of soil had been removed from the site and the 450 foundation piles were completed. Construction works were paused while integrity testing was undertaken to check the foundation piling due to variable soil conditions found on the Hospital Hill site.

Further work on site was then put on hold until the detailed design for the Centre for Health's 700 rooms was completed. The PCT and the Army undertook this review in July, to agree and sign off the room data sheets so that the design could be frozen.

The main construction phase, with contractor Alfred McAlpine for the Aldershot Centre for Health has now commenced with work starting on Tuesday 29^th August 2006.

The programme for completion of the project has been updated:

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Appendix Two

Winchester and Eastleigh Healthcare NHS Trust

`Fit for the Future' Questions and Answers. 5 September 2006

Many of you are asking questions about savings plans. We know you want more information and so have compiled these Frequently Asked Questions.

1. "Who are The Health Works and why are they here?"

The Health Works is a team of highly skilled and experienced people with a track record in helping NHS trusts modernise, make substantial savings and, most importantly, remain viable. They were invited by the Trust to advise and support us because our own financial recovery plans were not going to produce the level of saving required to safeguard our future. Together, we are developing a plan to ensure that we can maintain our high quality services in a difficult financial environment. This plan and the work it entails is called `Fit for the Future'.

2. "What can they do that we couldn't do on our own?"

They take a fresh approach, using national benchmarks and applying methods proven to work at other trusts. The Health Works have used our data (activity and financial) to understand our working practices (good and bad), inefficiencies and opportunities to improve. In addition, they establish rigorous project management and accountabilities that are focused on delivery and outcomes.

But only we can make it work - it's down to us to make Fit for the Future a success.

3. "Is this very different from savings programmes we have had before?"

Yes and No!

No, because in many ways, the projects and ideas are familiar and focus on how we use beds, staff and the estate.

Yes, because this time the financial position is worse than ever before and we absolutely have to iron out the inefficiencies, find ways to deliver services differently and make the savings. The situation demands that we sort out our problems properly and not go for a quick fix that will leave us in the same situation next year.

4. "What stage is the work at?"

Very early! - The Health Works have just finished working out the size of the problem and how much we could save and by when.

To give ourselves a realistic chance to get back into financial balance, we are looking to save at least £15m by December 2008. It won't be easy but it must be done.

Work on how the various projects is at the planning stage in most cases.

Programme and project managers are now in place - these are existing staff using existing resources. A steering group will soon be set up and this will manage progress, make key decisions and refer issues to Trust Board for decision (if necessary) and approval.

5. "How will I be kept updated and hear more about Fit for the Future?"

This month's core brief sessions (RHCH - 27^TH @ 2pm, Education Centre and AWMH, 29^TH @ 10.30 pm, Conference Rm) are open to all, with papers available.

In addition, monthly progress newsletters and more Q and As like this will be issued. Plus, Chris and other directors will be attending staff meetings to update you.

6. "What does this all mean for staff?"

In the first instance it means a lot of hard work for those involved in specific projects - this is why it is so important to support colleagues rather than create anxiety by spreading rumours.

Staff numbers will reduce in line with changes to the way we run beds and services, including non-clinical services too. It is too early to give out exact numbers. It is hoped that staff turnover and recruitment restrictions will deliver most of what's needed in terms of savings from the wage bill. We can't rule out compulsory redundancies but these will be the last resort. The Trust will adhere to legislation, including full consultation with staff.

7. "What about bed numbers?"

We know that running hospital beds costs us more than we get for doing it. We also know that many patients prefer to go home on the same day if possible or come in on the day of their hospital treatment, rather than spend the previous night on a ward. We need to build on the excellent progress in increasing the percentage of patients treated as day cases. We are also planning to establish pre-assessment clinics in outpatients, use telephone pre-operative assessment and set up more pre-op clinics to review patients before surgery to help us check they are ready for treatment, thereby cutting cancelled operations.

Many of our beds are occupied by patients whose hospital discharge is delayed and who have no medical need to remain with us. This is bad for individual patients, additional stress for busy staff and expensive for the Trust.

In addition, patients with chronic conditions are often admitted as emergencies when this is not always the best option for them.

Reducing our delayed discharges will require firm action from staff, other NHS partners and local authorities. It will be beneficial for patients to be able to leave hospital sooner or, with the help of Primary Care, to be supported at home so that that long term conditions can be managed without the need for hospital admission.

Tackling delayed discharges and better management of conditions in the community will be better for patients and allow us to provide services from fewer beds. This will have an impact on staffing.

8. "What about the site?"

Compared to other trusts, we use a lot of site for our services, which is costly. As well as capital charges (a form of rent), there are maintenance costs. Older or underused buildings and land take money away from patient care. We must work towards having sites that fit our needs. We can't afford to be sentimental at a time when we should be focusing on the future of the Trust itself. Selling surplus estate provides a short term boost with a longer term benefit of lower upkeep costs and capital charges. Many options are being considered because we must build our site around our services. There will be more on this and other plans in the papers at core brief.

9. "I keep hearing the phrase `best in class' - what does this mean?"

There is a wealth of evidence by which we can compare ourselves to other trusts. Our MRSA rates and stroke care (to name just two) are top of the table. Day case rates are also very good. Being `best in class' is about providing high quality services but doing so efficiently. Invariably, an efficient service is a good service because it is planned around the patient and their pathway between primary and secondary care.

10. "What do I do if I've got good ideas and want to make a difference?"

Please speak to Mary Probert (via email or on 01962 824281) who is coordinating the work programmes. She can put you in touch with the relevant project manager.

Issued on behalf of Chris Evennett and the Trust directors. Questions about this Q&A should go to Louise Halfpenny, via email or on 01962 825286