Archived decisions

Contact: Denise Holden ex 7338

e-mail: [email protected]

1. Summary and Purpose

1.1. The purpose of this report is to alert Members to proposals from the NHS to vary or develop health services provided to people living in the area of the Committee.

1.2. Proposals that are considered to be substantial in nature will be subject to formal public consultation. The nature and scope of this consultation should be discussed with the Committee at the earliest opportunity.

1.3. The response of the Committee will take account of the Framework for Assessing Substantial Change and Variation in Health Services agreed by the Hampshire, Isle of Wight, Portsmouth and Southampton Joint Committee in March 2005. This places particular emphasis on the duties imposed on the NHS by Section 11 of the Health and Social Care Act 2001.

1.4. This Report is presented to the Committee in 2 parts:

_ Items for information: these alert the Committee to forthcoming proposals from the NHS to vary or change services. This provides the Committee with an opportunity to determine if the proposal would be considered substantial and assess the need to establish formal joint arrangements

_ Items for action: these set out the actions required by the Committee to respond to proposals from the NHS to substantially change or vary NHS services.

1.5. This report and recommendations provide members with an opportunity to influence and improve the delivery of health services in Hampshire and therefore

support the delivery of the Corporate Strategy aim of maximising well being.

Items for Information

2. Maternity Services in South East Hampshire

2.1. The PCT has been invited to attend a joint Hampshire and Portsmouth Health Overview and Scrutiny Committee on 13 March to set out how it intends to proceed.

Recommendation

2.2. Members are kept up-dated on the progress of the Joint Committee, taking account of the SHA review

3. Closure of Maternity Beds and Review of Maternity Services in South West Hampshire

3.1. SUHT has confirmed that, due to a delay in the rehabilitation services moving from the Ashurst site the opening of the new centre will be delayed.

Recommendation

3.2. Members are apprised of the anticipated opening date of the new Birth Centre at Ashurst.

4. South Central SHA: Review of Community Hospitals

4.1. South Central SHA has signalled that it will be reviewing community hospitals in its area during 2007/08 and that it wishes to engage HOSCs in determining the criteria by which these facilities are evaluated.

4.2. South Central HOSC's will meet on 15 May to decide how they wish to take this work forward.

Recommendation

4.3. That the Committee is kept apprised of progress with this work

Items for Action

5. Hampshire Partnership NHS Trust: Mental Health Services for Older People in the wider Southampton Area

5.1. Hampshire Partnership NHS Trust has issued a consultation on proposals to modernise services for older people in the Southampton area. This is attached at Appendix 1.

5.2. Specific points that members may wish to consider include:

· Overall the document is not clear about the changes being made and the reasoning behind these. It suggests that it is closing a ward at the Western Hospital, but in fact is setting out the case for moving Allington West Ward from Moorgreen to that facility. Section 4 highlights that that the move of the ward could release land for sale.

· There does not appear to be any analysis of the need for the services affected given our aging population and the fact that there is a going proportion of our population that will be affected by dementia.

· There is no assessment of the impact that the move will have on access, particularly for people in the area of Eastleigh and Southern Parishes

5.3. There is also a need for the document to be clear about the impact of the changes proposed on other service providers, including adult services.

5.4. Adult services views on the proposals have been invited and the document shared with colleagues in Eastleigh Borough Council and the P&PIF.

Recommendations

5.5. That the Committees agrees the key issues to be included in the response from the HOSC

6. South East England SHA: Acute Service Reconfiguration

6.1. In the absence of the information requested form West Sussex PCT on 17 January, Hampshire and Portsmouth City Health Overview and Scrutiny Committees made the following joint statement to West Sussex PCT and South East England SHA on 22 February 2007:

6.2. `Both Hampshire County and Portsmouth City HOSCs have written to West Sussex PCT setting out our expectations of the information necessary to enable us to come to a view on whether the proposals would be substantial in terms of impact on health services in our respective areas. Whilst it has been helpful to directly reflect our concerns to the CX of West Surrey, at the time of writing this we have yet to receive the information we requested about patient flows and services affected.

6.3. You will also note that NHS organisations in Hampshire were not aware of the plans of the PCT. We would expect that any proposals put forward take full account of the potential changes to patients flows across boundaries. We have not had any indication that this discussion and planning has taken place. This latter point is key in as much as changes to some patient flows (e.g. around A&E/trauma) could have a significant impact on our services. As services are currently configured this could mean that A&E at Portsmouth Hospitals and ambulance cover would need to be extended with additional investment.

6.4. In response to Candy Morris' letter of 1 November 2006 we have taken steps to enable our Committees to contribute as appropriate should we need to be part of a joint HOSC to consider the proposals. We do not have the information that will allow us to come to a view on this matter or the consultation period that would be necessary. The absence of this, the fact that election `purdah' will be beginning in late March and our need to initiate appropriate steps, taking into account governance issues, to enable members to decide whether the proposals substantially affect our local population ( and therefore form part of a Joint HOSC), suggests that it is not feasible for the PCT to commence consultation at this point in time'.

6.5. Subsequent to this statement West Sussex Pct has now indicated that the formal consultation will not now go ahead until after the May elections.

6.6. Further information was been provided by the PCT about the range of services that may be affected by the changes 0n the 27 March 2007. This confirmed that one of the options under consideration is for St. Richard's Hospital, Chichester to become a Local General Hospital instead of a Major General Hospital . In this event it would provide such services as an Urgent Care Centre, Midwifery Led Birthing Centre, diagnostics to support primary care, some elective care and some "step-up" beds. It would not provide a full Accident and Emergency Service, consultant-led obstetrics or Intensive Care Unit.

6.7. Should the status of St. Richard's hospital change it would have an impact on some Hampshire residents who access services at St. Richard's. It would also have an impact on services at Queen Alexandra Hospital, Cosham resulting in increases in day cases, elective inpatients, maternity episodes and emergency admissions. Estimates of the potential impact are contained in a letter from West Sussex Primary Care Trust which is shown as Appendix 2.

Recommendation

6.8. Members determine if they consider that the impact of the changes have the potential to be significant for local people in accordance with section 7 of the Health and Social Care Act 2001.

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.

File Location

None

Appendix 2

Re: Potential impact of West Sussex Fit for the Future strategy on neighbouring authorities

As you will be aware, West Sussex PCT is currently developing options for reconfiguration of acute hospitals as part of our Fit for the Future strategy. I know that your HOSC wishes to consider whether our proposals might constitute a significant service variation for its residents and therefore whether it would want to join the Joint HOSC which is being set up to oversee the process.

The only aspect of the proposals that is likely to affect your residents is a variation of services at the Royal West Sussex NHS Trust in Chichester (RWS). Although the proposals affecting the RWS have not yet been finalised, I can provide you with the following information which I believe will be enough for you to make your decision as to whether the proposals may constitute a substantial variation for your residents. I must stress that these figures are DRAFT as we are still finalising our analysis.

Under all options being considered, RWS will not provide fewer services than would be provided by a Local General Hospital (an LGH would provide a wide range of services such as an Urgent Care Centre, Midwifery Led Birthing Centre, outpatients, diagnostics to support primary care, some elective care and some "step-up" beds - it would not provide a full A&E service, consultant-led obstetrics or ITU)

1. The potential impact on your local residents who currently use hospitals situated in West Sussex

The current use by residents of Hampshire PCT of services at the Royal West Sussex that might be affected if RWS were to become an LGH is:

· Daycases: 500 per annum

· Elective inpatients: 250 per annum

· Non-elective inpatients (including maternity): 1,650 per annum

This is around 5% of the current activity at the RWS and constitutes a small proportion of the activity currently commissioned by Hampshire PCT.

2. The current utilisation of your local hospital by residents of West Sussex and the potential impact on your local hospital of inflows of West Sussex residents as a result of reconfiguration

One of the hospitals used by your residents is Portsmouth Hospital - we anticipate that there will be an impact on this hospital if Royal West Sussex Trust (RWST) becomes a Local General Hospital. This could result in flows to Portsmouth Hospital by 2008/09 of:

One of the hospitals used by your residents is the Royal Surrey County Hospital (RSCH) - we anticipate that there will be an impact on this hospital if Royal West Sussex Trust (RWST) becomes a Local General Hospital. This could result in flows to the RSCH by 2008/09 of:

I hope that this information will allow your HOSC to make an analysis of significant service variation. We would be very happy to meet with you and members of your HOSC to discuss this further if that would be helpful. We would also be delighted to send a senior representative from the PCT to your HOSC meeting on 11^th April in order to answer any queries from members if that would be helpful.

Please do not hesitate to contact me if I can provide any additional information.

Yours sincerely

John Wilderspin

Chief Executive