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: Childhood Immunisations: Uptake by 5^th Birthday in Hampshire PCT

Appendix Three: SUMMARY OF KEY PCT PERFORMANCE TARGETS

Smoking Quitters

As anticipated, the PCT missed its 2006-07 Quitters target by some distance (26%). Within the PCT there are local areas of commendable performance and Jean Bradlow (Director of Public Health) has initiated a range of actions, documented on Page 4 of the report to ensure the PCT Smoking Turnaround Plan will deliver the required number of quitters in 2007-08.

Cancer Waiting Times

As at the end of April 2007 the PCT met all cancer waiting time targets. An improvement in performance was noted at Winchester, whilst Basingstoke's performance fell below the 95% target as the result of a single patient breaching the 62 day maximum waiting time.

Sexual Health: 48 Hour Access to Genito Urinary Medicine (GUM) Services

Based on locally reported data the majority of local providers of GUM services achieved the 81% target for the number of patients seen within 48 hours at the end of March 2007. As a result, the PCT should receive a positive assessment in the Annual Healthcheck. Technical issues at the DoH mean that no further update is available. The GUM Action Plan implementation is underway and is reviewed regularly at the PCT's Turnaround & Performance Group.

18 weeks - Diagnostic Waiting Times

Performance deteriorated markedly in April, with in excess of 200 more 13+ week waiters than at the end of March 2007. Considering SLAs have been signed with local providers committing them to delivering a 4 week diagnostic wait by March 2008, it is of considerable concern that performance is currently deteriorating. The Contracting team are urgently investigating specific areas of poor performance.

18 weeks - Inpatient & Outpatient Waiting Times

Outpatient performance was on target again in April, with no areas of concern. There was an increase in the number of breaches (45) of the 20 week inpatient milestone in April, putting a halt to encouraging progress seen earlier in the year. Long waiters are being followed up with specific providers.

Infection Control - MRSA

No new data to report, although work is underway to create a PCT wide picture for Clostridium Difficile.

Choose and Book

A marginal improvement in performance can be seen, with the PCT approaching 31.3% of appointments booked using C&B. The Choose & Book project plan proposes a maximum achievement of 60% by March 2008 compared to the national target of 90% by September 2007. Risks have been identified and a detailed set of actions proposed.

Appendix Four

Alton Community Hospital

Overview for HOSC - June 2007

1. July 2005 Inwood Ward temporary closure due to staff shortages of trained / untrained staff.

2. Public meeting held September 2005 attended by Chief Executive Debbie Glenn and Director Richard Samuel.

3. PCT agreed to work with local stakeholders to formulate ideas and options for future use of the beds.

4. Stakeholder's workshop held on 26 October 2005 - proposal to use beds for step up / step down and rehab.

5. Board paper with recommendation of stakeholder group 24/1/06.

6. Stakeholder Group formed which included local residents, GP's, League of Friends, Town Mayor, PPIF, Health review committee member. Decision taken to refurbish Inwood Ward and open as a new Nurse Led Unit.

7. Members of the Stakeholder Group formed the project Implementation Group and were involved in all aspects of pathway redesign, admission criteria, recruitment and staffing.

8. Inwood Ward refurbishment commenced July 2006, with a view to completion by October 2006.

9. A new Service Level Agreement (SLA) was agreed with the Wilson Practice for the provision of medical cover for the Wards at Alton. The contract terms provide for GP cover of two hours per day Monday - Friday which includes support for the weekly ward round, a weekly multi-disciplinary meeting and day to day care for individual patients. Out of hours care is still provided by Thamesdoc.

10. Privacy and Dignity review at Alton and Chase Hospital using Essence of Care to benchmark. The review team was led by Sally Bassett, Director of Nursing, and involved senior staff from other NHS Trusts, and members of the Patient Forum. All hospital inpatients were:

· Provided with a letter informing them of the review

· asked to complete a questionnaire

· interviewed by member of the review team (where appropriate)

The outcomes of the review were used to formulate a project stream (action plan) and this was presented to the Clinical Governance Committee. The Patient Forum members are involved in the ongoing development of the community hospital and the work of the project stream.

11. Inwood Ward reopened as Nurse Led Unit 27 October 2006 with 12 beds for stroke/rehab and palliative care.

12. Opening ceremony with Richard Samuel reported in the local press - the Herald and Gazette.

13. Sarah Garland attended the `Basingstoke with Alton and Bordon' PPIF meeting on 12 January 07 to update on the progress made at ACH.

14. All staff have now received venepuncture training and during July and August 07 they will be trained to administer intravenous antibiotics/fluids. This will enable patients requiring these services to receive treatment locally and prevent/avoid acute admissions. The hospital is also planning to provide blood transfusion services for patients by November 2007.

15. Future planning of services will be looking at Urinary Tract Infection (UTI) pathways linked to A & E and MAU admissions in secondary care with a view to preventing secondary care admissions and when this is not achieved being able to provide step down care for these patients at the community hospitals.

16. There are currently staff vacancies at the hospital which have been advertised but regrettably there was a poor response and the candidates were poor quality. Recruitment and retention is still a problem. However, all staff have had an appraisal which has provided them with a personal development plan.

17. Alton Hospital (with Chase Hospital) has recently achieved Practice Development Unit (PDU) status accreditation through the University of Bournemouth. The project looked at the following key areas to improve the patients journey -

· environment

· discharge planning

· patient centred approach to nursing care - using 4^th day plan care meetings, which are patient led to identify their goals and discuss their discharge plan

· resuscitation decisions

· patient's property

· nutrition - the hospitals now have protected meal times

· Fire project - identifies vulnerable patients who may be at risk when they return home. These patients are referred to the Fire Brigade who offer a complete a home assessment and can provide and fit a free smoke detector.

· Medicines management - to ensure patients are able to cope with their medication on discharge

· Message in a bottle - a safe and secure way to store emergency information in the patient's home

Alton Community Hospital Consultation and Engagement

1) Objectives

· Ensure local population is kept informed with the developments

· Ensure other stakeholders understand and support the changes.

· Ensure the relevant organisations are represented on and able to inform the Implementation Group/Project Stream.

2) Key Audiences and Stakeholders

· Local residents

· North Hampshire PPIF (now Hampshire PCT Patient Forum)

· North Hampshire Hospital (Basingstoke and North Hampshire Hospital FT)

· Local GPs

· League of Friends

· HCC

· PCT Staff

· Social Services

3) Action Plan

· Regular meetings with Implementation Group/Project Stream

· Staff Updates

· Press release when ward re-opens

· Regular updates to OSC

· Report back to PCT Board, HOSC, PPIF and other stakeholders

ACS/HOSC

06/07