Archived decisions

Item 2

AT A MEETING of the HEALTH OVERVIEW AND SCRUTINY COMMITTEE of the COUNTY COUNCIL held at The Castle, Winchester held at The Castle, Winchester on Tuesday, 27 November 2007.

PRESENT

Chairman:

p Councillor Dr. R.J. Ellis

Vice-Chairman:

p Councillor Mrs. A.M. McNair Scott

Councillors:

Co-opted Members:

Councillors:

p Mrs. M. Kerley

p R. Love

P. Luffman

p J. Marsh

Also in attendance Councillor B. Dash at the invitation of the Chairman and Councillor Felicity Hindson, MBE, Executive Member for Adult Social Care; Councillor David Stephen Butler, Portsmouth City Council and F. Rust Hampshire Patient and Public Involvement Forum

123. DECLARATIONS OF INTEREST

Members were mindful that, where they believed that they had a personal or personal prejudicial interest 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 save for exercising any right to speak in accordance with Paragraph 12 of the Code .

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 the NHS

Councillor D. Wright - wife a General Practice Manager.

Councillor L. Dunsdon - wife employed by NHS

Councillor Mrs. M. Kerley - Andover and Romsey Hospital Friends

124. MINUTES

The Minutes of the Meeting of the Committee held on 12 October 2007 were

confirmed as a correct record, and signed by the Chairman.

125. CHAIRMAN'S COMMUNICATION

a. Mental Health Workshop

The Chairman reported that Hampshire had hosted a joint Hampshire and Isle of Wight metal health workshop on the area, including work taking place in the Isle of Wight to allow people to self assess their needs and the provision of free personal care to people over 80.

b. South Central Issues

The Chairman reported that a meeting of the South Central Health Overview and Scrutiny Committees had taken place in Bracknell on 26 November 2007. Issues covered included the role of the Strategic Health Authority, an up-date on the review being conducted by Lord Darzi, key performance areas. Additionally discussions have taken place with the acting Chief Executive, Chris Everett and the Strategic Health Authority have agreed that regular monthly meetings with me and the vice Chairman would be beneficial.

c. Specialist Commissioning

The Chairman reported that a workshop set up by the Centre for Public Scrutiny had been held in the South Central area on the 7 November 2007. Strategic Health Authority leads, Health Overview and Scrutiny Committees and Patient and Public Involvement leads from NHS Trusts had attended. The South Central Health Overview and Scrutiny Committees would consider how to work collaboratively in response to any planned changes to these services at its next meeting.

d. Care at the End of Life

The Chairman reported that the Healthcare Commission had provided some funding towards the work with Southampton University to get feedback from service users and Cares. The University had formally appealed against the decision of the Ethics Committee. In the meantime talks are taking place to explore options for taking this work forward in other ways.

e. Southeast Health Overview and Scrutiny Committees

The Chairman reported that the Southeast Health Overview and Scrutiny Committees had met on 19 November. A key issue discussed included the progress of commissioning health care, which were of concern to a number of Health Overview and Scrutiny Committees and national bodies.

f. Fareham Community Hospital

The Chairman reported that the business case for Fareham Community Hospital had now been approved be the Primary Care Trust Board. He commented that the title hospital was misleading as there was no provision for hospital beds, it was more a diagnostic and treatment centre.

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The Chairman left the meeting to represent the County Council at a Conference and the Vice-Chairman took the chair.

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COUNCILLOR MRS. A.M. MCNAIR SCOTT IN THE CHAIR

126. CARE AT THE END OF LIFE

The Chief Executive presented a report providing an update on progress with the recommendations arising from the Care at the End of Life Review ( Item 6 in the Minute Book). Claire Hooke, Commissioning Manager, Adult Services, Hampshire County Council and Elizabeth Emms, head of Adult Services, Hampshire Primary Care Trust gave details on on:

· Protocols for transferring patients

· Agreement on a single, synchronised assessment process

· Progress with a County -wide strategy for Carers

· Access to support for carers

· Audit of information for patients and carers

RESOLVED:

That the Committee receive an update on the continued progress being made with implementing the recommendations of the Care at the End of Life Review in May 2008

127. INQUIRIES RECEIVED AND ACTION TAKEN

The Chief Executive presented a report on enquiries received, the

source of each enquiry and the action taken (Item 4 in the Minute Book). The enquiries related to:-

Incidence of Deaths from Clostridium Difficile at Winchester and Eastleigh Healthcare NHS Trust and Southampton University Hospitals Trust

Representatives from Southampton University Hospitals Trust and Winchester and Eastleigh Healthcare NHS Trust gave a presentation on Clostridium Difficle giving details on how it was spread, the severity of illness, the scale of the problem as well as the challenges of control and actions being taken to reduce incidences.

Community Hospitals in Hampshire

· Fordingbridge Hospital

Following the closure of the hospital to in-patient admissions on the grounds of patient safety the Chairman had written to the Primary Care Trust seeking clarification about the process being followed, when investigations into the quality of patient care would take place and the arrangements in place to ensure that patients were being treated as locally as possible. Ann Smith, Chief Operating Officer, Hampshire Primary Care Trust reported that all in-patients had now been discharged, the wards were being deep cleaned and necessary investigations were under way. The in-patient wards would reopen as soon as it was safe and practicable to do so. The Patient and Public Involvement Forum had visited the hospital on two occasions and its reports were shown as Appendices two and three to the Chief Executive's report. Members highlighted the problem with travelling to alternative hospitals and confirmed their expectation of the reopening of Fordingbridge Hospital to in-patients as soon as possible.

· Oak Park Hospital, Havant

The business case for the new Oak Park Hospital was presented to the Committee and shown as Appendix four to the Chief Executive's report. Inga Hebden, Hampshire Primary Care Trust, reported that space at the Oak Park site and at the proposed new Fareham Community Hospital was being reserved for possible expansion in the future. St. Mary's Hospital, Portsmouth would, if required, accommodate any overspill if necessary. Members expressed concern about mapping capacity figures for southeast Hampshire and requested an update in July 2008 to include information about local engagement and capacity.

· Milford on Sea War Memorial Hospital

A meeting with key stakeholders had been held on 23 October 2007 which indicated broad support for the way forward proposed by the Primary Care Trust. The Primary Care Trust's recommended next steps were shown as Appendix 5 to the Chief Executive's report. The Trust's Chief Executive had written to the Chairman asking if the Committee was content for the implementation of the proposals to proceed.

Continence Services

Further to the last meeting additional information has been requested from the PCT as follows:

· the rationale/evidence base underpinning the policy limiting the supply of continence pads to 4 per day.

· how individual patient need is assessed and by whom?

· how the limitation on supplies is enforced?

· the prevalence of this policy across Hampshire.

· what arrangements are in place to ensure that patients' dignity/well being is protected at all times- particularly those people with mental health conditions?

· how patient satisfaction with these arrangements is evaluated?

· what happens if a patient needs more pads?

· what are the cost implications of providing pads according to need across different care settings?

The policy sent by the Primary Care Trust confirmed that people were limited to 4 pads per 24 hours. Subsequent information suggested that for new patients the limit is three pads in any 24 hours. The Primary Care Trust had not yet responded to the questions raised and Members agreed that the Chairman should request the Primary Care Trust to provide the required information within two weeks and a representative of the Trust attend the next meeting to answer questions.

Development of the Primary Care Strategy

The Director of Public Health reported that the Hampshire Primary Care Trust Board had recently approved the strategy. She updated Members on the recent MORI survey that had been commissioned, the results of which would be published on the web and circulated to Members.

Hampshire Primary Care Trust Performance

A summary of the Primary Care Trust's performance against key target areas was shown as appendix seven to the Chief Executive's report.

RESOLVED:

That:

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

b. A further update on progress being made with Care at the End of Life be presented to the Committee in March 2008.

c. A representative of Hampshire Primary Care Trust attends the next meeting to report on the outcome of the investigations on the quality of patient care at Fordingbridge Hospital.

d. The Hampshire Primary Care Trust updates the Committee on developments with Oak Park Hospital, Havant in July 2008 including information on local engagement and the Southeast Hampshire Capacity Plan.

e. The proposed changes for services at Milford on Sea War Memorial Hospital be supported.

f. A representative of the Hampshire Primary Care Trust attends the next meeting of the Committee to give an update on Continence Services and answer questions.

128. 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) Maternity Services in Southwest Hampshire

It had previously been reported to the Committee that there had been delays at the Ashurst site and that it should be opening as a new birthing centre in Autumn 2007. The Chairman had sought reassurances about this and Southampton University Hospitals Trust now advises that the opening of the new birthing centre will now not happen until June 2008. No representatives from the Trust attended the meeting to explain the reasons for the delay and the information requested from the Trust had not been provided. Members expressed concern that they had not been kept appraised of delays to the opening of the new birth centre. The Committee and local people had supported the proposals on the grounds that there would be improved facilities for local women

RESOLVED:

That the Chairman writes to Southampton University Hospitals Trust requiring the Committee be provided with clear information about the timeline about to the opening of the birth centre at Ashurst and the way in which this has been communicated to local people within two weeks and that a senior member of the Trust be required, in accordance with legislation, to attend the next meeting of the Committee to answer Members' questions.

(b) NHS Review - Joint Response from the Executive Member for Adult Social Care and the Chairman of the Health Overview and Scrutiny Committee

Following an invitation to comment on the Darzi Review of the NHS the Executive Member for Adult Social Care and the Chairman of the Health Overview and Scrutiny Committee agreed a response, built on the findings of the Committee, particularly with regard to Care at the End of Life, which was shown as Appendix one to the Chief Executive's report.

RESOLVED:

That the initial response to Lord Darzi be noted.

(c) Southeast Specialist Palliative Care Team - Withdrawal of Portsmouth City Primary Care Trust

Hampshire Primary Care Trust had alerted the Committee to a formal notification from Portsmouth City Primary Care Trust of its intention to withdraw from existing arrangements for commissioning specialist palliative care services in southeast Hampshire.

RESOLVED:

That:

i. Hampshire Primary Care Trust and Portsmouth City Primary Care Trust provide the Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee with full details of the anticipated impact of the proposals on services delivered to the residents of southeast Hampshire and Portsmouth.

ii. If appropriate, the Joint Committee, in discussion with Portsmouth City Health Overview and Scrutiny Panel, comes to a view on whether the proposed changes are substantial.

(d) Surrey and Hampshire Borders Partnership NHS Trust - A New Design for Day Services: Improving Adult Mental Health Day Services in Surrey Heath and Northeast Hampshire

Surrey and Hampshire Borders Partnership NHS Trust had alerted the Committee to proposals for improving Adult Mental Health Day Services in Surrey Heath and North Hampshire. Hampshire Adult Services had confirmed that it was not anticipated that this would have an impact on Hampshire residents. Surrey Health Overview and Scrutiny Committee. Rushmoor Borough Council and Hart District Council had been made aware of the proposals. Members requested information about the provision of occupational therapy and acute depression services for Hampshire residents.

RESOLVED:

That the proposals by Surrey and Hampshire Borders Partnership NHS Trust for improving Adult Mental Health Day Services in Surrey Heath and North Hampshire be noted and further information be requested on occupational therapy and acute depression services for Hampshire residents.

Under items requiring action he gave details on:-

(e) West Sussex Primary Care Trust - Acute Service Reconfiguration

Hampshire and Portsmouth Health Overview and Scrutiny Committees had now completed the joint work they were leading on Accident and Emergency Services as part of the formal select committee process, the report is attached as appendix two to the Chief Executive's report. Following this the Chairman had responded to the West Sussex Joint Health Overview and Scrutiny Committee setting out issues from a Hampshire perspective , this was shown as Appendix three to the Chief Executive's report.

The formal consultation by West Sussex Primary Care Trust had ceased on 14 November 2007 and 42 alternative options had been received. Hampshire and Portsmouth members of the Joint Committee had asked its Chairman to convey a number of concerns to the West Sussex Primary Care Trust which were shown as Appendix four to the Chief Executive's report..

RESOLVED:

That the Committee be kept appraised of the progress of the West Sussex Joint Health Overview and Scrutiny Committee.

(f) Maternity Services in Southeast Hampshire

The Committee's response to the consultation by Hampshire Primary Care Trust was shown as Appendix five of Chief Executive's report and the Primary Care Trust's responses to the consultation and preferred option which was to be presented to its Board was shown as Appendix six.

RESOLVED:

That:

i. The Committee congratulates the Hampshire Primary Care Trust on its excellent consultation on proposals for maternity services in southeast Hampshire.

ii. The Primary Care Trust's preferred option of the provision of three 24 hour midwife led birth centres at The Grange, Petersfield (8beds), Black, Gosport (11 beds) and a co-located service in Portsmouth (currently at St. Mary's Hospital (12 beds), moving to the new Queen Alexandra Hospital, Cosham in 2009(9 beds)) be agreed and that the Primary Care Trust regularly reviews birth rates and demands for services in the light of changes locally and in neighbouring areas to ensure that the configuration of birth centres is best placed to meet local needs. If there are significant changes in birth rates or demand the Primary Care Trust reconsiders the development of a birth centre within phase 2 of Fareham Community Hospital taking account the experience of local women accessing other birth place choices.

(g) Surrey Primary Care Trust - Fit for the Future Commissioning Intentions

Surrey Health Overview and Scrutiny Committee had confirmed to Surrey Primary Care Trust that, with the exception of renal services, it had not considered the proposed changes as substantial. It had, however, indicated that it would expect Surrey Primary Care Trust to:

· Continue to engage with local stakeholders to shape and inform the commissioning intentions, including district councils.

· Engage with Hampshire PCT, Adult Services and Children's services as the process rolls forward to ensure that any changes that affect service delivery in Hampshire can be taken into account.

· Undertake further work with GPs and community service providers across the area affected and ensure that appropriate staffing and infrastructure is in place across community and primary care to deliver the changes envisaged.

· The need to engage with a range of local stakeholders, including district Councils was recognised.

Hampshire residents would be less affected by the proposals so it was unlikely that the impact on local service delivery would be significant.

RESOLVED:

That :

i. The Committee agrees with the view of Surrey Health Overview and Scrutiny Committee that, with the exception of renal services, the changes proposed by Surrey Primary care Trust do not, at this point in time, constitute a substantial change in service delivery.

ii. The Committee receives details of proposals to vary renal services in order to come to a view on whether the proposed changes would be of a substantial nature for Hampshire residents.

(h) Local Involvement Networks (LINks) Regulations

The Department of Health had circulated its consultation on the draft regulatory framework for LINks which had been electronically circulated to members. The draft response on the consultation was shown as Appendix seven to the Chief Executive's report.

RESOLVED:

That the draft response to the Department of Health be approved.

129. FORWARD PLAN

The Chief Executive presented the Committee's Forward Plan (Item 7

in the Minute Book).

RESOLVED

That:

a. the Forward Plan be approved subject to the inclusion of issues raised at this meeting.

b. Andover War Memorial Hospital redevelopment and Ambulance Service responses be included on a future agenda.

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