Archived decisions

Item 3

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, 26 May 2009.

PRESENT

Chairman:

p Councillor Mrs. A.M. McNair Scott

Vice-Chairman:

p Councillor Mrs. P.A. West

Councillors:

Co-opted Members:

Councillors:

p Mrs. M. Kerley

p R. Love

p P. Luffman

a J. Marsh

Also in attendance Councillor Mrs. P.G. Banks, Executive Member for Children and Families and Tom Smith, Chairman of Hampshire LINk

186. 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 and on Advisory

Committee of The Trinity Centre,

Winchester.

Councillor Mrs. M. Kerley - Member of the League of Friends, Andover

War Memorial Hospital.

Councillor R. Love - on Advisory Committee of The Trinity Centre,

Winchester.

Councillor P. Luffman - Healthcare Worker.

Councillor Mrs. A. McNair Scott - on Advisory Committee of The Trinity

Centre, Basingstoke.

Councillor Mrs. P. West - Andover War Memorial Hospital Stakeholder

and daughter-in law works for NHS.

Councillor D. Wright - Wife a General Practice Manager.

187. MINUTES

The Minutes of the two Meetings of the Committee held on 31 March 2009 were confirmed as a correct record, and signed by the Chairman.

188. CHAIRMAN'S COMMUNICATION

a. NHS Hampshire (Formally Hampshire Primary Care Trust)

The Chairman reported that she had met with the acting Chief Executive and Chairman for NHS Hampshire on 29 April 2009. Key issues raised related to:

· Ambulance performance

· access to Queen Alexandra Hospital and service shifts

· Servicing Queen Alexandra Hospital Private Finance Initiative and affordability ( including the NHS Hampshire financial position)

· Progress with Hampshire Community Services

· Support for children with severe disabilities in the community (short breaks)

b. Short Breaks Conference - 12 May 2009

The Chairman reported that a workshop had been held on 12 May 2009 looking at progress with the introduction of `short breaks' for children with complex or life threatening needs. Whilst significant progress had been achieved there remained some uncertainty about how service providers respond to those children with complex and/or palliative care needs. She said that this could, potentially, be a topic for an in-depth review in the coming year.

c. Tamerine House, Horndean - Respite Services for People with a Learning Disability

The Chairman welcomed Keith Goss, a parent whose son uses Tamerine House and representatives of NHS Hampshire who gave an update on the services provided at Tamerine House. Following concerns about a possible closure in 2006 Tamerine House had now been refurbished and provided 4 beds with 15 people receiving respite care. It was now a viable, well used and fully operational unit that was supported by all concerned.

189. 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:-

a. Mental Health Services at Andover War Memorial Hospital

NHS Hampshire gave a presentation on progress being made with the

re-organisation of Mental Health Services for older people in the Andover area. Details were given of the work that had been undertaken to date, including public and patient engagement and what had been learned, the changes proposed and the implications for staff. The proposed changes were:

· The 8 beds in the Allan Gardiner Unit would close.

· Outpatient clinic, memory clinic, day therapy space and new team base created.

· Capacity in Winchester and Basingstoke would serve those people who need inpatient hospital care.

· Specialist input into Kingfisher Ward and care homes would support care staff.

It was agreed that the proposals did not constitute a substantial change to services.

Concern was expressed about travel arrangements for patients and their families having to travel to Winchester and it was confirmed that the "shuttle bus" would be made available for patients and their families.

b. Southeast Capacity Plan

NHS Hampshire gave an update on the proposals contained in the Southeast Capacity Plan but stressed that under the current economic climate no decision on capital programmes could be guaranteed and that any changes to proposals would be reported to the Committee:

Queen Alexandra Hospital (QAH)

· The main hospital building at QAH was due to be completed on 15 June 2009.

· The project was on target.

· A very complex commissioning process commences 16 June and was scheduled to last 4 weeks.

· The commissioning process has been reviewed and approved by an external independent panel of experts .

· During the 4 week commissioning process, some services would move from the Royal Hospital Haslar and St Mary's Hospitals to QAH. This included the main maternity unit, oncology, gynaecology among others.

· Members were offered a tour of the hospital once the commissioning process was complete.

St Mary's Community Hospital

· The Planning application had been submitted in April 2009 for the planning development which would lead the St Marys Community Hospital on the current St Mary's site.

· Work was continuing to produce a business case which would be finalised following planning consent.

Fareham Community Hospital

· Fareham Community Hospital was under construction

· Construction was due to be completed March 2010 followed by a commissioning period with occupation by end of May 2010

Oak Park Community Hospital (OPCH)

· Planning permission was granted for OPCH February 2009

· Section 106 agreed in detail April 2009

· Business Case being developed

Gosport War Memorial Hospital (GWMH)

· The main construction work related to the redevelopment of GWMH had been completed in January 2009

· There were a number of projects underway to complete the commissioning phases

· Planning consent had been received for the new GP surgery onsite and the changes to the car park had been agreed with the planning authority May 2009

· All of the services that were temporary decanted offsite, apart from the GP's, had returned to the Hospital

· Services would move from the Royal Hospital Haslar to the GWMH during June and July

· Phlebotomy services from the Royal Hospital Haslar and GWMH would move to local GPs' surgeries in Gosport and South Fareham on 3 July 2009

c. South Central Ambulance Trust Performance

The Chief Executive presented the current information on the performance of the South Central Ambulance Service in Hampshire. There had been overall improvements in the service in recent months. Councillors D Wright and Mrs P. West gave presentations on the days that they had recently spent with the ambulance service and highlighted their experiences. Buckinghamshire and Oxfordshire County Councils had also been experiencing difficulties with ambulances services in rural areas and were considering establishing a Joint Health Overview and Scrutiny Committee to examine the problems. It was agreed that, should a Joint Health Overview and Scrutiny Committee be established to investigate ambulance performance in rural areas, Hampshire should be part of the Joint Committee

d. Minor Injuries Unit, Havant War Memorial Hospital

NHS Hampshire reported that the Minor Injuries Unit at Havant Memorial Hospital was still closed but that some trained staff had now been appointed and that others were in the process of being trained. It was hoped that the unit would reopen in July 2009.

e. Access to Health Services for People who are Homeless

NHS Hampshire gave an update on the work being carried out on access to health services for people who are homeless. Over the next 2 months they would focus on:

· a comparative analysis of the two current models to determine how best to meet needs for the future;

· Further analysis of responses from GP practices to identify "hot spots";

· Ensuring that appropriate arrangements exist for transfer of information for registered patients seen at Trinity to avoid any clinical risk.

f. Swine Flu: State of Readiness in Hampshire

NHS Hampshire and the County Emergency Planning Officer outlined the work in place in Hampshire to ensure a state of readiness should swine flu be declared a pandemic.

g. LINk Work Programme

Tom Smith, Chairman Hampshire LINk advised the Committee of the forthcoming work programme for Hampshire LINk:

June to November 2009 the LINk work plan would include:

· Phlebotomy services in Gosport

· OOH services- with a specific focus on the patient experience and possibly complaints

· Ambulance Services- with a specific focus on the patient experience and possibly complaints

· Maternity services (working with a mum to be)

December 2009- March 2010

· Social care in nursing homes

· Patients' experience of hospitals

· Bed blocking (possibly linked to dementia)

· Patients/clients outcomes (e.g. return to independent living)

· Access to talking therapies

RESOLVED:

That:

i. The report be received and the actions outlined in it be

endorsed.

ii. The proposals for mental healthcare for older people in

the Andover area be not considered substantive.

iii. An update on the Southeast Capacity Plan be presented to the Committee in July 2009.

.

iv. Arrangement be made for Members to be given a tour of Queen Alexandra Hospital in due course.

v. Should a Joint Health Overview and Scrutiny Committee be established to consider ambulance services in rural areas Hampshire should join the Joint Committee.

190. CARE AT THE END OF LIFE

The Committee received a presentation from representatives of the Care at the End of Life Steering Group giving an update on progress following the Care at the End of Life review. Details were given of the achievements and progress made, stakeholder engagement and the strategy that had developed which include the use of the various tools available and the need to ensure:

· Identifying

· Care planning

· Co-ordinating

· Delivering (including care after death)

A grant of £10,000 had been made to each hospice providing care for Hampshire residents, £5,000 of which was being given by NHS Hampshire within the next month. The money was identified specifically to support carers who were caring for individuals at the end of life.

A joint health and social care education and workforce development strategy was being developed with the South Central Strategic Health Authority and the Hampshire End of Life Programme Board was giving priority to focusing the activity of staff across agencies and organisations who actually provided the majority of services.

RESOLVED:

That a further update on progress with the Care at the End of life review, to include how different funding streams were coming together, be presented to the Committee in November 2009.

191. 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 4 in the Minute Book). He presented the report in two parts which comprised 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. Winchester and Eastleigh Healthcare NHS Trust: Outpatients Relocation

Proposals to relocate the Royal Hampshire County Hospital outpatients services to Avalon House, Winchester were still under consideration by the Winchester and Eastleigh Healthcare NHS Trust. Issues that had been identified by the Committee and still to be addressed were:

· Access, including car parking and access for people with a disability or using public transport

· The supporting diagnostic and other services to be provided on the site (e.g.. phlebotomy, x-ray) and the logistics to relocations these to a distant site

· Clear patients' pathways to ensure that patient flows are easily planned and managed. Not all out-patient consultations would be suitable for a remote site

RESOLVED:

That the Winchester and Eastleigh Healthcare NHS Trust provides the Committee with an update on progress on 28 July 2009.

Under items requiring action he gave details on:-

b. Surrey and Borders Partnership NHS Trust - proposals to Reconfigure 24 Hour Assessment and Treatment (Inpatient Mental Health Services)

The Chief Executive reported that, following the last meeting of the Committee the Chairman had written formally to the Trust setting out the views of the Committee. The Chairman's letter together with the Trust's response were shown as appendices 1 and 2 to the Chief Executive's report.

RESOLVED:

That Surrey and Borders Partnership NHS Trust confirm proposals for the next steps to the meeting of the Committee on 28 July 2009

c. West Sussex Primary Care Trust: Acute Service Reconfiguration

West Sussex Primary Care Trust had confirmed that it was looking at its commissioning intentions for maternity services, in patients paediatrics and emergency surgery with a view to having an agreed position by the end of July 2009. It was not yet clear how much stakeholder input was informing this process but there is an intention to have some public engagement in August 2009. The Primary Care Trust Board would decide how it wished to proceed in September and this was likely to be the trigger for reconvening the Joint Health Overview and Scrutiny Committee.

It was reported that a local MP, in a recent address, had said that the Accident and Emergency Service at St. Richard's Hospital, Chichester had closed. It was confirmed that this was not the case and that the service was still open and running.

RESOLVED:

That the Committee be kept appraised of the situation.

d. Fluoridation of Drinking Water in Southampton and Southwest Hampshire

The response of the South Central Strategic Health Authority to the Chairman's letter following the last meeting of the Committee and the Chairman's subsequent reply were shown as appendices 3 and 4 to the Chief Executive's report

RESOLVED:

That the Committee be advised of subsequent replies from the South Central Strategic Health Authority.

e. South Central Specialist Commissioning Group: Establishing a Burns Centre for Southwest England

The Specialist Commissioning Team had advised the Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee of potential changes to the location of burns services for the most seriously burnt patients. The evidence base supporting this change was shown as appendix 5 to the Chief Executive's report..

As part of the work to identify a suitable Burns Centre for the Network the Joint Health members were invited to a series of visits across the South West Area. Councillors Chapman and Mrs. McNair Scott went to Fenchay Hospital, Bristol on 28 April 2009, and Councillor Mrs. McNair Scott visited Salisbury NHS Foundation Trust on 29 April 2009. The Chairmen of the Isle of Wight Health Overview and Scrutiny Committee and Portsmouth Health Overview and Scrutiny Committee visited Bristol Children's Hospital and Swansea Hospital respectively.

It was anticipated that the establishment of a Burns Centre in Swansea would affect 1-2 patients per year from across Hampshire and would increase the chance of survival of the most seriously burnt patients.

The vast majority of burns patients would continue to be treated as Salisbury NHS Foundation Trust.

Further work needed to be undertaken to ensure community and other local services were supported to enable the repatriation of patients at the earliest opportunity.

It was agreed that the proposed changes to burns services did not constitute a substantial variation to services'

RESOLVED:

That:

i. The changes proposed for burns services in Southwest England do

not constitute a substantial variation in service.

ii. The Hampshire , Southampton, Portsmouth and Isle of Wight Health

Scrutiny Joint Committee continues to monitor progress with the

setting up of the Burns network to ensure any the outstanding issues

identified by members are acted on.

192. WORK PROGRAMME 2008/09 - OUT OF HOURS SERVICE AND

UNSCHEDULED CARE

With the Agreement of the Committee this item was deferred until the next meeting.

193. FORWARD PLAN

The Chief Executive presented the Committee's Forward Plan (Item 8

in the Minute Book)

RESOLVED

That the Forward Plan be approved subject to the addition of any changes made at the meeting.

.