AT A MEETING of the HAMPSHIRE, SOUTHAMPTON, PORTSMOUTH AND ISLE OF WIGHT HEALTH SCRUTINY JOINT COMMITTEE held at Ryde Castle Hotel, The Esplanade, Ryde, Isle of Wight on Wednesday, 22 July 2009.

PRESENT

Members Officers

Councillors:

Hampshire Ray Love Denise Holden

Anna McNair Scott David Pryke

Pam Mutton David Crosby

Pat West Ruth Dixon

Angela Roling

Portsmouth David Horne Katie Benton

Isle of Wight Margaret Webster Marian Jones

Southampton Edwina. Cooke

Apologies were received from Councillors: Keith Chapman; (Hampshire); Margaret Adair (Portsmouth)

1 APPOINTMENT OF CHAIRMAN

RESOLVED:

That Councillor Anna McNair Scott be appointed Chairman of the Joint Committee for the ensuing year

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COUNCILLOR ANNA MCNAIR SCOTT IN THE CHAIR

2. DECLARATIONS OF INTEREST

Councillor Pat West declared a Personal Interest - Daughter-in-law a paramedic

3 MINUTES

The Minutes of the meeting of the Committee held on 7 April 2009 were confirmed as a correct record.

4. PROTOCOL

David Pryke presented proposed amendments to the Joint Protocol to reflect the fact that much of the business for the Joint Committee was also now considered at the South Central HOSC meetings. Members agreed that the Joint Committee should continue to meet at least annually and requested the Protocol to be amended accordingly.

RESOLVED:

That the Protocol be amended to reflect the fact that, in future, the Joint Committee should meet at least annually.

5. APPOINTMENT OF VICE-CHAIRMAN

RESOLVED:

That Councillor Edwina Cooke be appointed Vice-Chairman of the Joint Committee for the ensuing year

6 APPOINTMENT OF SECRETARY

RESOLVED:

That David Pryke of Hampshire County Council be appointed Secretary to the Joint Committee for the ensuing year.

7 APPOINTMENT OF PRESS OFFICER

RESOLVED:

That the Press Officer for Hampshire County Council be appointed Press Officer to the Joint Committee for the ensuing year.

8 IMPLEMENTATION OF THE HAMPSHIRE MODEL WORKSTREAMS - FREE CRISIS CARE

Ruth Dixon presented a report relating to the delivery of adult social care and major changes that had been approved by Hampshire's Executive Member for Adult Social care

The report of Hampshire County Council's Commission of Inquiry into personalisation and the future of adult social care, `Getting Personal: a fair deal for better care and support,' published in November 2008, included a recommendation that free care is available `for all those at risk of admission to hospital and in need of urgent social care.' This recommendation, along with measures to support people on discharge from hospital, had been included in the development of the Hampshire Model for adult social care. The Executive Member has now agreed a strategic approach, within the existing eligibility criteria, for the implementation of the `Free Crisis Care' work stream and the county wide delivery of Community Innovations Teams. This included a stepped approach to the delivery of free crisis care as it was difficult to quantify the total demand for free crisis care at this stage and there were service and resource constraints that require effective management. The initial phase of this approach would concentrate primarily on setting up particular services which would enable people to access elements of free care at specified times of crisis. This would make the financial impacts of service development more controllable. This incremental approach was based on the development of key elements of a social care re-ablement framework that could meet the most urgent need; that could form the basis for further development and held the potential for integration with NHS led services. This framework would include the following:

· Extension of `step down' beds across the county following the evaluation of the `'Time to Think' pilot in South East Hampshire.

· A county wide contract for the provision of Welcome Home from Hospital Support for vulnerable people needing help on discharge from hospital

· One off Direct Payments for vulnerable people needing help on discharge them hospital

· Assertive intervention and re-ablement social care teams with potential to integrate with Hampshire Community Health Services (HCHS) and mental health services to provide short term intensive support at home, rehabilitation and re-ablement for people in a crisis - These teams would be a major step forward for Hampshire in aligning social care staff with GP led Practice Based Commissioning Clusters.

9 CARDIOVASCULAR SERVICES

Rachel Wastie of the South Central Cardiovascular Network spoke about the proposed changes in the treatment of hearty attacks. There were currently two types of treatment for heart attacks, dependent on geographical location the treatment you received would be either Primary Percutaneous Coronary Intervention (PPCI) or Thrombolysis.

If a heart attack victim gets to a centre within 120 minutes then PPCI would be the treatment most liable to help with fast recovery. Past that 120 minute time frame the Thrombolysis was the most likely to help.

With Thrombolysis recovery could be anywhere up to 4 weeks in hospital, but with PPCI the recovery time could be as little as 3 days.

Currently Winchester and the Isle of Wight do not offer PPCI facility, the closest centres being at Portsmouth and Southampton both of which offer a round the clock service.

The various options were to be the subject of a formal consultation during December 2009 - February 2010 with a view to implementation in March 2010.

Particular concerns were raised in that the Isle of Wight was unlikely to benefit from PPCI centres due to the difficulty in reaching the mainland within the time limit, Ambulances from other rural areas may also find it difficult to reach a PPCI location in time,

It was agreed that this topic needed to be raised at a Joint South Central meeting and should include areas outside the South Central Strategic Health Authority area that could be affected by the proposals, such as Chichester.

Members asked whether there was any legal liability on the ambulance crews if they choose the incorrect treatment for a heart attack and were advised that it was unlikely that any liability would come back to the Ambulance Crews / Paramedics, but the information would be checked out and forwarded onto the Joint Committee.

10 QUEEN ALEXANDRA HOSPITAL, COSHAM

A range of information/advertising had been completed during the re-fit of the new Queen Alexandra hospital, updating the public on the status of the work.

There were some concerns raised about the access to the hospital and the parking arrangements, but members were assured that this had been rectified.

The Foundation Trust application had been delayed but the Foundation Trust shadow board had been set up and is already very active.

11 UPDATE FROM LOCAL AUTHORITIES

Isle of Wight

The Carers Strategy and action plan was on schedule to be completed in August 2009 and had been based on the feedback from the carers survey in June 2008


Portsmouth

A visit had been made to the new Queen Alexandra Hospital and a further visit planned for September 2009. An agreement had been made with Portsmouth LINk on a new protocol for areas of joint working. A review was currently drawing to a close which consulted with stakeholders on landscaping, infrastructure, parking and support services at the to-be-built St. Mary's Community Health Campus

Southampton

Two residential homes had recently been closed in Southampton. The walk-in centre had been closed because a ward was being prepared for the swine flu pandemic which had resulted in more people attending Accident and Emergency and ambulance delays

Hampshire

A Joint Health Overview and Scrutiny Committee with Buckinghamshire, Oxfordshire and West Berkshire was in the process of being established to look at ambulance response times in rural areas.

The following issues were being considered:

· NHS Hampshire Budget

· Fluoridation of Drinking Water in Southampton and Southwest Hampshire

· Southeast Capacity Plan

· Therapy Services for Children attending Special Educational Needs Schools

· Out of Hours and Unscheduled Care Services