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, 28 July 2009.

PRESENT

Chairman:

a Councillor Anna McNair Scott

Vice-Chairman:

p Councillor Pat West

Councillors:

Co-opted Members:

Councillors:

Marion Kerley

p Ray Love

Peter Luffman

p John Marsh

Also in attendance Councillor Ray Bolton and Councillor Margaret Webster (Isle of Wight Council) at the invitation of the Chairman

In the absence of the Chairman the Vice-Chairman took the Chair.

__________________________________

COUNCILLOR PAT WEST IN THE CHAIR

1. 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 Brian Collin - wife employed by NHS

Councillor Phryn Dickens - employed by NHS

Councillor Peter Edgar - does work for NHS

Councillor David Harrison - employed by NHS

Councillor Pam Mutton - daughter employed by NHS

Councillor Angela Roling - brother and sister-in-law employed by NHS

Councillor Pat West - daughter-in law employed by NHS.

2. WORK PROGRAMME

The Chief Executive gave a presentation on the Select Committee Structure, the work of the Health Overview and Scrutiny Committee, its terms of reference and elements of its work programme (Item 2 in the Minute Book). Following on from the review of Access to services for people with alcohol problems by the Safe and Healthy Select Committee it was suggested that the reasons why people got alcohol problems may be a suitable topic for the work programme.

RESOLVED:

That the Committee's Work Programme be approved subject to the issues raised at this meeting and the feasibility of exploring the cultural reasons behind alcohol abuse should be looked at as a possible future topic for review in conjunction with the Safe and Healthy People Select Committee as the work programme allowed.

3. MINUTES

The Minutes of the Meeting of the Committee held on 26 May 2009 were confirmed as a correct record, and signed by the Chairman.

4. CHAIRMAN'S COMMUNICATION

a. New Members

In addition to welcoming new members the Chairman introduced Margaret Webster, Chairman of the Isle of Wight Health Overview and Scrutiny Committee and Tom Smith, Chairman of the Hampshire LINk.

b. Swine Flu

Being aware that Swine Flu was an issue that was of interest to members. In addition to the pages that appeared on the County Council's internet about what staff should do if they are concerned the Chairman tabled an up-date from the Strategic Health Authority which gave a picture of services across the South Central area.

c. Treatment for Heart Attacks

The Chairman reported that at the Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee last week Members were alerted to some potential changes to the treatment of heart attacks. This was an issue that would affect all the population across the south central area and the consensus was that this would constitute a substantial variation in these services. As such the Joint Committee was required to look at forming a formal joint committee to consider these proposals. Papers outlining the options being considered by the Primary Care Trusts were available on the website or through the scrutiny officers. It was anticipated that the formal public consultation would take place early in the New Year.

d. Ward Closure

The Chairman reported that Winchester and Eastleigh Healthcare NHS Trust had confirmed that Twyford Ward at the Royal Hampshire County Hospital had closed. This would not lead to redundancies or any change in service. The gastro-intestinal patients that were formerly treated on the ward would now be cared for on Victoria ward.

5. APPOINTMENTS

Consideration was given to the appointment of representatives to other Health bodies.

RESOLVED:

That the following appointments be made:

Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee:

The Chairman and Vice-Chairman and Councillors Keith Chapman, Peter Edgar and Ray Love.

South Central Health Overview and Scrutiny Committees:

The Chairman and Vice- Chairman

Portsmouth City Council Health Overview and Scrutiny Panel:

Councillor Peter Edgar.

West Sussex Joint Health Overview and Scrutiny Committee:

Councillors Ann Buckley and Liz Fairhurst

Rural Ambulance Services Joint Committee:

The Chairman and Vice-Chairman with Councillor Phryn Dickens as standing deputy.

and that in the event of any of the appointed Members being able to attend any of the meetings of these bodies the officers, in consultation with the Chairman, be authorised to appoint deputies.

6. OUT OF HOURS AND UNSCHEDULED CARE

Helen Clanchy, Director of Primary Care NHS Hampshire gave a presentation on the Out of Hours and Unscheduled Care services in Hampshire. She said that out of hours services were:

_ Primary care services for urgent problems when GP surgeries closed

_ Weekdays 6.30pm to 8am, weekends and bank holidays

There were four service providers in Hampshire, North Hampshire Urgent Care, a community benefit society with GP members; Thamesdoc, a limited company, formerly a GP co-operative, based in Surrey; Southampton City Primary Care Trust and Portsmouth City Primary Care Trust with each provider covering a geographical area. The services provided included:

_ Telephone answering

_ Diversion to Ambulance service for critical conditions

_ Assessment of the problem by a clinician ( GP or nurse)

_ Advice on management of less serious problems

_ Face to face consultation for problems needing attention before the patient's GP was open again

_ A home visit where the clinical condition warranted it.

She gave details of primary care centres where patients could see GPs out of hours and the standard of services that could be expected.

Questions were asked about how telephone triage was quality assured and Members were assured that complaints were monitored and Accident and Emergency Services and local GPs fed back any problems. Members requested further information on the cost of the service, the number of calls received, bench marking and out of hours dentistry services and it was agreed that this should be reported to a future meeting of the Committee.

RESOLVED:

That NHS Hampshire be requested to provide an update on out of hours and unscheduled care services covering the cost of the service, the number of calls received, bench marking and out of hours dentistry services and it was agreed that this should be reported to a future meeting of the Committee.

7. 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 7 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

The Chief Executive reported that no further information had been received from Winchester and Eastleigh Healthcare NHS Trust except that Avalon House, Winchester remained as a possible solution for the relocation of outpatients.

RESOLVED:

That:

i. Winchester and Eastleigh Healthcare NHS Trust be requested to

attend the next meeting of the Committee to confirm the progress of works and other capital developments that were being considered.

ii. Councillors Brian Collin, Pam Mutton and Pat West be appointed to act as a point of contact for the Committee in relation to Winchester and Eastleigh Healthcare NHS Trust.

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 Surrey and Borders Partnership NHS Trust had now confirmed the anticipated timetable for confirming its next steps although there remained a lack of clarity about the impact the proposed changes would have on Hampshire residents. The Trust's Board would be considering proposals on 29 July 2009 which would be followed by consideration by NHS Surrey and NHS Hampshire. The feedback report would be sent to the Committee as soon as possible.

RESOLVED:

That Surrey and Borders Partnership NHS Trust updates the Committee at its next meeting.

c. West Sussex Primary Care Trust: Acute Service Reconfiguration

The Chief Executive reported that West Sussex Primary Care Trust had confirmed that it was now looking at its commissioning intentions for maternity services, in-patient paediatrics and emergency surgery, however the timetable had slipped and its Board would now be considering how it wished to proceed in the autumn. It was not clear what the impact of the proposals would have on health services in Hampshire.

RESOLVED:

That The Committee be kept appraised of the situation.

d. Fluoridation of Drinking Water in Southampton and Southwest Hampshire

The Chief Executive reported that the South Central Strategic Health Authority had now been served with a judicial review challenge to its decision to proceed with proposals to fluoridate water in Southampton and parts of southwest Hampshire and a decision as to whether this should proceed was expected from the courts in early August 2009. The Strategic Health Authority had still not responded to requested information about the costs of the proposals. The County Council had reaffirmed its concerns about the basis on which the Strategic Health Authority decided to proceed with the proposals and had referred the matter back to the Committee to assess the feasibility of a referendum or other mechanism to give local people a voice in the decision making process. There had been a media campaign to put pressure on the Strategic Health Authority to put their plans on hold and Southampton MPs had supported this. It was suggested a referendum could possibly be held at the same time as the forthcoming General Election.

RESOLVED:

That:

i. The South Central Strategic Health Authority be pressed for clarity about the costs and affordability of implementing the proposal.

ii. The assessment of the feasibility and legal implications of a possible referendum be reported back to full Council in September.

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

The Chief Executive reported that the Chairman had written to the Southwest Commissioning Group confirming the views of the Committee that it did not consider the proposals for a burns centre at Swansea to be substantial and identifying key areas that required further action.

RESOLVED:

That the Hampshire, Southampton, Portsmouth and Isle of Wight Health Scrutiny Joint Committee be requested to monitor the progress with the setting up of the Burns network to ensure that any outstanding issues identified by Members were acted on.

8. INQUIRIES RECEIVED AND ACTION TAKEN

The Chief Executive presented a report on enquiries received, the

source of each enquiry and the action taken (Item 8 in the Minute Book). The enquiries related to:-

a. Mental Health Services at Andover War Memorial Hospital

Councillor Pat West reported that the Allan Gardiner Unit would be closing shortly and patients transferred to the to the Royal Hampshire County Hospital. The consultation for changes to the Mental Health Services had been effective and had included staff, patients and public. She confirmed that arrangements were in place to enable patients and their families to use the "shuttle bus" to get to the Royal Hampshire County Hospital.

b. South Central Ambulance Trust - Road Closures

Phil Pimlot of South Central Ambulance Trust reported that the Trust now received regular updates on highway work in the South Central Area which were given to the ambulance control centres to enable them to re-route ambulances. They were in the process of changing all radio communications and satellite navigations so that they were standardised across the region so as to enable faster responses. With regard satellite navigations they were investigating the use of a system that would highlight width and height restrictions which would also assist in faster responses.

c. Minor Injuries Unit, Havant War Memorial Hospital

NHS Hampshire explained the history of the Minor Injuries Unit at Havant War Memorial Hospital and why it had been temporarily closed. Staff resources were a problem and there were no appropriate skills to treat children and when open services were provided in an ad-hoc way. They took the view that there was a need to rationalise the services in the area. Members questioned the closure and said that closure on a short term basis on patient safety grounds was acceptable but said that closure on such grounds should not be abused.

d. Southeast Capacity Plan

Richard Popperwell, Acting Chief Executive NHS Hampshire, gave details of the problems facing NHS Hampshire and updated the Committee on the delivery of the Southeast Capacity Plan. In the last few months the NHS had been advised by the Department of Health to expect only a limited growth in its budget over the next two to three years. In real terms, this might mean a reduction in resources given that inflation (driven by an ageing population in Hampshire, combined with the cost of new technologies and treatments) tended to be higher for the NHS and bit more deeply into its finances. The Hampshire NHS's response to this challenge was already being developed, and would include:

· ensuring every possible efficiency and cost control was exercised in back office and procurement functions;

· redesigning pathways of care to deliver quality improvement and increased sustainability;

· working with local people to determine the priorities for future service provision and determining which treatments or services may be of a lower priority;

Like many public and private sector organisations, NHS Hampshire would also need to review all of the developments that it had commissioned in a time of relative growth to test their affordability in the light of the significantly changed financial environment. This was the only responsible action that NHS Hampshire could take as a publically funded authority. With this in mind it had commenced a rapid appraisal of significant investment proposals across the whole of Hampshire, and taken steps to ensure that it did not incur any unnecessary development costs in the months of June and July. It was proposed that an update on this work would be presented to the Board of NHS Hampshire in September 2009. The rapid appraisal process would consider each significant planned development against five key questions in order to determine whether it should continue unchecked, or whether it needed to do more work in partnership with local people to ensure it could deliver a sustainable model of care. He updated the Committee on the current position with Queen Alexandra Hospital, Cosham, St. Mary's Hospital, Portsmouth, Fareham Community Hospital, Gosport War Memorial Hospital and Oak Park Community Hospital, Havant. Members expressed concerns and said that the residents of Southeast Hampshire were worried about the future of community services after repeated assurances that the planned community hospitals were affordable and necessary. Members were of the view that changes to proposals already agreed might constitute a substantial change to services.

e. Access to Physiotherapy Services in Southwest Hampshire

The Chief Executive reported that a Member had raised concerns about a patient's access to physiotherapy services in southwest Hampshire. The individual patient details had been passed to NHS Hampshire and additional information had been sought about waiting times for access to physiotherapy services.

f. Waiting Times in X-Ray

The Chief Executive reported that concerns had been raised about X-Ray waiting times at Royal Hampshire County Hospital. The concerns had been raised with Winchester and Eastleigh Healthcare NHS Trust and Hampshire LINk had agreed to look into the matter and determine whether any further action was required.

g. Therapy Services for Children with Disabilities and Complex Care Needs

The Chief Executive reported that the Children and Young People Select Committee had held a workshop on 12 May 2009 on access to short breaks for children with severe disabilities, the notes of which were attached as appendix three to the report. On consideration of the report of the workshop the Children and Young People Select Committee had recommended that a joint scrutiny panel should be established, led by the Health Overview and Scrutiny Committee, consisting of Members of the Health Overview and Scrutiny Committee and the Children and Young people Select Committee to consider access to therapy services for children with disabilities and complex care needs. Councillors Brian Collin, Liz Fairhurst and Pam Mutton expressed and interest in serving on a joint panel.

h. Ambulance Response Times in Rural Areas

The Chief Executive reported that arrangements were in place for Hampshire, Buckinghamshire, Oxfordshire and West Berkshire to establish a Joint Health Overview and Scrutiny Committee to look at ambulance response times in rural areas.

RESOLVED:

That:

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

ii. The Chairman writes to NHS Hampshire expressing deep concern about the confusing information received about the re-opening of the Minor Injuries Unit at Havant War Memorial Hospital and the lack of clarity about the future of services in southeast Hampshire.