Archived decisions

Agenda Item 7

HAMPSHIRE COUNTY COUNCIL

Report

1. Summary and Purpose

1.1. The purpose of this report is to alert Members to proposals from the NHS to vary or develop health services provided to people living in the area of the Committee.

1.2. Proposals that are considered to be substantial in nature will be subject to formal public consultation. The nature and scope of this consultation should be discussed with the Committee at the earliest opportunity.

1.3. The response of the Committee will take account of the Framework for Assessing Substantial Change and Variation in Health Services agreed by the Hampshire, Isle of Wight, Portsmouth and Southampton Joint Committee in March 2005. This places particular emphasis on the duties imposed on the NHS by Section 11 of the Health and Social Care Act 2001.

1.4. This Report is presented to the Committee in 2 parts:

_ Items for information: these alert the Committee to forthcoming proposals from the NHS to vary or change services. This provides the Committee with an opportunity to determine if the proposal would be considered substantial and assess the need to establish formal joint arrangements

_ Items for action: these set out the actions required by the Committee to respond to proposals from the NHS to substantially change or vary NHS services.

1.5. This report and recommendations provide members with an opportunity to influence and improve the delivery of health services in Hampshire and therefore support the delivery of the Corporate Strategy aim of maximising well being.

Items for Information

2. Winchester and Eastleigh Healthcare NHS Trust: Outpatients Department relocation

2.1. No further information except confirmation that Avalon remains as a possible solution for the relocation of outpatients.

2.2. Issues to be addressed previously identified by the HOSC include:

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

Recommendations

2.3. That WEHT be invited to attend the HOSC on 28 September to confirm progress with the work and other capital developments that are being considered.

2.4. That Cllr Pat West and one other Member be appointed to act as a point of contact for the HOSC in relation to WEHT.

Items for Action

3. Surrey and Borders Partnership NHS Trust: Proposals to reconfigure 24 hour assessment and treatment (inpatient mental health services)

3.1. At its meeting on 31 March members expressed a number of continuing concerns about proposals from Surrey and Borders NHS Foundation Trust to reconfigure inpatient mental health services to three sites based in Surrey.

3.2. Key stakeholders, including local district councils and patient groups also expressed concerns about the proposals.

3.3. Hampshire PCT and Adult Services supportive of the broad direction of travel proposed by the Trust but there remained a lack of clarity about the impact that the proposed changes would have on Hampshire residents.

3.4. The Trust has written to the HOSC setting out the anticipated timetable for confirming its next steps. This is attached at Appendix One.

Recommendations

3.5. Further information provided by the Trust is shared with the HOSC on 29 September.

4. West Sussex Primary Care Trust - Acute Service Reconfiguration

4.1. West Sussex PCT has confirmed that it is looking at its commissioning intentions for maternity services, in patients paediatrics and emergency surgery however the timetable for this has slipped since this was last reported to the HOSC.

4.2. It is not yet clear how much stakeholder input is informing this process or how the public will be engaged.

4.3. The PCT Board will decide how it wishes to proceed in the autumn and this is likely to be the trigger for reconvening the Joint HOSC.

4.4. It is not clear if this work will impact on health services in Hampshire

Recommendations

4.5. That the Committee be kept appraised of any further developments relating to this work.

4.6. Representatives for the Hampshire HOSC (previously Cllrs Mrs Buckley and Wright) are agreed on 28 July.

5. South Central SHA: Consultation on proposals to fluoridate drinking water in Southampton and South West Hampshire

5.1. The SHA has now been served with a Judicial Review challenge to its decision to proceed with proposals to fluoridate water in parts of Southampton and South West Hampshire and a decision on whether this should proceed is expected from the courts in early August.

5.2. The response of the SHA to the questions about costs and monitoring of the proposal should it proceed is attached at Appendix Two.

5.3. The County Council has reaffirmed its concerns about the basis on which the SHA decided to proceed with the proposals and referred this matter back to the HOSC to assess the feasibility of a referendum or other mechanism to give local people a voice in this decision making process.

Recommendations

5.4. Members continue to press the SHA for clarity about the costs and affordability of implementing this proposal.

5.5. The assessment of the feasibility of a referendum is reported back to full Council in September

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

6.1. Further to the discussion at the meeting of 26 May 2009 the Chairman has written to the South West Commissioning group confirming the views of the HOSC that the changes associated with the establishment of a Burns Centre at Swansea did not constitute a significant service change. It is anticipated that the establishment of a Burns Centre in Swansea will affect 1-2 patients per year from across Hampshire and will increase the chance of survival of the most seriously burnt patients. The vast majority of burns patients will continue to be treated as Salisbury NHS Foundation Trust.

6.2. A number of key area requiring further action were identified as set out below:

· Clarity about the thresholds at which transfer is necessary that take account of both survival and other quality outcomes

· The engagement of the Ambulance Services and any associated training issues for emergency service staff

· Confirmation of the support available to meet the travel and expenses of families needing to spend time with patients

· How patients requiring palliative care will be managed within the network

· How patients with other conditions, including functional and organic mental health problems will be managed as part of the network arrangements.

· The availability of outreach services into community settings to support the repatriation of patients.

· BUGS (and presumably other voluntary patients support groups) do not receive any dedicated funding to support their activities. Given the key role that these groups play in supporting burns patients the scope for more formal support needs to be considered.

Recommendations

6.3. The Hampshire Portsmouth Southampton and Isle of Wight HOSC continue to monitor progress with the setting up of the Burns network to ensure any the outstanding issues identified by members are acted on.

IMPACT ASSESSMENTS:

1. Equalities Impact Assessment:

N/A

2. Impact on Crime and Disorder:

N/A

Appendix One: Re: Our Future Our Say Consultation on Future of Hospital Services. Response from Surrey and Borders NHS Trust. 21 July 2009

I wished to take this opportunity to update you and your Committee on our progress with regards to the above following our last letter to you of May 2009.

I am conscious that in my last letter to you of May 2009 I had hoped that we would be in a position to publish our response to the extensive feedback we received during our joint consultation with NHS Surrey and also to share with you our intended next steps. However due to the careful consideration we are giving to the feedback we have received this is taking us a little longer than we had hoped.

We have now established a Strategic Change Programme Board which will oversee all our major change programmes. The independently collated report on the feedback received from the consultation has now been received by us and by NHS Surrey (Surrey PCT). Our project team is now reviewing the Case for Change in the light of all the feedback and developing options and a recommendation for our Board to consider to decide the way forward; this in turn will then be considered by NHS Surrey's Board for their decision before we proceed. 

Due to the timing of formal Board meetings for our two organizations our Board will make its considerations at our July meeting (29^th July) and NHS Surrey will consider it at their meeting in public in early September.  Our intention is to publish the feedback report at the same time as a joint response to the specific feedback we have received from NHS Surrey and ourselves, but this also needs to be approved by our Boards and so will not happen until after the end of July at the earliest. We will ensure your Committee and its member receive copies upon publication.

Thank you for your continued interest in our proposals for improving hospital services for the people of north east Hampshire.

Appendix Two: South Central SHA: Proposals to add Fluoride to Drinking water in Southampton and South West Hampshire- letter to HOSC

South Central Strategic Health Authority

First Floor, Rivergate House

Newbury Business Park

London Road, Newbury

Berkshire

RG14 2PZ

01635 275500

22^nd June 2009

Anna McNair Scott

Chairman, Health Overview & Scrutiny Committee

Hampshire County Council

Room 149, Chief Executives Department

The Castle

Winchester

SO23 8UJ

Dear Anna,

Proposals to add fluoride to drinking in Southampton and south west Hampshire

Thank you for your letter of 12 May 2009.

In my previous letter to you of 26 April I confirmed that the Board fully took account of the views expressed by the local people. However, you will be aware that this was not the only evidence that was before the Board and not the only criteria on which they were required to make their decision.

Your recent letter highlighted two further issues, which I will respond to below:-

1. Work is being done with Southern Water on the costs of the fluoridation scheme. We are meeting them to discuss the basis for their costs for implementation of the fluoridation scheme. At this stage I do not have an indication as to when this will be completed but will be happy to make this information available to you in due course.

2. The way in which monitoring of the population will be carried out is also being worked on. You will appreciate that the results of any research carried out will be of great interest to many parties and it is therefore extremely important that it is designed carefully and correctly. Public Health Observatories nationally are looking in detail at how monitoring is taking place on the effect of water fluoridation in those parts of the country that have relevant schemes. The SHA is also planning to work with local academic groups to consider designing research studies associated with the introduction of water fluoridation in Southampton. I agree with you that the SHA should engage with communities and this is something we are keen to do.

Jim Easton

Chief Executive

Cc: Cllr Ken Thornber, Leader Hampshire County Council

Andrew Smith, Chief Executive, Hampshire County Council

Hampshire Water Fluoridation Review Panel Members

Cllr Margaret Eaton, O.B.E., Chairman, Local Government Association

Hugh Whittall, Director, Nuffield Council of Bioethics

Sir Ian Chalmers, Editor, The James Lind Library

Professor Trevor Sheldon, Health Services Research, University of York

Cllr Cathie Frasier, Eastleigh Borough Council

Cllr Anna Rostand, New Forest District Council

Cllr Peter Boulton, Test Valley Borough Council

Chris Huhne, MP

Dr Julian Lewis, MP

Desmond Swayne, MP

Sandra Gidley, MP

Dr Caroline Lucas, MEP

Kathie Sinnot, MEP

The Earl Baldwin of Bewdley

Dr Geoffrey Harris, Chairman, South Central SHA