Agenda Item 8

HAMPSHIRE COUNTY COUNCIL

Report

1. Summary and Purpose

1.1. This report provides Members with information about the issues brought to the attention of the Committee and the response to these referrals. It sets out the inquiries received, the source of this inquiry and any action taken. Where appropriate comments have been included and copies of briefings or other information attached.

1.2. The approach adopted provides the route through which Local Involvement Networks (LINks) and other partner organisations (Hampshire district councils, NHS organisations, voluntary and independent sector providers and organisations that are representative of social care service users and carers) can raise issues with the Committee.

1.3. Where inquiries raised with the Committee are already subject to monitoring or other performance management activities the action taken will be focused on the local resolution of inquiries through appropriate sign-posting to the agency best placed to respond.

1.4. Where an issue cannot be satisfactorily resolved between the parties concerned then the Committee can consider options for further action.

1.5. New issues raised with the Committee, and those that are subject to on-going reporting are set out in Table One of this report.

1.6. The recommendations included in this report support the Corporate Strategy aim of maximising wellbeing through the overview and scrutiny of health services in the Hampshire County Council area.

Table One: Inquiries Received and Action Taken

Section 100 D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents that disclose exempt or confidential information as defined in the Act.

Appendix One: Transforming mental health services for older people in Andover. HOSC response to Hampshire Partnership NHS Trust

Thank you for arranging for Eileen and Jane to attend our meeting on 26 May 2009. I am sure that they will have told you of the views of the Health Overview and Scrutiny Committee (HOSC) but I thought it would be helpful to set these out in writing.

Members were very appreciative of the amount of work that had taken place to engage with local people in developing the proposals. This point, together with the positive feedback from Cllrs Mrs West and Mrs Kerley, helped the HOSC come to the view that it did not consider the changes proposed to be substantial. This is however contingent on the continuation of the planned engagement and involvement of local people and key partners in taking this work forward. Through our Member representatives we will continue to take an interest in the progress of the Trust and request regular updates.

There were also a number of points that were raised in the discussion at the meeting that will require a further response from the Trust. These were:

· Travel arrangements between Andover and Winchester are not good. There is potential for some patients and visitors to use the WEHT / HCC sponsored bus and we would therefore ask that this is explored further with a view to Hampshire Partnership contributing to the costs of running this service. There were also concerns about the timings of the bus, which currently finishes in early afternoon and the location of the bus stop in relation to Melbury lodge.

· It would be helpful to have further details about the role and membership of the Steering Board that will oversee the implementation of these proposals. In particular we would be keen to see the Hampshire LINk involved and the Steering Board taking an active role in ensuring that the intended benefits are delivered for patients and their families, particularly with regard to monitoring care and support in people's homes.

· We would not expect the current beds at Andover to close until there was absolute confidence that the services to provide the required levels of support in the community were in place. Clear information for service users about these services and the levels of care they should expect should be provided.

· Given that there can be significant variation in beds occupancy we would appreciate confirmation of the continued availability of Kingfisher Ward for these patients.

· The steps to be taken by the Trust to ensure that the skills of existing staff working in this highly specialised area are retained.

Subject to the outcome of the recent election we will confirm the HOSC Members that will be the main links with Trust as this work is rolled forward on 28 July 2009. In the meantime it would be helpful to have an up-date on progress at our meeting in January, if possible from the Steering Board. Please let me know if this causes any difficulties.

Appendix Two: Transforming Mental Health Services for Older People in Hampshire; Except from Hampshire Partnership NHS Foundation Trust Response to the HOSC- 25 June 2009.

I will set out the steps that we are taking to respond to the issues raised in the discussion at the June meeting of the Hampshire Health Overview and Scrutiny Committee to which you refer in your letter

· Travel arrangements: We are pursing the option of using the WEHT Hampshire County Council sponsored bus with Michael Leggatt of Winchester and Eastleigh Health Care Trust, with a view to us contributing to the cost of running this service, we also acknowledge the concerns raised about the timings of the bus and the location of the bus stop. Once we have received a response from Eastleigh and Winchester Health Care Trust we will of course inform you.

· The role and membership of the Steering Board that will oversee the implementation of these proposals is set out as follows

o The Board will consist of membership from our partners in the Primary Care Trust and from Adult Services. This will ensure that implementation is completed in partnership, that different parts of the service work better together and that the communication between all partners is maintained. This was one of the key views we gained from our engagement process.

To ensure that the implementation meets the needs of patients and carers a Reference Group will be set up to feed views, test developments and ensure the projects delivers the proposals. It is proposed that the reference Group will continue to be a source of patients and users views during and after the implementation.

As part of our implementation plan we do not anticipate closing beds at the Allan Gardiner Unit until we have put in place the additional planned community resources in order to ensure that support is in place and effective.

· Service information is currently in production including details of the level of care that can be expected. We will advise you of further progress regarding this

· Access to Kingfisher Ward: Further to our recent discussions we expect to shortly receive formal confirmation of the availability of the Kingfisher Ward from Eastleigh and Winchester Health Care Trust.

· As advised at the meeting steps are being taken to ensure that all existing staff have their employment position addressed through our organisational change policy. The process of one to one interviews was concluded on 19 June 2009. At present it would appear that all of the trained nursing staff will be redeployed within the Trust to areas of their preference. We are also optimistic that the same will apply for the unqualified staff.

We look forward to attending the overview and scrutiny committee meeting in January 2010 to update you in the progress of this project.

Appendix 3

Health Overview and Scrutiny Committee

with

Children and Young People's Select Committee

Provision of Therapy Services for Children with Disabilities and Complex Care Needs

Preliminary Scoping for Joint Review

1. Introduction

1.1 Two related areas of work concerning children are currently under consideration by scrutiny committees. One relates to a review originally undertaken by the Health Review Committee in 2005 which looked at `Access to Therapy Services for Children in School and Pre-school'. In this context the Chairman of the Health Overview and Scrutiny Committee (HOSC) agreed at a full council meeting in late 2008, that the Committee would consider reviewing the issue of nursery provision for SEN children.

1.2 The second area of work, is an ongoing `Scrutiny of Short Breaks, Palliative Care and Carer Services for Children with Severe Disabilities'. This was identified as a topic by the Children and Young People's Select Committee in 2007 for their 2008 work programme, and has been ongoing since early that year.

1.3 It has become apparent that the two reviews share some common features, that is to say, they both involve services provided to children with disabilities. It seems reasonable, therefore to consider the possibility that both pieces of work might be better progressed as a joint scrutiny comprising members of both committees. In further support of this is the fact that for both issues, the same Government guidance and policy would apply, and many of the same key stakeholders would be involved.

1.4 The Health Overview and Scrutiny Committee should therefore be requested to take the lead, working jointly with the Children and Young People's Select Committee to undertake a joint review, based on the recommendation at 3.1 This will ensure that the NHS responds fully to any issues raised in relation to this work.

2. Common legislation

2.1 The Government focus on children, their health, care and education is evident in a large number of publications relevant to either one, or both of the work areas above. Examples of the publications include:

· Choice for parents, the best start for children: a ten year strategy for childcare (HM Treasury et al, 2004)

· Disabled Children and Young People and those with Complex Health Needs ( DH & DES, NSF for CYP&MS, Oct 2004)

· The Childcare Act 2006

· Aiming High for Disabled Children, May 07 (Treasury, Dept Education and Skills)

· Better Care: Better Lives, February 08 (Dept of Health/CNO-D-CF&M)

· Healthy lives, brighter futures - The strategy for children and young people's health, February 09 (Department of Health, Department for Children, Schools and Families)

· Every ^disabled Child Matters (campaign by 4 leading organisations working with disabled children and their families) some local authorities have developed their own `charters' to recognise this concern.

· Bercow Report: a review of services for children and young people (0-19) with speech, language and communication needs.

Aiming High for Disabled Children

2.2 Of particular significance for both committees is Aiming High for Disabled Children. Firstly, it is directly relevant to the concern shared by both committees about disabled children, for instance it highlights the importance of specialist services, such as:

2.2.1 Short Breaks:

"4.2 Families with disabled children often face particularly high levels of stress which may result in family breakdown. For parents and siblings of disabled children, short breaks reduce stress, allow a rest from caring, provide time to carry out tasks and activities that other parents take for granted and allow more time with other children...

4.4 Furthermore, short breaks can also have a positive impact on disabled children, as they help to tackle social isolation, provide access to leisure activities, friendship networks, and promote development."

2.2.2 Therapy Services:

"...4.13 Therapy Services for disabled children are key to improving their outcomes. Speech and language therapists, occupational therapists, and physiotherapists help to enable and promote communication, improve and manage posture, and maximise mobility. The ability to communicate is fundamental to children's learning and progression..."

2.2.3 The Aiming High document also emphasises the need for `universal services' to be available for all disabled children, this encompasses things such as childcare and access to early years services. Whilst these services often do exist, it is not necessarily the case that local provision is supported by enough appropriate training or equipment to properly include disabled children.

2.2.4 Nursery provision for SEN children

Nursery provision comes within `universal services' ("...Universal services are those services (sometimes also referred to as mainstream services) that are provided to, or are routinely available to, all children and their families. Universal services are designed to meet the sorts of needs that all children have...", Every Child Matters, ) such as, childcare,

"4.8 ...As well as facilitating parental employment, childcare will benefit disabled children as it benefits non-disabled children, with the provision of high quality education and care at an early age...".

"3.16 To allow Local Authorities and PCTs to plan and provide for their population, Government will look to all Local Authorities and PCTs to collect data on:

· The number of disabled children in their area, where possible classified by type of disability; and

· The percentage of this disabled children population accessing both universal and specialist services, such as short breaks or therapy services"

Healthy lives, brighter futures - The strategy for children and young people's health

2.3 Healthy Lives, Bright Futures is described as a "strategy for children and young people's health" (Department of Health, Department for Children, Schools and Families, February 2009). This recent document builds on, and assumes the previous publications, including Reaching High. It is hard to find a case for separating the issues identified by each of the committees, when legislation, guidance and the Strategy would treat them all as important concerns of interest for disabled children and their families.

2.4 It is understood that NHS Hampshire is currently drafting a child health strategy. This document should detail the commitment of the local NHS to national priorities for disabled children, and to addressing local needs.

Issues related to `specialist services'

2.4.1 Short Breaks

Every disabled Child Matters: Short breaks tracking Interim Report, April 2009:

· Non-pathfinder areas reported lack of real choice over services received,

· lack of information,

· lack of clarity about direct payments,

· lack of support for parents from LAs in managing direct payments

It should be noted that Hampshire County Council approved a commissioning strategy for disabled children in late 2008, and now has a programme in place.

2.4.2 Therapy Services

(see A Review of Therapy Services for Children across Hampshire incorporating Occupational Therapy, Physiotherapy & Speech and Language Therapy, College of Occupational Therapists, August 2008):

· There are strong and positive relationships between professionals across agencies; and proposals have been made for improved and focused services.

· There is a great variation across the county in the types of therapy provision that children receive

· A greater consistency and equity across the region is required.

· The provider services, although numerous, are stretched in attempting to meet local needs, with varying degrees of success.

· Users, although largely complimentary about the services received, felt they had to "fight" for services.

· There are some noticeable gaps in service:

· Services to special schools are inadequate.

· Little/no therapy input into services for children and young people with autism.

· Little/no service to secondary age children or transition services to adult life.

Note: this report has not been published by the PCT, but the issues raised may be addressed in their forthcoming child health strategy.

2.4.3 Palliative care

Palliative Care Services for Children and Young People in England, Department of Health, 2007:

· Enormous overlap between children with disabilities and complex care needs and those requiring palliative care. Services for these groups should be planned together.

· Lack of understanding of what children's palliative care involved, most assuming it was just about end of life care.

· Lack of clarity about who was responsible for leading planning and development of services...requires health, education and social services to work together.

· Committed workforce spent too much time battling the system

· Poor information base with no nationally agreed figures on prevalence and little evidence of good needs assessments

· Little evidence of trend data being used in the planning of services

· Lack of transition services to manage the transfer to adult services

· Huge variation in the availability of services across England

· Children and young people often subject to multiple assessments and then often received no resulting service

· Families wanted more community services able to offer help and advice 24/7

Issues that have been identified in relation to `universal services'

2.4.4 Recurrent themes, as for example, identified in the Parliamentary Hearings on Services for Disabled Children, October 2006, and Aiming High for Disabled Children, May 2007, include:

· Staff Training - to increase their knowledge of disabled conditions and potential of disabled children to achieve success

· The availability of appropriate equipment to help make universal services more accessible to disabled children

· `Diagnostic overshadowing' where a health diagnosis fails to identify physical health needs because they are assumed to be part of another condition

2.4.5 In addition not infrequent reference is made to the strongly supporting role of `key workers' who ensure that children and their families receive a coherent package of services. This is a vital resource in a multi-agency, multi-disciplinary partnership context where such complexity needs effective management.

3. Progress with the `Scrutiny of Short Breaks, Palliative Care and Carer Services for Children with Severe Disabilities'

3.1 The Children and Young People Select Committee has been undertaking scrutiny of short break, palliative care and carer services provision in Hampshire since mid 2007. Following a workshop held 12 May 2009, the Committee added to the notes and feedback the following recommendations:

Commissioners and statutory provider agencies consider the findings of this workshop, and how they might generally improve communication with their `customers' and smaller 3^rd sector providers

In particular, consideration should be given to:

Ensuring that customer centred information is provided at the right time, in the right way, and with the right information - and that all information is first tested with customers before being made widely available.

Prioritising the commissioning of additional support to increase capacity for disabled children to access universal services through programmes where specialists train staff in knowledge and techniques to maximise positive outcomes for disabled children in universal or mainstream contexts.

3.2 Critical to the equitable delivery of both universal and specialist services across the County is adequate support funding. In line with Government policy and legislation cited above in section 3, the Department for Children, Schools and Families committed a total of £430 million (Aiming High for Disabled Children). £340 million of which is revenue funding allocated to local authorities for the transformation of specific service areas:

· Short breaks

· Childcare

· Transition

· Parent forums

3.3 An additional £90 million is committed to capital funding for short break services. All of this is for the period 2008 - 2011.

3.4 In February 2009, the Child Health Strategy, `Healthy lives, brighter futures' promised an additional £340 million to PCTs for disabled children. Again, the letter from Government stipulated how this money should be spent. £310 million is to be spent over the period on short break, community equipment and wheelchair services, while £30 million is for children's palliative care. These monies are not ring fenced, however the letter to chief executives went on to say,

"We shall be asking SHAs and PCTs to prepare a commentary to accompany the publication of 2008-09 performance data in September 2009. As part of that commentary, we shall be mandating a local statement by PCTs setting out the actions, either alone or in partnership with the LSP, in the four areas of:

· Short breaks

· Community equipment

· Wheelchairs

· Palliative care

This will enable local review and challenge with partners, service users and the wider community of the 2008-09 position and of the action taking place in 2009-10. It will also provide the basis for local discussions on priorities and areas for joint working in 2010-11."

3.5 The funding committed above is additional for local authorities and health services which should therefore provide scope for substantial improvements in targeted, specialist and universal services for disabled children. This joint review provides a timely opportunity to contribute to encouraging transparency and helping those most affected to, "know how much of the £340m has been spent by PCTs on short breaks and that will enable parent groups to scrutinise and ask the right questions about how the money has been spent" (Ed Balls, June 2009), and by extension, also about the wider range of services to which disabled children are entitled. It is therefore recommended for the purposes of this review that:

Members will wish to seek evidence that commissioners and provider agencies are showing commitment to being fully transparent about their funding, and plans to address the current inequitable provision of services, including therapies, in line with government priorities and expectations for disabled children.

4. Proposed way forward

Scope:

4.1 Taking account of the current evidence available it is recommended that:

the scope of this joint review be, in the first instance, targeted at following up on the recommendations and conclusions of the independent "...Review of Therapy Services for Children across Hampshire incorporating Occupational Therapy, Physiotherapy and Speech and Language Therapy" undertaken in 2008, whilst noting that the report has not yet been published.

4.2 In addition it is recommended that:

the focus should be confined to the most vulnerable children, that is, those with Special Educational Needs. This will enable the work of the joint review to focus specifically on gaps identified in the provision of the key services, where improvement can be achieved, and on the allocation of resources that are sufficient to address the identified gaps in provision.

Opportunities to add value:

· Potential to make general recommendations, eg. to NHS/HCC commissioners concerning equitable access to services within the scope of the joint review.

· Potential to make recommendations to NHS/HCC providers regarding readiness to meet the core standards criteria (above)

· Possibly to make specific recommendations relating to specific services, eg: `short breaks'; `palliative care'; `carer services'; or `nursery provision/therapy services'. Alternatively to frame the work at a higher level of generalisation in terms of `universal' and `specialist' services.

· Possibly to make recommendations about structuring services in order to achieve desired and agreed outcomes and equitable service provision.

· Perhaps a critical question ought to be what has prevented improvements being made to an equitable provision of services across the county following the reviews in 2005 and 2008? Hence potential to possibly make a contribution to improving the effectiveness of scrutiny.

4.3 Note1: what the committee does not want to do is to repeat the exercises undertaken in 2005, or more recently in 2008, but to determine how progress might be made and identify where the obstacles are.

4.4 Note 2: Whilst the Aiming High agenda is quite specific about the areas for which funding was intended, Aiming High also acknowledges that "therapy services are key to improving their ( outcomes". There would seem to be some logic in thinking that the additional funding should provide additional scope for commissioners and providers to address the short falls in provision across the specialist and universal service provision.

Indicative timeframe:

4.4 See attached timeline sheet

Indicative Stakeholders:

· HCC

o Children's Services - Education

o Children's Services - SEN

o Children's Services - Therapy, commissioning leads

o Schools / Special schools

· Children / parents

· NHS

o Commissioning leads

o Therapy services

o School nursing

· 3^rd Sector

o Independent providers

o National orgs / charities

· Experts

5. Definitions

5.1 Universal Services: are provided to, or are routinely available to, all children, young people and their families.

5.2 Specialist Services: are provided specifically for children and young people with specialist, acute, complex or very high level need who would otherwise be at great risk of poor outcomes.

IMPACT ASSESSMENTS:

Equalities Impact Assessment:

N/A

Impact on Crime and Disorder:

N/A

Appendix Four

NHS HAMPSHIRE

UPDATE ON THE DELIVERY OF THE

SOUTH EAST HAMPSHIRE CAPACITY PLAN

July 2009

1. INTRODUCTION

1.1. In November 2008, NHS Hampshire [NHSH] presented the Hampshire Health Overview and Scrutiny Committee [HOSC] with a detailed briefing on the progress in implementing the southeast Hampshire Capacity Plan. Details were given about the background to the capacity plan, involvement and consultation and the key next steps (a copy of the presentation is attached at Appendix A). As part of the briefing, the HOSC received information about the future disposition of beds at Queen Alexandra Hospital along with inpatient and outpatient services proposed across the rest of south east Hampshire.

1.2. The HOSC agreed to the continued delivery of this plan, ensuring continued public engagement and the need for routine briefings back to the HOSC at regular intervals. A further update was received at the May 2009 HOSC meeting.

1.3. This paper provides the HOSC with a progress report on the implementation of the south east Hampshire capacity plan and identifies any further work required.

2. RAPID APPRAISAL

2.1. In the last few months the NHS has 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 may mean a reduction in resources given that inflation (driven by an ageing population in Hampshire, combined with the cost of new technologies and treatments) tends to be higher for the NHS and bites more deeply into its finances.

2.2. The Hampshire NHS's response to this challenge is already being developed, and will include:

· ensuring every possible efficiency and cost control is 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;

2.3. Like many public and private sector organisations, NHS Hampshire will also need to review all of the developments that it commissioned in a time of relative growth to test their affordability in the light of the significantly changed financial environment. This is the only responsible action that NHS Hampshire can take as a publically funded authority.

2.4. With this in mind we have commenced a rapid appraisal of significant investment proposals across the whole of Hampshire, and taken steps to ensure that it does not incur any unnecessary development costs in the months of June and July. It is proposed that an update on this work will be presented to the Board of NHS Hampshire in July 2009.

2.5. The rapid appraisal process will consider each significant planned development against five key questions in order to determine whether it should continue unchecked, or whether we need to do more work in partnership with local people to ensure we can deliver a sustainable model of care.

2.6. The five key questions are:

a) Are the revenue consequences of the proposed development financially significant when balanced against a £1.8bn operating budget? [it is proposed that this will be schemes with a recurrent revenue cost of over £500,000 per annum];

If schemes are over £0.5m, it is proposed that they should be subject to pause and review, unless supported by one of the following criteria

b) Has the development already commenced? [this can either be the actual construction of capital developments; the employment of staff; or signing of legally binding contracts for service developments]

If a scheme has already started and there would be significant additional cost or penalty incurred without benefit as a consequence pausing, it should continue.

c) If the scheme does not progress it would rapidly result in greater cost being incurred by the NHS in order to accommodate services or clients in alternative accommodation

If the scheme can be demonstrated as being the most cost-effective solution for supporting services or clients, with the consequence of pausing being greater unavoidable cost, it should progress;

d) Does a critical decision need to be made on the development within the next 12 months? [this will include approval of final business case or stage 2 submission for capital developments; or the tendering of services for service schemes].

If planning for the scheme can be delayed without incurring cost as a consequence of the delay, the scheme should be subject to pause and review (unless supported by one of the other criteria)

e) Is the development of the scheme a national requirement

If the scheme is being supported by national ringfenced capital or revenue that can not be deployed for alternative use; or it is a requirement of a regulator or national policy, it should progress

2.7. The south east Hampshire capacity plan comprises five key developments, set out below:

· Queen Alexandra Hospital [QAH]

· St Mary's Community Hospital [SMH]

· Fareham Community Hospital [FCH]

· Gosport War Memorial Hospital [GWMH]

· Oak Park Community Hospital [OPCH]

2.8. NHS Hampshire is directly responsible for Fareham Community Hospital, Gosport War Memorial Hospital and Oak Park Community Hospital, and so these programs have been included in the rapid appraisal process.

2.9. The NHS Hampshire Board will receive an update on progress at its meeting on 23 July 2009. Any developments arising from that Board meeting will be reported verbally at the HOSC meeting.

3. DEVELOPMENT UPDATE

Queen Alexandra Hospital

3.1. Portsmouth Hospitals NHS Trust has completed all the patient moves into the new state-of-the-art Queen Alexandra Hospital in Cosham on time and on budget. Over the past four weeks nearly 200 moves involving staff and equipment have taken place smoothly.

3.2. The new hospital took ten years to plan and signals the coming together of the current Queen Alexandra Hospital, and St Mary's Hospital and The Royal Hospital Haslar.

3.3. The new build is more than double the size of the previous Queen Alexandra provision with about 1,400 patient beds and has been designed to continue the success infection reduction. One third of beds in the new build are in single rooms with en-suite facilities and the remaining are in four-bed rooms with their own shower. Each bed is 10% bigger than the current standards and have more space between each other.

3.4. While the acute services have relocated to Queen Alexandra Hospital, Portsmouth Hospitals Trust will be providing enhanced outpatient services at facilities across south east Hampshire.

3.5. The final phase of the development which is mainly work in the retained estate and construction of a further decked car park will be completed by 15th July 2010.

St Mary's Community Hospital

3.6. It is understood that Portsmouth City Primary Care Trust Board is scheduled to consider the full business case for the £18m development of the community health campus on the St Mary's Hospital site on 29 July 2009.

Fareham Community Hospital

3.7. Building of a new community hospital for Fareham commenced on the Coldeast site in the western wards of Fareham, in January 2009.  Work is on target to complete in March 2010 and the new facility will be open to treat patients by the end of May 2010.  This facility will provide a wide range of outpatients, diagnostics, therapies and a new intermediate day care facility.

Gosport War Memorial Hospital (including Gosport Medical Centre)

3.8. The remodelling of Gosport War Memorial Hospital is now complete and the minor injuries service has transferred from the Royal Hospital Haslar and is co-located with the GP Out of Hours service.

3.9. This development also means that Gosport War Memorial Hospital will now provide over 60 outpatient clinics including: audiology, orthopaedics, diabetes, oncology, ear, nose & throat, diagnostics, pain clinic, paediatrics, endoscopy, dermatology and ophthalmology. As part of this project and following successful pilots at Forton Medical Centre, Lee on Solent Medical Practice and a practice in Porchester, phlebotomy services moved out of hospital on 6th July and are now provided via appointment based clinics from six GP surgeries in Gosport and Stubbington.

3.10. Gosport Medical Centre has received planning consent from Gosport Borough Council and the draft stage 2 business case will be considered by the PCT Board in July. If approved, construction would commence in the autumn. Construction and commissioning is planned to be complete within 12 months, autumn 2010.

Oak Park Community Hospital (OPCH)

3.11. As the HOSC is aware, proposals to develop a community hospital facility serving the southern part of the population of East Hampshire has been long in development. Following the receipt of planning permission for the Oak Park Community Hospital in February 2009, NHS Hampshire has been working towards the submission of an Oak Park Community Hospital stage 1 Business Case for government agency approval in summer 2009.

3.12. The NHS team and the private sector LIFT partner have been working hard to produce a full and comprehensive document, which meets the stringent approval criteria for this form of major public health care development.

3.13. In the light of the recent announcements on NHS funding in the future the NHS has, as part of the approval process, had to undertake a rapid appraisal of the project's long term affordability. This appraisal is currently underway and will make sure that the necessary checks and safeguards have been adhered to and that the Oak Park project is still affordable within the current financial environment.

4. NEXT STEPS

4.1. Huge progress has been made in bringing the south east Hampshire capacity plan to reality. The redevelopment of Gosport and Queen Alexandra Hospital is complete, with Fareham Community Hospital scheduled for completion in 2010.

4.2. Looking forward, it is anticipated that the outcome of the rapid appraisal of significant developments will be reported to the NHS Hampshire Board in July 2009. An early assessment indicates that the Fareham Community Hospital and Gosport Medical Centre developments will continue unchecked in the light of their advanced progress and relative costs. There is a risk, however, that the NHS Hampshire Board will receive a recommendation that the Oak Park development will not meet the criteria to continue unchecked.

4.3. This may require NHS Hampshire to do more work in partnership with local people to ensure we can deliver a sustainable model of care for the future.

4.4. It is proposed that an update on the rapid appraisal process is provided verbally at the HOSC meeting.