AT A MEETING of the HAMPSHIRE, SOUTHAMPTON, PORTSMOUTH AND ISLE OF WIGHT HEALTH SCRUTINY JOINT COMMITTEE held at Ashburton Hall, Winchester on Tuesday, 2^nd December 2009

PRESENT

Members Officers

Councillors:

Hampshire Anna McNair Scott (Chairman) Denise Holden

Pat West David Pryke

Pam Mutton David Crosby

Ray Love

Portsmouth Margaret Adair Jane DiDino

Isle of Wight Margaret Webster Marian Jones

Southampton Edwina. Cooke (Vice-Chairman)

Apologies were received from Councillors: Keith Chapman, Peter Edgar (Hampshire) David Horne (Portsmouth)

12. DECLARATIONS OF INTEREST

None

13 MINUTES

The Minutes of the meeting of the Joint Committee held on 13 October 2009 were confirmed as a correct record.

14. Treatment of Heart Attacks with Primary Angioplasty

Dr Balfour gave a presentation on the future of primary percutaneous coronary intervention (PPCI) services in the Hampshire and Isle of Wight areas.

The Committee heard:

· The NHS South Central Region is currently looking at proposals for providing PPCI in a way that could save at least 250 lives. The proposal is to create large centres of clinical excellence with at least two catheter labs where PPCI is available 24/7

· Primary Percutaneous Coronary Intervention (PPCI) is also known as emergency angioplasty and is viewed as the gold standard treatment for certain heart attacks.

He explained what Primary Percutaneous Coronary Intervention is:

· Also known as emergency angioplasty or coronary angioplasty and stenting

· Involves inserting a balloon and then stent through an artery to hold the blocked artery open and allow blood to flow more easily to the heart

· A form of PCI that can be used after a heart attack.

The proposed configuration of PPCI in Hampshire and the Isle of Wight is:

· Basingstoke & North Hampshire Hospital provides PPCI 24/7 and are currently working towards full compliance with clinical criteria

· Queen Alexandra Hospital, Portsmouth currently provide daytime PPCI service

· Frimley Park Hospital provides PPCI 24/7 and are currently working towards clinical criteria

· Southampton General Hospital provides PPCI 24/7 and already meets clinical criteria

He explained that the NHS are commissioning a high quality service across the county and this means:

· Centres must take a minimum of 400 angioplasty procedures

· Each operator must perform in excess of 75 angioplasty procedures per year

· Centres must agree that the paramedic determines diagnosis and destination of the patient

· Patients are taken direct to cardiac catheter laboratory, not stopping at A&E

· Aiming for 75% of all cases to achieve a `call to balloon' time of 120 minutes or less in the first year.

With regard to PPCI on the Isle of Wight:

· The PCT is in discussion with the air ambulance to provide a service to transfer patients for PPCI during daylight hours. This could be extended to 24/7 with a new helicopter

· Whilst not ideal this is a practical stepped solution that would significantly improve the situation for IOW residents

· The timing for introducing this service is largely dependent on the need for a public consultation and the impending moratorium due to the coming general election.

Sarah Tiller set out to the committee about the way in which NHS Southampton City, NHS Hampshire, NHS Isle of Wight and NHS Portsmouth are working to ensure that relevant groups, organisations, clinicians and patients are informed about the PPCI gold standard and about the need to meet clinical standards for PPCI treatment.

Engagement activities included:

· Writing to a wide range of interested groups and individuals

· Working local LINks to engage members

· Holding community events

· Discussions at various patient and carer groups

· Discussions with key stakeholders such as MPs, HOSCs and LINks

· Discussions with staff and clinicians

· Articles in various community, partnership and voluntary sector newsletters

· Newspaper advertising

The view they have received back include:

· Mainland

o Broad acceptance of proposals in Portsmouth and Southampton

o However some concerns about ensuring service is equitable across the county

o Questions about ambulance response times especially in rural areas

· Isle of Wight

o Concerns that IOW will be getting a "Second Class" service

o Concerns about emergency conveyance and response times

o Concerns over transport for relatives and carers to mainland hospitals

The committee heard that the engagement process is ongoing until March 2010, Cllr. Webster stated that formal consultation would be essential on the Isle of Wight.

There would be a report to the Joint HOSC in six months setting out progress and including:

· Monitoring ambulance response times

· Reviewing and developing cardiac rehabilitation services

The Joint HOSC was clear that support in the development of heart attack services on Isle of Wight was subject to:

· Isle of Wight resolving local service issues

· Consultation with local people

RESOLVED:

Action: for the NHS to provide the Joint HOSC with figures relating to the ratio of attending paramedics to ambulances on the Isle of Wight.

Action: for the NHS to continue to provide ongoing information relating to community engagement surrounding the issue of PPCI

Action: for the NHS to provide the Joint HOSC with information relating to the ambulance response times.

18 UPDATE FROM LOCAL AUTHORITIES

Portsmouth

· Have put in a request for extra funding from the Centre for Public Scrutiny

· Alcohol service review is ongoing

· A helpful presentation about a co-responder scheme which was good.

Isle of Wight

· PCT came and gave a report relating to the Care Quality Commission.

· The LINks will be coming to explain their duties and function.

· The PPCI debate will continue and hopefully result in full consultation.

Southampton

· Currently making enquiries into the NHS and they have set up a meeting with the PCT Director.

· Have 5 meetings arranged to deal with their Obesity review.

Hampshire

· Ambulance service review is ongoing and they are liaising with Bucks/Oxford relating to rural and urban response times.

· Oak Park community hospital and NHS Hampshire's plans to terminate the development.

· Closure of Psychiatric Intensive Care Centre.