Issue - meetings

To consider the report of the Director of Transformation and Governance on proposals from the NHS or providers of health services to vary or develop health services in the area of the Committee.

Items for Monitoring

a) Portsmouth Hospitals Trust: Spinal Surgery Service Implementation update

b) Southern Health NHS Foundation Trust: Update on Temporary Closure of Older People’s Mental Health Ward (Beaulieu)

Items for Information

a)    Southern Health NHS Foundation Trust: Planned Changes to West Hampshire Learning Disability Service

Items for Monitoring

a. Portsmouth Hospitals Trust: Spinal Surgery Service Implementation update

Members received a brief update regarding the transfer of the Elective Spinal Service from Portsmouth Hospitals NHS Trust to University Hospital Southampton NHS Foundation Trust on 31 October 2018.  No specific patient feedback or concerns had been noted but Members drew attention to the difficult nature of recovery from surgery.

RESOLVED

That the Committee:

a) Note the progress on transitioning the Elective Spinal Service from Portsmouth to Southampton.

b) Request a further update from University Hospital Southampton for the November 2019 meeting.

b. Southern Health NHS Foundation Trust: Update on Temporary Closure of Older People’s Mental Health Ward (Beaulieu)

Representatives from Southern Health updated Members on the reopening of Beaulieu Ward with a new dementia friendly environment, a significant cultural shift, and multidisciplinary recruitment that will benefit all new patients.  The facility is now updated, environmentally friendly, and single sex compliant.  While the ward is reopening with 3 fewer beds (17 to 14), this will have no impact of patients and allow for improved patient service and innovative care.  This very first frailty friendly ward will be staffed with providers who have all necessary qualifications to improve outcomes and keen, positive ward managers providing a positive experience for patients and carers in the long run.

In response to questions, Members heard:

• Members had an invitation to visit and walk through the ward before it is open to patients.
• The reduction in beds will improve quality care without adverse impact.
• The staff make an effort, when possible, to get patients to enjoy the outdoors and there is an outside space as well.
• There is a meaningful plan to make sure patients’ days are varied and engaging.
• Effort is made to accept patients, brought in by carers, from the entire county but with proper and prompt admission and only for as long as needed.
• Demand and availability of beds will be monitored.

RESOLVED

That the Committee:

a)         Note the update of the improvements and reopening. 

b)         Request a further written update statement be circulated to HASC Members for the November 2019 Meeting

Items for Information

a. Southern Health NHS Foundation Trust: Planned Changes to West Hampshire Learning Disability Service

Members heard from Southern Health NHS Foundation Trust that due to enduring logistical challenges, a change in base for the staff would make possible a more efficient and effective range of services for users.  Users and carers had been engaged and the change was positively received.  The new location will be easily accessible with better technological connectivity that will allow for better and more effective use of time. It is anticipated to be short term move.

In response to questions, Members heard there will be:

• Dedicated NHS connection in the building
• Two dedicated disability parking spots which will be adequate for users
• Public transportation will not be an issue because users are often reliant on family member driving them

RESOLVED

That the Committee:

a)         Note the update of the change  ...  view the full minutes text for item 137

To consider the report of the Director of Transformation and Governance on proposals from the NHS or providers of health services to vary or develop health services in the area of the Committee.

Items for Monitoring

a)    Hampshire Hospitals NHS Foundation Trust and West Hampshire Clinical Commissioning Group: Andover Hospital Minor Injuries Unit - Update

b)    Southern Health NHS Foundation Trust: Move of patients to Eastleigh & Romsey Community Mental Health Team - Update

a) Hampshire Hospitals NHS Foundation Trust and West Hampshire CCG: Andover Hospital Minor Injuries Unit - Update

Representatives from the Hospital Trust and Clinical Commissioning Group presented a report providing an update on the situation with Andover Hospital Minor Injuries Unit (see report, Item 6a in the Minute Book).

Members heard that the Trust continued to hold four vacancies for Emergency Nurse Practitioners and therefore was continuing to close the Minor Injuries Unit (MIU) at 6:00pm. No increase in attendance at the Emergency Departments of the Trust’s other hospitals had been seen. Nationally there was a move to consolidate services treating minor injuries into the Urgent Treatment Centre (UTC) model, therefore commissioners were looking to transition the offer at Andover hospital to an UTC. The UTC model included extended access to primary care services at evenings and weekends.

NHS England had indicated that UTC services should be available by July 2019, however it was unlikely this would be achievable in Andover. Commissioners locally were aiming for October or December 2019, although there was a chance this would slip into 2020. Commissioners were reviewing the demand from the local population, to consider whether a service open for twelve hours a day every day was necessary for the Andover population.

In response to questions, Members heard:

·      It was hoped the new model would help with recruitment to staff the revised service

·      Engagement had been undertaken nationally on the UTC model, and communications would be provided locally when the new UTC was ready to launch

RESOLVED

That the Committee:

a)    Note the progress on transitioning the MIU at Andover War Memorial Hospital to an Urgent Treatment Centre.

b)    Request a further update for the November 2019 meeting.

b) Southern Health NHS Foundation Trust: Move of patients to Eastleigh & Romsey Community Mental Health Team - Update

The Select Committee received a report providing an update on the move of patients who had previously been supported by the Southampton East Community Mental Health Team to come under the care of the Eastleigh and Romsey Community Mental Health Team (see report, Item 6b in the Minute Book).

RESOLVED

That the Committee:

a)    Note the update on the transition

b)    Request a further update be circulated to HASC Members once the transfer is complete

To consider the report of the Director of Transformation and Governance on proposals from the NHS or providers of health services to vary or develop health services in the area of the Committee.

Items for Monitoring

a)    Hampshire Hospitals NHS FT and Hampshire Partnership CCG: Chase Community Hospital - Update on re-provision of Hampshire Hospitals NHS Foundation Trust services and Health Hub plans

Hampshire Hospitals NHS Foundation Trust and Hampshire Partnership Clinical Commissioning Group: Chase Community Hospital - Update on re-provision of Hampshire Hospitals NHS Foundation Trust services and Health Hub plans

The Select Committee received a report from the Hampshire Partnership Clinical Commissioning Group, providing an update on re-provision of Hampshire Hospitals NHS Foundation Trust services previously provided from Chase Community Hospital, and the latest position on plans for a Health Hub in the area in the future (see report, Item 6a in the Minute Book).

RESOLVED:

That the Health and Adult Social Care Select Committee:

a) Note the update.

b) Request a further update be provided to a future meeting of the HASC when alternative proposals relating to the health hub have been developed.

To consider the report of the Director of Transformation and Governance on proposals from the NHS or providers of health services to vary or develop health services in the area of the Committee.

Items for Monitoring

·         Hampshire Hospitals NHS FT: North and Mid Hampshire Clinical Services Review Update

·         Southern Health NHS FT: Update on temporary closure of Beaulieu Older People’s Mental Health ward

Hampshire Hospitals NHS Foundation Trust: North and Mid Hampshire

Clinical Services Review Update

Representatives from Hampshire Hospitals NHS Foundation Trust and West Hampshire Clinical Commissioning Group presented a report providing an update on the latest position regarding the North and Mid Hampshire Clinical Services Review (see report appended to Item 6 in the Minute Book).

Members heard that:

·         Following the decision not to pursue the creation of a new Critical Treatment Centre, the Trust had reviewed the sustainability of continuing to provide services from both the Winchester and Basingstoke hospital sites

·         Funding had been received to make improvements to both Emergency Departments (ED), and the Trust was creating a separate children’s pathway in ED

·         Women’s services had been considered and no areas of concern identified. There was no compelling reason to centralise services over the next 3 to 5 years

·         For surgery, it had been identified that there may be a benefit to consolidating certain procedures at one site, subject to further review

·         Maps had been provided showing the outcomes of a review of the maintenance need of the existing estate. This indicated that a significant proportion of the buildings were deemed poor quality

·         A clinical strategy for the next 3 to 5 years was in development

·         The Clinical Commissioning Group continued to work on new care models that focused on preventing hospital admission and provision of some services in the community

In response to questions, Members heard:

·      The Trust had not ruled out the possibility of centralising services to one site in future, but was currently focused on provision from the current sites

·      An estates plan was being developed, to plan how maintenance works could be carried out while protecting service provision

RESOLVED

That the Health and Adult Social Care Select Committee:

a) Note the latest position following the clinical services review.

b) Request the Trust and commissioners keep the HASC informed of developments to Emergency Departments.

c) Request the Trust and commissioners return to the HASC, should any proposals to change service provision at Hampshire Hospitals sites arise in the future.

Southern Health NHS Foundation Trust: Update on temporary closure of Beaulieu Older People’s Mental Health ward

The Select Committee received a report from Southern Health NHS Foundation Trust providing an update on the temporary closure of Beaulieu Older People’s Mental Health ward (see report appended to Item 6 in the Minute Book).

RESOLVED

That the Health and Adult Social Care Select Committee:

a) Note the update on the position regarding the temporary closure of the Beaulieu Older People’s Mental Health ward.

b) Request a further update on the position for the May 2019 meeting.

To consider the report of the Director of Transformation and Governance on proposals from the NHS or providers of health services to vary or develop health services in the area of the Committee.

Items for Monitoring

·         Hampshire Hospitals NHS Foundation Trust: Outpatient and X-ray services in Whitehill and Bordon (Chase) – Reprovision of services from alternative locations or by an alternative provider

• NHS Guildford and Waverley CCG and Hampshire Partnership CCG: West Surrey Stroke Services – Update on Implementation; once the new service model has been fully embedded, to include monitoring information on the ambulance response times in the affected Hampshire area, and treatment times once patients have reached Frimley Park Hospital

·         Hampshire Hospitals NHS Foundation Trust: Andover Hospital Minor Injuries Unit

Items for Information

·         Southern Health NHS Foundation Trust: Staffing Issues affecting Beaulieu and Poppy Older People’s Mental Health wards

Hampshire Hospitals NHS Foundation Trust: Outpatient and X-ray services in Whitehill and Bordon (Chase) – Re-provision of services from alternative locations or by an alternative provider

Representatives from Hampshire and Isle of Wight Partnership of Clinical Commissioning Groups and Hampshire Hospitals NHS Foundation Trust (HHFT) presented a report on the re-provision of services (see report, Item 6 in the Minute Book).

Members heard that the latest position regarding proposals for a new health hub in Whitehill and Bordon as part of the ‘healthy new town’ programme was that a planning application was due to be submitted in December 2018. Members attention was drawn to section 3.5 in the report, which outlined the services currently provided by HHFT at Chase Community Hospital; where the services could be accessed in future; and the outcomes of approaches to alternative providers who had been invited to provide those services at Chase instead. 

In response to questions, Members heard:

·      That Sustainability and Transformation Partnership Capital funding had been applied for to fund the new health hub.

·      It was intended to take an outline business case for the new health hub to the CCG governing body in December

Members expressed disappointment that for the majority of services HHFT was ceasing to provide from Chase, other providers deemed the levels of activity too low to provide the service from Chase. However Members thanked CCG staff for their efforts in approaching alternative providers. Members expressed concern that the changes were not in the interest of the service users affected, as they would have to travel further to alternative locations to access those services in future, and the local member indicated that public transport links serving the area were poor.

RESOLVED:

a. The Committee concluded that the changes proposed are not in the interest of the service users affected, due to concerns over transport to alternative locations.

b. The Committee requested a further update be provided for the February 2019 meeting of the HASC, including regarding the development of proposals for the Health Hub.

NHS Guildford and Waverley CCG and Hampshire and Isle of Wight Partnership CCG: West Surrey Stroke Services

The Committee received an update on implementation of changes to stroke services affecting patients in north east Hampshire (see report, Item 6 in the Minute Book).

RESOLVED:

That the Committee:

a.    Note the update on implementation of the new service model.

Hampshire Hospitals NHS Foundation Trust: Andover Hospital Minor Injuries Unit

A representative from Hampshire Hospitals NHS Foundation Trust presented an update on the Minor Injuries Unit at Andover Hospital (see report, Item 6 in the Minute Book).

Members heard that the Minor Injuries Unit continued to close at 6:00pm, due to difficulties recruiting sufficient staff to run the service for longer hours. The current agreement on opening hours, agreed with the Clinical Commissioning Group, ran until December. There was no evidence of impact of displaced need on other emergency departments. The Trust had tendered for a provider for an Urgent Treatment Centre (which would provide GP services  ...  view the full minutes text for item 89

To consider the report of the Director of Transformation and Governance on proposals from the NHS or providers of health services to vary or develop health services in the area of the Committee.

Items for Action

• Hampshire Hospitals: Outpatient, X-ray and community midwifery services in Whitehill & Bordon: Reprovision of services from alternative locations or by an alternative provider
• Southern Health: Plans to develop Secure Forensic Mental Health and Learning Disabilities Services

Items for Monitoring

·      North Hampshire CCG and West Hampshire CCGG: Transforming Care Services in North and Mid Hampshire

Hampshire Hospitals NHS Foundation Trust: Outpatient, X-Ray and Community Midwifery Services in Whitehill and Bordon:  Re-provision of Services from alternative locations or by an alternative provider

The Chief Executive of Hampshire Hospitals NHS Foundation Trust appeared alongside a representative from Hampshire CCG Partnership in order to speak to a report on service in Chase Hospital, Whitehill and Bordon (see report, Item 6 in the Minute Book).

Members heard that the Trust had chosen to appear before the Committee at this early stage, as the proposals had caused some concerns locally, and it was important to outline the reasons for proposing the withdrawal of some services from Chase Hospital.  The report considered these reasons in detail, but primarily they related to a reduction in the use of Hampshire Hospitals by those in the Whitehill and Bordon area as their preferred provider of acute secondary care services, which had reduced the number of outpatient and other specialty appointments being attended.  Most of the population in this area chose instead to receive services from the Royal Surrey, Frimley Park or Portsmouth.  The report covered travel times to these hospitals, showing that these services tended to be chosen because the acute services were closer to home than those offered by Hampshire Hospitals in Winchester and Basingstoke.

The reduction in the number of referrals was leading to reduced efficiency in clinical staff time, since they needed to travel from acute service sites in order to attend clinics in Chase.  The report showed that approximately 1.5 hours per session were lost through clinician travel, which could better be used at other sites to tackle rising waiting times and an increasing number of patients.  The Chase Hospital had a number of different providers operating from the same building, duplicating the same services, which was also inefficient; further thought needed to be given by the CCG, working in conjunction with providers, to see how the mix of providers could be adjusted to reduce these inefficiencies.  It was too early at this stage to report on whether any of the services that Hampshire Hospitals proposed to withdraw from the Chase could be replicated by another provider.

In relation to maternity appointments, expectant mothers were currently receiving antenatal appointments from Hampshire Hospitals midwives but choosing to have their babies at an alternative provider.  It was proposed that as most of these individuals were choosing to give birth in Royal Surrey County Hospital, it would make clinical sense for their maternity appointments to be supported by the Royal Surrey’s midwives.

The Chief Executive of the Trust noted the five tests of service change that the HASC needed to consider in coming to a view on the nature of a service change, and accepted that in relation to GP support, engagement and patient choice more work needed to be completed before the full picture was available.  It was also recognised that transport options from Bordon to Alton were limited and further work would need to take place around this.

The CCG and  ...  view the full minutes text for item 63