Agenda and minutes

To receive any apologies for absence.

Apologies were received from Councillors Thornton and Forster. Councillor Hiscock, as the Lib Dem standing deputy and Cllr Quantrill, the Conservative deputy were in attendance in their place.

All Members who believe they have a Disclosable Pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to the circumstances described in Part 3 Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore all Members with a Non-Pecuniary interest in a matter being considered at the meeting should consider whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, consider whether it is appropriate to leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with the Code.

Members were mindful that where they believed they had a Disclosable Pecuniary Interest in any matter considered at the meeting they must declare that interest at the time of the relevant debate and, having regard to the circumstances described in Part 3, Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter was discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore Members were mindful that where they believed they had a Non-Pecuniary interest in a matter being considered at the meeting they considered whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, considered whether it was appropriate to leave the meeting whilst the matter was discussed, save for exercising any right to speak in accordance with the Code.

No declarations were made.

To confirm the minutes of the previous meeting

The Minutes of the meeting of the Health and Adult Social Care Select Committee (HASC) held on 10 July 2018 were confirmed as a correct record and signed by the Chairman.

To receive any deputations notified under Standing Order 12.

The Committee did not receive any deputations.

To receive any announcements the Chairman may wish to make.

The Chairman made two announcements:

Dorset Clinical Services Review Update

The Chairman told the Committee how three Members on HASC had been taking part in a joint committee with colleagues in Dorset over the past few years to scrutinise proposals impacting on Bournemouth and Poole hospitals, used by some Hampshire residents on the border. In 2017, following consultation, the Dorset CCG agreed the option to centralise urgent care at Bournemouth Hospital, and planned care at Poole Hospital. The Hampshire Members on the JHOSC supported the CCG’s planned option.

A member of the public initiated a judicial review of the proposals, so implementation of the changes had been on hold. The outcome of the judicial review was announced on the 5 September, in favour of Dorset CCG. The court confirmed that Dorset CCG had taken into consideration all the matters they were required to consider during the Clinical Services Review (CSR) and consultation processes. The High Court decision would now allow the planned improvements to health and care services in Dorset to be implemented without further delay.

It was anticipated that the JHOSC would meet again later in 2018 to review the implementation.

Sustainability and Transformation Partnership (STP) Working Group update

The Chairman confirmed that in 2017, the HASC agreed terms of reference for a working group to consider the STP plans for the Hampshire area. The group held its first meeting in December 2017, a meeting in March 2018 and was due to hold a further meeting at the end of September.

At the first meeting, the group received an overview of the position for both the Hampshire and Frimley STPs. At the March meeting, the group received a presentation from Lesley Stevens, Clinical Director, on the Mental Health Alliance work stream of the H&IOW STP. A presentation was also received from Jane Hogg, Integration and Transformation Director, giving an overview update on the Frimley STP.

At the September meeting, the group were due to receive an update from Frimley STP on their Urgent & Emergency Care programme, and from H&IOW STP on their New Models of Care work. The Working Group would continue as required, and report back to the HASC when relevant.

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

·      Southern Health NHS Foundation Trust: Community Mental Health transition from Southampton East team to Eastleigh and Romsey team for patients living in the Eastleigh Southern Parishes

Items for Monitoring

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

·      Portsmouth Hospitals Trust and Hampshire and Isle of Wight Partnership CCG: Spinal Surgery Service update

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 Hospitals NHS Foundation trust (HHFT) and the Clinical Commissioning Group (CCG) presented a report on the re-provision of services (see report, Item 6a in the Minute Book).

Following previous discussion at the May 2018 HASC meeting, Members received updates on five points as detailed in paragraph 1.6 of the report. Five common issues had been established after a survey conducted primarily with Chase users, and these included transport, the expansion of the town and elements of choice for treatment, with the priority being the service existing as opposed to who it was provided by. Public transport continued to be a concern due to long journey times, and these were listed on page 23 alongside car journey times. The full survey results were attached as an appendix to the report.

The table in Section 5 of the report detailed the acute services along with the outcome of discussions and proposed new arrangements, which were all highlighted to the Select Committee.

In response to questions, Members heard:

·      Non urgent X-ray appointments are generally met within six weeks, and the issues were not with the equipment available, but with the radiologists available to operate it. Talks were already in place with educational establishments to help with the national shortage of radiographers.

·      Audiology appointment waiting times were long and this was an area already being looked into. Whilst some appointments across all services were being missed, these weren’t generally down to transport issues.

·      Whilst parking charges were high in some areas, this was to deter shoppers from using the car parks (i.e. in Winchester, where the High Street is relatively close to the hospital).

·      Emergency X-rays were available sooner than the six week waiting time, but portable machines was something that could be looked at long term if the staff issue was addressed.

·      It was anticipated that it would cost approximately £100,000 to get a bus funded on an existing route and acknowledged that developers could be approached more routinely to acquire funds for public transport links.

·      The Health Hub was anticipated for 2020 and services would not move until it was complete. There would be a loss of service whilst waiting for the Hub to be established.

·      Whilst important, the services being discussed at the meeting represented less than 20% of those offered at The Chase.

·      Services relocated to GP surgeries were acute services operated by Royal Surrey hospital and therefore did not interfere with appointments nor the day-to-day running of the surgery and did not effect GP’s based there.

·      Transport would be an ongoing priority to be looked at along with voluntary organisations.

RESOLVED

a.    The Committee agreed unanimously that the changes proposed constituted a substantial change

b.    The Committee were not convinced that the proposed changes were in the interest of the service users affected, and therefore requested further information as listed  ...  view the full minutes text for item 81.

To consider a report of the Director of Transformation and Governance on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.

·       Portsmouth Hospitals NHS Trust: Care Quality Commission Comprehensive Inspection Report

·       Southern Health NHS Foundation Trust: Care Quality Commission and Mazars recommendations – update on progress

Care Quality Commission (CQC) Inspection of services – Portsmouth Hospitals Trust

Dr John Knighton from the Portsmouth Hospitals Trust (PHT)  presented a report on the CQC inspection (see report, Item 7 in the Minute Book). It was acknowledged that the Trust had an overall rating of ‘Requires Improvement’ following the CQC Inspection.

Dr Knighton was pleased to confirm that some areas had seen significant improvement since the last inspection, including Critical Care, which  was one of few areas to be awarded ‘Outstanding’. Children’s Services and End of Life Care had also performed well.
 

Maternity Services and Accident and Emergency had both been focuses for the new leadership team, with programmes for change already being implemented before the inspection. Despite some areas still needing further attention, it was a positive step that there had been no surprises arising from the inspection and areas of need had already been identified and a Quality Management Plan established, which would focus on medicines management and provision of safeguarding primarily.

In response to questions, Members heard:

·      The matrix within the report confirmed overall scores, with 30 areas marked as ‘Good’ or above and 23 as ‘Requiring Improvement’ or ‘Inadequate’.

·      Whilst there were high standards of cleaning, the cleanliness as part of the inspection related to inconsistence with clinical cleaning, for example beds and bedside equipment and there was a risk standards could be jeopardised during busy periods.

·      There had been a large increase in the requests for X-rays and scans and a national shortage of radiographers, but more imaging capacity was being provided via a temporary scanner for over the winter period.

·      Part of the £2.8 million grant will go towards regenerating the A&E department at Queen Alexandra (QA) which was an old part of the building designed around the 1979 provisions and not updated during the 2009 work.

·      Last year the QA hospital had been the most successful with preventing the spread of the Norovirus, with no beds being lost due to good infection control.

·      A new role of ‘Director of Integrated Governance’ had been created, with a focus on openness and transparency and closer working with other colleagues and organisations.

·      A separate bereavement suite had not yet been established, but there was a suitable area reserved for such incidences.

·      Mental Health nurses were on the daily rota within the A&E department to assist with difficult behaviour, but it was acknowledged that such behaviour was not always a result of mental health problems.

·      It took 8-10 years to train radiographers and difficult to know what the requirement would be for them over than length of time. Due to great cost, there had been a caution to not over train and have more than was needed, but this was a difficult balance to get as the sudden increase in demand could not have been predicted.

·      There was a quiet space available for those who needed it, which could also be used by those with autism if required.

RESOLVED

The Committee:

1. Noted the findings  ...  view the full minutes text for item 82.

To consider and approve the Health and Adult Social Care Select Committee Work Programme.

Councillors Briggs, Campbell, Cartwright, Craig, Finlay, Harrison, Hayre and Warwick had left when this was considered.

The Director of Transformation and Governance presented the Committee’s work programme (see Item 8 in the Minute Book).

It was suggested that further information on Child and Adolescent Mental Health Service (CAMHS) assessments of children in schools and the change in provider come to a future meeting as an update. There was also discussion around autism and whether training would be beneficial to the Committee at a future meeting.

RESOLVED:

The Committee’s work programme was approved, subject to the amendments above.