Agenda and minutes

To receive any apologies for absence.

Apologies were received from Councillors Steve Forster and Jan Warwick. Councillors Graham Burgess and Lance Quantrill, as the Conservative standing deputies, attended in their place. 

Apologies were also received from Councillor Martin Boiles, Councillor Tonia Craig and co-opted member Councillor Trevor Cartwright.

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 18 September 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:

Respite service at Orchard Close, Hayling Island

The Chairman announced that Hampshire County Council was holding a public consultation to seek the views of service users, the public, and other interested stakeholders on proposals to close Orchard Close Respite Service, Hayling Island, with a view to providing more personalised and tailored respite solutions to those people who currently use the service. The Chairman reminded Members that a workshop had been arranged for members of this committee as part of the consultation, due to take place on Tuesday 4 December. The decision about Orchard Close was due to be considered by the Executive Member for Adult Social Care and Health in February, and an additional HASC meeting had been convened on Monday 11 February, so that the Select Committee could pre scrutinise the decision.

Referral support service: West CCG

The Chairman reported that West Hampshire CCG had notified the HASC that they would be bringing in a referral support service. Referral support was a system designed to support the patient, referrer, provider and practice when a decision to refer was being considered or made. This was to help ensure patients are managed as consistently as possible and if referred are seen at the right place and at the right time. Referral support would be a fundamental part of the outpatient pathway. Slides about this had been provided and would be circulated to committee members for information following the 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 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.

• Southern Health NHS Foundation Trust: Care Quality Commission Comprehensive Inspection Report

• Hampshire Hospitals NHS Foundation Trust: Care Quality Commission Comprehensive Inspection Report 

Care Quality Commission (CQC) Inspection of services – Southern Health NHS Foundation Trust

Representatives from Southern Health NHS Foundation Trust presented a report on the Care Quality Commission comprehensive inspection of the Trust undertaken in June/July 2018 (see report, Item 7 in the Minute Book).

Members heard that the overall rating given to the Trust was Requires Improvement, the same as the previous inspection in 2014. However, the CQC had recognised that there had been significant improvements since the last inspection, with a number of areas being considered good or outstanding. 26 service areas had achieved an improved rating, 43 the same, and 6 had gone down.

An enforcement action was implemented in July regarding Bluebird House, and within three weeks the Trust had responded and it was lifted. The CQC report contained 20 must do actions and 74 should do actions. The Trust had come up with an action plan to respond to these areas, organised around seven themes; workforce; safeguarding; end of life care; records management; medicines management; privacy and dignity; supervision.

A Member commented on a report in the national press regarding a psychiatrist having been found to have worked in the UK for 20 years who didn’t have the relevant qualifications. Members were assured that the Trust was auditing their processes to ensure this would not happen.

RESOLVED:

That the Committee:

a. Note the findings of the most recent CQC inspection of Southern Health NHS Foundation Trust.

b. Note the approach of the Trust to respond to the findings and request provision of the improvement plan.

c. Request the Trust attend the HASC meeting in March to provide an update on progress made against the recommendations of the Care Quality Commission report.

d. Request the Trust be transparent about the findings of a review of procedures regarding checking staff qualifications.

Care Quality Commission (CQC) Inspection of services – Hampshire Hospitals NHS Foundation Trust

Representatives from Hampshire Hospitals NHS Foundation Trust presented a report on the comprehensive inspection of the Trust undertaken in June 2018. (see report, Item 7 in the Minute Book).

Members heard that the overall rating given to the Trust by CQC was Requires Improvement, which was a decrease from the previous rating of Good. A presentation was provided that summarised the actions CQC required of the Trust and the action the Trust was taking in response. Members asked questions for clarity and to explore particular areas.  

RESOLVED:

That the Committee:

a. Note the findings of the most recent CQC inspection of Hampshire Hospitals NHS Foundation Trust.

b. Note the approach of the Trust to respond to the findings and request provision of the improvement plan.

c. Request the Trust attend the HASC meeting in February to provide an update on progress made against the recommendations of the Care Quality Commission report.

To receive an update on actions in the action plan that had a target to be achieved within the first 3 months.

The Director of Adults Health and Care provided an update on actions in the action plan arising from the Care Quality Commission (CQC) Local System Review of the Hampshire Health and Care System, that had a target to be achieved within the first 3 months (see Item 8 in the Minute Book).

Members heard that between April and September 2018 there had been a 32% reduction in delayed transfers of care due to social care delays. An App called ‘Connect to Support Hampshire’ had recently been launched and was being promoted, as a further route to provide information about social care to the public.

RESOLVED:

a) For the Health and Adult Social Care Select (Overview and Scrutiny) Committee to note the updates on the action plan for the 3 month gateway.

b) For the Health and Adult Social Care Select (Overview and Scrutiny) Committee to receive a further update in March in relation to the 6 month gateway.

To receive an overview of proposals arising from the Hampshire and Isle of Wight Sustainability and Transformation Partnership.

The Director of Adults Health and Care and Senior Responsible Officer for the Hampshire and Isle of Wight Sustainability and Transformation Partnership (HIOW STP) provided a report and supporting presentation regarding the system reform proposals arising from the HIOW STP (see Item 9 in the Minute Book).

Members heard that the direction of travel for the local health and care system was to work towards an Integrated Care System (ICS) for those aspects best dealt with at a Hampshire wide level. Other services would be organised around footprints linking to the acute hospitals, and more local level services would be organised around 23 clusters.

RESOLVED:

That the Committee:

a) Receives an update on the continued developments of the Hampshire and Isle of Wight Sustainability and Transformation Partnership (STP).

b) Note and consider the recommendations outlined in the Hampshire and Isle of Wight System Reform Proposal.

c) Identify and propose additional or different system reform proposals, as it sees fit through the Health and Adult Social Care Select Committee Working Group.

To consider an annual update on Adult Safeguarding.

Representatives of Adults Health and Care presented a report providing an annual update on adult safeguarding (see Item 10 in the Minute Book).

RESOLVED:

That the Committee:

a) Note the content of the report.

b) Receives a further update on Adult Safeguarding in 12 months’ time.

To receive the findings of the HASC Working Group on Social Inclusion, and consider the draft report due for consideration by the Executive Member for Adult Social Care and Health at her 5 December 2018 Decision Day.

Representatives of Adults Health and Care provided a report and supporting presentation regarding the findings of the HASC Working Group on Social Inclusion and a draft report due for consideration by the Executive Member for Adult Social Care and Health at her 5 December 2018 Decision Day. (see Item 11 in the Minute Book).

Members heard that of the £55.9m savings the Adults’ Health and Care Department was required to make under the agreed Transformation to 2019 programme, £2m had been identified to be found from social inclusion services. Following detailed work, it was now proposed to provide £1.8m savings from this budget and make up the remainder from other budgets.

The changes proposed had been developed via close working with districts and boroughs who also provide services for homeless people. It was proposed the new arrangements start in August 2019 to allow a transition phase. Consultation had been undertaken, and the feedback received supported the principle of focusing the funds available to support the most vulnerable.

District Council’s were receiving additional funding and responsibilities in this area, so the County was working closely with them on the overall provision for this cohort. The HASC had held a task and finish group looking in to the detail of this service change, and the conclusion of this group had been to support the proposed recommendations to the Executive Member. This service was not a statutory requirement.

RESOLVED:

a) That the recommendations in the report ‘Homelessness Support Services: Outcome of the Social Inclusion Transformation to 2019 Review’ under section 1 are endorsed to the Executive Member for Adult Social Care and Health for decision.

b) That the County Council actively participates in partnerships, at a district and county level, to reduce homelessness and end rough sleeping.

c) That the County Council actively engages with all partners to explore how the varying needs of individuals and families can be met earlier and before they may need more intensive services.

d) That the County Council continues to offer expertise to and partners with any District or Borough Council choosing to put in bids for additional funding opportunities, where the objectives of this funding aligns with the objectives of the Social Inclusion Services.

e) That the County Council monitor the impact of these changes.

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

The Director of Transformation and Governance presented the Committee’s work programme (see Item 12 in the Minute Book).

RESOLVED:

That the Committee’s work programme be approved, subject to any amendments agreed at this meeting.