Agenda and minutes

RESOLVED: that the minutes of the meeting held on 28 March 2008 were correctly recorded and that they be signed by the Chairman.

Members welcomed the draft rolling action sheet that had been prepared, while making a number of suggestions regarding improvements to the format and topics that had been omitted.

RESOLVED: that an updated version of the rolling action sheet should be considered at each meeting of the Committee as a standing item.

1)     Dr Robinson reported on the Working Group of Members that had met on 25 April to speak to NHS colleagues from a number of trusts about their Core Standards declarations. A summary of the information gathered at this meeting was before the committee, along with a similar summary relating to the full Committee meeting on 28 March.

2)     Dr Robinson said that a lot of useful information had been gleaned, providing the Committee with baseline data for the process of preparing third-party commentaries for the next Annual Health Check. The Committee would need to ensure that it was gathering evidence-based information for this purpose throughout the course of the coming year.

3)     A Member suggested that, when the Committee was scrutinising the work of a local NHS body, it might meet in the actual area concerned. The Chairman suggested that the Committee would also need to involve Members of the County Council in each area in the process of gathering information for third-party commentaries on local NHS trusts.

RESOLVED:

a)     retrospectively to agree to the setting up of the Working Group that considered the self-declarations of the six remaining Trusts on 25 April 2008 – with similar arrangements to be made regarding the gathering information for third-party commentaries in respect of 2008–9; and

b)     to note the information set out in the summaries of the Working Group meeting on 25 April 2008 and the Committee meeting on 28 March 2008.

1)     The Committee had before it a draft Work Programme, covering the period from June 2008 to April 2009.

2)     The Chairman referred to the intention that the Committee would consider, on 28 November 2008, a report on criteria and policy for assessing future reconfigurations and rationalisations of NHS services. He thought this would entail making recommendations to the Cabinet and possibly also the County Council itself.

3)     The Chairman also referred to the intention that the Committee would consider, in December 2008, a report on NHS funding and delivering value for money in Kent – possibly prepared with assistance from an external organisation, such as the King’s Fund.

4)     The Chairman reported that he, along with the Overview, Scrutiny and Localism Manager, and Graham Gibbens, the Cabinet Member for Public Health, had met the Chief Executive of the Council to discuss the resourcing of the Committee. The Chief Executive had given an assurance that resources would be made available to the Committee to support both these substantial pieces of work.

5)     Members discussed various aspects of the proposed Work Programme that was before them.

RESOLVED: to agree the draft forward Work Programme for June 2008 to April 2009, while recognising that it was not wholly fixed, and might well require revision in practice.

Liz Shutler, Director of Strategic Development, Howard Jones, Director of Facilities, East Kent Hospitals NHS Trust, Lynne Selman, Director of Citizen Engagement, Sheila Pitt, Head of Practice-based Commissioning, and David Meikle, Director of Finance, Commissioning and Performance, Eastern and Coastal Kent PCT, will be in attendance for this item.

(Liz Shutler, Director of Strategic Development, Howard Jones, Director of Facilities, East Kent Hospitals NHS Trust; Lynne Selman, Director of Citizen Engagement, Sheila Pitt, Head of Practice-based Commissioning, and David Meikle, Director of Finance, Commissioning and Performance, Eastern and Coastal Kent PCT, were in attendance for this item at the invitation of the Committee.)

1)     The Committee had before it a copy of a letter from the Patient and Public Involvement Forum for Eastern and Coastal Kent PCT, formally referring to the Committee the matter of healthcare services in Dover (dated 5 February 2008), along with a paper, setting out the reasons for referral, that was sent to the PCT (on 20 December 2007) and an annotated version of the paper, containing the PCT’s responses. These papers are attached to these minutes as Appendices 1 and 2.

2)     The Chairman reported that he had received a letter from Gwyn Prosser, the Member of Parliament for Dover and Deal, stating that he would have liked to attend the meeting, but was unable to do so, due to the lack of notice given. Mr Prosser had also gained the impression that he would not have been allowed to speak if he had attended the meeting.

3)     The Chairman said that he wished to apologise to Mr Prosser and emphasised that local Members of Parliament were always welcome to attend and speak at meetings of the Committee. Copies of Mr Prosser’s letter were circulated to Members.

4)     Lorraine Sencicle, formerly a member of the Patient and Public Involvement Forum for Eastern and Coastal Kent Primary Care Trust, addressed the Committee, at the Chairman’s invitation. Ms Sencicle said it had been stated that the basis for the Dover Project was the White Paper Our health, our care, our say. She believed that applying the principles of the White Paper to healthcare services in Dover must mean the establishment of a community hospital in the town – not a cottage hospital or a polyclinic. Funding had been made available for community hospitals, but Eastern and Coastal Kent PCT and East Kent Hospitals Trust had not put in a bid for this.

5)     Ms Sencicle said that Dover was entitled to a community hospital providing: outpatient clinics; diagnostic services; phlebotomy; chemotherapy; physiotherapy; occupational therapy; renal dialysis; podiatry; orthopaedics; a Minor Injuries Unit, open from 6am to 9pm, seven days per week; day surgery; in-patient observation beds; intermediate care beds; end-of-life care; and other services.

6)     Reg Hansell also addressed the Committee at the Chairman’s invitation. He said that Dover lacked hospital services and had poor transport links to other areas where these were being provided. Buckland Hospital was “dying from a thousand cuts”.

7)     Mr Hansell read out a message from Gwyn Prosser MP, supporting enhanced facilities at the Buckland Hospital site. He also read out a message from Charlie Elphicke, the Conservative Prospective Parliamentary Candidate for Dover and Deal, saying that he fully supported the idea of a community hospital  ...  view the full minutes text for item 19.

Stephanie Hood, Director of Strategy and Communications, and David Mallett, Assistant Director, “Fit for the Future”, South East Coast Strategic Health Authority, will be in attendance for this item.

(Stephanie Hood, Director of Strategy and Communications, and David Mallett, Assistant Director, “Fit for the Future”, South East Coast Strategic Health Authority, were in attendance for this item at the invitation of the Committee.)

1)     Stephanie Hood, Director of Strategy and Communications for South East Coast Strategic Health Authority, gave the Committee a presentation on the development of the South East Coast element of Our NHS, Our Future – Next Stage Review (the Darzi Review). Slides from the presentation are attached to these minutes as Appendix 3.

2)     The Chairman thanked Ms Hood for her presentation. He emphasised it should not be forgotten that the South East, despite being an affluent region overall, still had real problems of deprivation.

3)     A number of Members raised the question of polyclinics and the impact that these would have on local GP surgeries. Ms Hood responded that the work being undertaken in South East Coast around the Darzi Review was bottom-up and clinically led. It reflected what local people had told the NHS and was not being dictated from the centre. Whilst Lord Darzi had proposed a network of polyclinics for the NHS in London, this was not a blueprint for the rest of the country. Where polyclinics were proposed, it was to provide additional services, not to replace existing ones. And the Committee needed to focus on the ends that the NHS was trying to achieve, rather than on the means being employed.

4)     Regarding GP-led health centres, which had been described as polyclinics, Ms Hood accepted that PCTs were being required to introduce these – but there would only be one in each PCT area. These would provide additional services, targeted at underdoctored areas, and it would be down to PCTs to carry out appropriate consultation over their introduction.

5)     David Mallett, Assistant Director for “Fit for the Future” at South East Coast SHA, responded to a question about whether polyclinics might destabilise acute service providers by taking patients, and therefore funding, away from them. He said that the intention was now to deliver care locally both because this was cheaper and because it provided better access for patients. The NHS was now in financial surplus, having put an end to the “boom and bust” of the past, and this would enable some money to be taken out of the acute sector. Financial modelling had shown that, under Payment by Results, it would be possible to take marginal amounts of activity out of the acute sector without destabilising acute Trusts. There was no threat to the financial sustainability of any hospital in Kent and Medway, or anywhere else, caused by shifting activity into the community.

6)     Mr Mallett added, regarding polyclinics, that they were intended to enhance GP services, not to replace them. In any case, GP practices were not the NHS’s to close – they belonged to GPs as independent contractors.

7)     Responding to a question about maternity services, Mr Mallett said that, across South East Coast  ...  view the full minutes text for item 20.

The Committee had before it a progress report on Foundation Trust status applications, provided by South East Coast SHA. It was noted that the Committee had earlier agreed, as part of its Work Programme, to consider the application by Kent and Medway NHS and Social Care Partnership Trust on 13 June 2008.

RESOLVED: that the Foundation Trust progress report be noted.