Agenda and minutes

(1)       RESOLVED that the Minutes of the meeting held on 23 July 2010 are recorded and that they be signed by the Chairman.

Matters Arising

(2)       Further to Minute Number 8 the Chairman apologised that it had not been possible to circulate the letter prepared on behalf of the Committee as resolved at the end of Item 10 before being sent to the Secretary of State for Health.  The Committee noted that the letter and reply were included in the Agenda for the meeting.

(1)       The Chairman indicated that he had asked Tish Gailey, Public Health Policy Manager, to put before Members a summary of the NHS White Paper Equity and Excellence: Liberating the NHS (see Appendix 1) along with a copy of one of the related consultation documents, Local democratic legitimacy in health.  Ms Gailey invited Members to forward any comments on the paper to her to enable them to be incorporated into the response by Kent County Council.

(2)       Members thanked Ms Gailey for the information and the opportunity to forward comments.

Geoff Catling (Director of Technical Services and Logistics, South East Coast Ambulance Service NHS Trust), Janine Compton (Senior Communications Manager, South East Coast Ambulance Service NHS Trust), Darren Reynolds (Head of Business Development, South East Coast Ambulance Service NHS Trust), and Steve Rose (Senior Operations Manager, South East Coast Ambulance Service NHS Trust) were present for this item.

(1)       Representatives of the South East Coast Ambulance Service NHS Trust (SECAmb) explained that they were attending to provide an update on the Make Ready Programme, but were happy to answer any questions on any aspects of the organisations activity as there were a number of interesting new developments, such as ‘hear and treat’, ‘see and treat’ and a new Computer Aided Despatch system which had gone live in Kent one month previously.  The Coxheath Despatch Centre was staying in its current location.

(2)       The background to the Make Ready Programme reached back to 1974 when ambulance services transferred from local authorities to the NHS.  This meant that ambulance stations were based on local authority estate locations and there was often now room to expand or improve facilities and the locations of them could have an impact on ambulance response times.  A range of issues arising from this resulted in an Estates Strategy for SECAmb in May 2008 which established the direction for the Make Ready Programme. 

(3)       SECAmb representatives explained the current system was more akin to ‘make do’ than ‘make ready’.  Between 40 minutes and 1 hour 15 minutes was often lost from each shift due to ambulances not being fully prepared for the start of each shift, with ambulances often having to go to different locations in order to become fully equipped.  Crews were also currently responsible for cleaning their ambulance and a call could often come in during cleaning meaning that an ambulance responded without the cleaning process being completed.

(4)       Infection control was stated as one of the main drivers behind the Make Ready Programme.  The idea behind Make Ready Depots was that they would be built specifically for the purpose of being somewhere where specially trained staff would clean and prepare the ambulances for the beginning of each shift, freeing up paramedic time.  The extended cleaning the ambulances would receive, along with a six-weekly deep clean would dramatically improve infection control.  The Care Quality Commission had inspected and approved the programme on two occasions.  The intention was also to locate Make Ready Depots near accident and emergency departments in order to clean ambulances after particularly severe incidents and allow ambulance crews to have a break from the event.

(5)       Three Make Ready Depots had already been opened, at Chertsey, Hastings and Thanet in Kent.  There were plans to open a number of further depots as the Programme was rolled out.  The next two planned would also be in Kent, at Paddock Wood and Ashford, both in 2011.  The plan was for the one in Ashford to also include a hazardous response unit.  ...  view the full minutes text for item 3.

This item will be examined in two sections as follows:-

a)         The Future of PCT Provider Services                    10:10 – 11:20

            BREAK

b)         The Use of Community Hospitals                            11:30 – 12:40

Anne Tidmarsh (Director of Commissioning and Provision, East, Kent Adult Social Services),Ashley Scarff (Head of Business and Corporate Planning, Maidstone and Tunbridge Wells NHS Trust), David Meikle (Acting Chief Executive, NHS Eastern and Coastal Kent),Philip Greenhill (Managing Director, NHS Eastern & Coastal Kent Community Services), Phil Edbrooke (Associate Director of Quality, Performance and Corporate Development, NHS Eastern & Coastal Kent Community Services), OenaWindibank (Operations Director, NHS Eastern & Coastal Kent Community Services),Paul Duncan (Associate Director of Business Development, NHS Eastern & Coastal Kent Community Services), Alison Davis (Assistant Director of Commissioning, NHS Eastern and Coastal Kent), Ruth Brown (Lead Commissioner for Community Services, NHS Eastern and Coastal Kent), Mark Sheppard (Managing Director, West Kent Community Health), Judy Clabby (Assistant Chief Executive, NHS West Kent), Dr Mike Parks, Medical Secretary, Kent Local Medical Committee), and Ray Fullerwere present for this item.

(1)       The discussion of this item was divided into two sections, looking at the future of Primary Care Trust (PCT) Provider Services to commence with.

(2)       It was explained to the Committee that the broad direction of travel had not changed as a result of the General Election in that the separation of provider and commissioner functions of PCTs would continue.  However, PCTs as commissioners were to be abolished.

(3)       Representatives of the NHS provided further written information to assist in clarifying the timeline of developments locally (see Appendix 2).  Eastern and Coastal Kent Community Services (ECKCS) would become a separate NHS Trust from 1 October 2010.  The intention of both PCTs was that West Kent Community Health would separate from NHS West Kent and join with ECKCS and a new organisation called Kent Community Health Trust would be formed on 1 April 2011.

(4)       The Business Case for joining together of the two provider services needed to be approved by the Cooperation and Competition Panel and the judgment was expected in December.  Even with this, the Kent wide community services organisation was not a foregone conclusion and the views of stakeholders would be sought early next year.  

(5)       From the perspective of General Practice, the Local Medical Committee (LMC) believed that community services were key to local delivery and hoped that a Kent Trust could be used as a framework within which to further integrate health services and rebuild primary healthcare teams and allow for community healthcare staff to move back into surgeries.  However, many surgeries were not fit for purpose and would need improvements to deliver more services.  The LMC have been involved in the discussions over the Kent wide Trust and were relieved that vertical integration with the Acute Trusts in Kent was not the favoured option in Kent.

(6)       Concern was expressed by Members that a Kent wide Trust may miss the local dimension, particularly when contrasted with GPs who were localised.

(7)       Mr Greenhill from ECKCS explained that his organisation was currently the fifth largest provider of community services in the country and that  ...  view the full minutes text for item 4.

(1)       It was reported to Members that a letter had been received from the Highways Agency explaining that little could be done to improve the A21 at present and that a response from the Cabinet Member for Environment Highways and Waste on the A228 was expected.

(2)       Members had before them information on the engagement events which had and were being carried out by NHS West Kent in relation to Women’s and Children’s Services and Maidstone and Tunbridge Wells NHS Trust.  Mr Cooke asked that it be noted that the listed focus groups were by invitation only and at ones he had observed only 1 person had attended.  The view was expressed that this cast doubt on the level of public engagement being carried out by the NHS.

(3)       The attention of Members was drawn to the public meeting being held on Women’s and Children’s Services and Maidstone and Tunbridge Wells NHS Trust on 9 October.  HOSC Members were also welcome to attend the Co-design Stakeholder Event at the Hop farm on 22 September.  Clarification over the Co-design event was being sought from the NHS.

(4)       RESOLVED that the Committee receive the report and note the additional meeting of the Committee on Monday, 20 September 2010.

Members agreed the Forward Work Programme with the addition of the SECAmb Make Ready Programme item returning on 8 October and a suitable opportunity for returning to the Future of PCT Provider Hospitals and the use of Community Hospitals be found in early 2011.

(1)       Members expressed their satisfaction that both the main items would be returned to.

(2)       It was suggested that a full meeting be given over to discussing the Public Health White Paper.  As it had a potential impact on the whole of Kent County Council, the Overview, Scrutiny and Localism Manager suggested that this may be an issue that the Scrutiny Board could consider.