Agenda and minutes

(1)       Further to Minutes of 26 March 2010 the Chairman informed the Committee that the Department of Health had confirmed that the initial assessment of the Committee’s referral to the Secretary of State for Health was ready for the attention of the Secretary of State.

(2)       RESOLVED that the Minutes of the meeting held on 26 March 2010 are correctly recorded and that they be signed by the Chairman.

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

a)         The Future of PCT Provider Services                    10:10 – 11.15

            BREAK

b)         The Use of Community Hospitals                            11:25 – 12:25

John Ashelford (Chief Executive, Hospice in the Weald), Dr David Goodridge, Oliver Mills (Managing Director, Kent Adult Social Services) and Anne Tidmarsh (Director of Commissioning and Provision, East, Kent Adult Social Services) were present for this item.

(1)       The Committee had previously considered the Plans of the two Primary Care Trusts in Kent concerning their proposals for the future development of their provider services at the meeting of 30 October 2010.

(2)       The Committee had before them a briefing paper prepared by the Research Officer to the Committee, and supplementary briefing material provided by Kent Adult Social Services, NHS Eastern and Coastal Kent, and NHS West Kent.

(3)       The Chairman informed the Committee that both Primary Care Trusts had been in receipt of advice from the Department of Health stating that until there was clarity over the direction of Government policy on this topic, the attendance of NHS officers at the Committee should be postponed.  The Overview, Scrutiny and Localism Manager was requested to liaise with the Chairman, Vice-Chairman, Political Group spokesmen and colleagues in the NHS with a view to scheduling an alternative time for them to meeting with Members and answer questions on this topic.

(4)       Officers attending on behalf of Kent Adult Social Services (KASS) were first invited to introduce their paper on this topic.  Mr Mills explained that the proposed changes presented an opportunity to build on the joint work already being done between Social Services and the Community Services as currently organised in both halves of the county.  The idea of moving towards a whole county Community Foundation Trust was an opportunity to develop care pathways and bring care closer to home.  There could also be a role for elected Members in the governance of any Community Foundation Trust, although details would have to come from the NHS.  Other public service organisations could also be involved, and there was scope for reducing costs and working more efficiently.

(5)       Dr Goodridge outlined what he saw as the current perverse incentives in the way NHS finances were structured, with acute services subject to a tariff and community services a block contract meaning hospitals tended to absorb any additional NHS spending.  The capability to develop a local currency for community services has existed since April 2009.  He raised the suggestion that if there was a need to cut management costs, one Primary Care Trust for the whole of Kent and two community service providers would be more sensible and retain the closeness of service providers to their relevant community. 

(6)       Mr Ashelford spoke from the experience of having been Chief Executive of the Hospice in the Weald to provide information about palliative care and the connection between hospices and community services.  He argued that although the NHS has recognised the importance of end of life care, the role of community services has been diminishing in recent years with a reduction in the number of visits from community nurses and subsequent loss of shared knowledge.  There was a  ...  view the full minutes text for item 2.

(1)       Members had before them papers received from Medway NHS Foundation Trust providing information on how its registration with the Care Quality Commission.  Mr Wickenden was able to provide a verbal update based on information received from the Company Secretary that the Trust has applied to have the condition concerning training on the Safeguarding of children lifted as the requisite training has now all taken place and that the Care Quality Commission had acknowledge receipt of the application.

(2)       Members were also reminded that a briefing with local staff from the Care Quality Commission was scheduled to take place on 25 May.

(3)       RESOLVED that the report be noted. 

(1)       Mr Wickenden provided Members with a general overview of how the best practice of the Committee in agreeing a forward work programme with stakeholders and focussing more on outcomes in the development of scrutiny questions was potentially a model for adoption across more areas of Overview and Scrutiny.

(2)       Clarification was also provided to Members of the Committee that the proposed Select Committee on dementia would involve Members of the Health Overview and Scrutiny Committee while the parent Committee would be the Adult Social Services Policy Overview and Scrutiny Committee.  A representative from LINks requested that his organisation be included in the work of the Select Committee in some way and the Chairman felt that there would be numerous opportunities for this to occur because of the value they would be able to add to the process.

(3)       It was observed that much Committee time had been devoted to the issue of a new hospital in Dover and that as the scheme should be progressing there would be little need to include the issue on the work programme again.  However, Mr Wickenden was asked to request a written update from East Kent Hospital Trust for Members’ information.

(4)       The Researcher to the Committee indicated Appendix B to the Forward Work Programme and requested additional questions for the July meeting from Members.

(5)       RESOLVED that the Forward Work Programme be approved.

(1)       Members felt that as the main item on the Agenda would be returned to at a later date as agreed in Item 4, they had no further comments to make at this point in time.