Agenda and minutes

The Committee noted the following update to its Membership:

LINk Representatives (2): Dr M Eddy and Mr M Fittock.

RESOLVED that the Minutes of the meeting of 9 September 2011 are recorded and that they be signed by the Chairman.

Dr John Allingham (Medical Secretary, Kent Local Medical Committee), Helen Buckingham (Deputy Chief Executive and Director of Whole System Commissioning,NHS Kent and Medway), Geraint Davies (Director of Commercial Services, South East Coast Ambulance Service NHS Foundation Trust), Marion Dinwoodie (Chief Executive, Kent Community Health NHS Trust), Gordon Flack (Director of Finance, Kent Community Health NHS Trust), Dr Mark Jones (GP Clinical Commissioner, C4), Helen Medlock (Associate Director of Urgent Care and Trauma, NHS Kent and Medway), and Lesley Strong (Deputy Chief Executive/Director of Operations, Adults, Kent Community Health NHS Trust) were in attendance for this item.

(1)       The Chairman introduced the item by explaining that the current meeting was to be the first of two on this wide-ranging subject, with the next one scheduled to take place in November. While there had been some recent media coverage concerning local accident and emergency departments, the Chairman requested that specific questions be postponed until the November meeting, to which representatives of all four Acute Trusts in Kent and Medway had been invited.

(2)       The lead representatives present from the NHS organisations attending the meeting gave short overviews of the topic. From the perspective of the commissioners, the urgent care pathway was a clear example of whole system commissioning as it involved primary care, through intermediate care and up to acute services, so that while accident and emergency departments and the ambulance service may be the most visible parts, there were many other services to consider. The importance of taking a whole systems approach was endorsed by the representatives present from primary care, and the community health and ambulance services. The shared goal was for a health system which delivered the right care by the right person in the right place and that a good example of this was the primary angioplasty service based at William Harvey Hospital and covering the whole County. It was noted that it was also important to ensure individual patients moved through the system, seeing different providers, smoothly with no waiting between them.

(3)       While many patients would always need admitting to hospital, there was an agreement around the development of alternative pathways to deliver different interventions outside the acute setting. To this end the NHS Pathways assessment system and the Directory of Services were seen as key. This linked in with the coming introduction of the 111 number across England.

(4)       A number of Members raised issues around public awareness of the alternatives to accident and emergency departments, such as Minor Injuries Units. It was partly a question about whether or not people knew about the alternatives, and if they did, there were separate questions around whether people understood fully what counted as a ‘minor injury’ and how to access these services, including confusion around opening times. One Member expressed surprise, for example, that a broken limb could be treated in a Minor Injury Unit. There were parallel questions around the effectiveness of some current systems, such as making an appointment with a GP.  ...  view the full minutes text for item 4.

Glynis Alexander (Deputy Director of Communications and Citizen Engagement,NHS Kent and Medway), Dr John Allingham (Medical Secretary, Kent Local Medical Committee), Helen Buckingham (Deputy Chief Executive and Director of Whole System Commissioning,NHS Kent and Medway), Ann Judges, (Maternity Lead, NHS Kent and Medway), Lindsey Stevens (Head of Midwifery, East Kent Hospitals NHS University Foundation Trust) and Sara Warner (Assistant Director Citizen Engagement, NHS Kent and Medway) were in attendance for this item.

Michael Lyons declared a personal interest in this item as a Governor of East Kent Hospitals University NHS Foundation Trust.

(1)       The Chairman introduced the item by thanking the five Members of the informal HOSC Liaison Group who had continued to work with the NHS in East Kent on the review. He reminded the Committee that the focus for the meeting was on the consultation process itself, and that this had been formally launched that morning. Members had been provided with copies of the full consultation document at the start of the meeting. Demographic information about the ethnicity of mothers in East Kent had also been made available to Members at the start of the meeting in response to a specific request made by a Member of the HOSC Liaison Group.

(2)       Those Members of the HOSC Liaison group who were present for the meeting were each given the opportunity to speak first, and all took the chance to thank the NHS for the opportunity to comment on the draft consultation document. One Member felt that more stress could have been given on the retention of ante and post-natal clinics at both Canterbury and Dover. Another Member commented that most suggestions had been incorporated, though another Member regretted that the original Option 1 as presented in the report to HOSC on 9 September was no longer included.  In addition, Mr Collor explained that an Overview and Scrutiny Committee at Dover District Council had already met and made recommendations to the NHS, copies of which had been provided to the Chairman of the Committee.

(3)       One area of interest to Members was the timing and location of the 8 public events listed in the consultation document and there was concern that the timings and locations would not be sufficient to reach the intended audience. A case was made in particular for an additional meeting in Ramsgate. In response, representatives from the NHS explained that the timings and locations had been discussed with parents and parents-to-be as part of the pre-engagement process. Clinicians were going to be available at all the scheduled public meetings. It was also explained that the NHS would be present at 47 other events and that the consultation process was long enough so that if there was judged to be enough interest, further meetings could be scheduled. They were also happy to respond to invitations from any interested groups. In addition, a wide-ranging advertising and marketing campaign involving the local media had been organised.

(4)       The Members of the Committee were also  ...  view the full minutes text for item 5.

AGREED that the Committee note the report.

AGREED that the Committee note the report.

(1)       The ongoing importance of the subject of NHS Financial Sustainability was raised by a number of Members, with one reporting particular issues of sustainability in outer London. The idea of returning to the subject at some point next year found favour, as did the idea of receiving regular written updates from the local NHS.

(2)       The Researcher to the Committee was asked to liaise with local NHS organisations with a view to determining the best way in which to achieve this.

(3)       AGREED that the Committee note the report.

(1)       The Chairman began by thanking the Officers involved in preparing the report, which was there as a stimulus for discussion with the aim of ensuring that the right forum was found for the right topic, with the example given of issues facing one community hospital against an issue facing the whole community hospital system across the County.

(2)       A range of different perspectives were presented on this subject around the development and interpretation of the localism agenda across the County, as well as the balance between needing local mechanisms for various purposes and increasing bureaucratic systems which may use up time but achieve little.

(3)       AGREED that the Committee note the report.

(1)       The Chairman requested that as well as having an opportunity in the meeting, any further ideas for the Forward Work Programme should be sent to either himself or the Committee Officers.

(2)       A specific request was made by Councillor John Cunningham and Mr Mark Fittock that an opportunity be found for two reports on mental health issues produced by LINk and Maidstone Borough Council jointly with Tunbridge Wells Borough Council be brought to the Committee with a view to seeing what progress the local NHS had made against the recommendations contained within each. This was agreed and the Researcher to the Committee asked to liaise with a view to finding the most appropriate juncture for this to be facilitated.

(3)       AGREED that the Committee note the report.

Addendum to Agenda of 14 October 2011:

Item 5, Information from NHS Kent and Medway, p.21 of Agenda, Part b, Paragraph 2, should read:

“… they manage around an average of 15,000 calls from patients per month, rising to over 20,000 in busy months. Of these around 53% of patients are advised by telephone, or referred directly to another service. 35% are seen at a base and 13% receive a home visit….”