Agenda and minutes

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

RESOLVED that the Minutes of the meeting of 25 November 2011 are correctly recorded and that they be signed by the Chairman. There were no matters arising.

Meradin Peachey (Director of Public Health), Matthew Drinkwater (Head of Emergency Preparedness and Response, NHS Kent and Medway), Paul Mullane (Head of Emergency Planning, Response and Resilience, 2012 Olympics Lead, NHS Kent and Medway), Jon Amos (Contingency Planning and Resilience Manager, South East Coast Ambulance Service NHS Foundation Trust), and Geraint Davies (Director of Commercial Services, South East Coast Ambulance Service NHS Foundation Trust) were in attendance for this item.

(1)       The Chairman welcomed and introduced the guests before explaining that the purpose of the meeting was for Members of the Committee to seek reassurances from the NHS on behalf of the people of Kent that the appropriate plans were in place relating to emergency resilience, and specifically to the Olympics and Paralympics Games.

(2)       The Director of Public Health was invited to introduce the item and did so by explaining that she was the lead director for NHS Kent and Medway. The overall principle was to ensure there was one clear approach to mobilising emergency plans across all provider Trusts and the Primary Care Trusts in Kent and Medway. The call system operated 24-hours a day and the plans meant the whole resource of the NHS could be mobilised.

(3)       The publicly available plans produced by the NHS were contained in the Strategic Major Incident Response Plan which each NHS Trust produced and refreshed each year. This ran alongside the Business Continuity Plans which all organisations produced annually. This was a practice mirrored across all the organisations which were Category 1 and 2 responders and so were part of the Kent Resilience Forum.

(4)       There were a few key messages about NHS emergency resilience planning running through the information provided at the meeting. Representatives from the NHS were keen to stress that the emphasis was on developing capabilities rather than responses to specific scenarios as it was difficult to predict and plan for every possible event. This was complemented by the fact that plans could be scaled up across the local area, then regionally and nationally. What this meant in practice was that where necessary the NHS could call on the resources of any Trust, near or far, to provide resources and assistance, as well as call on the support of other organisations such as the police, fire and rescue service and the military.

(5)       While there were limits to how much detail could be provided on the lessons learnt from actual incidents elsewhere, representatives of the local NHS explained that events in New York and Mumbai had been closely studied and there was sharing of good practice relating to other events around the world, such as in Norway and Belgium. The particular position of Kent and Medway, neighbouring London as it does and containing a number of transport hubs, was incorporated into the planning. For example, in response to a couple of specific concerns raised about Manston Airport, it was explained that yearly interagency exercises were carried out at the airport, with a live one taking place  ...  view the full minutes text for item 4.

(1)       The Chairman introduced the item by explaining that the report in front of Members contained some preliminary findings and that the final report on reducing accident and emergency admissions would only be produced following the 3 February HOSC meeting at which the role that mental health services play would be considered.

(2)       A number of Members supported the Chairman’s impression that the NHS was becoming more a series of silos and less an integrated service. Several Members provided examples from their own experiences of the lack of communication between different NHS organisations.

(3)       Members felt that there were a number of ways in which attending an accident and emergency department (A&E) was becoming the default response of many people. Where GP surgeries could not carry out minor procedures, or could not do so within a reasonable amount of time, then members of the public may feel attending A&E was the only option. This tendency would be reinforced where there were issues around accessing GP out-of-hours services and uncertainty around the services which minor injury units and pharmacies could or could not provide. There were also areas, like Maidstone, which had no community hospital. The Chairman undertook to write to the Chief Executive of Kent Community Health NHS Trust to request information about opening times and the availability of services at community hospitals, minor injury units, and walk-in-centres.

(4)       One Member reported that a major report on this subject had come out the day after the last occasion the Committee had considered it. The Member felt that this would have changed the outcome of the debate if it had been known about and that the NHS may well have known it was about to be published and what it contained. It was felt that there was a need to take on board the findings of these report in order to develop a more accurate understanding of the realities of the health service.

(5)       AGREED that the Committee note the report.

(1)       The Chairman introduced the Forward Work Programme and highlighted some of the items proposed for future meetings. The Chairman requested that should any Member have any specific question relating to the 9 March item, Partnership between Dartford and Gravesham NHS Trust and Medway NHS Foundation Trust, then they should be forwarded to the Committee Researcher by the end of Friday 13 January. In addition, the Chairman commented that the idea of an event around April time looking at ‘One Year to Go’ before the new NHS system is introduced on 1 April 2013 had been passed on to the Health and Wellbeing Board, no response has yet been received.

(2)       On this subject, Members felt that it would be beneficial for them to receive information on the Health and Wellbeing Board and what it was considering because there was a possible role for the Committee in adding value to the development of the Joint Strategic Needs Assessment and the Joint Health and Wellbeing Strategy. The Researcher to the Committee undertook to ensure Members received information about future Health and Wellbeing Board Agendas.

(3)       On the subject of the partnership between Darent Valley and Medway Maritime, one Member explained that the Governors of each Trust were visiting the other on 1 and 15 February and felt any interested Member would be able to take part in either or both and undertook to provide the relevant contact details to the Committee Researcher in case any Member wished to enquire further.

(4)       A representative of the Kent LINk requested the opportunity to bring back a report on mental health issues in April and undertook to provide the necessary information to the Committee Researcher.

(5)       A range of views were expressed on the development of locality boards and how they would fit in with health scrutiny. There had been a paper on this subject included in the Agenda for 14 October 2011 and since then there had been developments around the Committee structure at Kent County Council which may also have an impact on the way health scrutiny develops. The Chairman felt that while it was something of a chicken and egg situation, the Committee would be able to accommodate and respond appropriately to any issue which came through the locality boards.

(6)       There were a number of broader points made about the role and effectiveness of the HOSC. One the one hand, the view was expressed that it was difficult to see what practical results the Committee was achieving in improving the local health service. On the other hand, the view was expressed that the Committee had created a major shift in the way the local NHS approached public consultation, with the recent work on maternity services in East Kent an example, and that this was a positive achievement.

(7)       There was clear consensus around the fact that the development of the Health and Wellbeing Board and other changes in the health and local government sectors would mean a change to  ...  view the full minutes text for item 6.