Agenda and minutes

The Overview and Scrutiny Manager reported that Lord Bruce-Lockhart and Dr T R Robinson had replaced the two Conservative Group vacancies on the Committee; and Mr B R Cope was substituting for Mr M J Angell and Mrs S V Hohler for Mrs B J Simpson.

The Overview and Scrutiny Manager reported that Mr A R Chell had stepped down as Chairman of the NHS Overview and Scrutiny Committee.  He sought and gained the Committee’s approval to appoint a new Chairman, as this would enable the Committee to continue to expedite its business.

(1)       Dr T R Robinson nominated Lord Bruce-Lockhart as Chairman of the Committee, with Mrs P A V Stockell seconding. There being no other nominations, Lord Bruce-Lockhart was duly elected Chairman without a vote.

(Lord Bruce-Lockhart presiding)

(2)       Lord Bruce-Lockhart thanked the Committee for electing him as Chairman of the Committee and paid tribute to Alan Chell for all the hard work that he had undertaken during his chairmanship of the NHS Overview and Scrutiny Committee.

(3)       In responding, Mr Chell informed the Committee that he had not stepped down as Chairman.

(4)       Lord Bruce-Lockhart then set out his vision for the future operation of the Committee and the areas to which he saw the Committee paying particular attention.

Matters Arising

(1)     Mr Fittock said that he felt that it was important there was continuity in the membership of the Committee in order for it to maintain its credibility.  This was acknowledged by Lord Bruce-Lockhart. He said that there should be no reason for substitutes except in case of illness.

Meeting with Maidstone & Tunbridge Wells NHS Trust Patient and Public Involvement Forum representatives

(2)     Mr Fittock asked for feedback on an item of correspondence received from Maidstone & Tunbridge Wells NHS Trust Patient and Public Involvement Forum had been dealt with.  Mr Chell said that he had held a very good meeting with representatives of the PPIF and explained in greater detail the role of the Committee and in particular the nature of Section 7 and Section 11 consultations.

Local Involvement Networks (LINks)

(3)     Mr Fittock indicated that whilst he was aware that there was an update report later on in the agenda relating to Local Involvement Networks (LINks) he was keen to ensure that the PPIFs were kept informed of progress being made in the establishment of a LINk.

Erville Millar, Chief Executive, Kent and Medway NHS & Social Care Partnership Trust, Lauretta Kavanagh, Director of Commissioning – Adult Mental Health Services and Substance Misuse and Marion Dinwoodie, Chief Executive, Medway PCT, Steve Phoenix, Chief Executive, Julia Ross, Director of Civic Engagement, Bob Deans, Director of Commissioning and Performance and Debbie Stock, Programme Manager for Mental Health, West Kent PCT will be in attendance for this item.

(Peter Hasler, Director of Nursing and Human Resources, Kent and Medway NHS & Social Care Partnership Trust, Lauretta Kavanagh, Director of Commissioning – Adult Mental Health Services and Substance Misuse, and Marion Dinwoodie, Chief Executive, Medway PCT, Steve Phoenix, Chief Executive, Julia Ross, Director of Civic Engagement, Bob Deans, Director of Commissioning and Performance and Debbie Stock, Programme Manager for Mental Health, Dr James Thallon, Medical Director, West Kent PCT, were in attendance for this item)

(1)       Mr Fittock declared that he had an interest in the Swanley Volunteer Centre and is a Trustee of the Invicta Advocacy Network (Dartford).  Mr London declared he is a Member of Sevenoaks MIND.

(2)       Further to Minute 37 of 2006, Mr Hasler gave a presentation (on behalf of Erville

Millar, who was regrettably ill and unable to attend the meeting) on the first year’s

operation of the Kent and Medway NHS & Social Care Partnership Trust.  A copy of the

presentation is attached as Appendix 1 to these Minutes.

(3)       Following the presentation Members of the Committee and others present raised a number of questions.

(4)       Lord Bruce-Lockhart asked about the reasons for increasing demand for mental health services across different age groups. Mr Hasler responded that there was an ageing population in the UK and, as a result, there were more cases of dementia – but people with this condition could now be managed at home for longer than previously. As far as young people were concerned, the Trust was working closely with schools in order to take a more preventative approach.    Lord Bruce-Lockhart asked whether there were clear statistics on dementia, for instance from bodies such as the Alzheimer’s Society.  Mrs Dinwoodie, Chief Executive of Medway PCT, said that this was a question for commissioners as well as providers. Demand and the patient pathway needed to be in alignment; this would be achieved through Local Area Agreements and needs assessments.

(5)       Mr Fittock asked about the audit of Kent Drugs and Alcohol Action Team (KDAAT) in 2006, in which the service had been assessed as ‘fair’, and whether measures were being taken to improve the service. Mr Hasler said that the audit of the service had pre-dated its transfer to the voluntary sector.  The current providers, KCA and Turning Point, both had good histories and he was confident that there would be improvement in the service.

(6)       In response to a question about early intervention for young people and the need for further work, Ms Kavanagh responded that the KDAAT was a multi-agency strategic partnership, chaired by the Managing Director of Communities at Kent County Council (Ms Amanda Honey).  She said that she would provide a written answer to Mr Fittock.  With regard to early intervention services for young people, national targets had been achieved. A new model of care had been implemented for 14–35-year-olds who were experiencing their first episode of psychosis.

(7)       Mr Fittock asked about a recent report in The Lancet, according  ...  view the full minutes text for item 44.

Julia Ross, Director of Civic Engagement, Barrie Collins, Director of Nursing & Professional Development, Sharon Jones, Director of Community Services and Debbie Lyndon-Taylor, Assistant Director Adult Services, West Kent PCT will be in attendance for this item.

(Julia Ross, Director of Civic Engagement, Barrie Collins, Director of Nursing & Professional Development, Sharon Jones, Director of Community Services and Debbie Lyndon-Taylor, Assistant Director Adult Services, West Kent PCT were in attendance for this item)

(1)       The following Members made declaration of interest:-

·        Mr Fittock - Member of Benenden Hospital

·        Mr Horne – Member of the League of Friends, Tonbridge Cottage Hospital

·        Mr London – Member of the League of Friends, Sevenoaks Hospital

(2)       A copy of the presentation given on the West Kent Community Hospitals Review is set out as Appendix 2 to these Minutes.  The Committee was informed that the recommendations in the West Kent Primary Care Trust Board report for July 2007 had been approved.  Mrs Ross spoke about the further work that needed to be done relating to the Minor Injuries Unit (MIU) at Edenbridge, the Tonbridge Cottage Hospital and the Livingstone Hospital in Dartford.  Ms Harrison said she felt that, where beds were being done away with, it was important that the Primary Care Trust explain what they were replacing these beds with; communication with the public was key to service-change.  This was acknowledged by Mrs Ross who very much hoped that local authorities would act as community leaders in concert with health colleagues.

(3)       Health colleagues said they aimed to reduce the number of unnecessary journeys and provide more services in community hospitals, including bed-based “step up” and “step down” services, end-of-life care and neuro-rehabilitation.  Mrs Ross informed the Committee that the Pembury Private Finance Initiative (PFI) hospital plans were predicated on the idea of a whole lot of services being provided in the community.  Turning to specific local issues, Mr Horne said that the original review of community hospitals undertaken by the consultancy firm Tribal had not been favourably perceived in the community.  The failure to come up with split tariff arrangements with local acute-service providers was detrimental to service-provision in the community hospitals.  The need for 24-hour and seven-days-a-week care in some cases had not been properly acknowledged.  Local GPs in the Tonbridge area had not been consulted, which ran counter to the idea of Practice-based Commissioning.  Mrs Ross said in response that the plans for Tonbridge Cottage Hospital still had not been finalised, that consultation would take place and that Mr Horne would be fully involved in this process.

(4)       Mrs Ross also confirmed that consultation would take place on the proposals for the Livingstone Hospital at Dartford when these had been finalised.  With regard to the split tariff Mrs Ross said that this was still being discussed and that there were no outcomes to report yet.  Ms Jones added that she had met with GPs on at least two occasions to discuss issues that had been raised in a letter to the Primary Care Trust.  She argued that achieving an optimal length of stay in community hospitals would allow more people to be treated using fewer beds.  She said that it would not be possible to keep  ...  view the full minutes text for item 45.

Dr Joan Hester, Consultant in Pain Management at King's College Hospital NHS Trust and President of the British Pain Society, and Mr Matthew Kershaw, Chief Operating Officer, East Kent Hospitals NHS Trust, Julia Ross, Director of Civic Engagement, West Kent PCT and representatives from Dartford & Gravesham NHS Trust and Maidstone & Tunbridge Wells NHS Trust will be in attendance for this item.

(Dr Joan Hester, Consultant in Pain Management at King's College Hospital NHS Trust and President of the British Pain Society, was in attendance for this item)

(1)              A copy of Dr Hester’s presentation is attached as Appendix 3 to these Minutes.  Members expressed concern that colleagues from the Primary Care Trusts and acute Trusts were not present for this item and asked that the Committee’s disappointment be communicated to them.

(2)              The Committee discussed and questioned with Dr Hester a range of issues around the complex matter of dealing with pain management at various levels.  Dr Hester acknowledged that the Committee was in advance of its counterparts elsewhere in addressing the issue and inviting her to speak on it.

(3)              Members were unanimous that this was a very important issue and one that they should seek to continue to address with colleagues in the Primary Care Trusts and acute Trusts. Health colleagues did not appear to have a strategy or a uniform approach to this important issue, which affected much of the population at some time during their lives.

(4)              RESOLVED that Dr Hester be thanked for a very informative presentation.

(1)       The Overview and Scrutiny Manager updated the Committee on the development of LINks.  The Local Government and Public Involvement in Health Bill, which set out the proposals for the development of a LINk, was expected to receive the Royal Assent in the autumn.

(2)       The proposal was that the Commission for Patient and Public Involvement in Health, and the Patient and Public Involvement Fora would be abolished on 31 March 2008 and LINks would be operational from 1 April 2008.

(3)       The Committee was reminded that it was often overlooked in the discussion on LINks that they would also be encompassing social care, as well as health services.

(4)       The Committee noted the issues that were emerging from those authorities that had been identified as “early adopter” sites.

(5)       Local Authorities across the country continued to struggle with the concept of LINks in the absence of any guidance. However, the Department of Health was clear that this presented an opportunity for local authorities to do what was right for them within the LINk framework.

(6)       A number of documents that had been delayed several times already were expected to be published shortly.  These included:-

a)    a model contract for procuring the host organisation to establish the LINk;

b)    what a model LINk might look like; and

c)    an interim report on the outcomes of the “early adopter” sites.

(7)       The Overview and Scrutiny Manager acknowledged that Patient and Public involvement Fora representatives were becoming disheartened by the lack of progress. However, existing Patent and Public Involvement Fora representatives had so much knowledge and experience that they would represent a key component of the LINk. He affirmed his offer to speak with Patient and Public involvement Fora, or their Locality Groups, to reassure them of their continuing contribution as the new structure emerged.

(8)       The Committee noted that a steering group led by the Cabinet member with responsibility for Public Health  (Mr G Gibbens), supported by a representative of the Chief Executive’s Directorate, was to be established to take the development of the Kent LINk forward. The NHS Overview and Scrutiny Committee  would have representation on this steering group.

(9)       RESOLVED that the report be noted.

Commencing at 10.00am in the Council Chamber Sessions House, County Hall, Maidstone