Agenda and minutes

The Chairman thanked the Vice Chairman, Mr M J Fittock, for chairing the Committee’s meetings while he had been away undergoing medical treatment.  He also thanked Members of the Committee for their support and best wishes during his treatment.

Members noted that Mr R A Marsh had joined the Committee in place of Mr D A Hirst.

(1) RESOLVED that the Minutes of the meeting held on 11 January 2008 were correctly recorded and that they be signed by the Chairman.   The Overview, Scrutiny and Localism Manager pointed out that a scoping document for the proposed Select Committee on Transport and Access to Healthcare, referred to in Minute 3, paragraph (c), had been tabled.

 (2)   The Chairman proposed, and it was agreed, that the Committee should have a regular agenda item, under the Minutes of the previous meeting, to look at what progress had been made on recommendations it had previously made.

(Mrs M Blanche, LINk Lead and Senior Policy Manager, and Ms R Gardner, Management Trainee, Kent Graduate Programme, were in attendance for this item.)

            (1)       Mr Gibbens thanked the Committee for inviting him to update them on progress on the LINk.  He explained that the LINk project had now reached the stage of launching the tendering process to find the host organisation.  Briefings had taken place with County and District Council Members and meetings with the voluntary sector.  Mr Gibbens outlined KCC’s role in relation to the LINk as being to manage the tendering process, stimulate public interest in the LINk and to performance-manage the host organisation.  He thanked Mrs Blanche and Ms Gardner for their work in developing the LINks project.

            (2)       In response to questions put to them by Members and Patient and Public Involvement Forum (PPIF) representatives, Mr Gibbens and Mrs Blanche explained the following:-

(a)               A key role of LINks was to ensure a better information flow to HOSCs.  A challenge to be addressed was how to ensure representation for hard-to-reach groups, such as gypsies and travellers, refugees, black and minority ethnic groups, etc.

(b)               The LINk, if it worked well, would draw in a good range of service users and organisations.  As the body responsible for commissioning the host organisation, KCC would have more influence over the LINk than it did over PPIFs.  A successful meeting, hosted by the PPIFs and aimed at voluntary organisations, and carer and user groups, as well as PPIF members, had been held at Lenham on 30 January.

(c)               Regarding arrangements for the transition to the LINk, 28 volunteers had so far come forward to join a Steering Group.  The Group would be meeting in March, chaired by the current Chairman of the Medway Steering Group (who could share lessons from Medway’s experience of having been a LINk “early adopter”).

(d)               Every local authority in England, regardless of size, had been allocated the same sum – £10,000 – to cover the cost of setting up LINks; in a large county, such as Kent, this would not go far.  Ten per cent of the overall annual funding allocation for the LINk – £492,000 – would be kept back by KCC to cover the cost of its ongoing performance-management role in respect of the host organisation.

(e)               A Member asked about the possible workload arising from the right of LINks to refer matters to HOSCs. Concerns were also raised by a PPIF representative about whether provision had been made for transitional arrangements from 1 April, in case the LINk was not operational from that date, as planned. He also questioned the planned top-slicing of the LINk funding allocation; some local authorities were not going to top-slice – and a few had actually contributed additional funding to their LINk budgets. Mr Gibbens and Mrs Blanche replied that the HOSC hoped to start the LINk as close to 1 April 2008 as possible. Top-slicing was occurring so that Kent had  ...  view the full minutes text for item 8.

David Meikle, Director of Finance will be in attendance for this item.

(Mr S Phoenix, Chief Executive of the PCT, was in attendance for this item at the invitation of the Committee.)

            (1)       The Chairman introduced Mr Phoenix and thanked him for attending.  He said that, although the HOSC had not yet been able to have any information on the PCT’s budget for 2008/09, he felt it was still very helpful for the Committee to have a discussion with each PCT about the budget-setting process.

            (2)       Mr Phoenix gave a brief introduction on the PCT’s current financial position.  The four PCTs that had preceded West Kent PCT had had widely differing financial performances and overall the outcome had not been good.  In October 2006, when he had taken up his current post, the PCT had had a £30 million financial recovery plan and by March 2007 it had moved to a £15 million overspend.  This and previous debts meant that the PCT had had to pay back £20 million in the 2007/08 financial year, leaving its budget very tight.  In addition, the PCT had experienced unexpected expenditure in several areas, including specialist tertiary treatment outside the area and high drugs charges.  However, the PCT expected to end the year in balance.

            (3)       Last year, the Local Delivery Plan had set out financial priorities for the three years ahead – but the PCT had not received its funding allocation until mid- to late- December 2007, preventing it from doing any effective financial planning before then.  The allocation given had been for one year only, not the expected three years.  The next two years’ allocations from the DoH were expected in spring 2008. The allocation formula was to change and the PCT was nervous that it would be disadvantaged by the new formula.  The PCT was required to meet the national targets and priorities for the NHS, set out in the 2008/09 Operating Framework and the “Vital Signs” indicators, which were a suite of national requirements and local priorities (identified through discussions with PPIFs, the ‘Fit for the Future’ process and work with PbC clusters).

            (4)       Three priority strands had been identified, which resonated with discussions that the PCT had had with the HOSC:

(a)          to reduce levels of Healthcare-associated Infections;

(b)          to improve access to healthcare;

(c)           to improve the health of the population and reduce health inequalities.

            (5)       In answering questions from Members and PPIF representatives, Mr Phoenix explained the following:-

(a)              The PCT was able to forecast its future demand reasonably well by looking at past patterns and emerging trends.  Patient choices were difficult to predict, however. Choose and Book offered patients choice at referral and, under PbR, the money followed the patient. Movement here so far was slow, but the exercise of choice was expected to become more prevalent in the years ahead.

(b)              PbC was already shaping this year’s one year plan and all PbC clusters had produced business plans for the coming year.  PbC had been slow to get going but it had speeded up in the  ...  view the full minutes text for item 9.

Council Chamber, Sessions House, County Hall commencing at 10:00 am