Agenda and draft minutes

(1)       RESOLVED that the Minutes of the meeting held on 12 January 2007 are correctly recorded and that they be signed by the Chairman.

(2)       Matter Arising – Maidstone & Tunbridge Wells NHS Trust – A new direction for surgical and orthopaedic care

(3)       Mr Daley asked whether the Minutes had been electronically recorded. The Overview and Scrutiny Manager informed the Committee that the Minutes had been recorded by hand and had been prepared on the basis that they may be required as evidence at a future date should the Committee decide to refer the reconfiguration proposals to the Secretary of State for Health.

(1)       The Overview and Scrutiny Manager informed the Committee that if they wished to approve the Minutes they would need to be declared as urgent business as the requisite legal notice had not been given because the Minutes were still being prepared. The Committee were happy for the Minutes to be dealt with as urgent business.

(2)       RESOLVED that the Minutes of the meeting held on 9 February 2007 are correctly recorded and that they be signed by the Chairman.

(3)       Matters Arising – Health Service Visitors Review

(4)       Mrs Angell sought the outcome of the review of the Health Visitors service.  The Overview and Scrutiny Manager said he would seek further information on the outcome of the review which was due to be completed by the end of March 2007.

 Mental Health Services

(5)       Mr Fittock asked that the provision of Mental Health Services across the County should be the subject of a future debate for the Committee.

Bill Millar, Assistant Director of Primary Care, West Kent Primary Care Trust and Jayne Macdonald, Head of Primary Care – Dentistry, Eastern & Coastal Kent Primary Care Trust will be in attendance for this item.

(Bill Millar, Assistant Director of Primary Care, West Kent Primary Care Trust and Jayne Macdonald, Head of Primary Care – Dentistry, Eastern & Coastal Kent Primary Care Trust were in attendance for this item)

(1)       The Committee had before them a briefing note on the provision of NHS Dental services across the county following the introduction of the new dentistry contract in 2006.  A letter from the Local Dentist Committee was tabled at the meeting.

(2)       The Committee asked Mr Millar and Ms MacDonald a range of questions which covered issues such as:-

a)         The average salary for a dentist which the committee acknowledged covered the premises, equipment and staffing of the dental practice.  It was noted that the average salary was £140,000 per annum;

b)         The number of dentists in each PCT area who were still in dispute over the new dental contract and how the PCT were seeking to resolve these disputes;

c)         recognising that there were many parts of the County where it was difficult to find any NHS provision what efforts were being made by each Primary Care trust to increase the number of NHS dentists available; and

d)         The number of units of dental activity purchased by Primary Care Trusts as some dentists were indicating significant increases in activity for which they were not funded.  The Committee noted that the average cost for a unit of dental activity was £20.

(3)       RESOLVED that:-

(a)       Mr B Millar, Assistant Director of Primary Care and Ms J MacDonald, Head of Primary Care - Dentistry be thanked for their attendance; and

(b) The impact of the new Dentist contract and the provision of NHS dentists across Kent be kept under review and a further report be made available to the November 2007 meeting of the Committee.

Mark Devlin, Chief Executive, Dartford & Gravesham NHS Trust and Karen Jeffries, Deputy Director of Provider Services, West Kent PCT will be in attendance for this item.

(Mark Devlin, Chief Executive, Dartford & Gravesham NHS Trust and Karen Jeffries, Deputy Director of Provider Services, West Kent PCT were in attendance for this item)

(1)       The Committee had before them:-

·              a briefing note;

·              some letters and correspondence from the former Dartford, Gravesham & Swanley Primary Care Trust (DG&S PCT) and the Dartford & Gravesham NHS Trust;

·              a media statement published by the DG&S PCT in April 2006; and

·              some correspondence between the two Trusts and the NHS Overview and Scrutiny Committee. 

(2)       The Committee were still receiving a number of concerns from local Members about the changes to some services being provided at the Darent Valley Hospital and the Gravesham Community Hospital.

(3)       In attendance for this item to answer the Committee’s questions were Mark Devlin, Chief Executive of the Dartford & Gravesham NHS Trust and Karen Jeffries, Deputy Director of Provider Services and Monica Blake, Head of Primary Care for Dartford, Gravesham and Swanley of the West Kent PCT.

(4)       Mr Devlin acknowledged that there was some confusion in the public as to which of the two Trusts provided services and where.  He made specific reference to a number of services provided at the Darent Valley Hospital and those where it was more appropriate in the community i.e. anti-coagulant. 

(5)       Ms Jefferies informed the Committee of the services, either currently being provided at the Gravesham Community Hospital or planned for the near future.

(6)       Members of the Committee expressed the concerns being expressed in the press about the services available, recognising that there needed to be a core provision of services available locally.

(7)       Ms Blake responded that there was some misunderstanding locally and she cited the example of 34 out of 39 general practitioners in the area had volunteered to provide anti-coagulant clinics.  Ms Blake added that some of the information and perceptions of the public were unfounded.

(8)       Mr Devlin acknowledged that it was a fair analysis that acute hospital services were being consolidated and there were a number of people who presented to acute hospitals for services where it would be much more appropriate for those people to be dealt with in the community much closer to their home.

(9)       Several Members expressed their concern at the ability of the public to access the services when transportation was not as good as it might be. 

(10)     Ms Blake informed the Committee that GPs locally would be making a decision shortly on the services that would be provided locally.  Ms Blake added that in theory there could be the provision of a range of services at each of the 39 GP sites throughout the area.  However, there were issues concerning whether the GP practices, the estate, staff etc were available.

(11)     Specific concerns were raised relating to the cataract service and the new Emergency Care Centre being provided at the Darent Valley Hospital.

(12)     The Committee noted that there continued to be a robust discussion taking place with regard to the cataract service.  ...  view the full minutes text for item 14.

John Beadle, Patient and Public Involvement Fora representative, Mark Devlin, Chief Executive, Dartford and Gravesham NHS Trust, Alex Willoughby, Head of Audiology, Medway NHS Trust and Ingrid Coburn, Commissioning Manager - Audiology, Eastern & Coastal Kent PCT will be in attendance for this item.

(John Beadle, Patient and Public Involvement Forum Representative, Alex Willoughby, Head of Audiology of the Medway NHS Trust and Ingrid Cobourn, Commissioning Manager – Audiology of Eastern & Coastal Kent Primary Care Trust were in attendance for this item.)

(1)       The Committee had before them a briefing note on Audiology Services which set out the background to the service in England, the modernising programme for NHS Audiology Services, current waiting times, national waiting time targets, issues relating to funding independent treatments centres and the future of NHS Audiology Services.

(2)       The briefing note also covered the National Audiology Action Plan/Improving Access to Audiology Services in England.  The Committee noted that the House of Commons Health Select Committee had recently conducted a short enquiry into Audiology Services in England and their report was expected soon. 

(3)       Ms Cobourn spoke on behalf of Eastern & Coastal Kent PCT of the strategy being deployed by the PCT for the provision of audiology services. 

(4)       Ms Willoughby indicated that the NHS had the capacity to meet the demand but what was not available was the funding.

(5)       Mr Beadle then addressed the Committee and said that Kent was one of the worst areas in the country for audiology services.  He informed the Committee that quite a few patients would not benefit from digital hearing aids.  He said that digital hearing aids were more difficult to tune rather than an analogue hearing aid.  As a result this often had an impact on those patients in the most deprived areas who were suffering the most.

(6)       He referred to best Practice Standards and a document produced by the Royal National Institute for the Deaf entitled Audiology in Crisis.  He said that digital aids had been introduced four to five years ago and at that time the National Institute of Clinical Excellence (NICE) had recommended that there should an audit of all audiology departments to prepare for digital aids.  However this had not taken place in many areas.  Kent did not undertake an audit and therefore capacity problems had arisen. 

(7)       Ms Willoughby acknowledged that no audit had been undertaken in Kent when introducing digital hearing aids and as a result they had been inundated by patients who wanted to go ‘digital’ from ‘analogue’.

(8)       There were a number of people who had stopped using analogue hearing aids sometime before who were interested in receiving a digital hearing aid. 

(9)       Ms Willoughby also raised concerns around lack of staff and the lack of funding.

(10)     The Committee were also informed by Ms Willoughby of a change in to the qualifications to become an audiologist which required a four year degree course.  This had also had an impact on the number of audiologists available in the “job market”. 

(11)     Members of the Committee and those present then asked a whole range of questions relating to:-

·              how well audiologists were paid;

·              the difficulty in patients, particularly from rural areas such as Eynsford, accessing services in either Medway or  ...  view the full minutes text for item 15.