Agenda and draft minutes

RESOLVED that the Minutes of the meeting held on the 10 November 2006 are correctly recorded and that they be signed by the Chairman.

Review of Health Visiting Services (Minute 49 of 2006 refers)

(1)       Mrs Angell asked Mr Phoenix whether the Health Visitors Review had been delayed to await the national review, as suggested by the Committee at its meeting on 10 November 2006.  Mr Phoenix responded that he had considered the NHS Overview and Scrutiny Committee’s views but he had decided not to wait for the national review, as it had only just started and was not due to be completed until March 2007.

(2)       Mr Phoenix informed the Committee that the Health Visitors model being proposed in West Kent had impressed the Department of Health and, anecdotally, the Secretary of State. He informed the Committee that it was likely that the national review would be influenced by what was going on in West Kent.  If the national review had an outcome of different conclusions, these would be would be taken into account in the West Kent model.  However, Mr Phoenix was anticipating that the national review would reach conclusions similar to the proposed model for West Kent.

(3)       West Kent Primary Care Trust’s Health Visitors Review consultation had finished at the end of December 2006. One change resulting from the consultation would be an increase in the number of health visitors by around five whole-time-equivalents compared to the original proposal.

(4)       The West Kent Primary Care Trust Board would meet on 25 January 2007.  Mr Phoenix anticipated that this, and other recommendations arising from the review, would be endorsed at that meeting.  To delay the review until the outcome of the national review was known would have put the Health Visiting Service into limbo.

West Kent Primary Care Trust

(5)       Mr Tolputt asked whether the Committee could have a structure chart and a list of Directors appointed to the West Kent Primary Care Trust. Mr Phoenix said that not all appointments had been made. Appointments were still being made to the remaining Director posts. However, all non-executive Directors had been appointed.  This information would be made available to the Committee.

The Chairman indicated that, following a recent meeting with colleagues from the West Kent Primary Care Trust, it had been agreed that proposals for the commissioning of homeopathy in West Kent should be the subject of an item at the Committee’s next meeting on 9 February 2007. 

Rose Gibb, Chief Executive of Maidstone & Tunbridge Wells NHS Trust and Steve Phoenix, Chief Executive of West Kent PCT, Dr Jeremy Mayhew, Medical Director and Paul Barratt, General Manager (South) from South East Coast Ambulance Service and Paul Skinner, Clinical Director – Orthopaedics and Philip Bentley, Clinical Director – Surgery from Maidstone & Tunbridge Wells NHS Trust were in attendance for the item, along with surgeon, physician and nursing colleagues from the Trust.

(1)       The Committee had before them a briefing note setting out the Trust’s proposals for changes to surgical and orthopaedic care, and the reasons for the proposals – together with objections, representations and views received from: County Councillors whose constituents looked to the Maidstone and Tunbridge Wells NHS Trust for their hospital services; the County Council; East Sussex County Council; Borough and District Council colleagues; Parish Councils; and other stakeholders. 

(2)       Attached as an Appendix to these Minutes is a copy of the presentation made by the Chief Executive of West Kent Primary Care Trust, the Chief Executive and colleagues of Maidstone and Tunbridge Wells NHS Trust.

(3)       By way of introduction, Mr Phoenix made it clear to the Committee that the presentation they were about to receive was being clinically led – because that was appropriate and was how the consultation had been handled by the acute Trust and the Primary Care Trust.

(4)       He indicated that the West Kent Primary Care Trust Board would consider all responses to the consultation and make a decision at its meeting on 22 February 2007.

(5)       Rose Gibb, Chief Executive of Maidstone and Tunbridge Wells NHS Trust – accompanied by a team including clinicians and representatives of the South East Coast Ambulance Service – made a presentation to the Committee on the Trust’s proposals. 

(6)       Ms Gibb indicated that the issues being addressed in the Trust’s proposals for change to surgical and orthopaedic care were extremely complex and were highly emotive.  She did not underestimate how difficult it was to set aside emotion and personal opinion.  The proposals before the Committee were all about providing health services which were clinically safe and meeting national standards.

(7)       Ms Gibb reminded the Committee that the proposals were to create a specialist centre for complex and cancer surgery by:-

(a)       centralising all inpatient emergency orthopaedic surgery and emergency general surgery operations at the Kent and Sussex Hospital, Tunbridge Wells, supporting day-care and 23-hour care;  and

(b)       centralising complex inpatient elective surgery at Maidstone Hospital, supporting complex cancer surgery, day-care and 23-hour care.

(8)       Ms Gibb said the reasons why change was necessary were as follows:-

(a)       to improve standards of care;

(b)       to ensure patients saw the right specialist every time;

(c)        to support training with good supervision and sustained development of specialist skills, e.g. stomach surgery;

(d)       to create safe modern trauma services, covered by specialists 24-hours-a-day;

(e)       to cancel fewer operations; 

(f)         to reduce risk of cross-infection, among elective patients in particular;

(g)       to better use staff skills;

(h)        to  ...  view the full minutes text for item 4.