To receive apologies for absence.

Apologies were received from Councillor KS Guthrie.

To receive details of any Member nominated to attend the meeting in place of a Member of the Committee.

There were no named substitutes.

To receive any declarations of interest by Members in respect of items on the Agenda.

GUIDANCE ON DECLARING PERSONAL AND PREJUDICIAL INTERESTS AT MEETINGS

The Council’s Members’ Code of Conduct requires Councillors to declare against an Agenda item(s) the nature of an interest and whether the interest is personal or prejudicial.  Councillors have to decide first whether or not they have a personal interest in the matter under discussion.  They will then have to decide whether that personal interest is also prejudicial.

A personal interest is an interest that affects the Councillor more than most other people in the area.  People in the area include those who live, work or have property in the area of the Council.  Councillors will also have a personal interest if their partner, relative or a close friend, or an organisation that they or the member works for, is affected more than other people in the area.  If they do have a personal interest, they must declare it but can stay and take part and vote in the meeting. 

Whether an interest is prejudicial is a matter of judgement for each Councillor.  What Councillors have to do is ask themselves whether a member of the public – if he or she knew all the facts – would think that the Councillor’s interest was so important that their decision would be affected by it.  If a Councillor has a prejudicial interest then they must declare what that interest is and leave the meeting room.

There were no declarations of interest.

To approve and sign the Minutes of the meeting held on 19 March 2008.

RESOLVED: That the Minutes of the meeting held on 19 March 2008 be confirmed as a correct record and signed by the Chairman, subject to the first two lines of resolution f (a) being amended to read “The Committee believes that the recommendations to improve services for Mental Health and Physical Disabilities…”

To consider suggestions from members of the public on issues the Committee could scrutinise in the future.

The Chairman reported that concerns had been expressed to her about Hereford Hospitals NHS Trust’s audiology service.  She proposed to invite the Chief Executive of the Trust to comment on the issue when the Committee considered its work programme to consider whether the matter merited Scrutiny.

To consider the preparation of the Committee’s commentaries on health bodies in Herefordshire as part of the Healthcare Commission’s Annual Health Check process.  

The Committee considered the preparation of its commentaries on health bodies in Herefordshire as part of the Healthcare Commission’s annual health check process.

Representatives from the West Midlands Ambulance Service NHS Trust, the Primary Care Trust (PCT) and Hereford Hospitals NHS Trust attended the meeting to comment on their performance during the year and answer the Committee’s questions.

West Midlands Ambulance Service NHS Trust

Sue Green, Regional Head of Risk and Planning Guidance, and Lee Hutchinson, Station Manager at Hereford Ambulance Station, referred to the written submission to the Committee included in the agenda papers and informed the Committee that the Trust expected to meet all its targets this year.

Performance statistics for Herefordshire, the Hereford, Shropshire and Worcester Division and the Trust as a whole had been circulated separately to the Committee.

In the ensuing discussion the following principal points were made:

·         In relation to the target of responding to 75% of category A calls within 8 minutes a question was asked about the implications of this for response times to the remaining 25%.  The Herefordshire performance over the year stood at 78%.  In reply it was stated that the Service was always seeking to improve response times.  The deployment of paramedic response units was enabling calls to be answered more quickly.

·         A question was asked about the number of complaints received.  It was stated that the Trust received some 4-5 complaints a month across the Region.  The Trust was required to respond to complaints within 25 days but set its own target of 20 days.

·         It was noted that the effect on performance of the reconfiguration of the Trust’s call centres would be something to consider in a few months time.

·         That it would be useful for the Committee to receive information at its next meeting showing a breakdown of response times across the County.  It would be helpful if Mr Hutchinson as Station Manager could attend to answer any questions.

·         It was noted that, in the more rural areas of the County, Community First Responders would play an important role in helping the Trust to meet the required standards.  It was agreed to reiterate the Committee’s comment in its response to the consultation on the reconfiguration of call centres that the Committee would want to see some reinvestment into the County of any resources realised through reorganisation.  Providing direct funding for equipment for Community First Responders would be a good place to start to seek to improve the provision of service to rural areas. 

·         Members welcomed the Trust’s success in winning the Ambulance Service of the Year Award from the Ambulance Service Institute.

The Chairman thanked representatives of the Trust for their attendance.

Herefordshire Primary Care Trust

Mr Chris Bull, Chief Executive Herefordshire Council/Herefordshire Primary Care Trust, and Mr Paul Edwards, Director of Commissioning and Strategy were present to answer the Committee’s questions together with Greg Barriscale, Performance Manager.

Greg Barriscale gave a presentation, supplementing the report in the agenda papers, summarising the health  ...  view the full minutes text for item 59.

To receive an update at the meeting from the Chief Executive Herefordshire Council/Herefordshire Primary Care Trust on the strategic review of provider services.

The Chief Executive Herefordshire Council/Herefordshire Primary Care Trust reported to the Committee on the strategic review of provider services.

He said that the University of Birmingham had been commissioned to carry out a review, to be completed within six months, looking at the role of community hospitals, the possible links with services provided by Hereford Hospitals NHS Trust the integration of health and social care services and the provision of mental health services, noting that the Primary Care Trust was only one of a very few in the Country that directly managed mental health services.  He emphasised that there was no intention to do anything to the detriment of the County Hospital or the Community Hospitals which were a tremendous asset.  The review was intended to look at how provision could be organised in the most effective way. 

He invited discussion of how the Committee might wish to be involved in the review process.  He proposed to make progress reports to each of the Committee’s meetings.

In the ensuing discussion the following principal points were made:

·         It was requested that Members of the Committee should be sent a copy of the design brief for the Review.

·         Members welcomed the proposal for regular progress reports.

·         It was proposed that Local Members should be kept informed of progress with the review and consulted on any proposals at the earliest possible stage.

·         That the Adult Social Care and Strategic Housing Scrutiny Committee also needed to receive regular progress reports.

·         It was noted that views of service users and the wider public would be sought as part of the review.

·         A comment was made on the need for consideration to be given to the remit of the Scrutiny Committees as the joint working arrangements were being developed, stressing the need for clarity and the importance of avoiding any gaps in scrutiny.  The Chief Executive HC/PCT acknowledged that consideration needed to be given to this matter including the scope for cross-cutting Scrutiny Committees.

RESOLVED:

That    (a)        a copy of the brief for the Review be circulated to Members of the Committee;

(b)               progress reports on the review of provider services be made to each of the Committee’s meetings; and

(c)               it be requested that Local Members should be kept informed of progress with the review and consulted on any proposals at the earliest possible stage.

To receive an update on work on communication issues between the Council and the Primary Care Trust.

The Committee had been provided with a report on progress on the creation of a unified communications team to serve the Council and the Primary Care Trust.

The Chief Executive Herefordshire Council/Primary Care Trust advised the Committee that work on this issue was ongoing and that it would be more appropriate for it to be considered at a later date by the Strategic Monitoring Committee.

The Committee accordingly did not consider this issue.

To update the Committee on progress towards procuring a host organisation for Herefordshire’s Local Involvement Network (LINk).

The Committee was informed of progress in procuring a host Organisation for Herefordshire’s Local Involvement Network (LINk).

An updated report confirming the appointment of the Carers Federation Ltd, an Organisation based in Nottingham, as host organisation was circulated at the meeting together with some key performance indicators and Service Level Agreement targets for the host organisation.

The Strategic Procurement and Efficiency Review Manager outlined some of the principal reasons for awarding the three year contract to the Carers Federation Ltd.  He added that the Organisation would have a local office which would be the public face of the Organisation with the Head Office in Nottingham carrying out the back office functions.  The key performance indicators would be monitored to ensure that the Organisation was meeting the agreed targets. It was intended that the first report to the Committee would be made in six months time followed by quarterly reports thereafter.

In the ensuing discussion the following principal points were made:

·         It was proposed that to ensure a strong working relationship with the LINk the Committee should invite 1-2 representatives of the LINk to attend and contribute to meetings of the Committee.  It would be helpful to have a presentation on the LINk’s structure and Work Plan once finalised.

·         The good work of the three patients forums was noted and the hope expressed that   their replacement by one body, the LINk, with its wider remit would if anything provide a stronger voice.  It was noted that the Organisation had a significant budget and it was important that the Organisation had the resources available to it to fulfil its role.

·         In response to a question it was confirmed that the LINk would have its own clear local identity.

·         The fact that key performance indicators were in place from the outset enabling the Committee to monitor performance was welcomed.

RESOLVED:

That    (a)        the formation of the LINk with a wider highly inclusive community involvement be welcomed together with the significant budget for it to carry out this consultative role county-wide;

(b)       the benefit of establishing performance indicators for the LINk from the outset be welcomed and regular outcome reports be presented to the Committee;

(c)        to ensure a strong working relationship with the LINk it be invited to nominate up to two representatives to attend and contribute to meetings of the Committee;

            (d)       That a report on the LINk’s structure and proposed work plan be presented to a future meeting; and

            (e)       That the Committee’s thanks for the work carried out by the Patients Forums be recorded.

To advise the Committee on initial discussions taking place between the Primary Care Trust and Children’s Services over the future provision of services for children with special needs.

The Committee was informed of initial discussions taking place between the Primary Care Trust (PCT) and Children’s Services over the future provision of services for children with special needs.

The Committee had received a report in December 2006 on the outcome of a consultation led by the Primary Care Trust on the possibility of developing a central building for specialist community services for children with special needs.

The Head of Integrated Services and Inclusion presented the report.  She said that the Council was reviewing its special school provision and would consult once a preferred option had been identified.  There was a link between this review and the previously proposed central building.  It was clear that special school provision was required.  Discussions were centering on the possibility of pooling resources and providing improved facilities.  It was intended to provide a further report once proposals emerged.

In response to comments the Head of Integrated Services and Inclusion acknowledged the sensitivity of the issue and reiterated that there was no intention of removing special school provision. It was intended that mainstream provision for pupils with less complex special needs would also be examined to ensure that appropriate resources were in place.

RESOLVED: That a further report be made once proposals had been formulated.

To consider the Committee’s work programme.

The Committee considered its work programme. 

The following additional items were identified further to discussion of previous items on the agenda: breakdown of the Ambulance Trust’s performance in Herefordshire, update on the strategic review of provider services; update on the response to the Committee’s review of Communication; provision of services for children with special needs; presentation on the structure of the Local Involvement Network and its work programme.

The Chairman had remarked earlier in the meeting on concerns expressed to her about Hereford Hospitals NHS Trust’s audiology service and the need to consider whether this issue merited scrutiny.

Mr Woodford, Chief Executive of the Hospital Trust, reported that whilst waiting times for the audiology service had been a matter of concern these had been significantly reduced in the last 12 months and by the end of May it was expected that they would be down to six weeks.

Mr Edwards, Director of Commissioning and Strategy, said that there had been a problem but considered that this had now been addressed. As commissioner of services the Primary Care Trust had invested additional resources in the audiology service in 2008/09. 

This reassurance was welcomed and it was agreed that a written update should be provided to the Committee’s next meeting confirming the position.

RESOLVED: That the work programme as amended be approved and reported to the Strategic Monitoring Committee.