To receive apologies for absence.

Apologies were received from Councillor T.M. James and Mr J. Wilkinson, Chairman of the Primary Care Trust Patient and Public Involvement Forum.

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 this agenda.

There were no declarations of interest.

To approve and sign the Minutes of the meeting held on 16th June, 2005.

RESOLVED: That the Minutes of the meeting held on 16th June, 2005 be confirmed as a correct record and signed by the Chairman, subject to noting that there had been some duplication in the printing process and pages 1-4 as printed in the agenda papers concluding at Minute no 8 represented the Minutes of the meeting.  (A revised set was accordingly presented to the Chairman for signature.)

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

No suggestions were made.

To advise the Committee of the work of the Trusts in the preceding year and future plans and thoughts.

The Committee had invited the Chief Executives of the Herefordshire Primary Care Trust (PCT) and the Hereford Hospitals NHS Trust (HHT) to advise the Committee of the work of the Trusts in the preceding year and future plans and thoughts.

The Committee had been provided with the Trusts’ Annual Reports 2004/05 and their respective strategies: from the PCT its “Strategy for Success a Statement of Intent” and from HHT its Strategy for 2005-2010.

Presentation by Mr Peter Harper, Medical Director and Deputy Chief Executive of the HHT.

Mr Harper, attending on behalf of the HHT Chief Executive, gave a presentation to the Committee.  He commented on the Trust’s strategy development, its two star performance rating from the Health Commission, clinical services, workforce, challenges faced, perception of the future (2006-2008) with the stated aim of achieving Foundation Trust Status by 2008, and the future beyond 2008.

He advised the Committee that HHT’s vision was excellence in the delivery of secondary care services to the local population, through partnership with patients, the public and other organisations.  This was to be delivered by being the provider of choice for patients and partner organisations, the employer of choice and the provider of excellent, high quality, innovative, patient centred, clinical and support services.

In relation to clinical services he highlighted the following points:

·          The partnerships which had been developed in the provision of vascular surgery, Ear, Nose and Throat Services and Cancer Services.

·          Length of stay in hospital noting that this was 80% of the national average, with hip replacements now having a 5 day average stay (down from a 10 day average), a high day case rate, with 80% of cases dealt with in a day compared with a national average of 65%.

·          The excellent service provided by the Charles Renton Cancer Unit.

·          The establishment of a dedicated stroke unit, whilst noting that the Unit could not provide a full rehabilitation service.

In relation to challenges he highlighted:

·          The pressures on clinical and non-clinical staff.

·          Infection rates, noting that whilst these were relatively low a team was actively engaged in keeping the level down, although it had to be recognised that infection was a fact of life.

·          The financial pressures facing HHT.

·          The requirement to meet targets, noting that improvements were being made with the time in 2005 between referral to treatment down to 62 days and the time from decision to treat to treatment down to 31 days.

·          Recruitment and retention of staff.

·          In terms of diagnostics he reported that there was a very long waiting list for MRI scans and some considerable waiting times for neurophysiology which was a particular problem because of the difficulties in recruitment.  However, some inroads were being made into the problem and waiting time for an ultrasound scan, which at one point had been well over a year, was now down to a few weeks.

·          The major pressures on the accident and emergency department.

·          The pressures on trauma and orthopaedic services, noting that in the case of  ...  view the full minutes text for item 14.

To note proposed changes to the local health service and endorse the response to the Strategic Health Authority.

The Committee received a report on proposed changes to the local health service and was invited to endorse the joint response submitted to the West Midlands South Strategic Health Authority (SHA) by the Leader of the Council and the Chairman of the Health Scrutiny Committee.

It was noted that the Chief Executive of the NHS had directed SHAs “to co-ordinate an exercise locally to ensure we have the right configuration for commissioning.”   The letter from the SHA setting out options for the future configuration of services was appended to the report together with the response submitted to the SHA by the Leader of the Council and the Chairman of the Health Scrutiny Committee.

The Director of Children’s Services commented on the tight timescale within which the response to the SHA had had to be submitted and drew attention to the content of the joint response as set out in appendix 2 to the report.

Members noted with concern the uncertainty faced by staff whilst the options for reconfiguration were considered and the implications for retention and recruitment.  It was suggested that once a decision had been made action should be taken as quickly as possible to reduce the uncertainty.

RESOLVED:   that the proposed changes to the local health service be noted and the response to the Strategic Health Authority as set out in appendix 2 to the report be endorsed.

To consider the Committee’s role in the Health Check process.

The Committee received a presentation by representatives of the Primary Care Trust and the Hereford Hospitals NHS Trust on the Health Commission’s new system of performance assessment for PCTs and NHS Trusts: the annual health check.

The presentation set out the role of the Healthcare Commission, the Core Standards against which performance would be measured and the timescale for submitting declarations to the Commission.  It was noted that for the first year of the system Trusts were required to submit a draft declaration for the period 1st April to 30th September, 2005 by 31st October, to be followed by the submission of a declaration for 2005/06 as a whole in April 2006.

The Committee noted that the system provided for it to submit comments for inclusion in the declarations made by the Primary Care Trust, the Hereford Hospitals NHS Trust and the Hereford and Worcester Ambulance NHS Trust.

Recognising that in this and other matters, such as the consultation on the reconfiguration of the Health Service which appeared elsewhere on the agenda, an urgent response sometimes needed to be made on the Committee’s behalf it was proposed that a general authority be given to officers following consultation with the Chairman, and with other Members of the Committee as practicable, to act on the Committee’s behalf.

RESOLVED:

That          (a)              that the Committee’s comments for inclusion in the draft health check declaration be finalised following consultation with the Chairman;

                                    and

                  (b)             in order to deal with urgent matters officers be authorised to act on behalf of the Committee following consultation with the Chairman, and where practicable other Members of the Committee.

To review action taken in response to the Committee’s recommendations.

The Committee reviewed action taken in response to the Committee’s recommendations made in its review of the management of the outbreak of legionnaires disease in Hereford in 2003.

The Committee’s review had been completed in July 2004 and it had considered it timely as part of its work programme to invite the key agencies involved in managing the outbreak to comment on progress.  Replies from the Health Protection Agency, Herefordshire Council, Herefordshire Primary Care Trust and Hereford Hospitals NHS Trust were appended to the report.

The Council’s Emergency Planning Officer commented on the specific duties now placed on the Council and its partners by the Civil Contingencies Act 2004 and the extent to which that had formalised co-operation. He explained the collaborative work underway and concluded that with the measures which had been put in place the ability to respond effectively to a similar outbreak of legionnaires and other diseases had been enhanced.

The Environmental Health Manager (Commercial) also said improvements had been made and he was confident that a professional, robust response would be delivered in the event of another outbreak or similar event.  Working relationships with the Health Protection Agency and the Primary Care Trust were good.  Concerns about  possible changes to the Service’s powers which the Committee had reflected in its recommendations, had largely receded.  The benefit of local knowledge in dealing with the outbreak had been demonstrated as had the public confidence in the Service.  He noted that other authorities were seeking to learn from the expertise gained in Herefordshire during the outbreak.

It was also noted that regular exercises were required by the Civil Contingencies Act and this would ensure the lessons which had been learned were not forgotten.

The Committee welcomed the action which had been taken.

To note progress on the review of Communication.

The Committee noted progress on the review.

To note progress on the review of GP Out of Hours Services.

The Committee noted progress on the review.