To receive apologies for absence.

Apologies were received from Councillors T.M. James and J.B. Williams.  Mrs A. Stoakes of the Primary Care Trust Patient and Public Involvement Forum also submitted her apologies.

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 23rd March, 2006.

RESOLVED:   That the Minutes of the meeting held on 23rd March, 2006 be confirmed as a correct record and signed by the Chairman

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

There were no suggestions.

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

The Committee received presentations from Mr David Rose, Chief Executive of the Hereford Hospitals NHS Trust, and Mr Simon Hairsnape, Deputy Chief Executive of the Herefordshire Primary Care Trust (PCT) on the work of the Trusts in the preceding year and future plans and thoughts and a statement by the Cabinet Member (Social Care Adults and Health.)

Presentation by Mr Rose

The presentation covered performance for 2005/06, key developments and issues for 2006/07 and the intention to seek to become a Foundation Trust.

Key points of the presentation were:

·          Key Operational Successes 2005/06: Mr Rose informed the Committee that Hereford Hospital was the strongest performing hospital in the West Midlands (South) area.  He highlighted success in achieving the standard that over 98% of patients waited under four hours for treatment in the Accident and Emergency Unit; that no patient waited for more than 11 weeks for an outpatient appointment and the hospital was close to achieving a maximum wait of 8 weeks, ahead of the Government target; there was a maximum 6 month wait for elective surgery: all patients booked appointments were fulfilled; cancer wait targets had been achieved; and a stroke unit with dedicated staff had been created.

·          That financial balance had been achieved and all financial responsibilities met.  It was particularly important, as a small hospital, that debt was not accumulated.

·          That the hospital had met all except one of the national standards for better health.  The one not met was standard C7c relating to undertaking systematic risk assessment and risk management.  An action plan had been agreed with the internal auditors which would ensure compliance by the end of July 2006.

·          Key developments and issues for 2006/07 included a move towards 18 week waits, with maximum waiting targets of 11 weeks for outpatients and 20 weeks for in-patients; maintaining performance on A&E and cancer waiting times; achieving a 90% target on choose and book appointments, a focus on improving theatre efficiency and utilisation; development of orthopaedic, gastroenterology, paediatric and diabetes services, noting the ongoing efforts to recruit 2 orthopaedic Consultants, and the recruitment of 2 paediatric consultants which it was hoped would secure the future of the service in Hereford; a focus on reducing the length of stay for emergency patients noting that this was both good for patients and would also allow the hospital to consider whether it could reduce the number of beds, so helping it meet its financial obligations; improving access to diagnostic services noting that if waiting times for diagnostic services were low this might encourage patients to choose to be diagnosed at Hereford making it likely that they would also then opt for treatment at the hospital, development of the Macmillan Renton Cancer Unit which would offer the best standards for patients, and the intention to bid to provide radiotherapy services.

·          The financial outlook for 2006/07 was difficult.  There was a financial deficit of £4.6 million to resolve, representing 5% of the budget.  Mr Rose commented on the pressure caused by  ...  view the full minutes text for item 55.

To consider cost saving proposals by the provider arm of the Primary Care Trust.

The Committee considered cost saving proposals by the provider arm of the Primary Care Trust.

Mr Mike Thomas, Director of Operations at the Primary Care Trust had submitted a briefing paper setting out proposals to achieve cost savings in 2006/07.

Mr Simon Hairsnape, Deputy Chief Executive of the Primary Care Trust introduced the briefing paper, explaining that as a consequence of the financial pressure on the NHS nationally the PCT was required to save £6.6 million of its 2006/07 budget (3.3%).  The savings made were to be contributed to a national NHS bank to fund NHS bodies in most difficulty.  This was a challenge.  However, the PCT was determined to act quickly in the belief that this would enable it to minimise the impact.  It was proposed that one-third of the money would be saved in Commissioning by focusing on value for money and managing emergency admissions (not to the detriment of services), one-third in Primary Care (a contractual matter with the GPs and consequently not a matter for the Committee), and one-third on Services provided directly by the PCT as described in the briefing paper.  Whilst the PCT maintained that the proposed savings on directly provided services did not have a significant impact on services it had been thought appropriate for the Committee to consider the matter.  However, he cautioned that if the Committee was minded to require a consultation exercise on the proposals the consequent delay in implementing reductions could mean tougher decisions would be needed later in the year.

Mr Thomas then presented the briefing paper he had submitted, commenting on each of the proposed reductions.  The paper noted that the proposals listed left a £350,000 shortfall in the savings target and that a range of other areas where savings could be made were being explored, again with the intention of not impacting on service provision.  It was also noted that an additional saving requirement, failure to achieve the savings as proposed or deterioration in the financial position could lead to a harsher saving proposal.

Mr Thomas emphasised in conclusion that the aim had been to avoid reductions in services or redundancies and that it was intended that the reductions would be temporary and that the services would be developed further in the future.

Mr Hairsnape added that the financial pressure on the NHS should only affect the current financial year.  He reiterated that the proposals were considered to be the best package that could be put forward to allow the PCT to break even and minimise the effect on services.

A question was asked about the decision to postpone the introduction of two new consultant posts in the Mental Health Service.  In reply it was stated that this did not impact on the current service but represented a future development opportunity.

It was noted that the proposals had been discussed with the Patient and Public Involvement Forum and were supported by them.

The Committee’s view was that the proposals could not be considered to represent a  ...  view the full minutes text for item 56.