To receive apologies for absence.

Apologies were received from Councillors AP Taylor and PJ Watts.

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

Councillor PA Andrews substituted for Councillor AP Taylor and Councillor JW Hope MBE for Councillor PJ Watts.

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 6 December 2007.

RESOLVED:  That the Minutes of the meeting held on 6 December 2007 be confirmed as a correct record and signed by the Chairman, subject to recording the apologies of Councillor WU Attfield and the attendance of Mr J Wilkinson, Chairman of the Primary Care Trust Patient and Public Involvement Forum.

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

There were no suggestions from members of  the public.

To consider a presentation on the Primary Care Trust’s Local Delivery Plan.

The Committee received a presentation on the Primary Care Trust’s Local Delivery Plan 2008/09

Mr Paul Edwards, the Primary Care Trust’s (PCT’s) Director of Commissioning and Strategy gave the presentation setting out the context within which the Local Delivery Plan (LDP) was being prepared and the Plan’s content. 

Copies of the latest version of the LDP were available at the meeting.  The Chairman proposed that these should be circulated to Members after the meeting and Members invited to provide any further comments to her for submission to the Primary Care Trust (PCT).

Mr Edwards noted that the PCT was normally required to produce a three year commissioning strategy/LDP.  However, this year the Department of Health required a one year LDP for 2008/09 pending the report of the review of  the National Health Service it had commissioned from Lord Darzi which was due to be published in the Summer of 2008.  This had affected the NHS allocations with only one year’s allocation therefore proposed for 2008/09 until the outcome of the review was known.

The presentation covered the following points:

·         The local vision - “ Our vision is one of developing timely, high quality Health & Care Services, which are needs led, user/patient focused and delivered as close to home as possible”.

·         The local priority -    “To redesign care pathways and service models to improve quality of care, value for money and to free up resources to invest in Primary Care.”

·         Turning the Vision into reality through assessing health need, understanding population expectation, deciding priorities, designing services, purchasing services from providers (including market development & management), managing demand and monitoring performance (including quality, finance & productivity).

·         Impacts on the health service included rising public expectations about health treatment, rising expectations about access to services, Increased expectation of engagement with health services about minor illnesses, increasing emergency admissions to hospital and increased numbers of elderly people – with resultant demand.

·         The following changes were highlighted: medical and pharmaceutical advances which are high cost, increased numbers of children with complex needs as premature birth survival rates improve, the impact of the European Working Time Directive for example on hours worked by junior doctors, changed Royal College standards so that care must increasingly be located in specialist units and a drive to develop shared care with GPs and more outreach from hospitals to the community.

·         The PCT’s aspirations were to improve health and address inequalities, achieve value for money, ensure choice & involvement, improve patient experience and achieve the principles of World Class Commissioning.

·         It was intended to do this through basing all services on sound needs analysis, easier access to services, more health services in community settings, improving preventative strategies, improving health outcomes, having an appropriate and well trained workforce, joined up commissioning capability, developing robust performance management and doing all this in partnership wherever possible & appropriate.

·         Key targets for 2007/08 had been achieving 18 weeks from GP referral to start of treatment, reducing rates of MRSA & other healthcare associated  ...  view the full minutes text for item 46.

To consider current radiotherapy service options and appropriate next steps.

The Committee considered current regional radiotherapy service options and appropriate next steps.

The report stated that the Three Counties Cancer Network (3CCN) (comprising Gloucestershire, Herefordshire and Worcestershire) had been considering the expansion of radiotherapy services.  Three options had been identified: expansion at the Gloucestershire Oncology Centre in Cheltenham; developing services at Hereford County Hospital; or developing services at Worcestershire Royal Hospital.  It had proved difficult to reach a consensus on a preferred option and the views of the relevant Health Scrutiny Committees were therefore being sought on this point.

The report set out reasons why the development of services at Hereford County Hospital should be the preferred option.  In particular it noted that the development of the Hereford option was supported by the National Cancer Strategy which amongst other things recommended that no patient should have to travel more than 45 minutes for cancer treatment.  Very few places in Herefordshire and Powys, where many of Hereford County Hospital patients came from, were within 45 minutes travelling distance of Cheltenham.

Whilst the form of any consultation was the responsibility of the three Primary Care Trusts (PCTs) involved, the 3CCN had also asked the Health Scrutiny Committees of all three Counties to recommend consultation strategies to guide its decision making process.  A recommended approach proposed by Mr E McPherson, Involving People Manager at Herefordshire PCT, was attached as Appendix B to the report.

The Chairman said that whilst the 3CCN had agreed there was the need for extra radiotherapy service capacity it had not been able to agree a preferred option.  Whilst the development of additional capacity might not be considered critical to Gloucestershire, given the existing level of provision at Cheltenham, both Herefordshire and Worcestershire clearly had a strong interest in the development of a satellite service in their areas. 

Mr Paul Edwards, Director of Commissioning and Strategy was asked to advise the Committee on the viability of the Hereford option and the justification for it.

He re-emphasised the provision in the National Cancer Strategy that no patient should have to travel more than 45 minutes for cancer treatment.  Extra radiotherapy service capacity was needed in the 3CCN area.  The travelling times faced by Herefordshire patients were especially demanding.

A report from an independent consultancy firm commissioned by the PCT and the Hereford NHS Hospitals Trust to investigate the feasibility of radiotherapy services at Hereford Hospital had concluded that the Hospital could justify having 1 Linac (linear accelerator) in the near term with a view to having two machines operating in the medium term by 2015.  The PCT was recommending development at Hereford to the 3CCN with the installation of 2 bunkers with one Linac initially or possibly two Linac machines.

He noted that the development would complement the ongoing development of the Charles Renton Unit for cancer patients at Hereford Hospital.

The necessary capital expenditure would be required in 2010.  The PCT’s assessment was that the number of patients needed to justify  ...  view the full minutes text for item 47.