To receive apologies for absence.

Apologies were received from Mr J Wilkinson of the Local Involvement Network.

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 5 December 2008.

RESOLVED:  That the Minutes of the meeting held on 5 December 2008 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 from members of the public.

To consider the report of the scrutiny review of the West Midlands Ambulance Service in Herefordshire.

The Committee considered the report of the scrutiny review of the West Midlands Ambulance Service in Herefordshire, commissioned by the Committee in September 2008.

The Chairman thanked the Review Group for their work and the balanced report they had produced. She also thanked the officers of the Ambulance Trust in particular for the open way in which they had responded to requests for information, together with officers of the Primary Care Trust and the Hospitals Trust.  She also thanked officers of the Council who had supported the review.

The Chairman of the Review Group was invited to comment on the Review Group’s findings.  He endorsed the Chairman of the Committee’s thanks to those who had contributed to and supported the review.   He then commented on the Group’s principal findings and recommendations as set out in the executive summary of the report.

Other Members of the Review Group commented on and highlighted some of the findings they considered to be of particular concern.

In the ensuing discussion the following principal points were made:

·         In response to a question about what happened if one of the vehicles from Herefordshire had to travel to Birmingham a representative of the Ambulance Trust confirmed that as soon as the vehicle had completed that one job it was returned to the locality and not retained for assignment to other calls in the Birmingham area.

·         Turnaround times at the hospital were a particular concern identified in the Review report.  The Ambulance Trust Locality Manager commented that, whilst there were improvements to be made, Hereford Hospital’s performance in this respect compared favourably with other hospitals.  One of the main problems faced in Herefordshire was the fact that there was only the one acute hospital so if a difficulty arose at that hospital there was no convenient alternative facility to which patients could be taken.

·         The resilience of the ambulance service in the county and the importance of regular needs assessments to ensure that the service was resilient was discussed.  It was noted that the review recommended additional resource be provided at Ledbury.

·         The recommendation that there should be improvement in collaboration and co-location of blue light services was discussed, noting that the national development of a shared radio system would represent one step forward.

·         The importance of examining patient outcomes rather than relying simply on the measurement of time-based targets was discussed. It was noted that a national consultation exercise on targets was underway and it was to be hoped that this would address this concern.

·         The Chief Executive of the Hospitals Trust commented that bed capacity clearly had a bearing on turnaround times.  However, the Trust had already made improvements in turnaround times and he would confirm progress in his formal response to the Review. 

·         The Review Group had been informed in February that the commissioners of the ambulance service had proposed their own independent review of the service in December 2008, the Committee’s own review having been commissioned in September 2008.  Assurance was sought  ...  view the full minutes text for item 44.

To note the award of a contract for the development of a GP-led walk-in health centre for Herefordshire and the provision of the out of hours service.

The Committee was informed of the award of a contract for the development of a GP-led walk-in health centre for Herefordshire and the provision of the out of hours service to Nestor Primecare.

The Chairman reported that, in response to comments made about the proposed development of the GP-led Health Centre at the Committee’s meeting in December  2008, she had met the Director of Integrated Commissioning and the Equitable Access to Primary Medical Care Programme Manager (EAPMCPM) to seek clarification and assurance on a number of points. 

The report summarised the history of previous reports to the Committee on the project and the clarification and assurances received in response to questions asked by the Chairman following the Committee’s meeting in December.

In the course of discussion the following principal points were made:

·         Mixed views were expressed about the advantages of the Centre, its cost and potential effect on existing services.  Further clarification was sought in particular on the implications for local GP surgeries within the County of the Centre’s ability to register patients.  The EAPMCPM emphasised in response that the Centre would only be able to register patients within the Hereford City boundary.  People living outside the City boundary would, however, be able to attend the Centre on a walk-in basis.  He added that registrations were restricted to 3,000 over the life of the five year contract representing some 5% of the City population.  The safeguards outlined in the report reflected the Primary Care Trust’s (PCT) aim to avoid destabilising the existing services but provide an additional service, a principal benefit of which would be to reduce pressure on the Accident and Emergency Unit.

·         In reply to a question about the views of Hereford City GPs it was replied that the Local Medical Committee (LMC) had invited Nestor Primecare to take part in LMC meetings.  The PCT had also been constrained to a degree in the discussions it could have with GPs during the tender process by the fact that a consortium involving some local GPs had submitted a bid for the contract.  Since the award of the contract the PCT was now able to discuss the plans more openly with the GPs and explain the safeguards in the contract, the absence of a financial incentive in the contract to increase registrations and the focus of the key performance indicators in the contract on reducing inappropriate A&E attendances through the provision of walk-in capacity.  This had addressed a lot of the GPs’ concerns.

·         Asked about recruitment of staff the EAPMCPM said that a local GP had been appointed by Nestor Primecare as the GP lead for the Centre.  Nestor Primecare’s wide contacts should assist in the recruitment drive.  Given the economic downturn Members suggested that Nestor Primecare should be encouraged to employ local people where possible.

·         The Director of Integrated Commissioning reported in response to a question that it was still hoped that it would be possible to accommodate the Centre on the Hereford Hospital site.  Discussions with the  ...  view the full minutes text for item 45.