To receive apologies for absence.

There were none.

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

There were none.

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

There were none.

To approve and sign the Minutes of the meeting held on 20 September 2010.

RESOLVED:  That the Minutes for he meeting held on 20 September 2010 be confirmed as a correct record and signed by the Chairman, subject to recording that Councillor WU Attfield had submitted her apologies for that meeting.

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

There were none.

To consider what Herefordshire Public Services are doing to improve access to health services.

The Committee considered what Herefordshire Public Services are doing to improve access to health services.

The Assistant Director Public Health, the Associate Director of Integrated Commissioning and the Consultant in Dental Public Health presented the report. 

The Assistant Director highlighted the role of the Rural Access Partnership which oversaw a number of programmes to address access to services in rural areas.

He also noted the role the Committee and all Members of the Council could play in developing and improving access to rural services, particularly around transport; supporting local projects within their wards; and lobbying for changes on a wider basis that would improve the health and wellbeing of the population of Herefordshire.

The report contained a detailed appendix on access to dental health services in response to a request from a member of the public to the Committee in June 2010 that this aspect be scrutinised.

The Associate Director emphasised the improvement made to access to dental care following an exercise to procure additional dental capacity with effect from 1 October 2010.  In September 2010 the percentage of the resident population of Herefordshire who had accessed NHS dental care within the previous 24 month period was 52.16%, compared to 56% in England as a whole.   The statistics quoted in the appendix to the report were not yet able to reflect the additional capacity provided from October 2010.  The picture was therefore brighter than shown in that report.

In discussion the following principal points were made:

·         The report stated that the percentage of Herefordshire households within set distances for most key services was much lower than for the West Midlands Region and England as a whole.  Access to GP surgeries within the nationally set distance of 4km had increased from 76% in 2007 to 83% in 2008.   It was requested that a further report be made to the next meeting on access, based on distance, to GPs, community hospitals, Hereford Hospital and other specialist hospitals out of the County. As a general principle it was requested that reports showed distances in both metric and imperial measures.

It was asked whether there was any intention to make additional provision to increase the percentage of people within the set distance of GP surgeries.  The Associate Director replied that the list size of GPs within the County was better than the West Midlands average with no single-handed practices.  Coverage was considered good given the rural nature of the County.

·         The implications for access to services of the Government’s reduction in the bus subsidy were noted.

·         The role played by the voluntary sector, for example in providing community transport, and the potential implications of a reduction in support to that sector because of the financial situation was discussed. 

The Grants and Partnership Officer commented that the community transport service was provided by independent charities that were dependent on grant and subsidy.   The cost of replacement vehicles was significant and the availability of external grants to finance this expenditure was decreasing.  Currently the Council provided  ...  view the full minutes text for item 41.

To invite the Committee to submit its formal response to the proposed changes to health and social care services in Herefordshire.

The Committee was invited to submit its formal response to the proposed integration of the provision of health and social care services in Herefordshire.

The report summarised engagement with patients, public and stakeholders on the integration proposals.   It also reported on feedback from Councillors provided at a seminar on 30 September.

Mr Woodford, Chief Executive of Hereford Hospitals NHS Trust, presented the report. He informed the Committee that there would be further opportunity for the Committee to comment on the proposals, noting that the Committee was scheduled to receive a report in January 2011.

In discussion the following principal points were made:

·         Mr Woodford confirmed that his team were working closely with commissioners and GPs to ensure that the changes would be well managed.  He considered that the GPs supported the proposals.

·         The Associate Director of Integrated Commissioning reported that relations between NHS Herefordshire (NHSH) and the GPs were good and that NHSH was working proactively with GPs on the proposals in the Health White Paper: Equity and Excellence – liberating the NHS, to establish GP Consortia to undertake the future commissioning of services.

·         That a financial overview of the integration proposals would be included in the report to the Committee in January.  Mr Woodford commented that the proposals were intended to deliver savings for reinvestment into services. 

·         The proposal to develop 8 neighbourhood teams was discussed.  Mr Woodford advised that this was compatible with the Council’s development of 9 localities as a basis for service delivery and arrived at as the practical solution in consultation with GPs.  It was requested that all Councillors and the PCT Board be kept informed of developments on this aspect of the proposals.

RESOLVED:

That (a)           the themes set out in the report arising from the Member seminar held on 30 September 2010 form the basis of the Committee’s formal response to the consultation exercise, emphasising the importance that the proposals were sustainable in terms of cost;

            (b)       a further report be made to the Committee in January 2011 describing the overall engagement process, the responses and any changes made to the proposed services as a result, together with a financial overview, at which point it be noted that the Committee would make further observations as it sees fit; and

            (c)        Councillors and PCT Board Members be kept informed of the proposals for the development of neighbourhood teams.

To update the Health Scrutiny Committee on the progress of the Mental Health Procurement Project (known as MHPP).

The Committee considered progress on the mental health procurement project.

The Associate Director of Integrated Commissioning presented the report.  He advised that there was still a significant amount of work to be undertaken to enable the new provider, once appointed, to operate as service provider with effect from 1 April 2011.

It was noted that the Section 75 arrangements for the provision of social care services for mental health and learning disabilities required careful consideration to ensure that the provider could deliver the required level of service.  The Associate Director said that a detailed specification had been drawn up and the potential providers were both experienced in providing the required range of services.

It was noted that the NHS Herefordshire Board had approved the procurement process in July 2009.  Concern was expressed at the length of time taken to conclude the process and it was requested that a review should be undertaken to see what lessons could be learned from the exercise.

The Committee was also assured that the Committee would be formally consulted on any detailed proposals varying the range and location of services.

RESOLVED:

That    (a)        the progress and next steps to procure a preferred partner to provide Mental Health (health & social care) services & Learning Disability (health care) services be noted;

            (b)       any proposals to vary the range and location of services upon which formal consultation is required be brought to the Committee as appropriate should that be necessary after the new provider is appointed; and

            (c)        the Committee’s concerns at the length of time taken to conduct the procurement exercise be registered and it be requested that officers undertake a review to see what lessons can be learned from this exercise and the outcome of the review be reported to the Committee.

To draw the Committee’s attention to aspects of the 2010 JSNA.

The Committee was informed of the key points and recommendations of the JSNA 2010.

The Assistant Director Public Health presented the report noting that the findings were intended to inform the planning of all council services.

In response to questions about the expenditure on preventative health measures the Assistant Director replied that this was being considered as part of the development of the Health Improvement Plan.

THAT (a)      key points and recommendations from the 2010 JSNA be noted; and

(b)      the use of the findings of the JSNA across the local health and social care economy, to inform future plans, strategy development, budget decisions and commissioning of services be encouraged.

To receive an interim update from Hereford Hospitals NHS Trust, West Midlands Ambulance Service NHS Trust and NHS Herefordshire.

The Committee noted the report.

To consider the Committee’s work programme.

The Committee considered its work programme.

The following additions were agreed:

·         a further report in relation to access to health services including information on access, based on distance, to GPs, Community Hospitals, Hereford Hospital and other specialist hospitals out of the County to enable the Committee to understand how the difficulties of distance are overcome or mitigated to ensure appropriate attention at health facilities;

·         an update be provided on dental health care of children in the County when the results of the next co-ordinated National Surveys were published.

·         a report on the outcome of a review of the mental health procurement exercise to see what lessons can be learned from this exercise.

·         the NHS Herefordshire update should include developments relating to the Health White Paper – Equity and Excellence – Liberating the NHS, including information on GP consortia, development of Healthwatch, Health and Wellbeing Boards; and information on proposals relating to the GP led Walk in Centre.

·         a presentation on West Midlands Ambulance Service’s plans to seek Foundation Trust Status.

RESOLVED:  That the Work Programme as amended be approved and reported to the Overview and Scrutiny Committee.