Apologies for absence were received from Cllr Cutter.

Officers present:  Dr S Aitken, Mr J Jones and Mr D Taylor

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

None.

Councillors RC Hunt and P Jones as Trustees and Directors of Leominster Tourist Association.

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

(There will be no discussion of the issue at the time when the matter is raised.  Consideration will be given to whether it should form part of the Committee’s work programme when compared with other competing priorities.)

None.

To note questions received from the public and the items to which they relate.

(Questions are welcomed for consideration at a Scrutiny Committee meeting so long as the question is directly related to an item listed on the agenda.  If you have a question you would like to ask then please submit it no later than two working days before the meeting to the Committee Officer.  This will help to ensure that an answer can be provided at the meeting). 

There were no questions from the public.

To receive a presentation on the work of the West Midlands Ambulance Service NHS Trust together with an overview of the Trusts current plans.

The Committee received a presentation from Mr P Murtagh, Commissioning Director West Midlands Ambulance Service.  The presentation is attached as Appendix 1.  During the presentation, he highlighted the following areas:

·         That there was a transformational strategy in place to move from functioning as a traditional ambulance service to becoming an integrated healthcare provider. 

·         That the Service was the only Ambulance Service to have achieved all its operational performance indicators in 2010-11.  This was challenging in rural areas of Herefordshire.

·         That the Quality and Risk Profile was improving  on a monthly basis.

·         That the move to Foundation status was entering its final phase, and the Trust should become a Foundation Trust by the end of the July 2012.  The change would mean greater involvement from the public, and accountability for the Trust.   There were 8,500 public members, from which a 15 Members of the 29 Council of Governors were elected. 

·         The Make Ready system was in place, with large hubs which serviced local ambulance crews.  Herefordshire was one of the first counties to open a hub, a system that maximised the time paramedics could be on the road by providing them with operational ready ambulances.

In the ensuing discussion, the following points were raised:

·         That there was concern over the timing of the consultation that had been issued regarding the operational change to the service and the subsequent closure of ambulance stations.    The consultation had been issued over the Council’s purdah period during the elections in 2011, and no response had been possible.

·         That the work that was being undertaken by the Service was designed to free up resources by improving clinical performance and efficiency.  The Make Ready Hubs would allow clinical staff more time with patients.  He said that the greater clarity would be provided by including local ambulance stations on the map in the presentation.  The Hubs would only have ambulances in them at night, because operational crews would be spread across the County during the day.

·         That whilst there had been a drop in performance against targets in July and August 2011, this was as a result of a number of staff undergoing advanced paramedic training. At the lowest point, the Service had still attained 84.62% of its targets.  Following the training, the Bromyard community paramedic scheme had hit 100% of its target (to reach all cases within 8 minutes) in September.  This scheme had proved to be invaluable, and would be rolled out across the County from April.  The Chairman commented that whilst this was a welcomed scheme, he did not want to see the County’s resources stretched with an emphasis on achieving targets in urban areas.

·         Herefordshire would not be marginalised, and the service would still be a local one throughout the County.  It was important that a rural presence should be maintained, and there were staff within the call centres who were dedicated to specific local areas within the area covered by the centre.  In reply to a specific question from a Member, he  ...  view the full minutes text for item 81.

To receive a presentation on the work of the West Mercia PCT Cluster.

The Committee received a presentation from Mr Eamonn Kelly, Chief Executive of the NHS West Mercia PCT Cluster.  The presentation is attached as Appendix 2.  During the presentation, Mr Kelly highlighted the following areas:

·         The national quality priorities for 2012/13.  These included a general message concerning the needs to address the shortfalls in dealing with older people, and the pivotal role of carers.  There was also an emphasis on the military and veterans’ health.

·         There were a number of national clinical outcomes against which there were quality measures.  In the past there had been different standards for rural communities for measures such as ambulance response times, but these were now all of a single standard.  The area of quality of life for those with long term conditions would continue to grow and managing this area would be a huge challenge; there were presently 145 different significant illnesses in this category.

·         Key challenges for Herefordshire included meeting targets for C Difficile and A&E admissions.  Wye Valley Trust were confident that both of these could be met in the coming year.

·         That the reform of the commissioning system to complete the transition to the new architecture would be radical.  Across West Mercia there would be six Clinical Commissioning Groups under one Commissioning Support Organisation.  This was considered to be the most effective model.  The West Midlands would be one of the local parts of the single National Commissioning Board.  Principle responsibility for public health would fall to the Local Authority.

·         This would be a challenging time for staff, 45% of which would be employed by the Clinical Commissioning Group and the Clinical Support Organisation, 20% from the National Commissioning Board, 17% from the local authority, which left 18% to be determined.  There were a number of schemes running to offer support, such as regular briefings, surveys and Q&A sessions.

·         The QIPP (Quality, Innovation, Productivity and Prevention) plans would present a huge challenge for West Mercia, which would have to save £377m over 4 years.  The providers would have the greatest challenge, having to save £21m out of a total of £295m

In the ensuing discussion, the following points were raised:

• That the Wye Valley Trust would provide integrated provider services, and the organisational model was currently being reviewed.  The single management authority for the PCT would no longer exist after the abolition of the PCT.  The Clinical Commissioning Group (CCG) would take its place with the Local Authority and would commission services from Hoople Ltd and Herefordshire Public Services (HPS)

• That the CQC would be responsible for regulating all healthcare providers; they were currently responsible for all community health care providers.  The first responsibility for assessing providers would be to get the appropriate combination of PCT, CCG and Local Authority clinicians under the aegis of the Joint Commissioning, Public Health and the Health and Wellbeing Board.

In answer to a question, Mr Kelly said that whilst the changes were complex and appeared fragmented, there would be a net reduction of  ...  view the full minutes text for item 82.

To consider the findings arising from the Task & Finish Group – ‘Tourist and Temporary Event Signage Review’ and to recommend the report to the Executive for consideration.

The Task & Finish Review Report: Tourist and Temporary Event Signage was deferred to the meeting to be held on the 19 March 2012.