Apologies were received from Councillors EPJ Harvey, and Brigadier P Jones and from Mr P Burbidge, Miss E Lowenstein and Mr P Sell.

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

There were no named substitutes.

There were no declarations of interest.

To approve and sign the Minutes of the meeting held on 4July 2012.

RESOLVED: That the Minutes of the meeting held on 4 July 2012 be confirmed as a correct record and signed by the Chairman.

The Chairman requested that it be recorded that, in order to develop the Committee’s  role in pre-decision scrutiny and ensure that this was discharged effectively, it was essential that there was a clear and transparent mechanism in place for ensuring that Cabinet’s response to recommendations made by the Committee was clear and on the record.

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.)

No suggestions had been received.

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). 

No questions had been received.

It was acknowledged that there had been a delay in responding to questions from Members of the public submitted to the Committee’s previous meeting.  The Chairman made clear his expectation that public questions should be dealt with in a clear and systematic way and the questions and answers published with the relevant Minutes.

To consider the arrangements for a review of stroke services.

The Committee considered the arrangements for a review of Stroke Services in the NHS Midlands and East Strategic Health Authority Area.

Mr Paul Ryan, Head of Contracts, NHS Herefordshire gave a presentation.   A copy of the presentation has been included with the agenda papers on the Minute Book.

In discussion the following principal points were made:

·         Members questioned the arrangements in place to ensure prompt diagnosis of stroke.  They were informed that 6 consultants would be required to maintain a 24/7 rota for stroke services.  Currently Wye Valley NHS Trust employed one consultant.  Efforts to recruit a second consultant had been unsuccessful.  It was noted that other Trusts in the Region had also found it difficult to recruit consultants for stroke services.  Currently Herefordshire and Worcestershire formed a stroke network.  Most networks were larger and the likelihood was that across the Country there would be a move to fewer but larger networks.

·         It was requested that a briefing note should be produced providing more information on the Herefordshire context.  It was noted that whilst Wye Valley NHS Trust had improved the service the improvement had not been as fast and far reaching as was required.  However, Herefordshire was not alone in facing this challenge.

·         It was confirmed that submissions to the review had already made clear and would continue to make clear that account needed to be taken of the significant number of patients in east Powys who received treatment in Herefordshire.

·         It was necessary to acknowledge that the sparsity of the County’s population meant that it was difficult to justify the recruitment of the number of senior staff required to sustain some services.  In these circumstances the focus had to be on seeking to achieve the best level of service for the county that could reasonably be achieved.

·         It was confirmed that the review would explore the scope for improved preventative primary care.

RESOLVED:

That (a)   a Task and Finish Group be established to consider the proposals for reviewing stroke services and authorised to respond on the Committee’s behalf as appropriate;

          (b)  the following Members be appointed to serve on the Task and Finish Group: Councillors WLS Bowen, JLV Kenyon, JW Millar and A Seldon; and

          (c)   a briefing note be circulated providing more detail on the Herefordshire context.

To consider a response to a consultation on Local Authority Health Scrutiny.

The Committee considered a response to a Department of Health consultation on Local Authority Health Scrutiny.

The report set out a draft response to the specific questions posed in the consultation document.

In discussion the following amendments to the proposed response were suggested:

·         In relation to the response to questions 1 and 2 relating to timescales it was proposed to add that any timescales should be realistic and deliverable.

·         That in the response to question 3  it should be added that the provision of support and information to assist authorities in assessing financial and resource considerations should be welcomed and should include assistance in assessing possible alternatives.

·         The draft response to questions 4-6 was not accepted.  Members instead supported the introduction of a formal intermediate referral stage to the NHS Commissioning Board (NHSCB).  It was considered that this would be a practical measure reflecting the changes in accountability flowing from the Health and Social Care Act and the likelihood that if a matter were referred direct to the Secretary of State one of the first things he would be likely to do would be to seek the views of the NHSCB.  A formal arrangement would encourage local dispute resolution and help to reduce the risk of the politicisation of service reconfiguration proposals. 

However, to avoid unnecessary delays occurring, Members considered there should be a clear time limit within which the NHSCB must consider and determine a referral, with the Council having the discretion to refer a matter direct to the Secretary of State if that timescale was not met.

RESOLVED:

That    (a)     the response to the consultation set out in the report be approved as amended; and

(b)       the Head of Governance be authorised to finalise the response after further consultation with the Chairman and Vice-Chairman of the Committee.