To receive an update from the Primary Care Trust. (Report to follow)

The Committee received an update from the Primary Care Trust.

The Director of Integrated Commissioning highlighted the following issues.

Swine Flu

He updated the Committee on the approach being taken nationally and locally to tackle swine flu. 

He cautioned that there were quite a lot of flu like illnesses currently prevalent and because swabs were no longer being taken from every individual it was not possible to be certain quite how prevalent swine flu itself was.  Three practices continued to test patients as part of the national monitoring system but were not observing a large increase in swine flu cases. 

However, past experience suggested that viruses of this type came in waves.  The Country may have reached the cusp of the first wave but statistically a more virulent second phase was to be expected, perhaps in the Autumn when schools reopened.

He reported that the experience to date had highlighted the need to strengthen business continuity plans.  The worst case scenario was 30% of staff absent and partnership working would be important to facilitate redeployment of staff to critical services.

It was being advised at national level that a vaccine would be available on a phased basis from the end of August 2009.

He added that the establishment of the National Flu line had seen a reduction in the number of calls to the out of hours GP service. 

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

·                In response to comment that mixed messages were being given to people concerned they might have the disease about the action they needed to take, the Director replied that the advice through the national flu line had been refined and should be consistent.

·                The position regarding the number of pharmacies authorised to distribute Tamiflu was also discussed.  The Director said that there were six pharmacies across the County stocking Tamiflu.  Asked if this was a sufficient number given the geography of the County he said that the number was determined in accordance with national guidelines.  Resilience was the key.  In the event of pressures on staffing the plan was to move to fewer but larger centres, the provision of critical services being a higher priority than geographical access.  However, it had been recognised that provision in Hereford City, with one outlet, needed to be bolstered by providing extra staff. 

·                Asked about the extent of local discretion in the measures being taken he said that the response was being driven nationally but there was some scope for local flexibility, the negotiated authorisation to use six pharmacies referred to above being one example.

·                Asked if the service was appropriately prepared he said the reopening of schools in the Autumn would be the test of that.  He added that the national and local response to the potential threat had been proportionate.

·                The potential for there to be extreme pressure on frontline services to the extent of even emergency cases having to be prioritised and the need for clinical decisions to be taken to provide sub-optimal care to patients was noted.  There were, for example, 6 intensive care beds in Hereford Hospital.  Whilst there were plans to expand provision services would have to be shared with neighbouring authorities.

Provider Services Review

The Director reported that work was continuing to divest the PCT of its provider role.  There was strong support for integrating community services and hospital services.

There were risks in the PCT providing mental health services in terms of retention, recruitment, governance and resilience.  The PCT Board had agreed to enter into a procurement process to secure a partner with expertise and resources to run the mental health service within the County.

Finance

The Director reported that there were a number of financial pressures, with the costs of continuing health care and specialist placements, learning disabilities and mental health increasing.  He commented on the importance of the funding available for health in the County across organisations being viewed as a whole.

Head and Neck Cancer Services

The Director reported on consideration being given by the Three Counties Cancer Network to consolidating Head and Neck Cancer Services, currently provided at Gloucester and Worcester, onto one site.  The Review Panel had concluded that Gloucester was the preferred site.  However, because the decision had been so finely balanced national advice was being sought on whether a solution involving provision at both locations was feasible.

The Committee noted that an update would be made to it in September.