To discuss the following areas of interest: the local delivery plan process, NHS dental services and primary care led commissioning.

The Committee received a presentation by Mr Simon Hairsnape, Director of Health Development at the Primary Care Trust (PCT) on three areas of current NHS interest: the Local Delivery Plan Process, NHS Dental Services and Primary Care Led Commissioning.  

Mr Hairsnape had produced a briefing paper summarising the current position on each of the three areas and elaborated on aspects of the paper as set out below.

(a)        Local Delivery Plan Process

Mr Hairsnape explained that the NHS planning cycle operated on a rolling three-year basis through the production of Local Delivery Plans (LDP).  The next planning cycle started on 1 April 2005 running until 31 March 2008.  An LDP was in preparation for submission to the Strategic Health Authority by 31 January  2005.

He outlined the demands placed on the Trust by the Government’s change agenda and the importance of devising a balanced financial plan in support, noting the expectation that additional resources would be made available to the NHS by Government in the forthcoming financial settlement and the opportunities this would provide.

He explained that the Trust would want to agree social care priorities with the Council and reflect them in the Plan. 

The Director of Social Care and Strategic Housing confirmed that there was enhanced scope for joint planning and the Council and the PCT agreed on the direction to be pursued in taking advantage of this opportunity.

In response to questions Mr Hairsnape confirmed that the PCT worked closely with all the Council’s Directorates, acknowledging the cross-cutting nature of health related issues.

(b)       NHS Dental Services

Mr Hairsnape noted the extent to which access to NHS dental services had emerged as a national problem, becoming a top priority.  He explained the current position in Herefordshire and the development of a Dental Action Plan, which had been agreed with the Department of Health, to provide additional NHS places.  He advised that the PCT was taking what steps it could to improve the situation but expected that it would take 12-18 months to achieve any marked improvement.

The Committee noted the difficulties faced and the action being taken.

(c)            Primary Care Led Commissioning

Mr Hairsnape advised that the introduction of indicative budgets for GP practices, to enable them to commission their own services, was another key aspect of the NHS System reforms.  All GP practices would have a right to choose to take part with effect from 1st April, 2005, the expectation being that this would rapidly become the norm for Practices.  Discussions with GP practices in Herefordshire about the system were currently ongoing.

In the course of discussion some concern was expressed as to whether the change would mean better services for the public or might even be open to abuse.  Mr Hairsnape advised that the commissioning process would have to be set out in the Local Development Plan and mechanisms would be included to manage the process.  However, the PCT had decided to adopt a flexible stance and there was good reason to be confident that the system would be of benefit to patients.  He confirmed that the requirement on the PCT to consult the Committee in the event of a substantial variation to a service would be unaffected by the initiative.