To receive an update on current issues.

Mr Simon Hairsnape, Deputy Chief Executive of the Herefordshire Primary Care Trust (PCT) provided an update on current health issues.

He commented as follows:

·          In relation to the presentation to the Committee by the Chief Executive of the Hereford and Worcester NHS Ambulance Trust, the previous item on the agenda, he said that the County was fortunate to have a high performing and innovative Ambulance Trust.  Any organisation seeking to change the way in which it delivered services, as that Trust was doing, would face some criticism and concern but he believed that the Trust was correctly looking to the future.

·          That the PCT was shortly to embark on the second year of the three year Local Delivery Plan (2005-08).  The Trust was to receive a further £15million in 2006/07 a 7.5% budget increase.  Both the PCT and the Hereford Hospitals NHS Trust had balanced their budgets.

·          Waiting times had been viewed by the Government as the foremost public concern and the evidence showed that this was being addressed.  There had been significant reduction in waiting times in the County.  The next target was to reduce the time from a patient seeing their GP to being treated in hospital as a day case to a maximum of 18 weeks. 

·          There was evidence that, contrary to some predictions, patients would exercise their rights to choose where they would have their treatment and this would present management challenges.

·          That the PCT was specifically dedicating resources to a public health programme in 2006/07.  The focus on Hereford City and in particular the South Wye area recognised the need to address the historically poor access to health services in that area.

·          A new dental contract would come into force in April 2006.  The PCT was now nearing the point where everyone in the County who wanted to register with an NHS dentist could do so.

·          In terms of cancer services discussions were taking place within the Three Counties Cancer Network about future radiotherapy provision.  It was recognised that travelling times from the West of the County to the present facility at Cheltenham were an issue and there was a wish to address this if possible. 

·          Practice based commissioning would provide an opportunity to develop services.

·          Reorganisation of the Health Service was also ongoing.  A consultation exercise was expected to be launched by the Strategic Health Authority on 14 December and run until mid-March.  The consultation document was to include the continuation of a Herefordshire PCT as a preferred option.  However, it would nevertheless be important to provide a robust argument in support of the PCT’s survival.   The joint working between the Council and the PCT, facilitated by the co-terminosity of the two organisations and which had been encouraged by the Department of Health, would be a key component of that case.

In response to this statement the following principal comments and questions were raised:

·          A question was asked about the potential threat posed by patient choice to the viability of providers.  Mr Hairsnape replied that it was being recognised that the PCTs would have an important role in managing the situation and controlling capacity to avoid a major provider being put in jeopardy.

·          Members emphasised the benefits of co-terminosity at a local level and the potential for new approaches to be tested in a relatively controlled environment.

·          Mr Hairsnape confirmed that no operations in Herefordshire were being cancelled because of lack of finance.  What restrictions there were on carrying out more work more quickly related to staff and capacity.

·          Further information was sought about the prospect of a radiotherapy facility in Herefordshire.  Mr Hairsnape emphasised the specialised nature of the service and the expectation that a facility needed to serve a population of 1-1.5 million people to be viable.  However, the Three Counties Cancer Network had asked Worcestershire Acute Hospital NHS Trust and Hereford Hospital NHS Trust to put forward proposals for a satellite centre for consideration in Spring 2006.  The PCT was keen to support the Hereford Hospital NHS Trust provided that a practical proposal could be made which would provide clear patient benefits and guarantee clinical safety.  He added that depending on the options which came forward a formal consultation exercise might be necessary.  In any event the Committee and the Patients Forums would be made aware of the position and invited to comment as appropriate.

·          A question was asked about the routing of patients from parts of Wales to Cheltenham rather than to Cardiff.  Mr Hairsnape suggested that there may be a number of reasons for this but the matter was principally one for local health Boards and the Welsh Assembly.