Agenda and minutes

Venue: Council Chamber, Fourth Floor, Easthampstead House, Bracknell. View directions

Contact: Liz Sanneh  01344 352233

Items
No. Item

34.

Welcome

Minutes:

The Chairman welcomed John Divall and Mark Ainsworth, South Central Ambulance Service, John Jones and Clare Culpin, Heatherwood and Wexham Park Hospitals Trust, and Dawn Hines, Berkshire East PCT.

 

Councillor Scott Burrows was welcomed to the meeting as an elected member of the Panel.

35.

Apologies for Absence/Substitute Members

To receive apologies for absence and to note the attendance of any substitute members.

Minutes:

There were apologies from Councillors Birch and Virgo who arrived late. There were no other apologies. There were no substitutes.

36.

Minutes and Matters Arising pdf icon PDF 104 KB

To approve as a correct record the minutes of the meeting of the Health Overview and Scrutiny Panel held on 3 September 2009.

Minutes:

RESOLVED that the minutes of the meeting held on 3 September 2009 be approved as a correct record, and signed by the Chairman.

 

Matters Arising

 

The Head of Overview and Scrutiny reported that the LINk newsletter had been circulated, as requested at the last meeting (item 23).  The letter concerning Heatherwood and Wexham Park Hospitals medium term options (item 26) had been composed, agreed and sent, and the response had been circulated with the Agenda (pages 20-24). The Joint East Berkshire Overview and Scrutiny Panel had formed a working party on hospital car parking charges, and a letter concerning this had been circulated on 4 September (item 32).

37.

Declarations of Interest and Party Whip

Members are asked to declare any personal or prejudicial interest and the nature of that interest, including the existence and nature of the party whip, in respect of any matter to be considered at this meeting.

Minutes:

There were no declarations of interest.

38.

Urgent Items of Business

Any other items which, pursuant to Section 100B(4)(b) of the Local Government Act 1972, the Chairman decides are urgent.

Minutes:

There were no urgent items of business brought to the meeting.

[Councillor Birch arrived]

39.

South Central Ambulance NHS Trust pdf icon PDF 1 MB

To receive a briefing from John Divall, Director of Corporate Affairs, and Mark Ainsworth, Divisional Director for Berkshire, on the performance and priorities of the South Central Ambulance NHS Trust

Minutes:

John Divall, Director of Corporate Affairs, South Central Ambulance Service, was invited to bring to the Panel an update of the Service’s recent Care Quality Commission results. He thanked the Panel for inviting him, and indicated that the letter outlining the CQC results for SCAS, together with updates of the Trust’s performance in the second quarter of 2009/10 and a letter to stakeholders, had been circulated with the Agenda papers.

[Councillor Virgo arrived]

 

Mr Divall gave a visual presentation of key facts. He acknowledged that the Service had been rated as weak this year for quality of service, but good for quality of financial management. He outlined to the Panel the challenges with performance over the past year, and indicated that the Service had missed all its performance targets. The Ambulance Service nationally had experienced challenges with Call Connect. The Panel was given information on how 999 calls were categorised by the call centre and Mr Divall said that an additional 300 staff had been employed. There were further challenges , which included rising demand of between 5% and 6% per annum, turnaround delays in Accident and Emergency departments, referrals by Forestcare, and long delays at hospitals when Accident and Emergency departments were full. There were also seasonal risks including pandemic flu.

 

The Chairman thanked Mr Divall, and invited questions. In response to a question concerning ambulance response times in Bracknell, the Panel was informed that ambulances were placed in six-minute-response zones around the area to give the best possible response times to residents. Waiting times at hospitals were a continuing problem, with every extra minute over 30 being granted £2.60 from the PCT, but it was felt that this cost should be passed on to the hospital trusts where the delays occurred. For every delayed ambulance at a hospital, a manager was sent in to try to manage the delay and free up ambulances and crews.

 

On the subject of recruitment and retention, Mr Divall indicated that there were staffing problems, mainly due to the high cost of living in the south of England, and many staff were lost to London where extra weighting was paid. There was currently a 10% vacancy rate for emergency care assistants across Berkshire.

 

In response to a question about rising demand, Mr Divall told the Panel that it was difficult to ascertain why there was an increase; for the frail elderly, the ambulance service was often seen as a failsafe – there were other options but 999 was easy to remember. The Service was trying to support and manage demand, with a helpdesk in many centres. Low priority calls were passed to a clinical support desk and could be referred to an out-of-hours service. There was also a problem in some areas with high numbers of non-UK residents who had no GP registration and who saw the ambulance service as the best way to gain medical advice and attention.

 

With regard to ambulances queueing at hospitals, Mr Divall told members  ...  view the full minutes text for item 39.

40.

Update on financial position of Heatherwood and Wexham Park Hospitals pdf icon PDF 700 KB

To receive an update from the Chief Executive of Heatherwood and Wexham Park Hospitals NHS Foundation Trust on the financial position, with reference to the Trust’s response to the Panel’s written questions, and the action being taken by the Trust on:

            a.      The statutory intervention notice issued by MONITOR; and

            b.      The Ratings of the Trust’s performance by the Care Quality Commission

 

Minutes:

John Jones, Director of Corporate Affairs, and Clare Culpin, Director of Nursing, from Heatherwood and Wexham Park Hospitals Trust attended the meeting in place of Julie Burgess, Chief Executive, who had been called away to a meeting with the Strategic Health Authority. They gave an update on the financial position at H&WPH, and indicated that documents showing the statutory intervention notice issued by MONITOR and the CQC rating had been circulated with the Agenda. A letter to the Chairman of HOSP, dated 14 October, had also been circulated.

 

In response to these recent developments, Christopher Langley had been appointed directly as Chairman, and a Medical Director had been sought; interviews were held and two applicants turned down the post, and there was now a temporary Medical Director in post. Mr Jones indicated that Monitor had made it clear that they had no concerns about patient care at the Trust. A major transformation programme was underway, with 150 cost improvement plans in place. The Trust was now working more effectively and the plans had been risk assessed to ensure safety of patients. Procurement contracts had been reviewed, and resources were being used more effectively. There would be a four year plan in January, and it was hoped to improve the Trust’s financial position and to turn around the organisation so that it became viable once again.

 

With regard to the declaration to the Care Quality Commission , which covered health and social care, 35 out of 42 standards had been met. There would be a formal declaration in the new year, and continuous assessment. The CQC had asked for mid-year declarations in April and October, following comprehensive review against all the standards. The Trust was working closely with the CQC and sharing detailed information in a bid to move forward.

 

The Chairman thanked the Trust representatives, and asked whether they were on track for licensing. The response was that they were working towards it and had had meetings with CQC who were reviewing progress, that a conditional licence was possible, but a decision would not be known until 2010. The Trust had undergone a very detailed assessment on core standards across the whole organisation, and they had reviewed all the evidence to assure themselves that it was robust. The conclusion was that they were now in a much better position.

 

Councillor Thompson asked about Monitor’s role, and whether there was continued contact. Mr Jones replied that the Trust needed to prove viability; the main difference in the plans was over governance and finance to ensure that the Trust made a surplus in two years’ time. Monitor had not rejected the whole plan, and Cllr Thompson was assured that there would be consultation about any major service changes.

 

With regard to the employment of agency staff, and the significant cost involved, Cllr Mrs Shillcock asked whether the Trust had examined its Terms and Conditions of employment to discover why staff did not want permanent contracts. Clare Culpin told the meeting  ...  view the full minutes text for item 40.

41.

NHS Berkshire East Budget pdf icon PDF 244 KB

To receive a report and briefing from Dawn Hines, Director of Finance and Performance, NHS Berkshire East, with particular reference to planning for cost reductions

Minutes:

The Chairman welcomed Dawn Hines, Director of Finance and Performance for NHS Berkshire East. She had been invited to attend the Panel to give an update on the PCT’s budget and to answer members’ questions with particular reference to progress on the PCT’s process to save 15%-20% of costs in the annual budget over the next five years. The budget paper had been circulated with the Agenda.

 

Ms Hines said that £20 billion was to be saved by the NHS nationally over the next five years, and NHS Berkshire East aimed to save £65 Million under world class commissioning. Ms Hines gave a brief presentation on the challenges and strategic plans for the PCT and drew members’ attention to the budget report. She told the meeting that the PCT was on target to deliver a surplus for the current financial year.

 

[Glyn Jones left the meeting]

 

Ms Hines told the meeting that the PCT had seen significant growth in the use of London hospital trusts, and for continuing care there were financial pressures. The PCT was reviewing the sale of Skimped Hill premises in light of the current financial climate.

 

The Chairman thanked Ms Hines and asked in what areas would there need to be change to make significant savings for the PCT. Ms Hines told the panel that they were currently using national benchmarking schemes. There was a high rate of outpatient appointments, so the PCT was asking whether they were buying the right level of service, and whether it could be bought more cheaply. They were looking at areas which were proven to be less clinically effective, and considering outsourcing pathology and diagnostics, prescribing, and specialist commissioning.

 

In response to a question about creditors, Ms Hines told the panel that the PCT was trying to streamline their payments process particularly for small businesses, and 70% of invoices were now being paid within 30 days. Councillor Burrows asked what assumptions had been made on continuing care, and Ms Hines advised that these had not yet been confirmed, but she would be happy to report on progress.

 

[Ms Hines left the meeting]

 

42.

Working Group Updates pdf icon PDF 62 KB

To note the written update from the three working groups:

Preparedness for Public Health Emergencies;

Bracknell Healthspace;

and

NHS Core Standards, including the letters sent to the NHS Trusts on the Core Standards Declarations.

 

 

Additional documents:

Minutes:

The Panel had received the Working Group updates with the Agenda papers.

 

Councillor Burrows introduced the progress report on the Preparedness for Public Health Emergencies Group, which had met six times, telling the meeting that this report would be written after meetings with the Health Protection Agency and others.

 

Councillor Virgo reported on Bracknell Healthspace Working Group which had met on nine occasions. The Group’s report had been drafted and was currently under consideration.

 

The NHS Core Standards Working Group had been formed following the last Health Overview and Scrutiny Panel, and letters sent out from this Group had been circulated.

 

43.

Overview and Scrutiny Quarterly Progress Report pdf icon PDF 98 KB

To note the Quarterly Progress Report of the Assistant Chief Executive (August - October).

 

Minutes:

The Head of Overview and Scrutiny introduced the report, which was self-explanatory. He drew the members’ attention to page 61 Developments, telling them that the Local Democracy, Economic Development and Construction Bill had been enacted and received Royal Assent. The progress report also included a summary of working groups with completed reviews and feedback questionnaires.

 

Richard Beaumont reported that on the ‘Strengthening Local Democracy’ consultation, resources for Overview and Scrutiny was one of the common questions asked by councils, and that extending powers without extra resources made the chances of success very remote. The Chairman agreed that this was an extremely serious matter as it was apparent to scrutiny panels that there was a lack of resource.

 

44.

Joint East Berkshire Health Overview & Scrutiny Committee Minutes pdf icon PDF 87 KB

To note the draft minutes of the Joint East Berkshire Health Overview and Scrutiny Committee meeting on 14 September 2009

 

Minutes:

The Panel noted the Joint East Berkshire Health Overview and Scrutiny Committee minutes of 14 September, which had been circulated with the Agenda.

 

Councillor Virgo told the meeting that the Joint East Berkshire Health Overview and Scrutiny Committee had set up a working party on hospital car park charges. Site visits were being planned, and the group would report back on their findings.

 

45.

Date of Next Meeting

4 March 2010 at 7.30 pm

Minutes:

The scheduled date of the next meeting was Thursday 4 March 2010 at 7.30 pm. The Chairman warned that Overview and Scrutiny was raising issues with the PCT and might need a meeting sooner. This was provisionally scheduled for Tuesday 22 December at 7.30 in the Council Chamber.

 

Contact Information

Democratic services

Email: committee@bracknell-forest.gov.uk