Agenda and minutes

Minutes of the meetings held on 19 January 2017 and the Joint Scrutiny Budget Committee held on 30 January 2017 (previously circulated).

RESOLVED that the Minutes of the meetings held on 19 January 2017 and the special Joint Scrutiny Budget Committee held on 30 January 2017 be signed as correct records.

(a) The Chairman welcomed Mrs R Saltmarsh who was attending the meeting in her capacity as a Co-opted Member of the County Council's Standards Committee to observe and monitor compliance with the Council’s ethical governance framework.

(b) The Chairman reported that that the Devon District Councils had appointed Councillor Diviani as their representative on the Committee in place of Councillor Christophers.

Items which in the opinion of the Chairman should be considered at the meeting as a matter of urgency.

The Chairman reported that this was his last meeting of the Scrutiny Committee as he would not be standing at the forthcoming County Council Elections. He thanked the Vice Chairman, Members and the Scrutiny Officer for their support over the last eight years. The Vice Chairman and other members thanked the Chairman for his impartiality and even handed control of meetings and good humour over this period.

Members of the public may make representations/presentations on any substantive matter listed in the published agenda for this meeting, as set out hereunder, relating to a specific matter or an examination of services or facilities provided or to be provided.

In accordance with the Council's Public Participation Rules, the Committee received and acknowledged oral representations made by Mr P Wearne, Councillor P Hayward (Axminster Town Council) and Councillor J Rowland (Seaton Town Council) (Minute *56 refers) on a matter to be considered by the Committee, namely ‘Your Future Care’.

The Chairman responded, thanking the speakers for their attendance and presentations which would be taken into account by the Committee during its subsequent deliberations.

(Councillors Ball attended in accordance with Standing Order 25(2) and spoke to this item and Councillor Parsons attended under Standing Order 25 (1) and spoke at the invitation of the Committee questioning the rationale for the decisions and impact on their respective communities of the proposed closure of community beds at Okehampton and temporary closure of beds at Holsworthy Community Hospitals).

Ms J Fitzgerald (Chief Officer, NEW Devon Clinical Commissioning Group CCG), M L Nicholas (Director of Strategy / STP Programme Director, NEW Devon CCG), Mr R Sainsbury (Chief Operating Officer, NEW Devon Clinical Group) and Dr S Kerr (Vice-Chair Eastern Locality, NEW Devon CCG) attended and spoke to this item at the invitation of the Committee.

The Committee considered the Report of NEW Devon CCG on the ‘Your Future Care’ on the outcome of public consultation which had commenced on 7th October 2016 and the subsequent decisions of the CCG Board on 2 March 2017.

The CCG Representatives reported that its Board at its meeting on Thursday 2 March 2017 had determined:

·         a reduction of community hospital beds from 143 to 72 in the Eastern locality

·         Tiverton & District Hospital to be a fixed point providing an inpatient unit with 32 beds

·         Exmouth Community Hospital as a 16-bedded hospital

·         Sidmouth Community Hospital as a 24-bedded hospital

·         in light of the rurality and associated factors, to commission further work to assess more extensively the services needed in the Okehampton area.

The decisions meant that community inpatients beds at Sidmouth, Exmouth and Tiverton community hospitals would remain, while those at Seaton, Exeter (Whipton), Okehampton and Honiton would close.

The Clinical Commissioning Group’s representative responded to Members’ questions and/or commented that: 

·         detailed planning for implementation of the changes would start as soon as possible and led by the community services provider, the Royal Devon & Exeter NHS Foundation Trust;

·         the robust implementation assurance process which would be in place and  inpatient beds would only close when the assurance process had been completed and this would be phased to ensure the new community services were in place and patient care could continue to be provided safely;

·         an assurance panel including consultant geriatricians, GPs and Healthwatch with social and primary care input, would be established and community representatives would be included from the areas affected by the changes;

·         a consultation response unit (CRU) had been set up to answer questions and could be contacted via d-ccg.yourfuturecare@nhs.net

·         approximate cost savings arising from the planned changes and that the detailed plans relating to staffing and resources arising from the proposals had not, as yet, been drawn up;

·         relevant Performance Indicators in regard to current and future outcomes would be provided.  

The Chairman undertook to seek a breakdown of the cost of the STP process in Devon reported at £2.6 million over the last 6 months.

The Scrutiny Officer outlined the timetable for any referral to the Secretary of State which would necessarily be preceded by a formal request to the CCG which should respond within 28 days to  ...  view the full minutes text for item 56.

3.40 pm

(a) Report of the Chief Officer for Communities, Public Health, Environment and Prosperity, attached;

(b)  Report of the Joint Scrutiny Spotlight Review (CS/17/11) attached 

The Committee considered the report of the Chief Officer for Communities, Public Health, Environment and Prosperity on the provision of Public Health Nursing Services and on the outcome of an extensive consultation exercise with staff and other health professionals and parents of children and others, on the three options set out therein.  

The Committee also considered the report of the Spotlight Review (CS/17/11) on the expiry of the current contract with Virgin Care Limited on 31 March 2018.

It was MOVED by Councillor Westlake, SECONDED by Councillor Sellis and

RESOLVED that following consideration of both the Chief Officer’s and the Spotlight Review recommendations the Cabinet be recommended to adopt Option 1.

3.15 pm

Report of the South Devon and Torbay Clinical Commissioning Group, attached 

Mr S Tapley and Dr N Roberts Devon and Torbay Clinical Commissioning Group, South Devon and Torbay Clinical Commissioning Group (CCG), attended and spoke to this item at the invitation of the Committee.

The Committee considered a report of the South Devon and Torbay CCG on the decision of its Governing Body meeting on 26 January and the implementation process following the extensive consultation and engagement processes. The Governing Body had agreed:

·       the statement that “the proposed model of care represents the best way of delivering quality of care in a manner that is sustainable and affordable.”

·       the proposals which formed the basis of consultation subject to the following changes:

·         rather than disposing of Ashburton and Buckfastleigh Hospital, it is recommended that the hospital be evaluated as a base for the area’s local health and wellbeing centre, including co-location of primary care

·         the demand for x-ray and for a minor injuries unit in the Bay is recognised and the CCG plans to meet this through the proposed establishment of an urgent care centre on the Torbay Hospital site

·         specialist outpatient clinics to continue to be provided in Paignton where the volume of patients makes this a more appropriate option to travelling to Brixham, Totnes or Torbay.

·         parameters for the implementation of changes relating to the care model

·         suggestions relating to implementation of the care model put forward in the Healthwatch consultation Report reviewed as part of the implementation process and progress reports on implementation of these proposals are reported quarterly to Governing Body.

The Clinical Commissioning Group’s representative responded to Members’ questions relating to:

·         approval of the arrangements by the SW Clinical Senate (report available on the web at http://www.swsenate.org.uk/category/senate-advice/

·         arrangements for staffing (which was almost up to the planned establishment) and other resources as a result of the planned changes

·         services available at the planned new Health and Wellbeing Hubs including physio and occupational therapies.

It was MOVED by Councillor Westlake, SECONDED by Councillor Sellis and

RESOLVED that the report be noted and the implementation of the care model be supported and that a progress report be submitted to this Committee in approximately 6 months.

4 pm

Report by the SW Ambulance Service Trust, attached 

Mr S Boucher, Head of Operations, West Division, SWAST (South West Ambulance NHS Service Foundation Trust) attended and spoke to this item at the invitation of the Committee.

The Committee considered a briefing note by the SWAST on a new Rota Review Project which sought to align rotas and fleet ratios to the new demand profile and tackle inefficiencies identified within current structures. The rotas would be aligned to ensure the right number of staff were on duty at the right time, in the right place. This would enable the service to manage peaks in demand, giving an improved response to patients as well as staff welfare and wellbeing.

The Committee also received a presentation from Mr S Boucher covering:

·         the objectives of the National Ambulance Response programme and benefits for Devon,

·         the timeline with expected implementation in Spring 2017 and the timeline for the Rota Review; and

·         rota review performance figures and numbers of Community First responders and public access defibrillator schemes and local funding raising events.

Mr Boucher undertook to investigate concerns about specific incidents and allocation of the most clinically appropriate vehicle within available resources and reasons for re-location of the Rapid Response Vehicle in Lynmouth.

4.20 pm

Report of the Scrutiny Officer (CS/17/04) attached

The Committee considered the report of the Task Group (CS/17/04) reflecting upon the impact of that Committee over the last 4 years, an account of the Task Group and Spotlight Reviews and recent changes in legislation and the challenges facing the NHS and social care services generally.

It was MOVED by Councillor Westlake, SECONDED by Councillor Sellis and

RESOLVED that the Task Group’s Spotlight 360 Review Report and its conclusions be commended to both the Cabinet and NHS Devon as a possible means of improving the effectiveness of health scrutiny in the new County Council.

In accordance with the previous practice, Scrutiny Committees are requested to review the list  forthcoming business (previously circulated) and to determine which items are to be included in the Work Programme. The Work Programme is also available on the Council's website at http://www.devon.gov.uk/scrutiny_programme.htm

The Committee may also wish to review the content of the Cabinet Forward Plan, available at  http://new.devon.gov.uk/democracy/how-the-council-works/forward-plan/ to see if there are any specific items therein it might wish to explore further.

The Committee noted that the Work Programme had been or would be amended to include a

changes arising from this meeting and consideration of of commissioning activity. 

The Scrutiny Officer confirmed that a response from the Secretary of State was still awaited in respect of the referral relating to the past closure of beds at Torrington Hospital.

 [NB: The Scrutiny Work Programme is available on the Council's website at

http://www.devon.gov.uk/scrutiny_programme.htm and the Council/Cabinet Forward Plan is

available at http://www.devon.gov.uk/forward_plan]

Below is a list of information previously circulated for Members, since the last meeting, relating to topical Health and Wellbeing developments including matters which have been or are currently being considered by this Scrutiny Committee.

(a) RD&E Press Release:  Move to improve stroke rehabilitation services in East Devon: Plans to integrate the stroke rehabilitation unit based at Ottery St Mary Community Hospital together with acute stroke services at the Royal Devon & Exeter Hospital at Wonford;

(b) DPT Publication: Mental Health Matters;

(c) Update briefings by the CCG: Re-shaping Community Health Services in South Devon and Torbay;

(d) Care Quality Commission regular monthly update publication.

The Committee received a list of information previously circulated for Members since the last meeting relating to topical Health and Wellbeing developments including matters which had been or were currently being considered by this Committee.