Present:

Councillors Westlake (Chairman), Boyd, Brook, Chugg, Clarance, Colthorpe, Gilbert, Morse, Sellis, Wragg and Wright

Member attending in accordance with Standing Order 25:-

Councillor Davis

Apologies

Councillors Dezart, Diviani, Greenslade and Gribble

Councillor Christophers (representing District Councils)

*126 Minutes

RESOLVED that the minutes of the meeting held on 20 January and the joint Scrutiny meeting held on 29 January 2016 were signed as correct records.

*127 Public Participation: Representations

In accordance with the Council's Public Participation Rules, the Committee received and acknowledged oral representations made by Mrs D Taylor on a matter to be considered by the Committee that day, namely St John s Court, Exmouth (Minute *132 below refers) commenting in particular on local objections and rationale for the proposed closure of the Unit by the Devon Partnership Trust.

The Chairman responded, thanking Mrs Taylor for her attendance and presentation which would be taken into account by the Committee during its subsequent deliberations.

*128 2016/17 Budget

The Committee received the Public Health Impact Assessment relating to the budget approved by the Council on 18 February 2016 to which it had had regard.

The Director of Public Health commented on the Public Health allocation and approved budget viz:

the allocation of 28,952,000, equivalent to 38/head, was significantly less than the national average 62/head and placed Devon 5^th from bottom of all local authorities in England in terms of public health grant per head

the lack of a national formula - new resource allocation (ACRA) - for a fair assessment and allocation which had been consulted upon but not applied which had resulted in Devon slipping down the per capita funding league

the lack of NHS England commissioning for the NHS Health Checks programme (the only place in England not funded)

additional funding responsibilities for Public Health Nursing equating to a reduction of 2.5 m in cash terms

saving plans to deliver the necessary financial savings in 2016/17, with priority to protect services for the most vulnerable and disadvantaged and children and young people

the addition of 500,000 by the County Council to the Public Health budget

areas of services affected by reductions: NHS Health Checks suspend and review universal service, Walking for Health programme, adult weight management programme, midwifery stop smoking service (no grant for 2016/17) and Books on Prescription, and grant reductions to District Authorities.

The Director also responded to specific questions raised by Members including:

support for the letter the Director had sent to Dr S Wollaston MP, Chair of the Health Select Committee concerning NHS Health Checks and the Council s Public Health funding

the benefits and opportunities by the declaration of a national Healthy Town designation for Cranbrook and resulting high level input from NHS England with the NEW CCG and Public Health, which would result in an excellent local case study for future learning and promotion of health and wellbeing

the impact of the general budgetary position on primary care and the growing impact and significance of professional skill shortages and poor NHS Work Force planning over many years

representations by the Director at a recent Health Select Committee including the need for Public Health to be included as a statutory consultee relating to development proposals

despite the poor funding position the relatively positive health benchmarks being achieved in Devon.

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

RESOLVED that the letter to Dr Wollaston MP be supported and copied to local MPs and Public Health England highlighting the poor per capita funding and lack of base-line funding for NHS Health Checks programme.

[NB: approved budget available on-line: : supplementary information CT/16/12.CMRrn=16/WD44dg=Public">http://www.devon.gov.uk/loadtrimdocument?url=filename=CT/16/12 - supplementary information CT/16/12.CMRrn=16/WD44dg=Public

The full list of services affected, along with the health impact assessments are available via the following link: https://new.devon.gov.uk/impact/public-health-reductions-to-grant/.

*129 Relocation of Thoracic Surgery to Plymouth Hospitals Trust

The Committee considered the report of the Royal Devon Exeter NHS Foundation Trust (PH/16/4 - text only | pdf PH/16/4) on the proposed relocation of thoracic surgery from the Royal Exeter Devon Hospital Trust to Plymouth Hospitals Trust. This was in line with the national direction for specialised services to be centralised into a smaller number of specialist centres, to help ensure capacity and resilience. The Report outlined the rationale and clinical case, process to date including consultation prior to planned implementation from June 2016.

Trust representatives responded to Members questions including:

the recent consultation process and patient feedback which had expressed a range of views

the close work and liaison with the Plymouth Hospitals Trust to help ensure that the service remained of a high standard for patients with sufficient capacity to avoid lengthening waiting times, as far as could be predicted

no current plans to relocate other services

how the Trust could further support and assist patients and families travelling from Northern Devon and Exeter currently there was accommodation available for family members at Plymouth which was not available in Exeter

confirming that only surgery would be carried out in Plymouth and other outpatient and assessment services would be retained locally.

The Chairman and members thanked the Trust for its comprehensive update.

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

RESOLVED that the RDE Hospital Trust be requested to inform the Committee of the outcome of consultations and that an update be made in a year s time.

*130 Northern Devon Healthcare Trust: Transition to Community Services

The Chairman reported that, following the request at the last meeting, the Trust had been unable to produce a report or field representatives for this meeting to answer members questions. He would write to the Trust to express the Committee s disappointment and its concerns and ask that a report be submitted to the next meeting by the Trust with representation in attendance.

*131 Leaving Hospital Healthwatch Devon Update

The Committee considered the report of Healthwatch Devon (PH/16/6 - text only | pdf PH/16/6) on their report published in July 2015, "Then What? A report of people's experiences of leaving hospital".

The update report was based on feedback to Healthwatch Devon from people with recent experience of hospital discharge. Most had had excellent treatment in hospital, but many reported that a generally good experience had been spoiled by problems with the discharge process; and the report outlined the responses from commissioners and providers and their plans.

The Healthwatch representative responded to Members questions including:

the three top issues identified as problems by patients: relating to timeliness, quality of aftercare, and communication between health and care staff

the complex nature of the discharge process and that Healthwatch s survey related to patients views and not an examination of the process across different providers in devon

the range of pledges and commitments made by commissioners and providers in their responses to the Healthwatch Devon "Then What?" report;

the actions of commissioners and providers and changes of priority as other strategies and short term pressures occur

target date of July 2016 (one year on) might be appropriate for assessing what progress commissioners and providers would have made.

It was MOVED by Councillor Boyd, SECONDED by Councillor Wright and

RESOLVED that a Task Group be established (with further consideration to inviting a member(s) from the People s Scrutiny Committee or form a joint Task Group) to investigate policies and procedures for the discharge of patients with an emphasis on the top three issues identified by Health Watch Devon.

*132 St John s Court, Exmouth: Progress Report

The Committee considered the report of the Devon Partnership Trust (PH/16/7 - text only | pdf PH/16/7) on proposed changes to better use its Estate including a proposal to sell St John s Court and relocate to more affordable premises in the Town.

The DPT representatives responded to Members questions including:

confirmation that the Trust would not make any decision about the future of the site until suitable alternative accommodation was found in the Town

the cost of the past refurbishment of the St John s Court and the estimated capital receipt from the sale of the building which had been earmarked in the Trust s capital programme for 2016/17 and hope for less expensive premises from which to deliver services in the town, on which there had been no definitive progress

the possibility of further use of St John s Court by a 3^rd sector party which had been explored and could not be progressed

the Success Regime for Devon, of which DPT was an active member, had brought additional focus on the need for change

Engagement Meetings continued to take place to provide the local campaign group, staff and service users an update on progress and address concerns and the Trust intended to hold further engagement meetings

the possibility of relocating some of the services currently located at St John's Court to Exmouth Hospital and the Trust confirmed that it was exploring this option, noting the parking and other difficulties at the site

the out-patient mental health services provided by the Trust at the St John s site

and the success of another hubs

possible difficulties for patients accessing services at the proposed Wonford Exeter Hub which the Trust would endeavour to address.

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

RESOLVED that the Chairman and Vice Chairman and other members visit the site and meet with the local campaign group and patient representatives for report to a future meeting.

[see also Minute 127 above].

*133 Health Wellbeing Scrutiny Committee Work Programme

The Committee reviewed the Scrutiny Work Programme and determined those items of business to be included therein for its sphere of activity, having regard also to the Council/Cabinet Forward Plan. The Scrutiny Officer reported on the progress of current Task Groups. The Work Programme was endorsed, subject to the addition of the following:

Success Regime - seminar on future proposals (April) and report to June meeting

new Task Group on quality of the discharge process from Hospital

consideration of a Task Group on Work Force Planning in Health Care services

review of the impact of all Task Group recommendations in the current administration

report on the role of NHS Property Services and analysis of ownership and control of NHS properties in Devon

report on the proposal by NHS England to secure a part closure of the Neurosurgical waiting list at Plymouth Hospitals NHS Trust (subject to confirmation by members).

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

RESOLVED that if appropriate, a special meeting of this Committee be held (prior to the June meeting) to receive Task Group reports relating to Torrington Community Services and the East Devon Community Services Spotlight Review.

[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]

*134 Information Previously Circulated

The Committee noted a summary of documents/publications previously circulated for members, since the last meeting, relating to Health and Wellbeing developments and including matters which were currently being considered by this Scrutiny Committee.

*DENOTES DELEGATED MATTER WITH POWER TO ACT

The meeting started at 2 pm and finished at 4. 25 pm

The Minutes of this Committee are published on the County Council s website at:-