Agenda and minutes

Minutes of the meeting held on 8 March 2016 (previously circulated).

RESOLVED that the minutes of the meeting held on 8 March 2016 be signed as a correct record.

Members observed a period of silence as a mark of respect. 

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

There was no item raised as a matter of urgency.

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 John Wardman, Trisha Martin, Diana Davey and  Margaret Brown on a matter to be considered by the Committee that day, namely  Torrington Community Hospital Task Group Report (Minute 5 below refers) commenting in particular on views of a local community group and the need for a referral to the Secretary of State. 

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

2.15 pm

Report of the Task Group (CS/16/05) attached

The Committee considered the report of the Task Group (CS/16/05) on the principles upon which any referral could be made to the Secretary of State for Health, reviewing the evidence and process by which decisions were made about Torrington Community Hospital and the steps that the Committee might take if there was a case or desire to make a referral.

The Committee noted that there remained some outstanding details and views/comments received following publication of the Report which some Members felt required further consideration by the Task Group before any further action could be taken on it.    

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

RESOLVED that the Task Group Report be referred to the Secretary of State for Health subject to the Task Group reconvening, in accordance with procedure for referrals, to consider outstanding points/views and a revised draft be sent to all Members for their consideration and endorsement.          

2.45 pm

Report of South Devon & Torbay CCG (PH/16/20) attached

The Committee considered the report of the South Devon and Torbay Clinical Commission Group (PH/16/20) on the status of the proposed reconfiguration of community services, updating on information previously provided, engagement which had taken place and the planned consultation approach and  details of proposals in South Devon as well as Torbay.

The Clinical Commissioning Group representatives responded to Members’ questions including:

·         the net loss of community hospital in-patient beds as result  of re-configuration of services to date from 156 to 96 and expansion of provision in Newton Abbot Community Hospital from 20 beds to 45  and closure of 4 Community Hospitals/hubs and re-investment in community services (to be detailed in the consultation documents); 

·         concerns about the working and effectiveness of the community hubs, in Bovey Tracey for example, with the loss of in-patient beds;

·         approval of the consultation processes by Torbay Council’s Scrutiny Committee;

·         details of the consultation changes per locality and subject to authorisation by NHS England development of a comprehensive consultation document, to be shared with this Committee, when available and supported by other more detailed documents;

·         the period for consultation was 12 weeks, starting from September 2016 which was welcomed by the Committee. 

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

RESOLVED that the Consultation process be accepted and that the consultation documents be forwarded to the Committee, when available, and that the details of the proposals be submitted to the next meeting in September 2016 by the Clinical Commissioning Group.

3.10 pm

Report of Northern Devon Healthcare Trust (PH/16/19) attached

(Councillor Barker attended in accordance with Standing Order 25(2) and spoke to this item at the invitation of the Committee).

The Committee considered the report of the Northern Devon Healthcare Trust (PH/16/20) on  winter performance and the financial impact of the transition from hospital to community services, impact on patients in terms of number of patients cared for in the community, number of admissions to the acute hospital and other community hospitals and impact on staff, details of the redeployment of staff from the community hospital (Bideford) and patient satisfaction with the community model of care, following a reduction of community hospital inpatient beds from 75 to 40, in line with commissioning intentions.

The Clinical Commissioning Group representatives responded to Members’ questions including:

·         in relation to the statistical information with a detailed narrative and interpretation in respect of the localities;

·         learning by the Trust and improvements arising from the ‘Test of Change’ initiative in Torrington; 

·         perception by some members of the need for improved Key Performance Target information in order to help make proper assessments, notwithstanding the information provided;

·         positive patient satisfaction surveys relating to in-patient care and community services;

·         information on the level of ‘red alerts’ relating to the North Devon Hospital which were lower compared against Exeter and Plymouth Hospitals (and on which further information would be provided to members from the Trust); 

·         the discharge process with use of path-finder teams for more complex cases;

·         comment from the Cabinet Member for Adult Social Care & Health Services relating to new and effective joint working through integrated social care and health packages commissioned by the County Council with NEW CCG and the Trust (as the provider) to promote independence and wellbeing at home.  

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

RESOLVED that the report be noted and that the Scrutiny Officer, in conjunction with Councillor Greenslade, discuss with the Trust development of Key Performance Indicators to help with assessment of performance arising from the changes to community services in the locality. 

3.40 pm

Report of RD&E NHS Trust (PH/16/22) attached   

The Committee considered the report of the Royal Devon & Exeter Hospital Trust (PH/16/22) on the implementation of its cancer plan which had resulted in significant improvements with the Trust achieving its treatment referral targets.  In November 2015 it had had been inspected by the Care Quality Commission (CQC,) with the Trust earning a rating of “good” overall and outstanding for “caring.”   The CQC report had commented positively upon a number of initiatives which have been implemented in the field of cancer care and the Trust was pleased with the considerable progress which has been made over the past six months. The clinical and management teams continued to place considerable focus on making the achievement of all cancer targets sustainable, whilst working hard to maintain the high quality of patient care for cancer patients.

The Trust and CCG representatives responded to Members’ questions including:

·         the significant improvements (despite the junior Doctors strike and winter pressures) made which would be sustained through effective joint planning with the Clinical Commissioning Group;

·         initiatives relating to psychological support pre and post treatment; 

·         on occasion breaches of the targets were as a result of patient choice and these were difficult to avoid;

·         concerns relating to the appointments system which were often chased up or confirmed by telephone (texts were used for follow-ups but not the initial appointment) and moves towards the development of an email system.

The Chairman thanked the Trust and CCG representatives for their report and presentation and asked that the Committee be kept informed of developments.

3.50 pm

Report of the Success Regime (PH/16/21) attached 

The Committee considered the report of the Success Regime (PH/16/21) on progress with developing the Wider Devon Sustainability & Transformation Plan (STP) and progress to date and key elements within the Plan and overall progress of the Success Regime, the case for change and early proposals for stakeholder engagement and consultation.

The Success Regime representatives responded to Members’ questions including:

·         the  strategic importance of the Sustainability and Transformation Plan (STP) which was place-based, covering multi-years built around the needs of the local population in line with national strategy articulated in the Five Year Forward Plan and with the full involvement of the three local authority Public Health departments in Devon (Devon, Torbay and Plymouth Councils);

·         the importance of work-force planning and accessible local training courses and apprenticeships for prospective nursing and care practitioners at all levels;   

·         importance of recognition within plans of access issues in remote areas of Devon (particularly North Devon), optimising local provision and reducing acute admissions; 

·         the Case for Change available on http://www.newdevonccg.nhs.uk/case-for-change-documents/101857;

·         governance arrangements relating to the Success Regime working collaboratively with  commissioner and provider bodies across Devon;

·         evaluation of the options for change and consulting on and development of solutions through public and stakeholder group events leading to robust consultation arrangements and documents (documents disaggregated as appropriate to include specialist services) by the end of July 2016 (subject to approval by NHS England).

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

RESOLVED

(a) that progress with developing the STP in preparation for the further draft submission on 30th June be noted;

(b) that progress on development of transformation plans under the Success Regime, be noted and that details of the consultation/engagement plans and documents be submitted to the Committee at the earliest opportunity.

The Committee noted that the Work Programme would be amended with the addition of a report on the NHS Property Service at the next meeting.

[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) Response by the Scrutiny Officer after member consultation on the annual Quality Accounts from RD&E Hospital Trust, Devon Partnership Trust, North Devon Hospital Trust and the Torbay and South Devon NHS Foundation Trust;

(b) Press Release: Outstanding for Caring - but CQC inspectors find Torbay and South Devon NHS Foundation Trust Requires Improvement;

(c)  Minor injury services in Sidmouth:  outline of changes;

(d) CQC launch of a new 5 year strategy for 2016 to 2021;

(e) Devon Patient Transport Advice Service (PTAS) information poster and new telephone contact;

(f) Spotlight on rural health: newsletter by the Rural Health Network, part of the Rural Services Network;

(g) Update on Transforming Community Services and the transition of adult complex care services in the Eastern Locality to the Royal Devon & Exeter NHS Foundation Trust;

(h) Press Release  regarding a report on End of Life Care – ‘A different ending: Addressing inequalities in end of life care’;

(i) Financial Times article on proposed increase in rents for health providers;

(j) Information on NHS organisations publicly ranked on their openness and transparency under a new ‘Learning from Mistakes League’ launched by Monitor and the NHS Trust Development Authority.

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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.