Agenda and minutes

Minutes of the meeting held on 19 September 2016 (previously circulated).

RESOLVED that the Minutes of the meeting held on 17 September 2016 be signed as a correct record.

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.

2.05pm

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 Wardman (Minute 28), Mr Williams (Minute 32), Ms Martin (minute 28), Mr Wearne (Minute 32), Ms Pearson (Minute 34), Dr Gardner (Minute 33),   Ms Fuller (Minute 32),   Ms Goffey (Minute 33) and Mr Perry (Minute 33) and on matters to be considered by the Committee that day, namely Secretary of State Response: Torrington (Minute 28 below refers), the Sustainable and Transformation Plan (Minute 32 below refers) and the  ‘Your Future Care’ consultation (Minute 33 below refers) and co-location of stroke services (Minute 34 below refers) commenting in particular on the referral process and representations, views of local community groups and concerns about the impact on local health and social care services. The Chairman responded, thanking the speakers for their attendance and presentations which would be taken into account by the Committee during its subsequent deliberations.

2.20 pm

Letter from the Secretary of State, attached  

The Committee considered the letter received from the Secretary of State for Health on the reconfiguration of health services in Torrington and the Independent Review Panel advice following the referral made by this Committee, noting the Town Council and other local community concerns about the content of Committee’s submission to the Secretary of State together with the request that the STITCH Report and representations from the Town Council be forwarded to the Secretary of State in full. 

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

RESOLVED

(a) that, consequent upon the Committee’s referral to the Secretary of State for Health the  submissions/representations by the local community group ‘Save the Irreplaceable Torrington Community Hospital’ (STITCH) and the Torrington Town Council be also submitted (recognising these are not the views of the Committee); 

(b) that the local County Member Councillor Boyd be requested to liaise with Geoffrey Cox MP and local community representatives with a view to seeking a meeting with the Secretary of State to discuss the Referral (including the additional information now submitted).  

2.30pm

The Cabinet referred the following to this Committee for consideration:

(a) Proposed Cuts to Devon Health Services and Impacts on Patients (Councillor Biederman) 

‘This Council is deeply concerned about the impact the proposed cuts to Devon health services will have on patients – especially the loss of whole departments including maternity services at North Devon District Hospital - and massive reduction in acute and community hospital beds across Devon, as set out in the sustainable transformation plan.

This Council also recognises that Governments have deliberately not provided the NHS with the adequate level of funding and now calls on local MPs to lobby government ministers to urgently and significantly increase the level of funding to the NHS, in order to protect our precious health services for current and future generations’.

(b) NHS Success Regime  (Councillor Greenslade) 

‘County Council believes that the NHS Success Regime project for Devon is now seriously flawed and accordingly calls on the Secretary of State for Health and NHS England to cancel it forthwith. County Council further calls on Government and NHS England to firstly address the issue of fair funding for our area and to ensure the general election promise of an extra £8 billion of funding for the NHS is taken into account when assessing the claimed deficit for Devon NHS services.

Until funding issues are addressed it is not possible to decide whether or not there is a local NHS budget deficit to be addressed. Unnecessary cuts to local NHS budgets must be avoided!

Devon MP’s be asked to support this approach to protecting Devon NHS services”

The Cabinet had resolved

“that the aforementioned Notices of Motion be referred to the Heath & Wellbeing Scrutiny Committee for consideration and report back”

(Councillor Biederman attended in accordance with Standing Order 25 and spoke to this item)

The Chairman noted that the Council’s Cabinet had previously agreed (Minute 82 refers) as promised by the Leader of the Council on 6 October 2016 (Minutes 55 and 56 thereof refer) to refer the Notices of Motion set out in the names of Councillors and Biederman to this Committee for consideration to this Committee for consideration and report back to a future meeting of the Cabinet.

The Chairman reported that additional issues relating to fair funding for health services in Devon would be investigated by the joint Task Group (with members from Corporate Services Scrutiny Committee) reporting in January 2017. Representations on funding for health services in Devon (and concerns about the Sustainable and Transformation Plan process) had been sent to the Secretary of State by the Chairman following the last meeting and a response by the Parliamentary Under Secretary of State for Community Health and Care had been circulated to Members of the Committee (also circulated at the meeting). 

The Committee was now invited to consider any amendments it might wish to offer the Cabinet on the Notices of Motion 

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

RESOLVED that the Cabinet be advised that the Notices of Motion should be accepted as now amended (shown below) in order that Cabinet may make a formal recommendation to Council for consideration on 10 December 2016, noting also the response from the Parliamentary Under Secretary of State for Community Health and Care to earlier  representations made on behalf of the Scrutiny Committee about the Sustainability and Transformation Plan and funding:

Proposed Cuts to Devon Health Services and Impacts on Patients (Councillor Biederman)  

‘This Council is deeply concerned about the impact the proposed cuts to Devon health services will have on patients – especially the loss of whole departments including maternity services at North Devon District Hospital - and massive reduction in acute and community hospital beds across Devon, as set out in the sustainable transformation plan.

This Council also recognises that Governments have [deliberately] not provided the NHS with a fair [the adequate] level of funding and now calls on local MPs to lobby government ministers to urgently and significantly increase the level of funding to the NHS, in order to protect our precious health services for current and future generations’.

NHS Success Regime  (Councillor Greenslade)  

‘County Council believes that the NHS Success Regime project for Devon is now [seriously] flawed and accordingly asks [calls on] the Secretary of State for Health and NHS England to put the process on hold, until issues relating to the ‘independence’ of the Success Regime are investigated and for fair funding to be considered[cancel it forthwith]. County Council further calls on Government and NHS England to firstly address the issue of fair funding for our area and to ensure the general election promise of an extra £8  ...  view the full minutes text for item 29.

Scrutiny Officer to report on representations received by this Committee     

The Committee acknowledged representations received from the residents of Okehampton and surrounding areas in respect of the ‘Your Future Care’ consultation relating to proposed closure of inpatient beds at Okehampton Community hospital and from residents in Northern Devon in relation to concerns over service changes as part of the wider Devon Sustainability Transformation Plan. Copies of the representations currently subject to formal consultations in respect of Your Future Care proposals, were available at the meeting and had been passed to the NEW Devon Clinical Commissioning Group. The Chairman also reported that he had received representations which he would pass to the local CCGs as appropriate.

Report of the Spotlight Review (CS/16/43) attached

The Committee received the Report of the Spotlight Review (CS/16/34) held on 5th October comprising Members from this Committee, the People’s Scrutiny Committee, Torbay Community Services Review Panel and the Plymouth Wellbeing Scrutiny Committee.  The review formed part of the on-going work to understand and scrutinise the activities in localities that followed the Sustainability and Transformation Plan.

The Review had agreed that there was general support for the model of care, for better outcomes for patients and for more intensive rehabilitation. However there were concerns over changes in each location and whether the additional services and staff would be in place.  There was a need for Councillors to be empowered with information in order to become ambassadors for change. The Scrutiny Committees would have an ongoing role as development of the STP continued and individual areas consulted on changes. The upper ties authorities would have a role in continuing to scrutinise the proposals.  

The Committee noted that from hereinafter each authority’s Scrutiny Committee could consider how they feed this collective piece of work into their scrutiny deliberations in the future.

The Report would also be used to inform the Fair Funding joint Task Group. 

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

RESOLVED that the Spotlght Review be commended to the Cabinet for approval.  

Report of the STP Team for NEW Devon and South Devon and Torbay CCGs, attached

(Councillors Brazil and Hawkins attended in accordance with Standing Order 25(2) and spoke to this item on the likely impact of service changes arising from the Plan (and subsequent consultations) on health service provision in their respective localities).

Dame Ruth Carnall, Ms A Pedder and Ms L Nicholas attended and spoke to this item at the

invitation of the Committee.

The Committee considered the report of the Sustainability and Transformation Plan (STP) Team for wider Devon on the Plan which had been formally published on Friday 4 November (and circulated to all members of the Council). The STP was the local plan to achieve the NHS ‘Five Year Forward View’ published in October 2014 and designed to provide the overarching strategic framework to achieve safe, sustainable and integrated local support by 2021 and on closing the financial gap that existed,  recognising that doing nothing was not an option.  The report covered the timeline and the next steps.

The representatives also gave a presentation covering: the Sustainability and Transformation Plan (STP) and its footprint and the NHS organisations involved, and also included care quality and financial challenges, priority areas and aspirations.

The representatives responded to Members’ questions relating to:

·         the role of local members in calling for additional resources from Government noting that the STP was developing within current resources

·         the scope for additional one-off funding in respect of transition arrangements arising from changes 

·         challenges in delivering services as a result of changes

·         information in the ‘Case for Change’ about comparative costs of acute beds vis a vis costs of care at home, which the representatives undertook to provide to members of the Committee.

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

RESOLVED that a special meeting of the Committee be arranged (for early December) to consider in detail the recently published Sustainability and Transformation Plan for wider Devon.

Report of NEW Devon CCG, attached

(Councillors Ball attended in accordance with Standing Order 25(2) and spoke to this item and Councillor McInnes attended in accordance with 25 (1) and spoke to this item at the invitation of the Committee expressing local community concerns about the consultation process, the limited options, impact of proposed bed closures at the Okehampton Community Hospital and limitations of care at home in rural areas).

Mr R Sainsbury, Dr S Kerr, and Ms J McNeill  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’ proposals - an integrated model of care designed to strengthen prevention and out of hospital care and to shift to community based service delivery. The Report  outlined, the context, content and process of the consultation and the next steps involving a further report to this Committee on 19 January 2017 with final recommendations/decisions of the NEW CCG Board being reported at 2 March 2017 meeting.

The representatives also gave a presentation covering:  the challenges, use of resources and  options for service reconfiguration in the CCG’s Eastern Locality,  and public consultation arrangements which had commenced on 7th October 2016 and would run to 6 January 2017; and also featured a video on a case study highlighting the benefits of care at home. 

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

·         impact of the changes in the west of the Locality

·         limitations of care at home and flexibility for patients

·         issues relating to the transfer of staff from hospitals to work within the community and the shortage of care staff and work to address the shortages of trained staff across many disciplines

·         the checks and safety checks carried out by the CCG before implementation of changes in terms of staffing and resources

·         the need for improved dialogue between the CCG and local communities, as part of the consultation process, in assisting the development of viable options in addition to the ones identified.

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

RESOLVED that NEW CCG be requested to liaise with local Councillors in order to assist with the development of additional options in response to the on-going consultation ‘Your Future Care’ for communities such as, for example, Okehampton and Honiton.  

3.10 pm

Report of the Northern Devon Healthcare Trust, attached

Dr C Bowman representing the Northern Devon Healthcare NHS Trust attended and spoke to this item at the invitation of the Committee.

The Committee considered the report of the Northern Devon Healthcare NHS Trust’s proposals to co-locate acute and rehabilitation stroke services at North Devon District Hospital (NDDH) from Bideford Community Hospital. The report outlined the case for change, the proposed stroke pathway and predicted impacts and the overall objectives. The representative also gave a presentation covering: the clinical and sustainability reasons for the change, the impact on Bideford and Barnstaple Community Hospitals, the non-impact on the STP process and engagement activities.

Dr Bowman responded to Members’ questions relating to reasons for no consultation on the change which represented an enhancement of service provision, the clinical imperative and engagement activity that would take place.

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

RESOLVED that the report be noted and a progress report on the changes be brought to this Committee in a year’s time.

3.30 pm

Report of NEW Devon Clinical Commissioning Group, attached

RESOLVED that this item be deferred for consideration at the next meeting.

In accordance with the previous practice, Scrutiny Committees are requested to review the list f forthcoming business (previously circulated) and to determine which items are to be included in the Work Programme. The Work Programme is also available on theCouncil'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 further report on NHS Property Services and rental charges in Devon.

[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 athttp://www.devon.gov.uk/forward_plan]