Report of the NEW Devon Clinical Commissioning Group and correspondence with the Committee, attached
(Councillor C Whitton declared a personal interest this matter in relation only to the Royal and Devon Exeter Hospital Trust by virtue of her employment with the Trust)
(Councillors M Shaw and I Hall attended in accordance with Standing Order 25(2) and spoke to this item)
Dr S Manton, (Director of Strategy, North East and West Devon (NEW Devon CCG) and South Devon and Torbay CCG), Mr R Sainsbury (Chief Operating Officer, NEW Devon CCG), Mr E Wilkinson Brice (Deputy Chief Executive/Chief Nurse, Royal Devon & Exeter NHS Foundation Trust); and Ms A Jones (Director of Integration Royal Devon & Exeter NHS Foundation Trust) attended and spoke to this item at the invitation of the Committee.
The local members attending under Standing Orders questioned the rationale behind the decisions by NEW Devon CCG and impact on the respective communities of the proposed closure of community beds at Seaton, Honiton, Axminster and Okehampton and calling for a referral to the Secretary of State for Health.
The Scrutiny Officer reported the receipt of 21 representations protesting at the proposed closure of beds in Honiton, Seaton and Okehampton Hospitals across the locality, and protesting at the commencement of implementation by the CCG prior to debate by this Committee and urging the Committee to make a referral to the Secretary of State.
The Committee considered the report of NEW Devon CCG on background information to the Your Future Care programme and decisions made by NHS Northern, Eastern and Western Devon Clinical Commissioning Group (CCG) Governing Body of 2nd March 2017, following public consultation, to reduce community hospital inpatient beds and units in the Eastern locality in the context of developing a new model of care for the area.
The decisions by the Governing Body had been as follows:
· 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 had 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 Committee also received copies of correspondence between the Chairman of the predecessor Committee and the North, East and West Devon Clinical Commissioning Group (NEW Devon CCG) relating to questions and concerns by Scrutiny and the CCG’s responses.
The Clinical Commissioning Groups’ and the Trusts’ representatives then responded to Members’ questions and/or commented that:
· the programme was designed to deliver improved outcomes and experiences for patients, improved experiences for staff and clinical and financial sustainability of community services and that detailed consultation with staff regarding implementation had commenced
· a breakdown of representations received would be provided by the CCG
· the projected savings and investments in community services based on work force planning to meet local need noting that it was not possible to ‘double-run’ due to staffing pressures
· any proposals relating to the estates strategy would be brought to the Scrutiny Committee
· patient audit in terms of community care needs carried out by the Royal Devon and Exeter Trust
· the assurance process through the Assurance Panel would ensure that decisions made by the NEW CCG Board under the Your Future Care would not be implemented unless shown to be clinically safe and sustainable
· evidence from South Devon and Torbay and other areas of the positive outcomes arising from the new model of working
Recognising the need for Scrutiny to work with the CCG to help ensure good decisions were made the CCG extended an invitation for scrutiny member attendance at the Assurance Panel and resolution of concerns. It was the view of some Members that the responses by the CCG in relation to the detailed points raised by the former Scrutiny Committee had not been satisfactory and that the case for the changes had not been proven and therefore a referral to the Secretary of State should be made prior to further implementation by the CCG.
The Scrutiny Officer outlined the referral process to the Secretary of State and requirement to address outstanding issues and develop detailed alternative proposals.
It was MOVED by Councillor Diviani and SECONDED by Councillor Berry and
RESOLVED that consideration of a referral to the Secretary of State be deferred pending a special meeting of this Scrutiny Committee (by end of July) to consider further information and evidence from the NEW Devon CCG in relation to the Your Future Care decisions.