Agenda item

(a)        Background Evidence

            Report of the County Solicitor (CS/17/23), attached (Pages 1 - 9)

(b)        NEW Devon CCG and Royal Devon & Exeter Foundation Trust: Response

Report of NEW Devon CCG and Royal Devon & Exeter Foundation Trust, attached (Pages 11 - 20)

(c)        Implementation Assurance Panel: Meetings held on 12 July and 19 July 2017 and Hospital and Community Visits

            Chairman and Members in attendance to report

(Councillor P Twiss declared a personal interest this matter by virtue of his membership of the East Devon District Council)

(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), Mrs 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 Committee received the report of the County Solicitor (CS/17/23) on an evaluation of the extent to which the requirements of a referral to the Secretary of State for Health had been met, to which regard was had by Members during the Committee’s consideration of this matter. The Report provided an overview of the answers that the Clinical Commissioning Group had provided to the questions that Scrutiny had asked and invited the Scrutiny Committee to determine if it was satisfied.  

The Report addressed in turn the nine points that were required by the scrutiny guidance for a referral to the Secretary of State for Health.

County Councillors attending under Standing Order 25 were invited to speak and 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 Chairman reported the receipt of representations (including from East Devon Health Scrutiny Committee protesting at the proposed closure of beds in the Eastern Locality and from East Devon District Council protesting at the bed closures in Seaton and Honiton without assurance about sufficient capacity for home care) referring to long distances carers would need to travel and for patients needing in-patient care.    

The Committee then considered the report of NEW Devon CCG and Royal Devon and Exeter Foundation Trust outlining the new model of care in the Eastern Locality and explanation of the implementation process (which would result in the reduction of in-patient beds from 143 to 72 in the Locality). The Committee also received a presentation from the NEW Devon CCG covering:

·         why the new Model of Care was needed and how implementation would ensure continued high-quality patient care;

·         the change in focus from bed-based care to a home-based model and why

·         how the investments in community health services would enable people to be independent and in their own homes;

·         the impact of the proposals on approximately three patients a week per site – patients who will be able to be treated at home and will no longer have to remain in a community hospital;

·         the assurance process to date.

The Chairman, Vice Chairman and Councillor Ackland also reported on their visit to an Integration Team and attendance as observers at the at NEW Devon CCG’s Implementation and Assurance Panel meetings comprising Clinicians and Lay persons and the Team’s  thorough examination of the implementation  process. Members at the Committee however noted remaining areas of concern relating primarily to the consultation process and lack of public confidence in the process and new model of care.

The representatives then responded to Members’ questions and/or commented that:

·         use of the Better Care Fund to promote integration of NHS and County Council adult care services

·         the consultation process and responses received and the methodology consistent with the South Devon and Torbay CCG area arrangements

·         the Model of Care model which had been accepted in the South and Torbay CCG area which was proving to be effective

·         work force planning to ensure capacity and sufficiency in regard to the new model of care

·         consultation with and support from the South Western Ambulance Trust

·         financial analysis based on work force changes.

The matter having been discussed and debated and having regard to the above and all relevant factors referred to at the meeting and set out in the Officers’ reports having been considered: 

It was MOVED by Councillor Gilbert and SECONDED by Councillor Russell and

RESOLVED that the Your Future Care proposals be not referred to the Secretary of State and that the NEW Devon Clinical Commissioning Group and Royal Devon and Exeter NHS Foundation Trust continue to work with the local communities affected and report progress to future meetings of this Scrutiny Committee.

[N.B. In accordance with Standing Order 32(4) Councillors asked that their votes be recorded as follows: For the Motion: Councillors Crabb, Diviani, Gilbert, Peart, Randall Johnson, Russell and Scott; Against the Motion: Councillors Ackland, Greenslade, Twiss, Way, Whitton and Wright; and in Abstention: Councillors Berry and Yabsley]