Adult, Community Services and Health Overview and Scrutiny Panel
Tuesday 15 March 2011 7.30 pm
ADULT, COMMUNITY SERVICES AND HEALTH OVERVIEW & SCRUTINY PANEL
15 MARCH 2011
PRESENT: Councillors Mrs Endacott (Chairman), Mrs Evans (Vice-Chairman), Baskerville, Mrs Kemp, Lenton, Mrs Napier, Mrs Proctor and Mrs Yong.
Non-Member: Councillors D Wilson
Also Present: Mrs Slinger (Berkshire Healthcare NHS Foundation Trust); Mrs Llewellyn (NHS Berkshire East); Mr Robinson and Mr Scales (Heatherwood and Wexham Park Hospitals NHS Foundation Trust).
Officers: Mr Herlinger, Mr A Scott, Mrs Shawcross and Mr Skerman.
part i
74/10 APOLOGIES FOR ABSENCE
An apology for absence was received from Councillor Majeed.
75/10 DECLARATIONS OF INTEREST
Councillor Mrs Endacott declared a Personal and Prejudicial Interest in agenda item 4 – Public Consultation on Mental Health Inpatient Facilities Serving the East of Berkshire and item 5 – Proposed Closure of Ward 14 at Heatherwood Hospital – as a Governor on the Trust. Councillor Mrs Endacott left the meeting during the consideration of those two items.
76/10 MINUTES
- RESOLVED: That the minutes of the Meetings of the Panel held on 25 January and 4 February 2011 be approved as a correct record.
77/10 PUBLIC CONSULTATION ON MENTAL HEALTH INPATIENT FACILITIES SERVING THE EAST OF BERKSHIRE
Members considered the report and supporting documentation that had been submitted to the Boards of Berkshire Healthcare NHS Foundation Trust (BHFT) and the NHS Berkshire East on the outcome of the public consultation on the provision of Inpatient Mental Health Services in East Berkshire.
Members were advised that the NHS Berkshire East had asked BHFT to progress to outline business case for option 1, which involved all beds being relocated to Prospect Park Hospital in Reading, as that would allow for the detail of that particular option to be worked up, including the consideration of additional community investment and how the transport scheme would work. Members were advised that both Board’s had been of the opinion that the proposal to provide a new unit on the Upton Park site in Slough (option 3) was unaffordable in the current and future economic environment. Also, the Boards did not support the proposal to provide beds for older people at St Marks Hospital, Maidenhead and for working age adults in Prospect Park Hospital (option 3) as that was not backed by clinicians as it would mean that older people would have to be cared for in an environment that mixed people with functional illness and those with organic problems and that was not conducive to high quality care.
In the ensuing debate Members raised a number of questions and concerns. In particular, Members re-iterated their concerns regarding the transport issues arising from the proposed transfer of the inpatient services to Prospect Park, including the distance that patients would have to travel, the cost of petrol for visiting families, the limited public transport provision and the longer journey times. Mrs Slinger, Chief Executive – BHFT, advised that a project group had been established to draw up an appropriate transport scheme that would address those concerns. Mrs Slinger stated that all options would be considered and that relevant stakeholders, including representatives from Overview and Scrutiny, would be represented on the group and included in the development of the scheme. Although the cost of the transport scheme would not be capped, Mrs Slinger stressed that it had to be affordable and that a provisional allocation of £100,000k per annum for the next five years had been earmarked for the scheme.
Mrs Llewellyn, Chief Executive - NHS Berkshire East, commented upon the change in the financial environment since the Right Care Right Choice consultation was undertaken and the financial constraints that the health service was now operating under. She indicated that the Upton Park proposal would only be reconsidered if alternative funding streams became available. Mrs Llewellyn advised Members that the transfer of the inpatient services would not affect the long-term viability of St Marks Hospital and reassured Members that the hospital was not under threat and that it would continue to provide essential community health service provision.
Mrs Slinger advised that the number of beds to be provided at Prospect Park would be 64, which was the figure previously outlined in the Right Care Right Place consultation. At present there were 88 beds available, although there was only a 70% occupancy rate. However, there would also be additional investment in the home treatment services of £400,000 per annum, which should be fully operational by the summer. Mrs Slinger re-iterated that, as inpatient admissions were very small, it would not be cost effective or safe to provide the service in a number of small units. She also confirmed that the possible re-provision of the mother and baby inpatient care service that had previously been provided at Heatherwood Hospital would be considered as part of the outline business case.
Members were advised that it was the intention that the outline business case be submitted to the respective Boards in June for approval. It was therefore suggested that the Panel meet in May/June prior to a decision being made by the Trusts’ Boards. Mrs Slinger indicated that she would welcome the opportunity to attend a meeting in May/June but stressed that the retention of inpatient services at St Marks Hospital had definitely been ruled out and would not be reconsidered.
- RESOLVED UNANMOUSLY: That a special meeting be held in May/June to provide update on the outline business case and the development of the transport scheme.
Members were advised that, for a number of years, the Older Adults wards in the East of Berkshire (Charles Ward at St Mark’s Hospital Maidenhead and Ward 14 at Heatherwood Hospital Ascot) had been under-occupied resulting in an inefficient use of the available resources. There were currently 43 beds for older people and there had only been a 39% - 58% occupancy rate at any one time for the past 9 months. In the light of that very low occupancy of beds, Members of the Panel were advised that the Berkshire Healthcare NHS Foundation Trust had proposed the consolidation of those resources to operate from Charles Ward and release resources to invest in the development of alternatives to hospital admission.
Mrs Slinger then responded to a number of questions. She advised that Charles Ward was not due to close until 2014 when the proposed alterations to Prospect Park in Reading were completed, and that, as only a handful of people would be affected, the Trust were prepared to fund the relatives’ transport cost. She also confirmed that if more than the 23 beds available were required, the additional care would be provided elsewhere, although she was confident that the Trust would not require more than the 23 beds.
79/10 HEATHERWOOD AND WEXHAM PARK HOSPITALS NHS FOUNDATION TRUST - UPDATE ON FINANCIAL SITUATION
The Panel received an update on Heatherwood and Wexham Park Hospitals NHS Foundation Trust’s current financial position and progress on key activities within the Trust’s Turnaround Plan.
Mr Robinson advised that the Trust’s expenditure was in line with the Annual Plan and that, although the Trust was still operating a deficit, it was track to break even by the end of the year. He referred to the higher than expected levels of activity that the Trust had experienced and commented upon the discussion that the Trust had had with NHS Berkshire East to address the situation. He advised that significant progress had been made on the quality of the Trust’s data and advised that the Trust had only been challenged on 1% of its data, which was better than the national average.
80/10 CHANGES TO THE PROVISON OF STROKE SERVICES
Members receive a presentation from Dr Jackie McGlynn, Deputy Medical Director, NHS Berkshire East, on proposed changes to the provision of stroke care services in the Berkshire East area. She stated that stroke was a major cause of death and disability and that 4616 patients in the East Berkshire area had suffered from a stroke in 2009, with the numbers predicted to rise by 16% by 2016.
Dr McGlynn outlined the key stages of the stroke pathway and highlighted that the first 72 hours care was vital to ensure the optimum clinical outcome for the patient. The Panel noted the elements of hyper acute care and noted that the provision of thrombolysis within 3 hours reduced the number of patients with long-term disability by 30%. Heatherwood and Wexham Park NHS Foundation Trust had commenced a thrombolysis service in July 2009 at Wexham Park Hospital but that was only available on weekdays from 9am to 5pm.
The Trust had confirmed that it would be unable to fulfil a 24/7 service, and therefore a combined pathway for Heatherwood and Wexham Park NHS Trust and Buckinghamshire NHS Trust, which would be located at Wycombe Hospital, had been developed. The Acute Stroke unit service, which would commence in June 2011, would accept new stroke patients 24/7 and would also receive repatriated local patients from the hyper acute stroke unit within 24 hours of notification of transfer subject to their condition. The Stroke Unit would provide 24/7 access to brain imaging including urgent imaging within 1 hours where indicated, continuous monitoring and a system whereby all new admissions would be seen by consultant within 24 hours of admission.
After Dr McGlynn had answered a number of questions, the Chairman, on behalf of the Panel thanked her for her presentation.
- RESOLVED UNANIMOUSLY: That the Panel supports the proposed changes to the provision of stroke care services in the Berkshire East area and looked forward to them being implemented as soon as possible.
81/10 UPDATE ON IMPLEMENTATION OF NHS WHITE PAPER: LIBERATING THE NHS
Members considered the report due to be submitted to Cabinet on 31 March 2011 that provided a summary of a number of issues arising from the publication of NHS White Paper on Public Health (November 2010), which set out public health functions, and sought confirmation on the setting up of a Health & Well-being Board, to be chaired by the Lead Member for Adult & Community Services.
Arising from discussion Members made a number of comments/suggested amendments as outlined below:
- clarification was sought as to the agreed level of Opposition Group Member and Scrutiny Panel Member representation on the Project Board and sub-groups established to develop the Health and Well-being Board.
- the report should provide further details on the discussions held between the Chairman of the Strategic Health Authority and the lead Member for Adult and Community Services (Paragraph 3.2.6).
- it was suggested that there should be greater local Councillor representation from the various areas within the Borough on the Core Membership of the Health and Well-being Board.
RESOLVED UNANIMOUSLY: That Cabinet be advised that the Panel endorses the report, subject to the comments/suggested amendments as detailed above.
It was noted that the report had been deferred and that a special meeting would be held to consider the report prior to its submission to Cabinet.
83/10 MEETING
The meeting, which began at 7.30pm, ended at 10.00pm.