Meeting documents

To elect a Chairman for the remainder of the year 2016/17.

Resolved

That Ronald Coatsworth be elected Chairman for the remainder of the year 2016/17.

To appoint a Vice-Chairman for the remainder of the year 2016/17.

Resolved

That Bill Batty-Smith be appointed Vice-Chairman for the remainder of the year 2016/17.

An apology for absence was received from Sarah Burns (West Dorset District Council).

There were no declarations by members of disclosable pecuniary interests under the Code of Conduct.

Cllr David Jones informed the Committee that his spouse was registered disabled. As this was not a disclosable pecuniary interest he remained in the meeting and took part in the debate.

Cllr Alison Reed informed the Committee that she was employed by Dorset Healthcare University NHS Foundation Trust. As this was not a disclosable pecuniary interest she remained in the meeting and took part in the debate.

Cllr Ros Kayes added that she was employed in the mental health profession outside of Dorset and on occasion, her employer received funding from Dorset HealthCare University NHS Foundation Trust. As this was not a disclosable pecuniary interest she remained in the meeting and took part in the debate.

To note the Committee’s terms of reference as follows;

(a)        To review and scrutinise matters pertaining to the planning, commissioning, provision and operation of health services in the area of the County Council.

(b)        To make reports and recommendations to relevant NHS Bodies and/or relevant health service providers and also to the Cabinet and other relevant committees of the County Council on any matter which is reviewed or scrutinised.

(c)        To give notice to require the Cabinet or the County Council to consider and respond to any reports or recommendations arising from the committee's work within two months of receipt.

(d)        Where relevant NHS Bodies and/or relevant health service providers have under consideration any proposal for a substantial development of the health service in the area of the County Council or for a substantial variation in the provision of such service:

(i)         to receive reports from the relevant NHS Bodies and/or relevant health service providers;

(ii)        to comment on the proposal(s); and

(iii)       to report in writing to the Secretary of State where any of the circumstances set out in paragraph 23(9) of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 apply.

(e)        To arrange for its functions under the 2013 Regulations to be discharged by an Overview and Scrutiny Committee of another local authority where that Overview and Scrutiny Committee would be better placed to undertake the functions and the other authority agrees.

(f)        In accordance with regulation 30 of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013, to appoint joint committees with other local authorities to exercise relevant functions under the said Regulations.

(g)        From time to time, as appropriate, to appoint a task and finish group consisting of members of the Committee to consider specific local issues relating to the overview and scrutiny of health.

Membership: 6 members of the County Council, or such higher minimum number which is necessary to achieve representation from the three main political groups based on the political balance rules.  Every effort being made so that each represents an area of the county which coincides with the district/borough council area in which their County Council electoral division is located, ie one County Council member to represent each of the following areas:

Christchurch, East Dorset, North Dorset, Purbeck, West Dorset and Weymouth and Portland.

1 member representing each of the 6 District/Borough Councils in Dorset.

The terms of reference for the Dorset Health Scrutiny Committee were noted.

Noted.

To confirm and sign the minutes of the meeting held on 8 March 2016.

The minutes of the meeting held on 8 March 2016 were confirmed and signed.

To consider a report by Dorset County Hospital.

The Committee considered a report by the Deputy Chief Operating Officer, Dorset County Hospital NHS Foundation Trust. The report outlined the work being undertaken to provide a seven day service to patients who needed emergency admission, diagnosis or treatment.

In line with NHS England’s direction, the Trust had to be seven day service compliant by 31 March 2020 but aimed to complete the work by March 2018. A recent audit had showed there had been good compliance in some areas, with work still to be done in others. In order to achieve full compliance, the Trust had developed an action plan which would be delivered through a project with clinical and senior management leadership. The report highlighted each area the audit had looked at and detailed the Trust’s progression in each area.

Noted.

To consider a report by the Director of Service Delivery, NHS Dorset CCG and the Director for Children’s Services, Dorset County Council.

The Committee considered a joint report by the Director of Service Delivery, NHS Dorset Clinical Commissioning Group and the Director for Children’s Services, Dorset County Council. The report outlined the service context for the provision of child and adolescent mental health services (CAMHS), focusing on the performance, particularly around access and waiting times. Improvements had been made in these areas as a result of the range of actions undertaken by the commissioners and providers. However, it was recognised that it was still an area of concern.

The report outlined areas of additional investment in Emotional Wellbeing and Mental Health through the submission of a transformation plan to NHS England on behalf of local partnerships. The report also outlined progress on the development of a new Emotional Wellbeing and Mental Health Strategy for children and young people. Public consultation on the strategy had been completed in May 2016, and the feedback received was now being analysed. An implementation plan would be published in September 2016.

Some concerns were raised by members regarding the increase in referrals and the increased number of patients being denied treatment. The Committee were reassured that increases were a reflection of what was happening nationally. Dorset’s number was below average compared other parts of the Country.

It was noted that historically, a large number of cases had not been identified as soon as they should have been. Officers explained that various different work streams had been undertaken with schools and teaching staff in an attempt to up-skill educational professionals to enable them to identify mental health issues in young people. This would help increase awareness and allow access to treatment at a much earlier stage. It was suggested that the recent review of youth services and changes being made to how Youth Workers delivered services would provide an opportunity to help recognise and prevent mental health issues at an early stage.

The committee felt that there were possible concerns arising over the effect of certain aspects of modern life and believed that the restructuring of youth services had a very important part to play. The Committee suggested that the matter be passed to the appropriate overview committee for consideration on a future agenda. Officers informed the Committee that work in this area had already been undertaken, and would be included as part of the relevant overview and scrutiny committee’s work programme in the future.

Noted.

To consider a report by the Director for Adult and Community Services.

The Committee considered a report by the Director for Adult and Community Services, which outlined the future work of the Committee planned for April 2016 to March 2017.

Discussion at a member’s workshop had resulted in a number of items being added to the work programme. It was noted that the forward plan was a standing agenda item and therefore members had the opportunity to amend the plan if they so wished, on a quarterly basis.

Noted.

To consider a report by the Democratic Services Officer.

The Committee considered a report by the Director for Adult and Community Services, which outlined membership to various bodies and asked the Committee to nominate members to fill vacancies.

Two vacancies had arisen on the Joint Health Scrutiny Committee. It was agreed that Councillors Ros Kayes and Bill Batty-Smith be appointed to fill the vacancies. Councillors Alison Reed and William Trite were appointed as reserve members to the Committee.

Resolved

1.         That Ros Kayes and Bill Batty-Smith be appointed to sit on the Joint Health Scrutiny Committee.

2.         That Alison Reed and William Trite be appointed as reserve members on the 3.     Joint Health Scrutiny Committee.

That membership on all other bodies remain as set out in the report.

To consider a report by the Director for Adult and Community Services.

The Committee considered a report by the Director for Adult and Community Services, which outlined the Protocol for the Dorset Health Scrutiny Committee. The revised protocol had been presented to the Committee at the previous meeting held on the 8 March 2016. Members had raised queries regarding two matters, which were clarified as follows;

·         The removal of reference to the scrutiny of the Supporting People Programme related to the transfer of this responsibility to the Adult and Community Services Overview Committee, which was agreed by Dorset Health Scrutiny Committee members on 11 March 2013.

·         Scrutiny of the Dorset Health and Wellbeing Board (HWB) was not within the remit of the Dorset Health Scrutiny Committee (DHSC). This was considered as part of the work of a task and finish scrutiny review undertaken by Dorset County Council members in late 2015/early 2016. The rationale behind the decision was as follows;

o   DHSC had a statutory role and terms of reference. It undertakes outward looking scrutiny of NHS bodies and proposals for substantial variations in the provision of health services. Part of the role of the HWB was also a scrutiny role. If DHSC was given a role in scrutinising the HWB then it would dilute and distract DHSC from its statutory role and result in the County Council having one scrutiny committee scrutinising the scrutiny conducted by another committee. The task and finish group reported to the Standards and Governance Committee on 25 January 2016 and their recommendations were subsequently agreed by the County Council on 15 February 2016.

As the proposed changes set out within the new Protocol were consequential of changes to regulations and guidance and clarified administrative matters, the changes could be approved by the Committee without the need for any referral to the County Council as host Council. In particular, there were no proposals to change the terms of reference of the Committee.

Resolved.

1.         That the revised protocol for the Dorset Health Scrutiny Committee, as set out in the report, be approved.

To consider a report by Diane Bardsley, Project Manager, NHS Dorset Clinical Commissioning Group.

Unfortunately there was no representative from the NHS Dorset Clinical Commissioning Group (CCG) to present the report. Members agreed that in order to give the matter proper consideration, it should be deferred to the September meeting so that a representative of the CCG could attend and present the report.

Resolved.

1.         That the report on the Dementia Services Review be deferred until the September meeting of the Dorset Health Scrutiny Committee.

To consider a report by Sally O’Donnell, Dorset Locality Director, Dorset HealthCare University NHS Foundation Trust.

The Committee considered a report by the Dorset Locality Director for Dorset Healthcare University NHS Foundation Trust (DHC). The report informed the Committee of a change to service provision at the Chalbury Unit in Weymouth and the implications these changes would have on patients and carers.

It was proposed that all NHS inpatient care beds for older people with dementia were provided at Alderney Hospital while options were considered for the provision of specialist dementia services across Dorset. DHC were making adjustments to the environment at Alderney Hospital to accommodate an additional 8 beds. Proposals to introduce different services in the West of Dorset were currently under development. Affected patients, relatives and staff were being consulted about the changes and, at present, it seemed likely that only one patient would have to be transferred to Alderney Hospital.  The remaining current patients would be placed in alternative accommodation.

Members asked for assurance that Chalbury Unit would not be closed and expressed concern regarding the lack of provision in the west of the County. It was confirmed that any arrangements in place currently were temporary, and the future of the unit would be considered as part of a larger review. At this time it was difficult to predict the future arrangements of the unit.

Members raised concerns over travel arrangements for patients and carers. It was suggested that an income based criteria should be used when arrangements for transport were reviewed. Members agreed that affordability should play a factor. However, members agreed that arranging the transport should not be the responsibility of patients and carers, regardless of their income or financial situation. Officers agreed to feed the comments back to those responsible for travel arrangements.

Resolved.

1.         That the Committee’s feedback around transport arrangements be fed back to the officers responsible for reviewing arrangements.

To consider a report by the Director for Adult and Community Services.

The Committee considered a report by the Director for Adult and Community Services, which highlighted the commentaries made following the most recent Task and Finish Group Meetings. The Committee were invited to comment on Quality Accounts prepared by local NHS Trusts on an annual basis. Two Task and Finish Groups had worked throughout the year with Dorset County Hospital NHS Foundation Trust (DCH) and Dorset HealthCare University NHS Foundation Trust (DHUFT) to discuss and review their Accounts and to formulate the Committee’s commentary for the 2015/16.

The Trusts were required to submit their Quality Accounts to Monitor by May 2016. The Task and Finish Groups formulated and submitted the commentaries outlined in the report, on behalf of the Committee, to both of the NHS Trusts concerned.

Future support for the Task and Finish Group meetings would no longer be provided by Democratic Services and reporting was therefore likely to be less formal in format.

Noted

The Committee considered a report by the Director for Adult and Community Services. The briefings presented in the report were primarily for information and noting.

Noted

The Committee expressed concerns with arrangements and the composition of the Joint Health Scrutiny Committee regarding the lack of information shared by the CCG. As a result, the Committee:-

Resolved

1.         Expressed its concern that the current composition of the Joint Health Scrutiny Committee did not allow adequate representation for the people of rural Dorset. The Committee recommended that there be an urgent review of the Joint Health Scrutiny Committee’s composition and officer support.

2.         Noted that whilst the Joint Health Scrutiny Committee was a legal requirement, for its Dorset members to contribute adequately to the process, there needed to be pre-scrutiny of the relevant matters at the Dorset Health Scrutiny Committee. The Committee strongly recommended that all materials were presented to the full Dorset Health Scrutiny Committee for comment, before any Joint Health Scrutiny meetings.

3.         Noted with concern the proposals from the CCG for the re-organisation of hospital services provision. The Committee very strongly expressed its view that such proposals as at present set out could be seriously detrimental to the people of Dorset. The Committee were concerned at the lack of detailed information that the Dorset Health Scrutiny Committee had received. The Committee requested that officers prepare a programme for full and intensive scrutiny and allowed for provision of all appropriate information.

No questions were asked by members under standing order 20(2).