Meeting documents

Apologies for absence were received from Cllr Ray Bryan (Dorset County Council), Cllr Tim Morris (Purbeck District Council) and Helen Coombes (Transformation Programme Lead for the Adult and Community Forward Together Programme).

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

Cllr Ros Kayes informed the Committee that she was employed as a mental health professional.  As this was not a disclosable pecuniary interest she remained in the meeting and took part in the debate.

Cllr Alison Reed informed the Committee that she was employed as a community nurse.  As this was not a disclosable pecuniary interest she remained in the meeting and took part in the debate.

To confirm and sign the minutes of the meeting held on 10 July 2017.

The minutes of the meeting held on 10 July 2017 were confirmed and signed.

To consider a report by the Transformation Programme Lead for the Adult and Community Forward Together Programme. (Appendicies to follow).

The Committee considered an update by the Transformation Programme Lead for the Adult and Community Forward Together Programme on the Joint Committee which had been convened to scrutinise the NHS Dorset Clinical Commissioning Group’s Clinical Services Review and the Mental Health Acute Care Pathway Review.

Members were informed that the Joint Committee had met on 3 August 2017 and  received representations from Opinion Research Services (ORS) and the CCG.  A letter had been sent to the CCG in response to the findings from the Clinical Services Review and Mental Health Acute Pathway Review consultations.  Both were attached to the report at Appendix 1 and 2 respectively.  It was noted that a Governing Body meeting would be held on 6 September 2017 to undertake further deliberations and at that meeting the letter from the Joint Committee would be considered.  The CCG’s special Governing Body meeting would be held on 20 September 2017, at which decisions would be made regarding the proposed changes to services.

The minutes of the CCG Governing Body meeting on 20 September 2017 would be circulated to members and a copy provided to the next meeting of the Committee on 13 November 2017.

Resolved

1.         That the Committee noted the report.

2.         That the minutes of the CCG Board meeting to be held on 20 September 2017 be circulated to the next meeting of Dorset Health Scrutiny Committee on 13 November 2017.

To consider a report by NHS Dorset Clinical Commissioning Group.

The Committee considered a report by the Lead Director Dorset ACS/STP, Director of Transformation, NHS Dorset CCG which updated the Committee on the status and progress of the Dorset Sustainability and Transformation Plan (STP).  It highlighted the key work streams of the plan, the governance of the oversight and progress so far with implementation of the plan.  There were five enabling portfolios within the plan all progressing at different pace across the system:

·         One Acute Network

·         Integrated Community and Primary Care Services

·         Prevention at Scale

·         Digitally Transformed Dorset

·         Leading and Working Differently

Dr Steve Killen had been appointed as Programme Director to plan and organise One Acute Network.  The Committee were informed the CCG were waiting for deliberations as to what decision would be made on 20 September 2017 before progressing further.

The Integrated Community and Primary Care Services Programme currently included work with the council’s planning and estates teams regarding community hubs,  increasing the depth of work that had already taken place.  A decision on mental health services would be announced the same time as the Clinical Services Review.

There were four main project areas within Prevention at Scale:

·         Starting well

·         Living well

·         Ageing well

·         Healthy places

With regard to Digitally Transformed Dorset there were approximately 20/30 projects the biggest of which was the Dorset Care Record shared system.  Collating the data and inputting the information on to the system was approximately 2 months behind schedule, although it was hoped this backlog would be recovered.  The Committee were informed this was not a technical or design problem it related to the volume of work and manpower available. The NHS digital teams were hoping to develop a single shared IT service across Dorset.  It was hoped the roll-out of the Dorset Care Record Shared System would be later in 2017.

The Community Services Programme had been modelled so that it would be better, if timetabled properly, for the system to have a full caseload of patients all day.  With regard to the digital system and safeguards for older people, the system would not be reliant on one digital system.  Age UK carried out a piece of work, nationally, on how different age cohorts would use technology and how to prepare them for the use of technology, which officers felt it might be helpful to read.

Members commented that retired people between the ages of 55 and 65 were competent with digital media, whereas older people often were not.  Dorset’s population was such that a high percentage were aged 60+ and concern was raised regarding this group of people and how the CCG would ensure sure they would not fall through the net and that safeguards needed to be in place for older residents.

In relation to delivering reductions in the number of out-patient appointments, concern was raised as to how members of the public were to get to Dorchester if there was no transport and, if cutting costs in travelling time for consultations was the motivation, was that clinically led  ...  view the full minutes text for item 31.

To consider a report by NHS Dorset Clinical Commissioning Group.

The Committee considered a report by the Head of Primary Care, NHS Dorset Clinical Commissioning Group on Primary Care Update.

The Committee were updated on the key areas of the report and it was confirmed there was a clear strategy supporting general practice and maintaining services within Dorset Primary Care to ensure they were integrated.  There were now 90 practices across Dorset, some of which were looking at how surgeries would share back-office systems, whilst others were looking at merging with another practice.  Officers had regular dialogue with practices regarding the right care and how they could learn from other practices to see what areas were working well and what was not working so well.  They were also looking at the different ways of delivering care into the community.  The CCG had been exploring joint working with hospitals and how to enable 24 hour access across Dorset.  Meetings had taken place between hospitals and GPs to look at how patients currently access NHS care and what improvements could be made.  Some patients used A&E departments as they could not obtain GP appointments, even though GP access in Dorset was considered one of the best in the country.  Data had been taken from both national and local surveys on access and the hard to reach groups.  This information had informed the national GP Forward View programme (GPFV) and in October 2017 engagement events would be held in Dorset to contribute to local planning.  The CCG continued to look at workforce planning, working with universities around primary care needs and how recruitment and retention of staff could be supported.  Investment in infrastructure and estates also continued.

The Chairman referred to paragraph 2.4 of the report and asked where the rest of Somerset, and Devon sat within the Local Medical Committees (LMC).  Officers responded that historically there had always been a Wessex Group with a strong national network and southern network.  It was recognised that patients should be able to access services and not be restricted by county boundaries.

The Committee queried how residents faced with the possibility of surgeries closing would access transport to and from their new surgery when public transport was not available.  Some thought was needed to be given to the way services were provided to ensure these people did not fall outside of the loop as it was no good suggesting changing surgery when there was no regular bus service.  It was reported that the voluntary transport co-ordinators did not have enough volunteers and were overburdened and that voluntary transport could not be relied upon to fill the gap if there was no suitable public transport.  Vulnerable people in rural areas could be disadvantaged if they had to pay for taxi fares that might cost in excess of £40.  In Bridport the community were trying to establish a community bus service to transport people from villages to hospital but this would need support from the CCG. 

The Committee asked for an explanation of what Project 1 and  ...  view the full minutes text for item 32.

To consider a report by the Transformation Programme Lead for the Adult and Community Forward Together Programme.

The Committee considered a report by the Transformation Programme Lead for the Adult and Community Forward Plan.

With regard to the workshop being held in conjunction with the LGA on the 27 September 2017 officers informed the Committee of the acceptances received from County Councillors to date.  A detailed agenda had not been set but the role of the Committee and scope would be considered and Councillor Ann Hartley from Shropshire had been invited to attend the workshop.

Resolved

That the Forward Plan be noted.

To consider a report by the Transformation Programme Lead for the Adult and Community Forward Together Programme.

The Committee considered a Briefings for Information/note by the Transformation Programme Lead for the Adult and Community Services Forward Together Programme. 

The Impact: Healthwatch Dorset Annual Report 2016-17

Margaret Guy from Healthwatch Dorset briefly outlined the work they had carried out  with the CCG around CSR and the report Healthwatch had produced regarding the public consultation.  She also noted the investigation into people making NHS complaints: all trusts had participated except Poole Hospital.  The Trusts had responded positively to recommendations, particularly Bournemouth Hospital. An investigation into activities provided at care homes had been carried out with 8 homes, looking at how people retained their sense of self.  The "Be Yourself: Everybody Else is Taken" project which raised young people’s mental health issues was supported by AFC Bournemouth, and the related App was launched at the Vitality Stadium.  Easy reading guides to making a complaint had also been produced.  During the current financial year Healthwatch Dorset were looking at Primary Care services and how easy it was to make an appointment and register with a GP practice.  The findings of the survey had gone to the Primary Care Commissioning Committee at the CCG.  The Be Yourself Project was continuing and a report had been sent to all 3 local authorities.  In terms of social care Healthwatch Dorset would be investigating access to health services such as GPs, dentists and opticians for care home residents and were carrying out a survey in conjunction with Bournemouth University around older male carers (over 85).  They were continuing to work with the CCG on the STP.  Future work would include looking at waiting times for social care assessments, as they had heard a number of concerns regarding this issue.

Chairman thanked Margaret Guy for her update.

The Health Scrutiny Committee Annual Report 2016/17

The Health Partnerships Officer, Adult and Community Services updated the Committee on Appendix 2 Dorset Health Scrutiny Committee Annual Report 2016/17 which was shared on an annual basis with other committees and three councils partnership.

The Pan-Dorset Sexual Health Services

The Committee received an oral update from the Health Partnerships Officer, Adult and Community Services on future changes to the delivery of pan-Dorset Sexual Health Services and informed the Committee a report went to the Joint Public Health Board in June 2017.  Work was being undertaken with providers, (Dorset HealthCare, Bournemouth and Weymouth Hospitals) looking at providing a more community based service with enhanced on-line access and  a lead provider.  The Health Partnerships Officer mentioned that if there were any substantial changes to services a report would be submitted to this Committee and Joint Committee as this was a pan-Dorset service.

To answer any questions received in writing by the Chief Executive by not later than 10.00am on Wednesday 30 August 2017.

No questions were received by members under Standing Order 20(2).