Meeting documents

Apologies for absence were received from Ray Bryan, Graham Carr-Jones, David Jones and Steven Lugg.

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

Cllr Bill Batty-Smith declared a general interest as his granddaughter was employed by the NHS.

Cllr Alison Reed declared a general interest as she was employed as a community nurse by Dorset Healthcare University NHS Foundation Trust.

Cllr Peter Shorland declared a general interest as a Governor of Yeovil Hospital. 

Cllr Ros Kayes declared a general interest as a mental health professional.

To confirm and sign the minutes of the meeting held on 4 September 2017.

The minutes of the meeting held on 4 September 2017 were confirmed and signed.

Public Speaking – Clinical Services Review and Referral to Secretary of State for Health

Three public questions were received from Deborah Monkhouse, Chris Bradey and David Holman at the meeting in accordance with Host Authority Standing Order 21(1). The questions are attached as an annexure to these minutes.  The response to the questions were addressed within the discussion outlined below.

Three public statements were received from Philip Jordan, Steve Clark and Margaret O’Neill in accordance with Standing Order 21(2). The statements are attached as an annexure to these minutes.

Councillor Bill Trite addressed the Committee as the Local Member for Swanage.  He endorsed the concerns expressed by the public speakers and referred to a local petition signed by 8000 people which reflected the serious concern in relation to this proposal.  He stated that it would take significantly longer for patients from Swanage and the Isle of Purbeck to travel to Bournemouth Hospital leading to an increase in fatalities due to the longer journey time.  Swanage had a high proportion of elderly and vulnerable people as well as the worst traffic congestion during the Summer and the ambulance service had a poor record of responding to emergencies in this area. 

He informed the Committee that Swanage Town Council submitted its views to the Dorset Clinical Commissioning Group (CCG) on 27 February and 18 September 2017.  The response by the CCG had not been received in time for consideration at a recent Town Council meeting, however, it failed to answer the points that had been made. He therefore asked the Committee to consider referring the matter to the Secretary of State for Health on the basis that the plans were insufficient to meet the needs of the area.

Cllr Ros Kayes stated that the matter should be referred to the Secretary of State by the Dorset Health Scrutiny Committee (DHSC) at this stage and that there were sufficient reasons to inform a referral such as the lack of an equalities impact assessment, no clear financial plan and the reduction in numbers of beds.  She considered that it would be inappropriate to wait until the Joint Health Scrutiny Committee meeting in February 2018 on the basis that implementation and funding of the existing plan would be underway.

The Chairman stated that Dorset was a member of a Joint Health Scrutiny Committee that had been set up to consider the proposals within the Clinical Services Review and any concerns related to those proposals and the associated consultation process.  However, the individual authorities, including Dorset, had reserved the right to refer the proposals to the Secretary of State.

In light of the concerns raised, the DHSC could invite the Joint Health Scrutiny Committee (JHSC) to further scrutinise the proposals regarding the reduction in the number of acute hospital beds and the travel and transport implications and provide a view on whether Dorset should make a referral to the Secretary of State.  This approach would fit with the governance arrangements as the scrutiny of the proposals  ...  view the full minutes text for item 39.

There were no petitions received at the meeting in accordance with the County Council’s Petition Scheme.

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

The Committee considered a report providing an update on the Joint Health Scrutiny Committee (JHSC) convened to scrutinise the NHS Dorset Clinical Commissioning Group’s Clinical Services Review (CSR) and the Mental Health Acute Care Pathway Review.

Members noted that the Clinical Services Review timeline had concluded in September 2017 and requested a more detailed timeline beyond this timeframe.  It was confirmed that a new timeline was currently being developed by the CCG that would be available in December 2017.

The Chairman asked whether a Memorandum of Understanding existed for the integration of paediatric services between Dorset County Hospital and Yeovil District Hospital.  He expressed the Committee’s view that it would be preferable if services were retained at Dorset County Hospital to avoid the need to travel out of the County. The Committee was informed that a Memorandum of Understanding had been agreed between the hospitals around working together and there would be a joint Dorset and Somerset CCG paper on a sustainable maternity and paediatric service for the West of the County.

Points were raised in respect of the CCG’s response to the letter on behalf of the JHSC regarding the findings of the CSR and Mental Health Care Pathway Review consultations.  It was noted that the letter included an invalid link to the equalities impact assessment, and members considered there to be a lack of value placed on the concerns expressed by Healthwatch and of the concerns of people who responded to the consultation through petitions, particularly in respect of the Poole A&E services. The Executive Director of Healthwatch confirmed its published review had commented that the CSR consultation could have been better and that further consultation with the public must be taken in future in relation to service delivery.

Noted

To consider a report by Weldmar Hospicecare Trust.

The Committee considered a report concerning the provision of End of Life and Palliative Care in Dorset.A presentation given by Hilary Lawson, Dorset Healthcare University NHS Foundation Trust, Neal Cleaver, Dorset County Hospital and Caroline Hamblett, Chief Executive - Weldmar Hospicecare, had been included in the report.

It was confirmed that the aim was to provide end of life care for people in the same way regardless of where a person lived and that community nurses worked closely with care homes in areas where there was no community hospital. 

Speaking as a community nurse working in a multi-disciplinary environment, Cllr Alison Reed raised a number of issues including the need for improved communication and patient history for patients not known to community nurses, problems in accessing information on the computer System 1 and issues of equipment being in place at the right time.  Hilary Lawson agreed to meet separately with Cllr Reed following the meeting with the aim of working towards resolving the problems experienced on the ground.

The Committee was subsequently advised that community equipment had been jointly commissioned by Health and Social Care for the past 3 years and that the issue could be one of a lack of knowledge. 

The CCG confirmed that a group working with the Dorset Care Record was looking at ways to improve access to System 1 across the Primary Care and Community Trusts.  This work was at an early stage and the concerns relating to access to the system by community nurses would be fed back to this group.

Members asked whether there was sufficient funding to employ a nurse for end of life care for people suffering from motor neurone disease.  It was confirmed that additional funding for a nurse had been provided by the CCG and Motor Neurone Disease Society and that charitable money would be used if this funding was not available in future.

The Committee discussed end of life live-in care packages in the home and were advised that some live-in packages were supported as part of the Dorset Care Framework jointly commissioned with Dorset County Council and the CCG.  There remained a fundamental issue of a lack of people in the workforce in order to provide the necessary care, even when all funding was in place.

Noted

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

The following members agreed to participate in the areas of work outlined below:-

·      Child and Adolescent Mental Health Services (CAMHS) – Ros Kayes

·      Transport for Health – Bill Pipe

·      Suicide Prevention – Nick Ireland

·      The Impact of Housing on Health – Alison Reed / Tim Morris

·      Road Traffic Collisions – Peter Oggelsby

Resolved

That the forward plan be noted.

To consider a report by the Director for Adult and Community Services.  This report includes the following items:-

·          

There were no briefings for information at this meeting.

To consider any updates from the liaison member for the following;

·         Dorset County Hospital NHS Foundation Trust.

·         Dorset Healthcare University NHS Foundation Trust

·         NHS Dorset Clinical Commissioning Group

·         South Western Ambulance Service NHS Foundation Trust

Cllr Ireland advised the Committee that he had attended a Dorset County Hospital Board meeting in September 2017 when the discussion had included nursing retention and recruitment (and impact of Brexit), the review of maternity and paediatric services and issues around the development of a strategy between Yeovil District Hospital and Taunton Hospitals.  There had been no formal consultation in Somerset yet.

To answer any questions received in writing by the Chief Executive by not later than 10.00am on 8 November 2017.

No questions were asked by members under Standing Order 20.