Special Health Scrutiny Panel. Minutes. Friday, 21st April 2006

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1 STAFFORDSHIRE MOORLANDS DISTRICT COUNCIL Special Health Scrutiny Panel Minutes Friday, 21st April 2006 PRESENT: Councillor M. Ahmad (Chair) Councillors F.R. Alcock, B.T. Cowie, A.E. Hobson, H.W.G. Jebb, Mrs. M.A. Motum, P.J. Roberts and C.A. Stone. Councillor W.D. Day County Council Representative NON-MEMBERS: Councillor J.A. Harrison APOLOGIES: Panel Members: Councillors J.N. Hails and A. Hart. Portfolio Holders: Councillor K. Harrison (Healthy Living) Councillor Mrs. M.J. Locker (Community Involvement) Non-Members: L. Watkinson (PPI, Staffordshire Moorlands) 64. URGENT ITEMS OF BUSINESS (64) There were no urgent items of business. 65. DECLARATIONS OF INTEREST There were no declarations of interest

2 DIRECTOR, SPECIAL PROJECTS AND SERVICE REDESIGN AND GARY RAPHAEL, ACTING CHIEF EXECUTIVE OF THE EASTERN CHESHIRE PRIMARY CARE TRUST ON: FUTURE HEALTHCARE IN EASTERN CHESHIRE AND MAKING IT BETTER, MAKING IT REAL The Panel was advised of two consultation papers relating to Future Healthcare in East Cheshire. The first public consultation had been published by Eastern Cheshire Primary Care Trust, in association with East Cheshire NHS Trust and Cheshire and Rural Partnership NHS Trust on 'Future Healthcare in Eastern Cheshire'. The second consultation, 'Making It Better, Making It Real', related to healthcare services for children, young people, parents and babies in Greater Manchester, East Cheshire, High Peak and Rossendale. At the last meeting of the Health Scrutiny Panel on 21st March 2006, Members raised the issue of consultations being carried out which related to services at Macclesfield Hospital. Since that meeting, research had found that the two consultation papers were currently being considered by a range of organisations and, therefore, the Chair requested that the Panel be given an opportunity to respond to the consultation papers. Firstly, the consultation paper on 'Future Healthcare in Eastern Cheshire' was actively seeking the views of local people on proposals for significant changes to the way in which health services are provided in Eastern Cheshire. These changes were aimed at ensuring that the local NHS was able to continue to provide high quality services which were safe, practical and would last for the next 15 years. It was stressed that they should also be focused on the needs of patients and, finally, they must be affordable. The document set out clearly the preferred option which is believed to offer the best solution for local people. This was option 1, which would involve a major expansion of primary and community services with more care delivered closer to home. The consultation paper indicated that one of the greatest challenges facing the health service in Eastern Cheshire over the next few years was the major shift in the make up of the population. More and more people were living into their 80s and 90s, thanks to improved nutrition, healthier environments and better treatments. At the same time, the birth rate was falling, so that by 2020 there would be almost twice as many older people as young people in Eastern Cheshire. However, longer life does not always mean healthier life. Many older people who are less mobile than others will be coping with one or more long-term conditions

3 DIRECTOR, SPECIAL PROJECTS AND SERVICE REDESIGN AND GARY RAPHAEL, ACTING CHIEF EXECUTIVE OF THE EASTERN CHESHIRE PRIMARY CARE TRUST ON: FUTURE HEALTHCARE IN EASTERN CHESHIRE AND MAKING IT BETTER, MAKING IT REAL (CONTINUED) Patients rise in expectations, the increasing trend towards specialisation by hospital consultants and European laws restricting working hours, are also driving changes to the way in which health services are provided. In addition, consideration needed to be given carefully to the current and future capacity of the NHS in Eastern Cheshire and its ability to achieve national targets. These included:- shorter waiting lists; speedier access to GPs; and improvement in the health and wellbeing of the population. This consultation was sponsored by Eastern Cheshire Primary Care Trust, East Cheshire NHS Trust and Cheshire and Wirral Partnership NHS Trust. This future healthcare publication had been prepared alongside a separate, but linked formal public consultation entitled 'Making It Better, Making It Real', which was being carried out by the children, young people and families network. The 'Making It Better, Making It Real' consultation proposed changes to some in-patient services for children, young people, parents and babies across the review area of Greater Manchester, Eastern Cheshire, High Peak and Rossendale. The summary of their proposals included, "What are the changes needed?":- people need more choice in deciding whether to have their care provided in a hospital, in another setting or at home; people want more health services provided out of hospitals; better in-patient care can be delivered in larger, more specialised units in hospitals. In larger units doctors and nurses see enough patients with certain conditions and illnesses to ensure they keep up their skills; national and local population trends show that there will be more older people and few children in future. The consultation document explained why a smaller number of hospitals should provide the more specialised in-patient maternity, paediatric and neonatal services and it gave options that suggested which hospitals could provide these in-patient services. It also gave information on how each option for change would

4 affect the local area. DIRECTOR, SPECIAL PROJECTS AND SERVICE REDESIGN AND GARY RAPHAEL, ACTING CHIEF EXECUTIVE OF THE EASTERN CHESHIRE PRIMARY CARE TRUST ON: FUTURE HEALTHCARE IN EASTERN CHESHIRE AND MAKING IT BETTER, MAKING IT REAL (CONTINUED) Within this consultation there were five options Option A, Option B, Option C, Option D and Option E, Option E being no change. The Chair referred Members to Option D as the key difference between Option D and Options A, B and C for Eastern Cheshire was that Macclesfield Hospital was one of the eight sites for the provision of local in-patient services. Therefore, it would mean that Option D would ensure that Macclesfield Hospital provided 24 hour in-patient services in paediatrics, neonatology and maternity. Under Option D pregnant women, children, parents and carers in Eastern Cheshire could choose to receive their in-patient care at Macclesfield Hospital. They would also be able to choose from a range of hospitals within reasonable travelling distance. Under Options A, B and C pregnant women, children, parents and carers in Eastern Cheshire would be able to choose from a range of hospitals within reasonable travelling distance. Members noted that the preferred option was Option A. In discussion of the consultation papers, Members raised concerns in relation to patient choice and eliminating choice for local residents unless the Panel support an option with the retention of services at Macclesfield Hospital. In response, it was emphasised that some hospitals had had to close wards due to the availability of staff. It was stressed that this did not apply to Macclesfield Hospital. Concern was also raised about the general population and the fact that if services are not provided at Macclesfield Hospital, young families are less likely to move to the area. Concern was also raised in relation to the provision of mental health during out of hours and it was agreed that more work needed to be done in relation to the mental health proposals, and that there was a need for a clear policy to deal with mental health cases. Members also expressed some concern in relation to the consultation that had taken place with local residents and emphasised that, in future, such consultation should be widely publicised. It was also suggested that contact should be made with the local GPs within the Staffordshire Moorlands in connection with these consultations

5 DIRECTOR, SPECIAL PROJECTS AND SERVICE REDESIGN AND GARY RAPHAEL, ACTING CHIEF EXECUTIVE OF THE EASTERN CHESHIRE PRIMARY CARE TRUST ON: FUTURE HEALTHCARE IN EASTERN CHESHIRE AND MAKING IT BETTER, MAKING IT REAL (CONTINUED) In relation to treatment in the community, Members asked about any proposals or developments in the Staffordshire Moorlands and it was acknowledged that investment needed to be made now in the community and the infrastructure developed before any changes to hospital facilities. DECIDED: (1) That, in response to the consultation 'Making It Better, Making It Real', the Health Scrutiny Panel support any option which includes the retention of services at Macclesfield Hospital. (2) That, in relation to the public consultation document 'Future Healthcare in Eastern Cheshire', the Panel support the preferred option, Option 1, which includes the retention of the Emergency Department at Macclesfield General Hospital, the development of a Healthcare Site at Congleton and Knutsford, more rehabilitation services within the community and a new range of services set up for people with long-term health conditions and the further development of community services and new ways of working within mental health services. 67. PRESENTATION FROM STAFFORDSHIRE MOORLANDS PCT - ANNUAL HEALTH CHECK DECLARATION The report presented to Members set out the Staffordshire Moorlands Primary Care Trust (PCT) position against the Department of Health 'Standards for Better Health' Core Standards for the year 1st April 2005 to 31st March Members were reminded that the self-assessment against the Draft Declaration acknowledged that the PCT was compliant with 40 of the 44 standards. The declaration stated that there was 'insufficient assurance' at that time to be able to declare compliance or non-compliance in relation to the four standards. Work had been undertaken and the PCT had identified compliance. A review of the 40 compliant standards had also been undertaken. Information had confirmed there had been non-significant lapses of compliance during the past five months. Indeed, additional assurances had been provided to meet compliance. The PCT was pleased to report that it was assessed in January 2006 by the NHS Litigation Authority and that it had maintained compliance with the Risk Management Standard (Level 1A). This standard included high risk areas such as minor injuries, child protection, health records, professional registration and re-registration

6 67. PRESENTATION FROM STAFFORDSHIRE MOORLANDS PCT (67) - ANNUAL HEALTH CHECK DECLARATION (CONTINUED) The PCT had limited assurance of compliance with the Core Standards for Better Health, in relation to its independent contractors, e.g. General Practice, Dental Practice, Pharmacy and Optometry services. Actions were planned to work with the independent contractors during Audits and reports on services, however, had been presented to the Trust Board, the Professional Executive Committee and to other committees/groups during the last 12 months. These included the Quality and Outcomes Framework audits. Whilst the PCT, the Healthcare Commission and the public recognised the financial challenges during 2005/06, Financial Governance was not part of the Final Declaration for that year - this would be dealt with separately via the Audit Commission. In summary, the Panel was advised that Staffordshire Moorlands PCT had taken a proactive and positive approach in order to undertake the Self- Assessment against the Core Standards. The PCT had reflected and learnt from this experience, recognising that it must further embed Standards for Better Health throughout the organisation and to work with its partners and the public. The Panel appreciated the opportunity to comment on the Draft Declaration and thanked the Trust for sharing the information and agreed that a response should be forwarded to the Trust to include the following comments:- The Health Scrutiny Panel had regular contact with the Staffordshire Moorlands PCT. Presentations had been made by the PCT to several Health Scrutiny Panel Meetings in relation to local and national initiatives and this contact had been valuable to the work of the Panel. The Panel had also worked closely with the PALS Team on resolving many issues, and the Director of Public Health when carrying out their scrutiny review in relation to 'Cancer Screening'. The Director of Public Health presented her annual report to the Panel each year. The Panel would appreciate early engagement with the Trust in respect of any service variations or developments in the future. Members wished to have ongoing discussions with the Trust in connection with: Out-of-Hours; the possible provision of a GP Centre and the Reviews being carried out by the Health Scrutiny Panel. Panel Members appreciated the attendance of the Officers at their meetings to assist their work programme. 67. PRESENTATION FROM STAFFORDSHIRE MOORLANDS PCT (67) - ANNUAL HEALTH CHECK DECLARATION (CONTINUED)

7 The Panel supported the suggestion by the Trust that they would work further with the independent contractors during DECIDED: That a response be forwarded to the PCT. The Meeting closed at 3.25 p.m. Chair Date

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