Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Committee Room 2 - 05/07/2004 10:00:00 AM)
Item: A0 Minutes
DURHAM COUNTY COUNCIL
At a Meeting of the
Health Scrutiny Sub-Committee held at the County Hall, Durham on
Monday 5 July 2004 at
10.00 a.m. COUNCILLOR J PRIESTLEY in the Chair.
Durham County Council Councillors Armstrong, Carroll Howarth Ord and Marshall
Chester le Street District Council Councillors Armstrong and Harrison
Easington District Council Councillors Burnip and Raine
Derwentside District Council Councillor Agnew
Durham City Council Councillors Simmons and Smith
Teesdale District Council Councillor Hamilton and Stansfield
Sedgefield Borough Council Councillors Crosby and Gray
Wear Valley District Council Councillor Lee
Co-opted Members G Eshelby
Other Members Councillor Firby, O’Donnell and Trippett
Apologies for absence were received from Councillors Agnew, Fergus, Harker and Porter.
A1 Minutes The Minutes of the meeting held on 29 March 2004 were agreed as a correct record and signed by the Chairman with the exception of the amendment of Minute No A7 . The second paragraph was amended by replacing the reference to ‘nurse or physiotherapist’ with ‘other primary care professionals’.
A2 Declarations of Interest There were no declarations of interest.
A3 Scrutiny Report: A Review of Pre-School Child Health in County Durham The Sub Committee considered a scrutiny report about pre-school health in County Durham (for copy see file of Minutes).
Resolved: That the report and recommendations contained within be approved.
A4 MRSA - Presentation The Sub Committee received a presentation from Dr John Sloss, Consultant Microbiolgist of Darlington Memorial Hospital and Bishop Auckland General Hospital.
Dr Sloss explained that he provided the infection control service for Darlington Memorial and Bishop Auckland General Hospitals. Two other colleagues provided the service at Durham University Hospital. This was a laboratory based service. Four teams of infection control nurses provided the service on the wards.
Staphylococcus aureus is a common microbe found on the skin of 10% of the population. It is not a life threatening microbe. MRSA has been around since the use of antibiotics began to be widely used. There are up to sixteen strains of MRSA. A major epidemic of MRSA 15 began in 1995. MRSA is difficult to treat but not impossible. There is concern about the increasing resistance to the new generation of antibiotics.
Dr Sloss said that the most vulnerable patients (usually older or elderly patients) were most likely to contract MRSA. Part of the problem arose from the increased pressure on hospital beds and the turn around in patients.
The larger regional hospitals usually had higher infection rates than the smaller general hospitals. Overall Dr Sloss was of the view that there was not a significant problem in County Durham.
Dr Sloss outlined three possible control strategies:
· Containment
· Ignore it - This was not an option as we are running out of antibiotics to treat MRSA.
· Search and destroy - It was felt that it was unlikely that we could get rid of MRSA.
Therefore the main task was to control the spread of MRSA. This could be done by:
· Limiting antibiotics - presently oversubscribed
· Hospital Organisation - good isolation facilities
· Hygiene and Infection Control
The current strategies employed include:
· Restrictive antimicrobial sensitivity reporting
· Use of Antibiotic Pharmacist to monitor and audit use of antibiotics
· Isolation of patients in high risk areas
· Screening - this can be very expensive and can’t eliminate MRSA
· Education of all staff - staff have limited knowledge of MRSA and it is important to disseminate good practice.
· Information to patients and relatives
Future Strategies should include:
· Computerised requesting, reporting and prescribing. This would give more control.
· Darzi changes - separate out patients - better control
· Better education for staff
· Further research.
Dr Sloss stressed the importance of not underestimating MRSA. He went on to say that MRSA was not an issue about dirty hospitals and that there was no correlation between dirty/clean hospitals and MRSA infection rates.
In response to a question about infection rates between old and new hospitals Dr Sloss said there was no discernible difference in the infection rates.
In relation to costs of dealing with MRSA and the number of deaths, Dr Sloss explained that it was difficult to obtain accurate comparative statistics for the UK and other European countries. Dr Sloss further explained that MRSA rarely infects babies and children and more usually infects older or elderly people.
In response to questions about the population generally having a lower resistance to disease and infection (ie the increase in asthma), Dr Sloss said that this had nothing to do with the spread MRSA.
Members suggested that it would be helpful to receive a further presentation and update on the position within the County at some time in the future.
The Sub Committee thanked Dr Sloss for his informative presentation.
Resolved: That the presentation be noted.
A5 Consultation on the Future of Services Provided from Homelands Hospital Crook The Sub Committee received a progress report from Andrew Kenworthy, Chief Executive Durham Dales Primary Care Trust on the current position of the consultation process on the future of Homelands Hospital Crook.
Three consultation events have been attended by local residents. They have indicated that they would like to see some kind of service retained in the area, including the refurbishment of the existing premises. It was estimated that a 20 bed facility would cost £5m while a 30 bed facility would cost approximately £7.5m It was felt that the re-investment of the proceeds from the sale of the site would provide better services for the area.
Resolved: That the report be noted.
A6 Outcome of Consultation Process Relating to Mental Health Services in North Durham The Sub Committee received a progress report from Harry Cronin about the outcome of the consultation process on adult mental health services in the north of the County. A report is to be submitted to each of the PCT Boards. The next phase of the process was beginning. A workshop is to be held on 16 July 2004 with sixty participants expected to attend.
In response to a question about the provision of future services, Harry Cronin explained that an outline business case for a new hospital was being prepared and a number of different options were being considered.
Resolved: That the report be noted.
A7 New GP Contract/Stanley GP Practises The Sub Committee received an update from Wynn Griffiths, Chief Executive Derwentside Primary Care Trust, on the current position on the new GP contract and the provision of out of hours service in the Derwentside Primary Care Trust area. A similar position exists within other PCT areas. From 1 September all GP’s will opt out of providing an out of hours service. GP’s will be invited to opt back into the service and extra shifts will be provided at the Urgent Care Centre
All PCT’s will be employing advanced practitioners though this will not be implemented until April 2005. It was therefore unlikely that residents would notice very little change before April 2005. Information is to be provided to County households explaining the changes.
Wynn Griffiths informed the Sub Committee of the proposals for future GP Practises in the Stanley area. There are currently 6 GP practises working within Stanley Health Centre. The PCT proposes a new model of care to increase access to the range and level of local health services for the population of Stanley and surrounding area.
The Sub Committee were of the view that it was difficult to give a decision at the present time and suggested that consideration of the proposals be deferred to the meeting to be held on 23 July 2004.
Resolved: 1. That the report on the current position of GP contracts and provision of out of hours service be noted.
2. That consideration of the proposals for the future reconfiguration of GP practises in Stanley be deferred to the meeting to be held on 23 July 2004.
A8 Development Session - 22 April 2004 The Sub Committee considered a report of the Head of Overview and Scrutiny about the development session held on 22 April 2004 (for copy see file of Minutes).
Resolved: 1. That the report be noted.
2. That the next project to be undertaken will be on obesity.
A9 Issues from Patient Forums and PAL’s Jane King of the Patients Forum informed the Sub Committee that the Forum were currently examining three projects. These were:
· Disposal of Needles
· Information in GP practises
· New health centre in Sedgefield
Resolved: That the report be noted.
A10 Choosing a Better Diet/Choosing Activity The Sub Committee considered a report of the Head of Overview and Scrutiny about two Government Consultation reports on Public Health - Choosing a Better Diet and Choosing Activity (for copy see file of Minutes).
Neil Charlton, Deputy Director of Education, informed the Sub Committee about a new LEA initiative to promote a healthier lifestyle in County Durham school children. Members of the Sub Committee asked for an update on the initiative to be submitted to a future meeting of the Sub Committee.
Resolved: 1. That the report be noted.
2. That the Head of Overview and Scrutiny be authorised to respond on behalf of the Sub Committee
A11 Scrutiny Projects and Work Programme The Sub Committee considered a report of the Head of Overview and Scrutiny about the work programme of the Sub Committee (for copy see file of Minutes).
Resolved: That the work programme be noted.
Attachments healthscrutiny05.07.04.doc