Councillors Armstrong, Carroll, Howarth, E Hunter, Marshall, Ord, Porter and Watson.
Apologies for absence were received from Councillors Fergus and Pye.
The Minutes of the meeting held on 5 and 23 July 2004 were agreed as a correct record and signed by the Chairman with the addition of Councillor Harrison’s apologies for the meeting held on 23 July 2004.
There were no declarations of interest.
The Sub Committee considered a report (for copy see file of Minutes) together with a presentation from Sandy Taylor, Chief Executive of the County Durham and Darlington Priority Services NHS Trust about the temporary relocation of Psychiatric Intensive Care (PIC) Services from Durham City to Darlington.
There are currently 19 PIC beds available across County Durham and Darlington. This includes 5 beds at the Tony White Unit (TWU) based at the County Hospital in Durham. Patients from all Primary Care Trust areas are able to access any of the beds.
It is proposed to open new purpose built facilities (25 PIC and special care beds) at West Park Darlington.
There are concerns about the environment at the Tony White Unit including safety, privacy and dignity. The facility does not meet Department of Health national standards. It is proposed to re-provide services at West Park as an interim measure until the opening of the new acute in patient facility in the north of Durham in autumn 2007.
· Capacity - there will be an increase from 19 to 25 beds
· Patient Transport - patients are already transported between Durham and Darlington. There are agreed protocols in place based on risk assessment and sufficient staff will be available.
· Visiting - numbers of visitors are small but transport will be provided via a Trust taxi contract if necessary.
The consultation process commenced on 9 August and will run until 9 November 2004. The Head of Overview and Scrutiny reminded the Sub Committee that their main role was to ensure that patients are properly consulted and are able to contribute their views on proposed changes to services. Members sought clarification on the extent of the consultation process. Sandy Taylor explained that there had been extensive discussions with users of the service including formal open meetings. In addition meetings had taken place with users groups and staff. Two additional public meetings had taken place at the request of Chester le Street and Durham PCT. Andrew Kenworthy Chief Executive, Durham Dales PCT confirmed that this issue had been considered by all PCT’s who had fully supported the proposals.
Helen McCaughey drew attention to the temporary use of beds potentially affecting the usage of the beds in the new unit at Darlington. She also pointed out there would be a reduction of one bed as a result of this proposal.
Liz Hopkins (a member of staff of the Tony White Unit) expressed the view that in her opinion, the consultation process was flawed as some of the information used was inaccurate and asked for an extension of the consultation timetable to allow staff’s views to be fully considered. Sandy Taylor advised the Sub Committee that the information used was taken from Trust data. It was confirmed that meetings with representatives of Unison and the Royal College of Nursing was part of the consultation process. The Sub Committee requested the Trust to have further discussions about the proposed changes with staff and their representatives. It was confirmed that the outcome of the consultation process would be reported to the Sub Committee.
Resolved: That the report and presentation be noted and that the Priority Services Trust be requested to engage in further discussions with staff about the proposed changes.
A4 North Durham Modernisation of Mental Health Services The Sub Committee considered a report (for copy see file of Minutes) together with a presentation from Sandy Taylor Chief Executive of the County Durham and Darlington Priority Services NHS Trust giving an update on the modernisation of North Durham Mental Health Services.
The new facility will replace the County Hospital and the Allensford Ward. Following a twelve week consultation ending in April 2004, an option appraisal workshop was held on 16 July 2004 which was attended by fifty people. From the sites examined, the Earls House site scored the highest and is therefore the preferred option.
The next step will be the production of an outline business case to the Primary Care Trusts and the Strategic Health Authority for approval. Further planning will be needed in terms of content, layout design and transport issues. Users and carers will be involved via the project team and sub groups. Completion is expected in autumn 2007.
Resolved: That the report and presentation be noted.
A5 Homelands Hospital Crook The Sub Committee received an update from Andrew Kenworthy Chief Executive of Durham Dales Primary Care Trust on the current position relating to Homelands Hospital Crook (for copy of document see file of Minutes).
The preferred option is the closure of Homelands with the replacement of some beds while redirecting the resources into the strengthening of community services. As part of an extensive consultation process which ran from 1 June to 31 August, over 1000 copies of the consultation documents were distributed and four public meetings were held. Presentations were made to the Sub Committee, the Patient Forum of County Durham and Darlington Acute Hospitals Trust and Wear Valley District Council. In addition Age Concern were commissioned to undertake consultation with carers and patients.
A number of key issues were raised from the consultation process. These included:
· The quality of care provided at Homelands Hospital
· Respite care
· Quality of private nursing home care
· Accessibility of local health services
· What will happen to money released from Homelands
· Development of a new community hospital
It was explained that at present there were no delayed discharges from hospital and that on average only 3 to 5 patients use Homelands Hospital. A new community hospital would cost between £3m to £7.5m. The PCT has no access to funds for this project and would need a PFI scheme to fund the building of a new community hospital. It was acknowledged that the local community supported the retention of Homelands Hospital or a replacement.
Councillor Carroll outlined the concerns of the local community who valued the service provided by Homelands Hospital. In particular there were concerns about transport difficulties to visit patients at Bishop Auckland Hospital or in nursing homes. In addition there were concerns about patients being able to access their own GP while in a nursing home.
Andrew confirmed that the PCT would continue to be responsible for the cost of respite care and there would be no disadvantage for the patient. In relation to transport it was acknowledged that there were concerns. However, where there are difficulties for the patient or carer, the PCT would pay for the cost of transport and this will be included in their individual care plan.
It was explained that a separate service had been established, mainly staffed by nurses who visited nursing homes to help with medication and the control of diabetes. This supplements the existing levels of care. Access to a patient’s own GP is still available.
It was advised that the proceeds from the sale of Homelands will go back to the Secretary of State and that there was no financial benefit to the PCT’s.
Resolved: That the consultation process to date be noted and that the Durham Dales Primary Care Trust should seek to try to further explain to the local community the benefits that will arise from the proposals.
A6 GP Contract Update The Sub Committee received an update on the current position on the new GP contract from Andrew Kenworthy Chief Executive of Durham Dales Primary Care Trust.
From 1 December 2004 there will be no out of hours cover provided by GP’s. A slightly different model is being used in each PCT area. All PCT’s are confident that new services will be up and running by 1 December 2004. A number of consultation meetings are taking place at the present time to explain the changes.
Resolved: That the report be noted.
A7 Urology Consultation The Sub Committee considered a report (for copy see file of Minutes) and Presentation from Edmund Lovell on behalf of the Acute Trust about the planned consultation process for proposals to establish a single urology service across Wearside, South Tyneside and County Durham.
Consultation on the changes is expected to commence in November and will last for three months.
Members were concerned about the accessibility of the proposed service at Sunderland from parts of County Durham together with the difficulties that may arise when visiting patients. In addition they asked whether this would place additional pressure on waiting lists.
Edmund Lovell explained that services were becoming more specialised with establishment of centres for the treatment of cancer. While patients would have operations at Sunderland, they would receive outpatient treatment and any follow up appointments at their local hospital for most of the time. A presentation will be made to the Sub Committee as part of the consultation process.
Resolved: That the report be noted.
A8 Consultations - Joint Committee Arrangements The Sub Committee considered a report of the Head of Overview and Scrutiny about the arrangements to be undertaken when Joint committees are established (for copy see file of Minutes).
Resolved: That the recommendation contained in the report be approved.
A9 Commission for Patient and Public Involvement in Health - Proposed Abolition The Sub Committee considered a report of the Head of Overview and Scrutiny about changes to the way that patient and public involvement forums are to be supported in the future (for copy see file of Minutes).
Resolved: That the report be noted.
A10 Chief Medical Officer’s Annual Report The Sub Committee considered a report of the Head of Overview and Scrutiny about the latest annual report of the Chief Medical Officer (for copy see file of Minutes).
Resolved: That the report be noted
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).
The Head of Overview and Scrutiny reminded the Sub Committee of the Child Health Improvement conference to be held on 15 November 2004. Members were informed that work on the next project (obesity) would commence following the publication of the obesity strategy for the County.
Resolved: That the work programme be noted.
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