Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Committee Room 2 - 09/01/2006 10:00:00 AM)
Item: A4 (b) Consultation: Proposals for Primary Care Trusts, New Strategic Health Authority and New Ambulance Trust
| Health Scrutiny Sub-Committee
9th January 2006
Consultation; Proposals for Primary Care Trusts, new Strategic Health Authority and
new Ambulance Trust. | |
| Report of Head of Overview and Scrutiny |
Purpose of Report 1. To explain that a consultation exercise has started to propose changes to the administrative structure of the National Health Service in the North East.
Background 2. A consultation exercise started on 14th December 2005 and will be ongoing until 22nd March 2006 setting out proposals to change the structure of the National Health Service in the North East of England. The consultation documentation indicates that these proposals do not focus on patient services but on administrative arrangements. As such, the role of Heath Scrutiny is not a statutory one but the Committee is part of the consultation process which needs to take place before final decisions are made ultimately by the Secretary of State for Health.
3. Copies of the formal consultation documents have been sent out and are awaited. All of the documents are on the Strategic Health Authority’s and the Primary Care Trusts’ websites, (
www.ntwha.nhs.uk). The documentation will be provided to Sub-Committee Members when it is available. This report sets out the broad proposals.
Primary Care Trusts in County Durham 4. There are two options affecting County Durham -
First Option · One new Primary Care Trust for County Durham and Darlington. This would mean merging the six Primary Care Trusts serving Durham and Chester-le-Street, Sedgefield, Easington, Durham Dales, Derwentside and Darlington.
Second Option · Create a new County Durham Primary Care Trust aligned to the boundary of Durham County which would mean merging the five current Primary Care Trusts in County Durham. A separate PCT would be established covering Darlington.
5. The bigger picture affecting the whole of the North East region is that it is proposed that the 16 current Primary Care Trusts will either be reduced to 4 covering the North of Tyne and Northumberland, South of Tyne and Sunderland, County Durham and Darlington and Teesside
or reduced to 12 Primary Care Trusts, one for County Durham and one for Northumberland and 5 for Tyne and Wear and 5 for Teesside.
6. The consultation document makes the point that a key issue for a County Durham-wide PCT will be “to ensure that locality structures are developed that enable resources and activity that are locality-specific, based largely on District Council boundaries, to remain so”.
7. The main stated reasons for the proposed changes to PCTs, which plan and purchase health services to meet the needs of local people, are to -
· Ensure PCTs are large enough to make the best use of their budgets but are still able to work closely with local GPs.
· Improve the range and quality of local health care so patients get more choice and have better access to high-quality services.
· Develop ways of improving health and encouraging healthy living.
· Make big reductions in expenditure on management and administration - across the North East savings of £14m need to be made to be reinvested in local services.
Strategic Health Authority Arrangements 8. There is a proposal to merge the two existing strategic Health Authorities which currently cover County Durham and Tees Valley and Northumberland and Tyne and Wear to form one Strategic Health Authority for the North East of England.
9. The main stated reason for this proposed merger is to -
· Create a brand new organisation fit for future purpose with the same boundaries as other regional organisations, such as the Government Office for the North East.
· To meet the changing role of Strategic Health Authorities in the light of increasing numbers of NHS Foundation Trusts, the likelihood of fewer PCTs and the drive to release more NHS money into patient care and treatment.
Configuration of Ambulance Trusts 10. There is also a proposal to extend the southern boundary of the North East Ambulance Service to include Teesside. The current boundary of the North East Ambulance Service covers Northumberland, Tyne and Wear, County Durham and Darlington. The proposal would involve adding part of the current Tees, East and North Yorkshire Ambulance Trust - covering Hartlepool, Middlesbrough, Redcar and Cleveland and Stockton-on-Tees.
11. The stated main aim is to introduce improvements by having larger and fewer Ambulance Trusts with the infrastructure, capacity and capability to deliver and sustain the patient centred changes for the NHS.
Some issues for the Scrutiny Sub-Committee 12. The consultation processes for these proposals extend to the 22nd March 2006. Perhaps the main role of the Scrutiny Sub-Committee is to seek to ensure that the patients and public have a full opportunity to influence the outcome of the consultation. As the focus is on structural change rather than direct patient care, it may be that it is not easy for patients to assess the benefits or otherwise of the proposals.
13. Some of the issues which may be relevant for the Sub-Committee to consider are set out below -
· Local authorities have invested significant time in joining up services with the current Primary Care Trusts. How can we be assured that the proposed new Primary Care Trust will not affect the progress which has been made in the delivery of local services?
· How will the local delivery of commissioning services be changed if one PCT is formed?
· One of the stated aims of the proposals is to make significant savings to be redirected into direct patient care. What savings can be expected in relation to County Durham and how will it be guaranteed that these savings will be redirected into services in County Durham?
· How will local need, particularly in areas of deprivation in County Durham, be addressed more effectively by larger PCTs?
· How will continuity of high level services be preserved in the light of the major changes to children’s and adult services in local government which is happening at the same time as these proposed major changes in the NHS.
· Will there be an assurance that any commitments from existing PCTs (and the Strategic Health Authority) will be fulfilled by any successor organisations?
· What are the implications for the public and patient involvement agenda and, in particular, Patient Forums and PALS? How will the progress made so far be maintained and improved? · The consultation process involves a number of local meetings in Chester-le-Street, Spennymoor, Consett, Bishop Auckland and Peterlee. What efforts are being made to ensure that the public and local organisations are aware of these proposals and have an opportunity to comment?
Recommendation 14. You are asked to consider these proposals
. | Contact: Ian Mackenzie Tel: 0191 383 3673 |
Attachments
Proposals PCTs - 9th January 2006.pdf