Meeting documents

Health Scrutiny Sub-Committee (DCC)
Monday 5 January 2009

            Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Council Chamber - 05/01/2009 10:00:00 AM)

                  Item: A3 Response to the public consultation on 'Seizing the Future' proposals for NHS service reconfiguration in County Durham and Darlington


Report of Head of Overview and Scrutiny

Purpose of the report

1. The purpose of this report is to present the findings of the Health Scrutiny Working Group review of NHS service reconfiguration proposals contained in the public consultation called Seizing the Future.


2. In October 2008 NHS County Durham (formerly County Durham Primary Care Trust) initiated a consultation on the Seizing the Future proposals of County Durham and Darlington NHS Foundation Trust (CDDFT) for the reconfiguration of its hospital services. Consultation on the proposals began in October 2008 and concludes on 12th January 2009. Because NHS County Durham is the body responsible for planning and purchasing health services for residents in the County Durham it is leading the public consultation.
Under Section 244 of the NHS Act 2006, local NHS bodies have a duty to consult local Overview and Scrutiny Committees on proposals for any substantial development or substantial variation in health provision in their areas. Decisions that are made in relation to these proposals will take into account views expressed during the public consultation and the contents of this report.

3. County Durham and Darlington Foundation Trust (CDDFT) has spent many months developing and refining its options for the future provision of its services across the three sites contained within Seizing the Future proposals. The review was initiated by clinicians at the Trust and supported by engagement with the Trusts governors, managers, stakeholders and staff. The Seizing the Future proposals are aimed at delivering high quality and safe healthcare services and ensuring the future of all of the Trust’s hospitals.
The County Durham Joint Health Overview and Scrutiny Committee (JHOSC) established a Working Group - the County Durham Seizing the Future Health Scrutiny Working Group to review the proposals in detail - the full Membership and Terms of Reference of this working group are contained in the attached report.

There are a number of challenges facing CDDFT:
· The need for specialist service provision;
· Accident and Emergency (A&E) departments need the back-up of a full range of medical and surgical services;
· Need to improve children’s services;
· European Working Time Directive;
· 24/7 Diagnostic cover.
The Trust is proposing two options to address the challenges it faces and to deliver the following benefits:
· Better access to specialist treatment
· Reduced risk of cancelled operations
· Reduced risk of hospital acquired infections
· Better rehabilitation after being ill
· Quicker tests and diagnosis
· Being on the right ward

Some communities perceive the proposals to reconfigure hospital services as a loss of some services and a downgrading of others.

The Health Overview and Scrutiny review has taken evidence from the CDDFT and its clinicians, and listened to the views of the trade union and a local campaign group, County Durham Local Involvement Network, and well as other public sector agencies including Durham County Council, the Fire and Rescue Service and others.
Findings and associated recommendations relate to:
(See Summary of recommendations on page 55, Section 9, of the report)

· The case for change is grounded in a strong clinical base that will provide for safe, high quality services that aim to improve patient/health outcomes; · The case for change must be delivered through a ‘whole systems’ approach that takes into account:
o the need for investment at Darlington Memorial Hospital (DMH) and University Hospital North Durham (UHND) to provide for adequate capacity to cope with the increased demand for emergency admissions;

o transport implications for people who have to travel to both specialist and generalist services;
o the need to ensure that services are developed as close to people’s homes and in their communities - investing in community hospitals and other community based health and
social care provision planned in partnership with social care providers and voluntary and community agencies;
o the need to invest in services at Bishop Auckland General Hospital (BAGH) to ensure future sustainability including:
§ establishing a centre of excellence for rehabilitation, investment in stroke services that are delivered alongside rehabilitation services, and central hematology and pathology services (diagnostic services);
§ consideration of basing the Trust’s headquarters at the hospital.
o a systematic approach to address health inequalities and the burden of ill health in a partnership context;
o community concerns about exactly what will be provided in district general hospitals, community hospitals, and community based facilities;
o the need to engage and involve key stakeholders and communities through on-going dialogue in the development of service improvement proposals, informed by the outcome of the consultation exercise and the decision on hospital reconfiguration by NHS County Durham;

· The recommendations of the National Clinical Advisory Team (Professor Sir George Alberti, August 2008) should be implemented in full including:
o Inclusion within the plans for a GP ward.
o Concerns about parking at Darlington Memorial Hospital must be addressed.

§ Significant energy has been expended and resources committed to consulting with the on the proposals. The consultation has ultimately been satisfactory in that it has enabled NHS Country Durham and CDDFT to hear community views and concerns in relation to the proposals, and for this process to help share an understanding of the proposals and what they will mean for communities in future.


4. The Health Scrutiny Working Group on Seizing the Future asks: · Members of Durham County Council’s Joint Health Overview and Scrutiny Committee to note the report, its findings and recommendations.
· The Joint Heath Overview and Scrutiny Committee to agree these recommendations.
· In line with the County Councils constitution (Part 4, paragraph 6, section (e) ) where policy issues are concerned, including consultations about substantial changes in relation to Health Services, the report is submitted to Cabinet for information only.

Contact: Feisal Jassat, Head of Overview and Scrutiny Tel: 0191 383 3506

Author: Jeremy Brock, Health Scrutiny Liaison Manager Tel: 07909 877136

Supporting papers: Seizing the future: a public consultation document - NHS County Durham and County Durham and Darlington NHS Foundation Trust, October 2008


 FINAL Report StF 22 Dec 08[1].pdf;