Meeting documents

Health Scrutiny Sub-Committee (DCC)
Thursday 12 March 2009

            Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Committee Room 1B - 12/03/2009 02:00:00 PM)

                  Item: A1 Minutes of the meeting held on 5 January 2009



At a Meeting of the Health Scrutiny Committee held at the County Hall, Durham on Monday 5 January 2009 at 10.00 a.m.

Durham County Council
Councillors J Armstrong, A Bell, R Bell, D Burn, J Chaplow, J Lee, P Stradling and O Temple

Chester le Street District Council
Councillors R Harrison

Derwentside District Council
Councillor I Agnew and D Lavin

Durham City Council
Councillor M Smith

Easington District Council
Councillors D Taylor-Gooby and R Todd

Sedgefield Borough Council
Councillor A Gray

Teesdale District Council
Councillors A Cooke and M English

Co-opted Member
Councillor D Bates

Other Members
Councillor J Moran

Apologies for absence were received from Councillors P Crathorne,
K Davidson, P Gittins and S Iveson.

A1 Minutes

The Minutes of the meetings held on 29 September and 21 November 2008 were agreed as a correct record and signed by the Chairman.

With reference to Minute No A5, Tees, Esk and Wear Valleys NHS Foundation Trust Consultation on Mental Health Services for Older People of the meeting held on 29 September 2008 the Committee were informed that the Trust had made a decision. A letter has been sent to NHS County Durham expressing the Committees concerns. A reply is expected and will be reported in due course.

A2 Declarations of Interest

There were no declarations of interest.


The Committee considered a report of the Head of Overview and Scrutiny on the response to the public consultation on ‘Seizing the Future’ proposals for NHS service reconfiguration in County Durham and Darlington (for copy see file of Minutes).

The findings and the recommendations of the Scrutiny Working Group were explained in detail.

Councillor Taylor-Gooby referred to the proposal to offer more services through community hospitals and pointed out that the community hospital provision across the County is very diverse and managed by different NHS organisations.
David Gallagher advised that the NHS County Durham is committed to the better use of community hospitals and that the important issue is ensure that the right services are provided at the right location and fit for local purpose. In terms of investment it will be necessary to plan for this over the next five years.

Councillor Gray drew attention to the waiting time for patients needing physiotherapy and occupational therapy and asked that consideration be given to this. David Gallagher advised that a significant level of resource has been invested in physiotherapy and occupational therapy services this year.

Councillor Temple referred to Professor Alberti’s report and the need for consistency for urgent care services across the whole County. The Head of Overview and Scrutiny advised that this will be addressed under recommendation 1 when the submission is made to NHS County Durham.

Councillor R Bell expressed concern that there may be deterioration in ambulance response times. In addition there needs to be clarity on the treatment that will be available at Bishop Auckland Hospital. David Gallagher
informed the meeting that the group monitoring the Dales ambulance response times had recently began meeting and a report will be submitted to the Committee. The Head of Overview and Scrutiny advised that the issue of clarity on services that will be delivered at Bishop Auckland is detailed in recommendation 1.

The Committee were informed that their response will be submitted by the 12 th January 2009 and this will go to the County Durham and Darlington Foundation Trust Board for consideration along with other consultation responses. The Trusts proposed way forward will be considered at a special meeting of the Committee.


That the recommendations set out in paragraph 4 of the report be unanimously approved.


The Committee considered a report of the Head of Overview and Scrutiny and received a presentation from Tony Byrne Assistant Director Planning and Involvement on NHS County Durham’s consultation on its commissioning intentions for 2009/10 (for copy of report and slides see file of Minutes).

It was explained that NHS County Durham has produced their commissioning intentions which will shape the Annual Operational Plan for 2009/2010. The document reviews progress in the implementation of the Annual Operational Plan 2008/2009. It also provides a starting point for discussion on the emerging commissioning intentions for 2009/10. NHS County Durham has prioritised ten key outcomes which were selected following work with partners on the Joint Strategic Needs Assessment.

The commissioning intentions document was sent to over 1,000 individuals and organisations. To date there have been around 112 responses. Most of the responses support the identified priorities. Two stakeholder events are planned for February 2009. Other issues identified in the responses include Bishop Auckland Hospital, alcohol smoking, cancer screening, waiting times, mental health etc. The first draft of the annual operating plan is expected to be ready by mid January and the final plan by end February.

Cllr Burnip referred to Healthworks in Easington and asked whether there is any intention to extend this type of project. Tony Byrne explained that Primary Care Centres are very much part of NHS County Durham’s approach to try and make services available in community based locations and are keen to extend these services to a wider range of the population.

Cllr Taylor-Gooby pointed out that substantial capital investment is needed to improve community health facilities. Tony Byrne advised that the Comprehensive Spending Review for health services for 2009/10 has been fair and this will provide NHS County Durham with £111M of additional investment. This is revenue based but should be enough to address all of their requirements Cllr Taylor-Gooby pointed out that substantial capital investment is needed to improve community health facilities. Tony Byrne advised that the Comprehensive Spending Review for health services for 2009/10 has been fair and this will provide NHS County Durham with £111M of additional investment. This is revenue based but should be enough to address all of their requirements. It is hoped that consideration could be given to capital requirements.

Cllr R Todd suggested that stakeholder events should be held in local communities so that messages on healthy living can be more effective and reach more people. Tony Byrne explained that the events are centrally based at Hardwick Hall Sedgefield and at Hallgarth Manor near Darlington. NHS County Durham would be happy for its patient carer involvement network to provide transport to the events if people would like to attend. It was pointed that NHS County Durham had used the ‘Big Conversation’ to talk to communities although it was acknowledged that there is a need to find different ways of engaging with communities. It was suggested that future stakeholder events should be held in the north of the County.

Cllr Temple informed the Committee that since the commissioning intentions document was published, an important piece of work by Professor Terry Wilkins on childhood obesity called the Early Bird Study has also been published. This seems to suggest that the majority of childhood obesity is fixed in pre-school years. The current obesity strategy is mainly primary school based. The study suggests that we should be seeking to reach families with pre-school children before they start school. Tony Byrne advised that he was sure that colleagues who lead in this area are aware of the report but undertook to raise this issue with them. There is a need to be flexible and innovative in how we deal with this problem.

The Committee proposed that transport should also be included as a commissioning intention.


1. That the commissioning intentions be noted.

2. That the Committees comments be submitted to NHS County Durham as part of the consultation.


The Committee considered a report of the Head of Overview and Scrutiny and received a presentation from Grace Bennet, Lead Commissioner for Mental Health and Learning Disabilities, NHS Count Durham and Les Morgan, Chief Operating Officer, Tees Esk and Wear Valleys (TEWV) NHS Foundation Trust about the proposals in relation to its Integrated Business Plan for key service changes to adult mental health services and potential changes to adult mental health services at Cherry Knowle Hospital that may impact upon North Easington residents (for copy see file of Minutes).

It was explained that NHS County Durham in conjunction with TEWV are looking to modernise and develop services which are community focussed and ensure that people are only in hospital when absolutely necessary. To ensure that this happens discussions have taken place to ensure that the changes are taken forward in a safe and secure manner.

One of the first areas to be looked at is the feasibility of transferring of patients from Cherry Knowle Hospital to services already provided by TEWV. The report on the alternative provision will be shared with the Committee when it is available.

The Committee was assured that the overview and scrutiny process will be used in a positive way and regular reports and updates will be provided to the Committee.

Councillor Todd expressed concern about the impact that the changes at Cherry Knowle would have on patients from the north Easington area. Les Morgan advised that in patient beds in Hartlepool would be provided at a recently opened facility at Sandwell Park. The in patient beds for Durham are currently provided at the County Hospital but will be re-provided on the Lanchester Road site.

Kate Harrington informed the meeting that she had been asked to attend the meeting on behalf of the County Durham and Darlington Mental Health Services Carers Forum to raise issues in connection with the consultation processes connected with changes to services that are being introduced and in particularly in relation to Cherry Knowle Hospital. The Forum has requested that there is a transparent consultation process. The Forum feels that a decision has already been taken to close Cherry Knowle Hospital and move beds. They also want to raise the issue of closures that have already taken place. TEWV have advised that it isn’t necessary to consult on the closures and in particular the closure of the Holly Ward. Carers are concerned about the closure as no information has been provided on the alternative provision. There also concerns about changes to day and community services and the lack of information about the alternative services.

Les Morgan informed the Committee that TEWV will not be consulting on any closure of Cherry Knowle as it does not provide the service and any consultation would be undertaken by NHS County Durham as commissioners. If NHS County Durham wishes TEWV to provide the service it will be provided at one of their existing sites. Les Morgan explained that he was willing to attend any user or carer event to explain the present position. In terms of Holly Ward it wasn’t necessary to consult as this was about existing patients who are being moved into community based services or other services as part of their care plans. Grace Bennet explained that as commissioners it was accepted that it was clinically unsafe for Holly Ward to continue taking patients as there were very few in patients on the ward. NHS County Durham has identified the need to undertake work on the community infrastructure. It was pointed out that Cherry Knowle Hospital is operated by the Northumberland Tyne and Wear NHS Trust and they are preparing proposals to go out to consultation on alternative provision for the Cherry Knowle site. It is therefore understood that no decision has yet been taken to close the site. NHS County Durham will be working closely with Sunderland PCT who will be leading the consultation process on the proposed closure to ensure that there is no duplication.

The Head of Overview and Scrutiny informed the Committee that any consultation process needs to be transparent and engage with those who are most affected by the proposals. Overview and Scrutiny needs to be kept informed of any substantial variation or change to services. The standard consultation period is 12 weeks though this may not be necessary in this instance.


1. That the NHS County Durham recommendations set out in Appendix 1 be noted.

2. That period of consultation in relation to Adult Mental Health in patient services is eight weeks.


The Committee considered a report of the Head of Overview and Scrutiny about a proposal to run a local leadership capacity event with a focus on promoting healthier communities (for copy see file of Minutes).

1. That the development of a leadership capacity initiative that will aim to promote healthier communities be noted.

2. That Members express an interest in the 15 places available for the JHOSC on the programme by contacting the Head of Overview and Scrutiny.

The Chairman of the meeting was of the opinion that the following item of business was of sufficient urgency to warrant consideration because of the need to keep Members informed.


Councillor Cooke informed the Committee that he had received a brochure which contained information on GP practices in the County that offer extended opening hours. It appeared that the leaflet had not been distributed very consistently.

David Gallagher informed the Committee that every PCT was required by the Department of Health to circulate information advising local residents of GP surgeries which are able to provide extended opening hours. He agreed to check where the brochures had been delivered. Councillor Cooke expressed his disappointment that the largest GP practice in Barnard Castle will not be offering extended opening hours.

That the information be noted.