Agenda and minutes

Apologies for absence were received from :-

Councillors H Scott (Darlington BC), W Stelling (Durham County Council), S Akers-Belcher (Hartlepool BC), J Blackie (North Yorkshire County Council) and S Bailey (Stockton BC).

D Brown for S Bailey, Stockton BC and L Tostevin for H Scott, Darlington BC

There were no declarations of interest declared.

To receive and approve the minutes of the Better Health Programme Joint Health Scrutiny Committee held on 21 July 2016

The minutes of the meeting on 21 July were confirmed by the Committee as a correct record and signed by the Chairman.

Presentation – Representatives of the Better Health Programme will give a presentation to the Joint Committee updating members in respect of the Phase 3 Engagement process including further information regarding the potential long list scenarios/options and evaluation criteria to be used during options appraisal

Ali Wilson, HAST CCG on behalf of the Better Health Programme Executive delivered a presentation which included a summary of the information the Committee had received so far including the details of the NHS England’s Five Year Forward View.

The presentation went on to inform Members about the Sustainability and Transformation Plans (STPs) which were being developed to deliver the NHS England Five Year Forward View.  Local NHS organisations and local authorities were developing their plans for health and care in their area by 2020/21. There are 44 geographic areas – known as ‘footprints’. There are no statutory bodies, the STPs were collaborations of organisations working together to ensure there was a shared strategy. Work was currently on-going in local communities between the local authorities and the CCGs etc.

Working in a larger geographical footprint ensured benefits from economies of scale but the plans would ensure that local information was not lost.

The STPs acted as an ‘umbrella’ plan and included plans for certain challenges, for example: improving cancer diagnosis; mental health care; transforming urgent and emergency care services; and providing more care outside hospital.

Footprint areas should build on existing engagement through health and wellbeing boards and other local arrangements. Each area was responsible for engaging local people and stakeholders on their draft proposals.

It was acknowledged that the introduction of STPs and the Better Health Programme, along with other local engagement could cause confusion for the public, when they are being asked to comment and get involved with the wide range of consultation on different issues. 

The draft STPs were submitted in June for review by NHS England and NHS Improvement. The Better Health Programme (BHP) was included as a key element for the Durham, Darlington and Tees footprint. The link between the STP and the BHP was based on how people currently used the services and how the services could work together. Discussions had taken place on whether or not health officials had got the footprint right and work was ongoing in that respect.

Work that had taken place with regard to the BHP meant that the Durham, Darlington and Tees Valley area was well ahead of many other areas in developing plans. BHP representatives explained that in considering patient flows across both the North East STP (covering Northumberland Tyne and Wear) and Southern STP, suggested changes to the ‘footprint’ of the southern STP had been put forward during August to remove North Durham CCG from the Southern STP and BHP footprint and add it to the North East STP Area. This had been put forward to take into account patient flows from North Durham into Tyne and Wear and meant local commissioners could influence the pattern of services to the North.  These recent developments across the 2 Regional STPs would have an impact on the original timescales envisaged for the BHP and formal consultation and the original timescale of November 2016 appeared unlikely.

Councillor Martin-Wells expressed his concerns that the STP was just another name, people  ...  view the full minutes text for item 5.

Presentation – Representatives of the Better Health Programme will give a presentation to the Joint Committee providing information in respect of performance across those key specialties within the Better Health Programme and which will include key performance challenges regarding staffing, outcomes and resources; how existing services compare with service standards elsewhere and performance information regarding patient flows and capacity across the BHP specialities including A&E

The Committee received a presentation by Julie Gillon, Dr Nick Roper and Caroline Thurlbeck. The presentation outlined information requested by the Committee on performance and emergency care.

The introduction outlined the issues the North East is facing in terms of visits to pharmacies, GP consultations, calls to NHS urgent and emergency care services, ambulance journeys, attendances at A&E and emergency admissions. Demand is growing, there are huge variations in mortality, the population is aging, deprived wards have higher mortality and improvements need to be made to improve clinical outcomes for patients.

The presentation outlined the patient flows for James Cook Hospital, The Friarage, North Tees Hospital, University Hospital North Durham and Darlington Memorial Hospital.

Local A&E performance statistics showed deterioration in the 95% standard for people being seen in A&E within 4 hours. Although this was nowhere near the deterioration that had been seen nationally. 

Councillor Robinson asked that information be prepared for the next meeting which explained the 4 hour statistics including the mechanism for deciding the process for how people were seen.

The committee were taken through the statistics for cancelled operations and ambulance response times.

The national vision was outlined to Members and included key issues such as:  faster and consistent same day; every day access to primary care and community services for people with urgent care needs; develop 999 ambulances so they become mobile urgent treatment services; not just urgent transport services; and support the co-location of community-based urgent care services in coordinated Urgent Care Centres.

The vision also suggested two levels of hospital based emergency centres to replace the inconsistent levels of service currently provided by A&E departments which included:  Emergency Centres which will be capable of assessing and initiating treatment for all patients; Major Emergency Centres which are larger units capable of assessing and initiating treatment for all patients and providing a range of specialist services; and Major Trauma Centres located at 12 major emergency centres nationally.

Report of the Better Health Programme Executive for information and comment

The Committee requested the information which outlined the terms of reference for the programme board.  The attached report provided details on the BHP governance arrangements, its responsibilities, consultation, decision-making and behaviours, accountability and authority, quorum, task and finish groups, membership and meetings.

The information was noted.

Members of the Joint Committee have previously requested details of Sir Bruce Keogh’s report into Urgent and Emergency Care and the establishment of Major Trauma Centres across England.  A copy of the report is attached for members’ information as well as a location map detailing the location of existing major trauma centres across England

The Committee was provided with the Keogh review report into Urgent and Emergency Care and the establishment of Major Trauma Centres. Further information was given in the presentation at item 6.

To consider the attached submission by North East Empowerment and Diversity

Information was received by the Committee from the members of the North East Empowerment and Diversity Group (NEED) in Hartlepool (which incorporated Save Hartlepool Hospital). The Group outlined a number of concerns they had that they wished the Committee to receive. The information raised a number of questions which it was felt were addressed by the presentation at the meeting.

The representatives from NEED agreed to re-group to consider the information heard following the presentation at the meeting

Agreed – that there would be an opportunity to revisit any outstanding issues and that a special meeting should be arranged to open up discussions with similar groups who may wish to present evidence to the Committee.

Members of the Joint Committee are requested to receive and note the attached Notice of Motion passed by Richmondshire District Council at its Council meeting held on 19 July 2016 in respect of the Better Health Programme

Richmondshire District Council submitted a Notice of Motion relating to the Better Health review of Critical Care services at Darlington Memorial Hospital, considered that their Council meeting held on 19 July 2016.

Councillor Blackie had requested consideration of the following notice of motion:

‘The Better Health review of Critical Care services, including Accident and Emergency and consultant-led maternity and paediatrics services at the Darlington Memorial Hospital is causing Richmondshire District Council great concern as any reduction or cut in these services would have a hugely detrimental impact on the health, well-being, and peace of mind of all those who live in the District. It strongly supports the initiative launched at the May meeting of North Yorkshire County Council which has led to a high level alliance between the Leaders of the political administrations at Darlington Borough Council and North Yorkshire County Council and the establishment of a joint Scrutiny of Health Committee between the two Councils.

It instructs officers at Richmondshire District Council: 1) to convey its deep concerns to the relevant NHS organisations, including the organisation conducting the Better Health review itself and the Hambleton, Richmondshire and Whitby Clinical Commissioning Group. 2) to inform Darlington Borough Council and their joint Scrutiny of Health Committee of its support, and to offer to join in these initiatives in any way it is considered appropriate.

Richmondshire District Council considers the maintenance at their current level, or preferably with an embedded programme committed to their continuous improvement, of the Critical Care Services at the Darlington Memorial Hospital essential to guarantee their availability to deal with the immediate, urgent and unplanned healthcare needs of all residents in the District, and it resolves accordingly to adopt appropriate actions or measures to resist any attempt to downgrade them.’

Councillors from Darlington were grateful for the enthusiastic support and construction discussions.

The Committee received the Notice of Motion and noted its contents.

No urgent items were received.

No other items of business were received.

Thursday 13 October 2016 at 1.00 p.m. – The Jim Cook Conference Suite, Municipal Buildings, Church Road, Stockton

Please note the start time of this meeting is 1.00 p.m.

Thursday 13 October 2016 at 1.00pm – The Jim Cook Conference Suite, Municipal Buildings, Church Road, Stockton