Agenda item
NHS Commissioning Update
Minutes:
The Committee received a joint presentation by the Chief Clinical Officer, DDES CCG and the Chief Clinical Officer, North Durham CCG about NHS Commissioning Update (for copy see file of Minutes).
The Chief Clinical Officer, DDES CCG gave some background information including:-
· What are CCGs?
· Strategic Policy Drivers
· Key Officers
· Key Partners
The Chief Clinical Officer, North Durham CCG updated the Committee on:-
· Sustainability and Transformation Partnerships
The Director of Integration went on to inform about:-
· Strategic Context
Finally, the Director of Commissioning updated members on the current developments, including:-
o Ophthalmology services
o Physically disabled unit
o South Durham community in-patient beds
o Fertility services
o Day hospital services
o Dermatology services
The Chairman asked how joining up ophthalmology services would be effective. The Director of Commissioning said that the impact of any changes would be evaluated by asking patients about their own experiences.
Councillor Bell referred to inpatient beds at the Richardson hospital and the reduction from 24 to 16 beds, and asked for assurance that the service would continue. The Clinical Director of DDES CCG said that the Richardson hospital had been built when the NHS had no funding issues however it was not the best place for patients as the focus was on trying to get them back to their own homes. The reduction of beds was due to Darlington not using the hospital and therefore less beds were needed. He added that it was an excellent facility and the NHS needed to find a better use for it.
Councillor Bell accepted the point about people being in their own homes but felt that the hospital offered rehabilitation services that helped people get back on their feet. Therefore closing the service would leave those people not ready for home vulnerable. He was advised that the focus would remain to get people back home and to provide all services from home including all rehabilitation services. The need for beds had dropped although it was recognised that there was a surge during the winter months.
Referring to the local health and social care plan, Mrs Hassoon sought assurance that the budget was in place to meet the need for people to receive care in their own home. The Director of Integration confirmed that joint budgets were in place and the Better Care Fund was being utilised for this purpose. She added that moving forward there would need to be talks with partners about pooling funding and how best to utilise it.
Councillor Savory expressed concerns about a ward closure at Weardale hospital and she asked for guarantee of sustainability as there was a great fear in the community of the hospital closing. The Clinical Director of DDES CCG advised that they were looking at how to better use all hospitals and as medicine and practices changed services needed to be reviewed. The Director of Integration confirmed that engagement would take place with the local community.
Councillor Robinson said that he had been given assurances about the Sedgefield area however the GP surgery was closing and the building used could be better utilised. He expressed concerns about the footprint of the STPs and whether there would be a merger of the 2 STPs covering County Durham.
The Clinical Director of North Durham CCG explained that there had been talks of changing the titles of STPs but in essence they would remain to plan across a large footprint of health care. He believed that one STP would be the best way forward for the people of County Durham. There were plans to merge the CCGs but at present having two CCGs helped to retain a significant influence regionally.
The Chairman said that this could have a knock on effect for services and funding and was concerned about the effects this would have on patients.
Councillor Temple asked if there were any positive improvements in the locality as the reports seemed to be about reductions and cuts. The Clinical Director of DDES CCG said that there was a focus on cuts but reported that there were a number of exciting developments in primary care. The development of “teams around the practice” would focus on the needs of patients within the community and the quality of care. Moving to community based care was one of the biggest successes and a move to one CCG would help maintain our services and have an influence on the local community.
Councillor Patterson asked for an explanation about why so much money was spent on dermatology services – was there more patients or were we paying too much to deliver services. The Clinical Director of North Durham CCG advised that the cost was higher but had a real effect in commissioning community services.
With reference to the Weardale hospital Councillor Patterson asked what pressure had been put on to the government from the CCG as there were concerns for the people in this rural area with transport. As it was difficult to get staff to cover palliative care in rural areas, especially in the winter months, she asked what was being done to extend services in these areas. The Clinical Director of North Durham CCG advised that the North Durham CCG Forum was part of an organisation that lobby the government on specific issues. The Director of Integration added that they do take into account rurality and would look at other uses for the community hospital by enhancing the community offer. Councillor Patterson further asked if there would be an alternative use for the hospital or if the service would be delivered in another location. The Director of Integration informed her that they would be a comprehensive review carried out and would look at all options. She added that there was no pre-empted outcome at this stage that the hospital would close.
The Clinical Director of DDES CCG commented that they were trying to provide services in different and more efficient ways. The health services needed to take into account that there were more elderly patients and therefore more dementia, diabetes and other ailments to treat. Although the budget was not growing at the same pace as the population more efficient use of resources would need to be delivered.
The Chairman commented that it was a good thing that people were living longer, especially coming from certain industry backgrounds. The Clinical Director agreed that this was a success story.
The Head of Planning and Service Strategy said that it was members of the public who wanted to see more integrated care and this was evidenced by community users of 30-40 year olds failing to see that integration. He added that it was important to evaluate from the service users perspective and to keep things as simple as possible to understand as services were always being told that systems were too complex.
The Principal Overview and Scrutiny suggested that briefing notes be circulated to the Committee to provide a level of detail on the verbal updates given in respect of the services referenced within the presentation.
The Chairman thanked officers for their presentation.
Resolved:
That the presentation be received and the CCGs prepare and submit briefing papers to the Committee on the service developments reported in respect of Ophthalmology services, the relocation of the physically disabled unit at Bishop Auckland Hospital, South Durham community in-patient beds, Fertility services, Day hospital services and Dermatology services.