Councillor David Smart declared that he was
attending the meeting as Substitute Member for Councillor Steve
Harmer-Strange.
40.2
Apologies were received from Jack Hazelgrove (Older People’s Council
representative) and from Councillor Craig Turton.
40B.
Declarations of
Interest
40.3
There were
none.
40C.
Declarations of Party
Whip
40.4
There were
none.
40D.
Exclusion of Press and
Public
40.5
In accordance
with section 100A(4) of the Local Government Act 1972, it was
considered whether the press and public should be excluded from the
meeting during the consideration of any items contained in the
agenda, having regard to the nature of the business to be
transacted and the nature of the proceedings and the likelihood as
to whether, if members of the press and public were present, there
would be disclosure to them of confidential or exempt information
as defined in section 100I (1) of the said Act.
40.6
RESOLVED -That the press and public be not excluded from
the meeting.
Minutes of the meeting held on 17 September
2008 (copy attached).
Minutes:
41.1
RESOLVED– That
the minutes of the meeting held on 17 September 2008 be approved
and signed by the Chairman.
42.
CHAIRMAN'S COMMUNICATIONS
Minutes:
42.1
The
Chairman informed members that she had recently attended an event
at the House of Lords for the Friends of East Sussex
Hospices.
43.
PUBLIC QUESTIONS
There is a public
question for this meeting:
“Polyclinics are likely
to undermine trust between patients and GPs” - that’s
the conclusion of research by Dr Carolyn Tarrant of the University
of Leicester. She states in the British Journal of General
Practice “[polyclinics] are
bound to reduce continuity of care”, and
“…medical outcomes may be adversely affected.”
Birmingham City Council’s HOSC has rejected
polyclinics after hearing that they would drive existing surgeries
out of business. Haringey PCT has reversed its decision to set up
large clinics when it was realised that 37 surgeries were at risk
(as reported in ‘Pulse’ 28/07/08). In view of this
evidence, would the HOSC question the spending of a large amount of
public funds on a large clinic in the centre of town? We already
have a Brighton and Hove out-of-hours primary care service, a
walk-in centre at the Royal Sussex in addition to NHS Direct, the
primary care telephone service. So why hasn’t Brighton &
Hove City Teaching PCT:
a)Carried out a health needs assessment to underpin
the need for a GP-led clinic?
b)Undertaken a specific consultation on its proposal
to build a large town-centre clinic?
c)Considered whether the money would be better spent
on local clinics in areas of genuine health need?
Ken Kirk
Minutes:
43.1
A Public Question was received for this
meeting:
There is a public
question for this meeting:
“Polyclinics are likely
to undermine trust between patients and GPs” - that’s
the conclusion of research by Dr Carolyn Tarrant of the University
of Leicester. She states in the British Journal of General
Practice “[polyclinics] are
bound to reduce continuity of care”, and
“…medical outcomes may be adversely affected.”
Birmingham City Council’s HOSC has rejected
polyclinics after hearing that they would drive existing surgeries
out of business. Haringey PCT has reversed its decision to set up
large clinics when it was realised that 37 surgeries were at risk
(as reported in ‘Pulse’ 28/07/08). In view of this
evidence, would the HOSC question the spending of a large amount of
public funds on a large clinic in the centre of town? We already
have a Brighton and Hove out-of-hours primary care service, a
walk-in centre at the Royal Sussex in addition to NHS Direct, the
primary care telephone service. So why hasn’t Brighton &
Hove City Teaching PCT:
a)Carried out a health needs assessment to underpin
the need for a GP-led clinic?
b)Undertaken a specific consultation on its proposal
to build a large town-centre clinic?
c)Considered whether the money would be better spent
on local clinics in areas of genuine health need?
Ken Kirk
43.2
The
Chairman thanked Mr Kirk for his question and invited Darren
Grayson, Chief Executive of Brighton & Hove City teaching
Primary Care Trust (PCT) to respond. Mr Grayson told the Committee
that the PCT was required to establish a GP-Led Health Centre in
accordance with Government policy; that the Brighton & Hove
centre would not be a polyclinic, but
rather a relatively small surgery offering a 7 day a week service
for both registered and unregistered patients; that the PCT had
undertaken consultation in regard to the location of the centre;
that the PCT was planning to encourage the separate development of
primary care facilities in ‘under-doctored’ areas of
the city; that the PCT would welcome tenders to run the GP-Led
Health Centre from local GPs; and that the centre was scheduled to
open in the summer of 2009.
43.3
Mr Kirk asked a supplementary question,
seeking clarification on the issue of consultation; on whether it
was Government policy to encourage the involvement of large
corporations in the delivery of primary care services; on whether
local GPs could survive competition with large scale providers; on
arrangements to protect patient medical data if it were to be held
by such corporations; and on whether large health centres would be
able to provide ‘continuity of care’.
43.4
Mr Grayson declined to
answer these supplementary questions at this time. The Chairman
told Mr Kirk that she would seek a written answer to these
points.
43.5
A member asked whether the
precise location of the GP-Led Health Centre had yet been
determined. Mr Grayson explained that the exact location would not
be determined until a successful bidder had been
identified.
43.6
The Chairman thanked Mr Kirk
for his question and Mr Grayson for his responses.
Report of the Director of
Strategy and Governance (copy attached).
Minutes:
47.1
Members
considered a report on the performance of local NHS Trusts
(2007-2008) as assessed by the HealthCare Commission. Senior
officers of local Trusts then answered members’ questions on
this issue.
47.2
In response to a question regarding the
Trust’s disappointing ratings, Paul Larsen, Interim Director
of Finance at South Downs Health NHS Trust (SDH), told the
Committee that SDH’s poor score
reflected problems with assurance rather than with performance
(i.e. that the Trust had generally undertaken required actions but
was not always able to provide evidence for this). However, SDH
took its rating very seriously and had put an Action Plan in place
to ensure that the 07-08 scores would not be repeated. The Chief
Executive of the PCT concurred with Mr Larsen’s view that
SDH’s problems were assurance
rather than performance based.
47.3
Richard
Ford, Executive Director, Sussex Partnership Trust (SPT), told
members that SPT was very pleased with its score, but was in no way
complacent.
47.4
Phil
Thomas, Clinical Director, Brighton & Sussex University
Hospitals Trust (BSUHT), told members that BSUHT was pleased with
its score, particularly in terms of its ‘excellent’
services. The Trust’s score of ‘fair’ for
finances reflected historical problems rather than the current
situation.
47.5
Darren
Grayson, Chief Executive, Brighton & Hove PCT, told members
that the PCT had delivered improvements in line with the
Trusts’ plans. Mr Grayson also congratulated BSUHT, SPT and
the South East Coast Ambulance Trust (SECamb) for their improved HealthCare Commission
ratings.
47.6
The
Deputy Chairman agreed that these Trusts should be commended for
their performance, but noted that SDH’s poor score was a serious blow to the
Local Health Economy and must be addressed by the Trust’s
management as a matter of some urgency.
47.7
RESOLVED –That the report be noted and that
letters be sent to the Chairmen of Sussex Partnership Trust,
Brighton & Sussex University Hospitals Trust and South East
Coast Ambulance Trust commending their organisations on recent
improvements in service.
Members
considered a report on the SOTC and questioned officers of the PCT,
of BSUHT, of Care UK and of the Department of Health.
48.2
In
response to a query as to why details of the number of procedures
performed by the SOTC were deemed ‘commercially
sensitive’, Darren Grayson informed the Committee that the
PCT and Care UK were currently negotiating a Deed of Variation.
Once negotiation has ended, the PCT will be in a position to
release the requested details.
48.3
In
answer to a question concerning Independent Specialist Treatment
Centre (ISTC) contracts, an officer of the Department of Health
told members that ISTC contracts ran for 5 years and were for a
defined number of procedures each year. Payment would be made in
full even if the defined number of procedures had not been
undertaken. However, the SOTC had undertaken procedures as per its
contract.
48.4
In
response to a query regarding the profitability of the SOTC,
officers of Care UK said that they were not willing to disclose
this information as it was commercially sensitive.
48.5
In
answer to a question regarding when the SOTC was expected to
achieve an 18 week waiting time, Mr Grayson told members that this
was anticipated by December 2008, in line with national
targets.
48.6
Mr
Grayson was asked why the clinical audit of the SOTC, planned in
2006, had in fact not taken place. Mr Grayson promised to provide a
written answer on this matter.
48.7
In response to a question as to why the SOTC
was not identified as an independent sector treatment centre via
the Choose and Book process, Mr Grayson told the Committee that
local GPs were encouraged to discuss treatment options with their
patients and could explain the nature of the SOTC at this
stage.
48.8
In
response to questions regarding recent HealthCare Commission
reports on the SOTC, Care UK officers told the Committee that
various remedial actions had been undertaken in response. These
included a greater focus on training (and particularly on having
systems in place to enable Care UK to provide assurance that
training had in fact been carried out). The only outstanding issue
was a Quality Report which was due to be completed by the end of
November 2008. Members requested a copy of this report when
available.
48.9
In
answer to questions concerning the impact of the SOTC on BSUH
finances, Phil Thomas, Clinical Director, BSUHT, told members that
there was an impact on BSUH, as the current split of elective
orthopaedic work between SOTC and BSUH was not necessarily
reflected in national tariff payments which tended to
over-compensate providers for relatively simple procedures and
under-compensate for very complex work. Since complex orthopaedic
procedures were generally dealt with by BSUHT (both in terms of
very complex orthopaedic work and in terms of patients with
significant co-morbidities), this effectively meant that BSUHT lost
income due to the split. It was difficult to estimate how much
income was actually lost, but the figure might well be £2
million to £3 million per annum.
48.10
Responding to a member request that the PCT
should release figures for the annual cost of the SOTC, Mr Grayson
indicated that he would be happy to do this.
48.11
RESOLVED
–
(1)That the report and additional information be
noted;
(2) That members
would consider the additional information requested (48.2;
48.10)
before determining whether further monitoring is
required.
Members
considered a report on the Link. Officers from Brighton & Hove
City Council and from the Link Host then answered
questions.
49.2
In
answer to a question concerning the tender process, members were
told that there were six initial bidders for the LINk contract. This was subsequently reduced to a
shortlist of three. One bidder then withdrew, and the remaining
bidders decided to combine their tender. This tender was not
initially accepted by the LINk Steering
Group, as there was felt to be some ambiguity concerning which
tendering organisation would actually be assuming responsibility
for the LINk. However, a revised tender
was accepted, with Community Voluntary Sector Forum (CVSF) winning
the Host contract.
49.3
Members were also informed that elections to
the LINk Steering Group had recently
taken place and that a Steering Group had now been established.
49.4
Other questions were asked concerning elements
of the LINk budget. Officers could not
provide answers on the spot, but agreed to submit written answers
in due course.
49.5
RESOLVED –
(1) That the report be noted;
(2) That a further monitoring report be
received in three months’ time.
50.
HEALTH OVERVIEW & SCRUTINY COMMITTEE: AD HOC PANEL UPDATE
Update on progress of the HOSC ad hoc
panel
Minutes:
50.1
Members were informed that work had not yet
commenced on establishing an ad hoc panel, but that, in the near
future, prospective panel members would be consulted on whether a
panel should be established at this time and, if so, what its Terms
of Reference should be.
The HOSC Deputy Chairman explained that some
amendments and additions had been made to the HOSC Work Programme
(as detailed in the update – see Minute Book).
51.2
RESOLVED – That the
amendments to the work programme be accepted.