Meeting documents

No apologies for absence were received. Pam Bacon was welcomed back after an absence due to ill health.

It was noted that the Clerk to the Committee would soon be changing roles and clerking the Cabinet in future. The Chairman thanked the Clerk for her work in supporting the Committee and informed the meeting that Senior Democratic Services Officer, Clare Gray, would be clerking the PHSOSC from the May meeting.

To declare any personal and/or prejudicial interests

Mary Baldwin declared a personal interest insofar as she is a Trustee of Age Concern, Buckinghamshire.

of the meeting held on 2^nd March 2007 to be confirmed as a correct record

The Minutes of the meeting held on 2^nd March 2007 were confirmed as a correct record.

The Policy Officer updated Members on progress with regard to outstanding actions from the March meeting as follows:

• Information about the Ambulance Trust’s performance against the A8 target was expected shortly
• Jane Taptiklis would provide information on the criteria and guidelines for continuing care clinical assessments once the task group commenced its work
• A letter had been sent to Janet Fitzgerald about the Chesham Healthzone and the Policy Officer was awaiting a response.

The newly appointed Chief Executive Officer of the Hospitals Trust will present to the Committee the recent performance of the Trust against national targets and will outline the key challenges facing the organisation in delivering services in Buckinghamshire.

Chief Executive Officer: Anne Eden

The Chairman welcomed Anne Eden, Chief Executive of Buckinghamshire Hospitals Trust and Liz Holman, Patient Safety Manager to the meeting. Anne Eden gave a short presentation on the recent performance of the Trust against national targets and outlined the key challenges facing the organisation in delivering services in Buckinghamshire. (A copy of the presentation is attached to the Minutes.)

A Member commented that she had recently been an in-patient at Wycombe Hospital and had written an informal report of her experiences. These included excellent medical care despite a 5 hour wait in Accident and Emergency with very high blood pressure, inadequate nursing care and bathrooms being used as store rooms. She agreed to provide a copy of the report to Anne Eden.

Action: Pam Bacon

Anne Eden apologised that care had been sub-standard in some respects. She indicated that the Hospital Trust had recently focused on improving assessment areas and she hoped that this had been achieved. Anne Eden agreed to provide a full written response to Pam Bacon’s report once the Hospital Trust had had an opportunity to consider it.

Action: Anne Eden

A Member expressed support for community hospitals and commended the excellent care they provided for older people. Anne Eden explained that community hospitals were managed by the PCT not the Hospitals’ Trust. A recent PCT board meeting had agreed to make greater use of community hospitals and Janet Fitzgerald and Anne Eden would be working together in this regard.

A Member asked whether there were particular periods when meeting the 4 hours Accident and Emergency (A&E) target was especially difficult. The meeting was informed that there were peaks in A&E between 5pm and 8pm in the evening, over the weekends and following bank holidays.

In response to a question, the Chief Executive explained that the Trust had a statutory responsibility to break even and had a good history of financial balance. The issue was that the break even position had been achieved by non - recurrent income from land sales. In 2007/08 the Trust would need to cover a £16 million deficit in order to achieve financial balance. It was hoped that the financial recovery plan would not involve changes evident to the patient at the front end of service provision. In terms of income maximisation, Anne Eden hoped to expand the hospitals’ provision of spinal and plastics and burns services to a national and international client base.

Concern was expressed about the sale of land being used to balance the books. A Member estimated that the Stoke Mandeville site had previously consisted of 90 acres and Anne Eden stated that the hospital was currently operating on about 35 acres.

The issue of abuse towards staff was raised and the Chief Executive indicated that this was not a particularly widespread issue in Buckinghamshire. A red card system was in place to address this, with the ultimate sanction being the withholding of treatment.

In response to a question, Anne Eden remarked that the Hospital Trust  ...  view the full minutes text for item 4.

The OSC has been approached to consider the proposed closure of the Benjamin Road GP surgery in High Wycombe and the relocation of improved services to Cressex Road surgery. Papers outlining the proposals are attached.

GP Dr Ajit Kardagamar

The Chairman welcomed Dr Ajit Kadirgamar, GP at the Benjamin Road Surgery in High Wycombe and Caroline Langley, Assistant Director of Primary Care, Buckinghamshire PCT to the meeting.

The Chairman informed the meeting that he, the Policy Officer and the Local Member, Wendy Mallen had met with Dr Kadirgamar several weeks previously to undertake a site visit and discuss the proposed closure of the Benjamin Road GP surgery in High Wycombe and the relocation of improved services to Cressex Road surgery.

Dr Kadirgamar outlined the case for the closure and relocation explaining that the premises at Benjamin Road were not suitable for the provision of primary care services and there was little opportunity for sustainable development of the site. Alternative high quality and easily accessible premises were available at Cressex Road and Lynton House.

Benjamin Road surgery was situated on a crowded street with very poor parking and difficulties in access for pedestrians and via public transport.  There were health and safety issues and the surgery had facilities that were less than adequate to meet patient needs. There were also a number of other GP surgeries in the vicinity, whereas Cressex Road was the only surgery servicing that locality. Full-time opening at Cressex Road would support improved access for patients and an enhanced range of services could potentially be offered including phlebotomy, Ophthalmic clinics, a Lady GP and a better nursing skill-mix.

The practice had approached the Primary Care Trust and the Overview and Scrutiny Committee early on in the process. All patients over 16 had been consulted and the feedback had been extremely positive. It was thought that the majority of Dr Allim’s patients would relocate with him, but patients could also be seen at Lynton House if they preferred.

Caroline Langley stated that the proposed changes were in line with PCT strategic development planning and would bring a surgery closer to where many of the patients resided. The PCT was also hoping to receive some funding from the Strategic Health Authority for GP surgery development.  

The Local Member expressed her support for the proposed changes and wished the practice every success. She suggested that the Committee should ask the PCT to consider further development of GP surgeries in light of the number of residential homes planned for High Wycombe.

A Member enquired as to whether any capital released from the sale of the Benjamin Road Surgery would be reinvested into the Cressex Road Surgery and she was assured that it would be.

In summation, the Chairman concluded that the relocation of services would help to augment services in an area of deprivation and expressed the Committee’s unequivocal support for the proposed changes. He indicated that the Committee would be writing a letter of support to this effect.

Action: Mike Appleyard and Angela Macpherson

Members will report to the Committee on the commentaries to be submitted to the Healthcare Commission for the 2006/2007 Annual Health Check.

PCT - Pauline Wilkinson

Hospitals Trust - Tricia Birchley

Mental Health Trust - Mike Appleyard

Ambulance Trust - Steve Adams

The Committee received and considered 4 commentaries on the performance of Buckinghamshire Primary Care Trust, Buckinghamshire Hospitals Trust, Oxfordshire and Buckinghamshire Mental Health Partnership Trust and South Central Ambulance Trust respectively to be submitted to the Healthcare Commission for the 2006/2007 Annual Health Check. The Policy Officer reported that draft letters had been sent to the various Trusts and 3 of the 4 had responded. Members of the Committee indicated that they were satisfied with the content of the letters and it was agreed that that the letters would be sent to the Healthcare Commission.

A Member commented that she had been very impressed by the steamed food on offer at the Waterside Unit in Amersham. It was noted that this new system of providing hospital food would be implemented at other hospitals. It was reported that John Summers had extended an invitation to Members to visit Stoke Mandeville and it was agreed that the Policy Officer would arrange the visit.

Action: Angela Macpherson

The Chief Executive of the Mental Health Trust will present to the Committee the Trust’s application for foundation status.

Chief Executive Officer: Julie Waldron

The Chairman welcomed Julie Waldron, Chief Executive of Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust to the meeting. The Chief Executive gave a short presentation on the Trust’s application for Foundation Trust (FT) status, a copy of which is attached to the Minutes.

A Member expressed her support for the FT application. However, she emphasised the need for the Trust to be on a secure financial footing and cited delays with Debenham House as an example of the kind of situation which should have been resolved more speedily.  The Chief Executive responded that she was confident of the Trust’s sound financial planning. She indicated that in March 2007 the Trust Board had agreed a consolidated estates strategy and that the Debenham House situation was progressing. Several new Non-Executive members of the Trust Board had strong financial backgrounds and Monitor would exercise financial scrutiny over the Foundation Trust once constituted. The Member requested that the Trust issue a statement to the public about progress with respect to Debenham House.

Action: Julie Waldron

In response to a question, Julie Waldron commented that the Trust had recently been successful in recruiting CAMHS consultants which should reduce waiting times for appointments.

The Chairman thanked Julie Waldron for attending the meeting and wished the Trust well with the Foundation Trust application.

The Forum Support Officer will update the Committee on key patient issues arising from the Forum’s current work programmes.

Mary Arnaud, Forum Support Worker, gave a brief update on the work of the respective Patient and Public involvement Forums (PPIFs).

Buckinghamshire Hospitals PPI Forum

• To date, 12 visits had been undertaken to individual wards and departments at Stoke Mandeville Hospital and Wycombe General Hospital. A report with recommendations was issued after each visit and sent to the Buckinghamshire Hospital Trust.  These reports and replies received from the Trust were available to Committee Members on request.
• Other work in the current programme included investigations into infection control, hospital signage and audiology.

Buckinghamshire Primary Care PPI Forum

The work programme included

• Cancer care for patients in Bucks – with particular emphasis on the future of Mount Vernon Hospital now that planned new hospital at Hatfield was not to be built.
• Visits to service providers, including GP surgeries and Harmoni, the out of hours service
• A review of preventative services for long term conditions
• Dentistry
• Engagement with the public including black and ethnic minority groups
• Monitoring any threats to community hospitals

South Central Ambulance Service PPI Forum

• This forum covers most of South East England down to Hampshire. The whole forum (21) members met quarterly and the 3 area groups met on a monthly basis.
• The current work plan included the future of public transport services including all allied transport facilities, acute admission waiting times (patients at A&E left on ambulance trolleys whilst waiting for admission).

The Chairman welcomed the work of the PPIFs and the Committee agreed to include an update from the Forums on future PHSOSC agendas.

 Action: Angela Macpherson

Upon request from a Member, Mary Arnaud undertook to provide an update on the work of the PPIF for the Mental Health Trust in her next report.

Action: Mary Arnaud

A Member requested an update on the future of Mount Vernon Hospital and the Policy Officer undertook to investigate what had happened to the task group set up to monitor this.

Action: Angela Macpherson

An opportunity to update the Committee on relevant information and report on any meetings of external organisations attended since the last meeting of the Committee.  This is particularly pertinent to members who act in a liaison capacity with NHS Boards and for District Representatives.

Buckinghamshire Hospitals Trust

The report of the Shaping Health Services monitoring group was noted.

Buckinghamshire PCT

Sir John Horsbrugh-Porter reported that the Board meeting on 10 April had been informed that the Choose and Book system was operating at 11% efficiency. It was hoped that rebuilding the system would achieve 40% efficiency.

Margaret Aston reported that a single point of access to Harmoni was being proposed. There was an issue around payments for phlebotomy services as each of the previous 3 PCTs had negotiated a different rate. It was noted that the overspend currently stood at £17.7 million.

District Council Health Scrutiny

The Chairman reported that Wycombe District Council Scrutiny Committee had been tasked with looking at health for the people of Wycombe.  The Chairman had made several suggestions in this regard and the outcome of discussions was not yet known.

The Chairman suggested that District Councils should take a more high profiled view of the health of their communities and asked the District Council representatives on the PHSOSC to progress consideration of the Task Group’s report on Eating Disorders in 11 – 16 year olds within their respective organisations.

Action: District Council representatives

May 11^th 2007 Mezzanine Room 3, County Hall, Aylesbury

Please note that this is a change in date.

May 11^th 2007 Mezzanine Room 3, County Hall, Aylesbury

Please note that this is a change in date.