Meeting documents

Apologies for absence had been received from Hedley Cadd.

To declare any personal and prejudicial interests

There were no declarations of interest for this Meeting.

of the meeting held on 6 July 2007 to be confirmed as a correct record

The Minutes of the Meeting held on 6 July 2007 were agreed as a correct record.

The overview of NHS dentistry provision in the county will focus on two key areas: firstly the public health perspective of assessing dental health needs, improving oral health and reducing inequalities. Secondly, the Committee will learn from the PCT Primary Care Manager, of the current status regarding accessibility to local dentistry services, details of the new contract and how the NHS is communicating change and information to the public.

Sandra White Dental Public Health Consultant

Michelle Campbell  Primary Care Manager Commissioning

Buckinghamshire Primary Care Trust

Sandra White, Dental Public Health Consultant gave a presentation on the public health perspective of assessing dental health needs, improving oral health and reducing inequalities. Michelle Campbell, PCT Primary Care Manager gave a presentation on the current status regarding accessibility to local dentistry services, details of the new contract and how the NHS is communicating change and information to the public. A copy of their presentations were attached to the agenda.

During discussion the following points were raised:-

Child Oral Health

• A study of 5 year old children showed that there was an increasing trend in active decay, particularly in deprived communities. If an x-ray was taken and no action was taken, although decay was present on the x-ray, this could potentially be a litigation issue.

General Information

• Oral cancer could be identified by looking under the tongue.
• Hygienists could do a scale and polish, therapists could do fillings and simple extracts and dentists undertook more complex treatments. NHS Dentists could not say there was a clinical need for a scale and polish and send them privately to a hygienist.
• Further information to be supplied to Members once investigated, on the reasons why there is a high % of children who had sepsis in Aylesbury.
• Preventative work was undertaken where possible to promote oral health, particularly through health visitors and schools. There was a Smile Award to encourage children to have healthy snacks. Additional resources would be beneficial for learning disability patients and for elderly patients, particularly in identifying oral cancer. Larger dental practices were particularly encouraged to promote oral health and where possible this was being written into the contract.
• People were keeping their teeth longer which meant more complex treatment at a later stage.

Communication

• There were patient information leaflets to inform them of their rights. It was important for the PCT to be informed of any complaints for monitoring purposes. Any feedback on improving leaflets/information was welcomed, particularly for those patients who had English as a second language.

Inspection/Performance Monitoring

• Peer Reviews were only effective if reviewed by dentists who operated good practice. Some neighbouring dentists could be operating under similar standards.
• Dental Reference Officers, based in Eastbourne, conducted examinations nationally every 3 years. They would look at patients attending the dentist and then examine their records.
• There was also a Dental Practice Advisor who also undertook inspections e.g instrument hygiene, child protection, Hepatitis B checks, sieves to catch amalgam. These inspections were completed every 3 years and were on a rolling programme.
• There was a national protocol to undertake a census of 5 year old children. This was a small sample of children. Bucks PCT undertook to look at every 5 year old.
• Concern was expressed about access to dental services for people who lived in deprived areas.
• There was no legislation to allow private dentists to be inspected. The PCT can only communicate with private dentists and send them information. Denplan practices were asked to fill in a self assessment form. The practice would  ...  view the full minutes text for item 4.

The Committee will hear a report on the current status of the ‘Right Care, Right Place’ Programme for the redevelopment of the Heatherwood and Wexham Park Hospitals site. The options for development and the timetable for consultation with Overview and Scrutiny will be outlined in the meeting.

Colin Hayton Chief Executive Officer Heatherwood and Wexham Park Hospitals NHS Trust

AntonyRodden Programme Manager ‘Right Care, Right Place’

Colin Hayton, Chief Executive Officer and Antony Rodden, Programme Manager attended the Meeting to report on the current status of the ‘Right Care, Right Place’ Programme for the redevelopment of the Heatherwood and Wexham Park Hospitals NHS Trust site.

During discussion the following points were noted:-

• Heatherwood and Wexham Park Hospitals NHS Trust had two successful years. They had been awared an ‘Excellent score’ for the quality of services by the Health Care Commission for 2005-6 – one of only eleven acute Trusts in the Country to be awared Excellent.
• They had become a Foundation Trust from 1 June 2007.
• They were currently looking ahead for the next 20/30 years to provide the right accommodation for the health services of the future. An outline case had been approved by Ministers in 2005 and more detailed planning was now in progress.
• Future plans were being discussed with Berkshire and Buckinghamshire and were being developed in line with the Our Health Our Care Our Say proposals. The future role of hospitals needed to be considered in line with PCT proposals to promote services in the community.
• The Berkshire East PCT Commissioning Strategy had been published in Spring this year.
• The realistic options for redevelopment were now being reviewed with the intention that any substantial changes in services would be the subject of public consultation from December 2007 to March 2008.
• The Overview and Scrutiny Committees in Buckinghamshire and Berkshire would need to work together to consider the consultation document.
• There was an urgent need to improve the facilities for patients particularly on the Heatherwood site.
• Changes at the A&E Department and Maternity Unit in High Wycombe could mean a rise in patients attending Heatherwood and Wexham Park Hospitals.
• A Member asked for information on which specialities were provided on which sites, including capacity. The Trust agreed to respond with this information.
• A Member commented on the good transport links to the Wexham Park hospital site.

Colin Hayton and Antony Rodden were thanked for attending the Meeting and were invited back to the Committee in December, to consider the consultation document. Further work would be undertaken on joint scrutiny arrangements with East Berkshire Overview and Scrutiny Committee regarding this issue.

In February 2007 a Task Group from the Public Health Overview and Scrutiny Committee published a review into the management of Eating Disorders for 11 to 16 year old children. The County Council Cabinet, the Children and Young Peoples Partnership Board, the Mental Health Trust and Primary Care Trust accepted all of the recommendations from the report. A Partnership Working Group was established to drive forward the key recommendations and this Group will report back to Committee on the progress achieved to date.

Yvonne Taylor – Director of Child and Adolescent Mental Health Services (CAMHS) for Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust

In February 2007 a Task Group from this Committee published a review into the management of Eating Disorders for 11 to 16 year old children. The recommendations from the report were accepted and a Partnership Working Group was established to drive forward the key recommendations. Yvonne Taylor – Director of Child and Adolescent Mental Health Services for Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust attended the Meeting to update Members on the progress achieved to date on the Action Plan.

During discussion the following points were noted:-

• A Countywide multi-agency workshop had been held to develop a common understanding of eating disorders and to determine gaps in provision.
• Discussions had been held with the Bucks Youth Cabinet who had suggested adding Eating Disorders to the PHSE syllabus.
• Guidelines were being developed for all those working in an educational environment for the early identification of the illness and also a GP pack for referrals. These were expected to be launched in November 2007 and Members of the Sub-Group of the Committee would be invited.
• Young people often did not want to talk to their parents so it was important to offer opportunities for young people to talk about their illness in a confidential environment eg in school.
• There were concerns about websites that encouraged eating disorders.
• It was important that there were other methods of referral not just through GP surgeries e.g voluntary organisations.
• Yvonne Taylor would talk to the Committee in the near future about developments within tier 3 Specialist CAMHS Services.

The Working Group would report back to the Committee in March 2008 to update them on progress. A letter would be sent to the Chairman, Chris Petford to ensure that she would be able to attend, with representation across all agencies to present a full report. The Chairman thanked Yvonne Taylor for attending the Meeting.

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

The Forum Support Officer would update the Committee at the next Meeting on key patient issues arising from the Forum’s current work programmes.

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.

There was nothing further to report.

5 October 2007 – Bucks County Council

2 November 2007 – Room 6, South Bucks District Council

7 December 2007 – Mezzanine Room 2, Bucks County Council

4 January 2008 – Bucks County Council

1 February 2008 – Conference Room, Winslow Centre, Winslow

7 March 2008 – Bucks County Council

4 April 2008 – Bucks County Council

2 May 2008 – Committee Room 1, Wycombe District Council

6 June 2008 – Bucks County Council

4 July 2008 – Bucks County Council

5 September 2008 – Large Committee Room, Chiltern District Council

3 October 2008 – Bucks County Council

7 November 2008 – Bucks County Council

5 December 2008 – Room 6, South Bucks District Council

2 January 2009 – Bucks County Council

6 February 2009 – Bucks County Council

6 March 2009 – Conference Room, Winslow Centre, Winslow

3 April 2009 – Bucks County Council

1 May 2009 – Bucks County Council

All BCC meetings for 2008/2009 will be held in Mezzanine Room 1.

The dates and times of future meetings were noted including moving venues around the District Councils. The next meeting would be held on 5 October 2007 at 10am.