Meeting documents

Apologies for absence were received from Mrs M Aston, Mr R Woollard and Sir J Horsbrugh-Porter (Chiltern District Council).

The Committee welcomed Lindsay Rowlands, the new District Council Member from Aylesbury Vale.

To declare any personal and prejudicial interests

There were no declarations of interest.

of the meeting held on 2 November 2007 to be confirmed as a correct record

The Minutes of the Meeting held on 2 November 2007 were agreed as a correct record.

The Chairman of the Committee will receive questions from members of the public relating to health issues.

There were no public questions.

‘Preparing Buckinghamshire PCT for the future’

Buckinghamshire PCT has recently set out their strategic objectives for the next 3 to 5 years.

The strategic objectives focus on addressing the health needs of the local population by improving average life expectancy, reducing health inequalities, enhancing quality and safety of patient services and enabling local people to have a greater voice in shaping local health services and managing their own healthcare.

The plan also identifies key areas for improvement that will work towards achieving the forecast deficit for 2007/2008 of £10m and achieving a run rate balance. The five areas that will contribute towards achieving financial balance are:-

• Acute care - urgent and non urgent(planned)
• Contracting
• Prescribing
• Provider services
• Non acute services

The Director of System Reform for Buckinghamshire PCT will provide more detail around how the PCT is driving these plans forward.

Richard Mills – Director of System Reform Buckinghamshire Primary Care Trust

Richard Mills, Director of System Reform gave a presentation on the PCT’s strategic objectives for the next 3 to 5 years. The strategic objectives focus on addressing the health needs of the local population by improving average life expectancy, reducing health inequalities, enhancing quality and safety of patient services and enabling local people to have a greater voice in shaping local health services and managing their own healthcare.

Following the presentation the following points were made during discussion:-

·        Whilst the situation had improved, the PCT were still forecasting a deficit of £10m overspend in 07/08. There had been some underlying problems in Buckinghamshire for a while which were not easy to resolve quickly. When the PCTs merged there was not enough financial control, which had led to increased expenditure. Now there were clear financial processes in place and cost savings had been made through reducing management posts and rationalising office accommodation. The PCT were also looking at how to use resources more effectively with no effect on services e.g different prescribing methods, using staff more effectively by reducing their travelling time, raising income through providing beds for social care. Improved work streams would result in better care and a reduction in expenditure. With a budget of £550 million, the current deficit represents approximately 2% of the budget.

·        The five areas that would contribute to achieving financial balance were:-

Acute Care

In Buckinghamshire by March 2008 it was planned that patients would not have to wait more than 18 weeks from a GP referral to the end of their treatment. An experiment was also taking place with a GP in A&E to treat people who did not need to be admitted to hospital. The GP would be used to assist junior doctors with their local knowledge of services and where the patient should be referred or which care package should be put in place, rather than admit them unnecessarily to hospital.

Contracting

The out of hours services would be re-tendered in October 2008. This was a good opportunity to make improvements, particularly making sure community services were being utlilised more effectively e.g Buckingham Community Hospital. The PCT were looking at the quality of the service; the primary aim was to stop people being admitted to hospital unnecessarily.

Prescribing

Generic drugs were being used as opposed to branded drugs, which were more expensive. Blood pressure checks were being undertaken more frequently and medicine prescribed to reduce the number of hospital admissions due to heart attacks.

Provider Services

Currently care was provided in hospital and through primary care; there were not many services in the middle. Community Hospitals were previously used as a rehabilitation centre but these now would be used as an assessment centre to get patients back to their own homes, and also for diagnostic and outpatient work. Many of the Community Hospitals had GP practices next door to them and this link would be strengthened so that the GPs would be involved in the running of the Hospital,  ...  view the full minutes text for item 5.

The Healthcare Commission is the independent watchdog for healthcare in England. The Annual Health Check is one of the most important of the commission’s activities and is aimed at driving improvements in healthcare for the public. The commission measures the performance of each NHS trust in England by assessing the quality of care and the management of resources.

Overview and Scrutiny Committees and patient and public involvement forums are invited to contribute to the Annual Health Check from evidence gathered during the previous year relating to the designated 24 core standards and 13 developmental standards.

A representative from the Commission will discuss what impact the Committee’s comments made in the 06/07 Declaration and offer support in preparation for the commentary for the 07/08 Declaration.

KouserChaudry, Assessor, South West Region

Healthcare Commission

Kouser Chaudry and Kate Dew gave a presentation on behalf of the Healthcare Commission, an independent watchdog for healthcare in England. The Annual Health Check is one of the most important of the Commission’s activities and is aimed at driving improvements in healthcare for the public. The Commission measures the performance of each NHS Trust in England by assessing the quality of care and the management of resources. This Committee and Patient and Public Involvement Forums are invited to contribute to the Annual Health Check from evidence gathered during the previous year relating to the designated 24 core standards and 13 developmental standards.

Following the presentation the following points were made:-

·        A data analyst looked at the information supplied by organisations and linked this to the core and developmental standards – either in a positive or negative way. The information was assessed by the strength of relationship to the standard e.g information relating to the PCT scored 1 High, 7 Medium and 3 Low.

·        One high rating was linked to a comment made regarding 3 visits looking at the quality of hospital food. This was a good comment because 3 visits were made and provided robust evidence regarding the standard of food. A high quality comment was representative of the whole County, gave good detail, good evidence and related to the standards set by the Commission.

·        The Commission would provide information about where Buckinghamshire was positioned in relation to other Committees.

Action: Kouser Chaudry

·        A Member commented that this information soon became out of date. In response to this Kate Dew informed Members that these commentaries helped improve healthcare. Government had laid down the core standards and it often took along time to affect change.

·        Members noted the suggested areas for comment for 2007/8.

·        No details had yet emerged about how the Commission would merge with CSCI but the formation of the new watchdog that combined the Healthcare Commission, CSCI and the Mental Health Act Commission would be formed in 2009. The Annual Healthcheck would then invariably change.

·        It was agreed that the Chairman would meet with representatives of the Commission to look at how improvements could be made to the Annual Health Check.

Action: Kouser Chaudry / Mike Appleyard

Kouser Chaudry and Kate Dew were thanked for their presentation.

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

There would be a report at a future meeting.

1. The Chairman will update the Committee on the recent meeting of the Overview and Scrutiny network for the South Central Strategic Health Authority region.
2. Members will 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.

The Chairman updated the Committee on the recent Meeting of the Overview and Scrutiny network for the South Central Strategic Health Authority Region. He informed Members that the network had grown in importance and that the Strategic Health Authority were keen to get involved with the network.

A written update on the meeting of the Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust Board was presented by Pam Bacon and would be circulated to Members.

 Action: Angela Macpherson

The following areas were raised by Aylesbury Vale to be discussed at the next meeting:-

·        Older People’s Chiropody Services/foot care in the home (it was thought that this was being looked at by Age Concern

Action: The Vice-Chairman would check this at her next meeting with them)

·        Missed appointments/transport issues - the Chairman referred to missed appointments and commented that generally there were real concerns about communication between GPs and patients. This was something that the Committee wanted to address in the future.

·        Elderly patients and care in hospitals eg diet (this had been looked at previously when visits had been made to hospitals to sample their food)

·        Dementia care provision, particularly early dementia (this was being looked at by the Continuing Care Working Group)

·        Young mothers support (this was undertaken by PACT)

·        Under use of Buckingham Hospital

·        Air quality versus traffic generation and growth

It was noted that the PPIF was visiting the Primary Care Trust on 17 December 2007 and they would provide feedback on their visit to the Committee. The Policy Officer would liaise with the Forum about their work programme.       

Action: Angela Macpherson/PPIF

The Chairman and the Policy Officer would look at the issues raised above and take forward one/two issues at the next meeting, which were not currently being addressed in other forums. Two areas that would be prioritized were Buckingham Hospital and the growth agenda.

Action:Angela Macpherson/Mike Appleyard

Friday 1 February 2008 – 10.00am

Please note this meeting will be held at the Winslow Centre

Friday 1 February 2008 at 10am at the Winslow Centre.