Meeting documents

Venue: Mezzanine Room 2, County Hall, Aylesbury. View directions

Note: Please note that this meeting will be webcast - please use the "Webcasts" menu link 

Media

Webcast: View the webcast

Items
Note No. Item

1.

Apologies for Absence / Changes in Membership

Additional documents:

Minutes:

 

 

Apologies were received from Mrs Matthews, Mr Shepherd (Mr Wertheim is substituting), Mr Brown, Mrs Blake and Mrs Aston.

2.

Declarations of Interest

To disclose any Personal or Disclosable Pecuniary Interests

Additional documents:

Minutes:

There were no declarations of interest

3.

Minutes pdf icon PDF 472 KB

Minutes of the meeting held on 24th November 2015 to be confirmed as a correct record

Additional documents:

Minutes:

The minutes of the meeting on 24th November 2015 were confirmed as an accurate record.

 

Julia Wassell highlighted under Item 7 - BHT Improvement Plan and Wycombe Hospital it stated the Trust was looking to have strategic plans for Wycombe Hospital finalised by March 2016.

 

 

Action

 

Buckinghamshire Hospital Trust to submit the strategic plans for Wycombe Hospital to the 22nd March meeting of HASC. (Committee and Governance Advisor to action)

4.

Public Questions

This is an opportunity for members of the public to put a question or raise an issue of concern, related to health.   Where possible, the relevant organisation to which the question/issue is directed will be present to give a verbal response.  The member of public will be invited to speak for up to four minutes on their issue.  A maximum of 30 minutes is set aside for the Public Questions slot in total (including responses and any Committee discussion). This may be extended with the Chairman’s discretion. 

 

For full guidance on Public Questions, including how to register a request to speak during this slot, please follow this link:

http://www.buckscc.gov.uk/about-your-council/scrutiny/getting-involved/

Additional documents:

Minutes:

Julia Wassell raised two public questions that she had received:

 

1.)  When was the Lynton Practice closing?

2.)  Members of the public had reported that Harlow House was due to close and a smaller facility for mental health services was due to open where the Central West Community Mental Health Team is based in Gordon Road, Wycombe. Members of the public feared there would be a loss of service and requested the Trust clarify this.

 

Actions

 

·         HASC to seek clarity around the proposed dates for closing the Lynton Practice. (Committee and Governance Advisor to action)

·         HASC to seek clarity and consultation proposals regarding any closure of Harlow House. (Committee and Governance Advisor to action)

10:05am

5.

Chairman's Update pdf icon PDF 220 KB

This will include an update regarding the application to open a Community Pharmacy in Waddesdon, consultation on the Bedfordshire and Milton Keynes Health review and changes in provider at the Mandeville Practice.

 

In response to a public question raised at the 24th November meeting, Leaders of all District Councils were contacted regarding priority housing provision for healthcare workers. A sample letter is attached.

Additional documents:

Minutes:

The Chairman highlighted:

 

The Public Account for Adult Social Care –Members were encouraged to read the document.  It was noted that Cllrs Noel Brown and Margaret Aston sit on the working group.

 

Waddesdon Pharmacy – The Chairman was approached about a pharmacy licence application for High Street Waddesdon in Buckinghamshire.

This was not considered to be an area that required pharmacy provision in the Pharmaceutical Needs Assessment (last updated April 2015) and signed off by the Health and Wellbeing Board. There is further concern that this might destabilise primary care provision in the area. The Chairman submitted concerns to NHS England. (South Central) NHS England is in the process of accessing the application and this will include a site visit and consideration of representations from interested parties and patient choice. HASC need to keep an eye on this in terms of changes to pharmaceutical provision.

 

The Lynton Practice – Consultation is taking place as the practice is deemed not fit for purpose. A letter was circulated to stakeholders in December, with a proposal that they will move to a smaller site within Wycombe Hospital. Public meetings were organised for late January and early: February: 3rd Feb 6.30 -8.30pm at Hannover House, 4th Feb 10.-12.30 and February 11th at 6.30-8.30pm at Rights Medical Centre

 

The Mandeville Practice – This will have a new interim provider from April 2016, once the existing GP Partnership has dissolved. NHS England are stating there will be now significant change, with ‘many’ of the existing staff transferring over. Once the interim provider is in place NHS England and the AV CCG will commence a project during 2016 ‘to determine the future scope of services and potential opportunities for integration and innovation to improve access to services and health outcomes for patients.’ It has stated  ‘Public and patient involvement in this process will be critical and the feedback will be used to shape the commissioning of future services and it will be helpful to share this with the HASC.’ Recent telephone conferences have not identified what plans are proposed nor volume of staff who are transferring. A year is a short amount of time for planning, any integration and implementation. HASC will need to keep an eye on what is happening.

 

The Bedfordshire and Milton Keynes Healthcare Review - From the initial stages of the Review two options for the provision of acute care in Milton Keynes and Bedford had been formulated, with one hospital becoming an Integrated Care Centre, with the other remaining a Major Emergency Centre. However, as the Review progressed, the Bedfordshire Clinical Commissioning Group, Bedford Hospital and Bedford GPs came forward with a third option for an Integrated Acute and Community Services (IACS) model, which would provide streamlined urgent care across primary, community and acute care provision. A consultation timetable has now been issued.  It has been agreed that a monthly newsletter will be issued to councillors to update them and that the Healthcare Review team provides details of the  ...  view the full minutes text for item 5.

6.

Committee Update

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.

Additional documents:

Minutes:

There were no updates from the Committee

10:10am

7.

Oral Health and Oral Health Promotion pdf icon PDF 361 KB

For Members to receive an overview of the Oral Health of Buckinghamshire residents, and an outline the Buckinghamshire Oral Health Improvement Strategy and the Oral Health Promotion service.

 

Contributors:

 

Sarah Mills, Public Health Principal, Buckinghamshire County Council

 

Lucie Daleki, Oral Health Improvement Manager (MK and Bucks), Central and North West London NHS Foundation Trust (CNWL)

 

 

Additional documents:

Minutes:

Sarah Mills (Public Health Principal- Buckinghamshire County Council ) and Lucie Daleki, (Oral Health Improvement Specialist – Milton Keynes and Buckinghamshire) presented an overview of oral health and health promotion in Buckinghamshire.

 

During discussion the following issues were covered:

 

·         1:4 of 5 year olds in Bucks have 3 / 4 decayed teeth.

·         29% of adults have 2-3 teeth with decay experience

·         Bucks compares well with the England average, but less so with its Thames Valley neighbours.

·         There are wide disparities with poorer socio-economic outcomes linked with poor oral health

·         Poor oral health is preventable but is still amongst the most common chronic disease

·         There are multiple social, economic, environmental and stress related barriers to good oral health.

·         Key documents regarding oral health in Bucks are: Thames Valley Oral Health Needs Assessment (2014), Buckinghamshire Health and Wellbeing Strategy (2013 – 2016) and Buckinghamshire Oral Health Improvement Strategy (2015 – 2020). The key is also to integrate with linked strategies.

·         The Oral Health Promotion Service works with early years settings and older, more vulnerable adults. The service runs an oral health accreditation scheme for early years and vulnerable & older people settings. The majority of Children’s Centres are accredited.

·         The ‘eat better, start better’ programme provides training to early years settings to offer healthier choices.

·         The ‘eat out, eat well’ awards reward businesses for offering healthy options

 

In response to questions from Members the following areas were highlighted:

 

·         There are large national campaigns around the dangers of high sugar levels such as recent change 4 life campaign.

·         HASC would find it useful to have an overview of what has been achieved to date against the oral health strategy actions.

·         Surveys are undertaken as part of a national epidemiological survey process and a sample of 5 year olds’ teeth are surveyed every four years. The Oral Health Promotion Service is for the first time rolling out an older peoples survey to assess oral health needs of people aged over 65 years.

·         Getting to parents regarding oral is key and the ‘smile’ award is aimed at training early years professionals, such as those working Children’s Centres.

·         Members stated that Children’s Centres are vital and any budgetary cuts will impact negatively on early years oral health promotion programmes.

·         School nursing staff are trained by the Oral Health Promotion Service to include oral health promotion within schools.

·         There are a number of national campaigns currently regarding sugar content awareness, including a recommendation that the Government considers a sugar tax.

 

 

10:40am

8.

The Commissioning of NHS Dentistry in Buckinghamshire and an overview of dentistry provision pdf icon PDF 696 KB

Members will receive:         

 

i.)    An overview of NHS provision in Buckinghamshire

ii.)   An overview quality of NHS dentistry provision and types of dental work NHS funding excludes.

iii.) An overview of contractual performance in Bucks.

iv.) A dentists perspective on the provision of dentistry in Buckinghamshire

 

 

Contributors:

 

Hugh O’Keefe - Contract Manager – Dental, NHS England South (South Central)

 

Nilesh Patel – Chair of Bucks Local Dental Committee

 

 

Additional documents:

Minutes:

Hugh O’Keeffe the Dental Contract Manager at NHS England South and Nilesh Patel, Chair of Bucks Local Dental Committee updated the committee on NHS dental commissioning and provision. 

 

During the discussions the following areas were covered:

 

NHS England

 

·         NHS England is responsible for commissioning all NHS dental services. Bucks comes within the Thames Valley region

·         10% of all 111 calls are dental.

·         Oxford University Hospitals NHS Foundation Trust are the providers for Maxillofacial Surgery.

·         Bucks Healthcare NHS Foundation Trust provides, (mainly at Stoke Mandeville Hospital) Oral Surgery, Orthodontics and Restorative Dentistry and is clinically linked to the Oxford University Hospital.

·         Community Dental Services are provided by Central and North-West London NHS Foundation Trust

·         Currently there are 75 NHS Dental Practices in Buckinghamshire, of this 30 practices only provide NHS dentistry for children and exempt patients. 95% of dental activity is delivered through the 45 practices delivering NHS dentistry to all.

·         Dentistry is a banded treatment system, which attract different charges. There are exemptions such as for children and people receiving benefits.

·         All NHS practices are measured in units of dental activity relating to the bandings. Practices are expected to deliver 92% of their activity targets set in their contracts. The level of activity commissioned in the Chiltern area has fallen due to some practices being unable to deliver their contracted activity.  (In Chiltern dental practices there is a higher rate of delivery below the targets. This money is recovered by NHS England.)

·         In 2009 there was a big push to invest in NHS dentistry. In Bucks there was a problem with investment going in not being utilised. South Bucks has the highest level of access in Thames Valley and Chiltern the lowest.

·         Some of the key challenges are:  population growth/new housing: impact on primary and secondary care services, financial pressures across NHS.

 

From a LDC perspective:

 

·         Buckinghamshire had a lower dental commissioned budget in 14/15, than Oxfordshire and Buckinghamshire. £14.6 million in Bucks, compared to £24 million in Oxon and £28.7 million in Berks. The outcome is lower units of dental activity in Buckinghamshire.

·         Bucks has a spend of £28.81 annually per head of population, compared to Oxon at £36.65 and Berks at £33.23. Bucks has 79% of the spend per person of Oxon and 87% of the spend of Berks.

·         Bucks has on average only 1,2 units of activity per person commissioned a lot lower than Oxon and Berks. NHS Commissioners need to look at this.

·         There was an issue with the way in which the 2008 Needs Assessment was conducted and this informed the 2009 spread of practices.

·         Most of Bucks underspend is getting re-distributed outside of Bucks.

·         There are two Prisons in Grendon and one in Aylesbury who now have new national dental provider which was appointed by a larger healthcare organisation. Dentistry only formed 1% of the questions. Not enough care is taken of providing dentistry for inmates. Previously the service was provided by local dental services who provided support for the inmates as they  ...  view the full minutes text for item 8.

10:40am

9.

A users perspective on the accessibility of NHS Dentistry pdf icon PDF 295 KB

Healthwatch Bucks to present findings from a review of access to dental services and an overview of feedback received from residents on dentistry.

 

Contributors:

 

Shade Adoh – Healthwatch Bucks

Phil Thiselton - Head of Research – Healthwatch Bucks

Additional documents:

Minutes:

Shade Adoh – Healthwatch Buck and Phil Thiselton Head of Research at Healthwatch Bucks updated the Committee regarding the review of access to dental services and feedback received from residents on dentistry.

 

During the discussion the following areas were covered:

 

·         Discrepancies over the number of NHS dental practices in Bucks. 25 of the NHS choice dentists stated they did not offer NHS appointments and were private practices.

·         Healthwatch research highlighted that NHS places were available but may not have been at the places people preferred. There was a lack of NHS practices in Beaconsfield, Chalfont and Gerard’s Cross.

·         Broader feedback is that quality of treatment is good, but not so good over appointments and waiting times.

·         Issues of some practices not sending in their patient satisfaction surveys. Good practice but practices are not obliged to conduct surveys.

 

Actions

 

·         The Chair to include the discrepancies in the number of NHS dental practices in Bucks in the letter to NHS England.

11:40am

10.

Work Programme pdf icon PDF 87 KB

For Members to note the work programme

Additional documents:

Minutes:

The work Programme was noted.

11:50am

11.

Date and Time of Next Meeting

The next meeting will take place on Tuesday 22nd March 2016, at 10.00am in Mezzanine Room 2. There will be a pre-meeting for Committee Members at 9.30am.

Additional documents:

Minutes:

The next full webcast committee meeting will be on 22nd March 2016 at 10am.