100121 HOSC Minutes - Norfolk Health Overview & Scrutiny Committee

NORFOLK HEALTH OVERVIEW AND SCRUTINY COMMITTEE MINUTES OF THE MEETING HELD ON 21 JANUARY 2010 Present: Mr M R H Carttiss Chairman, Norfolk County Council Michael Chenery of Horsbrugh No

NORFOLK HEALTH OVERVIEW AND SCRUTINY COMMITTEE MINUTES OF THE MEETING HELD ON 21 JANUARY 2010 Present:

Mr M R H Carttiss (Chairman), Norfolk County Council Michael Chenery of Horsbrugh Norfolk County Council

Also Present:

Norwich University Hospitals NHS Foundation Trust

Norfolk

Respite Services for Adults with Learning Difficulties

Hospitals NHS Foundation Trust

Hospitals NHS Foundation Trust

Trust

Trust

Chris Humphris NHS Great Yarmouth and Waveney

(For ease of reference, items are recorded in these minutes in the order in which they appear on the agenda This is not necessarily the order in which the items were

considered at the meeting)

1 Apologies for Absence

2 Glossary of Terms and Abbreviations

papers They also received on the table an explanation of the different medical procedures that were used in endoscopy (for use at item 7, when considering the report on the redevelopment of Cromer Hospital)

3 Minutes

by the Committee and signed by the Chairman

4 Declarations of Interest

response to the draft dementia strategy because he had a substantive contract with the Norfolk and Waveney Mental Health NHS Foundation Trust and he was also a Mental Health Practitioner

strategy consultation and the item about changes to NHS provided respite

services for adults with learning difficulties because he was a care home provider

redevelopment of Cromer Hospital because he was a Member of the Friends of Kelling Hospital

6.1 (a) Change of Membership

The Chairman welcomed back to the Committee Mrs Jenny Chamberlin in place of Mrs Alison Thomas who had become Deputy Cabinet Member for Vulnerable Children

6.2 (b) Change of Agenda Order: Cromer Hospital Redevelopment

The Committee agreed to a suggestion from the Chairman to consider urgent and emergency services in Norfolk as the first substantive item on this agenda and delay consideration of the item on Cromer Hospital redevelopment until after 11am when Krishna Sethia, Consultant Urologist

at the Norfolk and Norwich University Hospitals NHS Foundation Trust would be able to attend the meeting

The Chairman said that in the interests of all those who attended the Committee’s meetings it was important for Members to be able to consider items in the order in which they appeared on the agenda In future he would be unlikely to put forward changes in the agenda order after the papers had been published The agenda order was agreed with NHS witnesses at least some two weeks before the day of the meeting and that was the time for us to be advised if the proposed timing was inconvenient

6.3 (c) Meeting with Non-Executive Directors and Managers of NHS Norfolk

It was noted that the date for the meeting with NHS Norfolk Non-Executive Directors and Managers had been changed from 4 February 2010 to 29 March 2010 This meeting would be held in the Edwards Room at County Hall and details sent to Members in due course

6.4 (d) Norfolk LINk

The Chairman said that Norfolk LINk had invited the Committee to appoint

a Member to join one of Norfolk LINk’s regular meetings of its Older People with Mental Health Problems Working Group The Committee nominated Shirley Weymouth to attend the Norfolk LINk Working Group and Michael Chenery of Horsbrugh to be her named substitute

7 Cromer Hospital Redevelopment

Support Manager (Health), to a report from the Norfolk and Norwich University Hospitals NHS Foundation Trust that set out the results of its consultation on plans to redevelop Cromer Hospital and the recommendations that were due to

go to its Board on 22 January 2010 The Committee also received additional information from Norfolk LINk (that had been sent to Members in advance of the meeting) that set out Norfolk LINk’s comments on the redevelopment proposals and the public consultation exercise

Julie Cave, Director of Resources, Norfolk and Norwich University Hospitals NHS

FT

Krishna Sethia, Consultant Urologist, Norfolk and Norwich University Hospitals NHS FT

Michele Nash, Chairman, Cromer Hospital Action Group

Hilary Thompson, County Councillor for Cromer

John Perry-Warnes, Committee Member and County Councillor for Holt

Patrick Thompson, Norfolk LINk

7.3 In hearing from the witnesses and in answer to Members’ questions, the

Committee noted the following:

 The witnesses said that development work at Cromer hospital was due to start on site by the beginning of July 2010 and finish in 2012

 The Cromer Hospital project made maximum benefit out of the generous legacies left to Cromer hospital by Sagle Bernstein and Phyllis Cox The NNUH had agreed to commit the £15m legacy to the development of the new hospital and had set aside a small contingency reserve It would cost an additional £3m from the NHS to provide endoscopy at Cromer and this was too expensive for the NHS to include within the budget for the Cromer

hospital project

 The service model for the new Cromer hospital was aimed at providing mainly

“high volume, high frequency services that had a low clinical risk” Such

services excluded general anaesthetic surgery and endoscopy which were being relocated at the NNUH

 To provide an acute endoscopy unit at Cromer Hospital would require 700 square metres in order to meet hygiene requirements and the

decontamination regulations

 A new MRI scanner at Cromer hospital would deal with up to 4,000 patients a year

 The 18 week treatment time target applied at Cromer Hospital as it did

elsewhere

 The witnesses said the NNUH would be able to cope with the additional numbers of patients transferring from Cromer Hospital

 Members pointed out that there were potential transport difficulties for

patients who currently attended Cromer Hospital who would have to attend the NNUH some 25 miles away

 Some Members said those living in Cromer were fortunate to have a new hospital being build in their area because nothing similar existed for those living in the south of the county, and for whom a 25 mile journey to the NNUH was usual

 In response to a question from John Perry-Warnes, local County Councillor for Holt and a Member of the Committee, Krishna Sethia, Consultant

Urologist, NNUH, said that there were no known difficulties with clinicians having to travel daily to Norwich

 Michele Nash, Chairman of the Cromer Hospital Action Group, said that whilst some people were disappointed with some aspects of the

redevelopment plan, most people she had spoken with had broadly supported what was being proposed It might be possible for funds to be raised locally for keeping endoscopy at Cromer Detailed discussions with the NNUH about the types of services that could be provided in the hospital were continuing These discussions included the possibility of a GP practice being sited within

the hospital grounds

 Hilary Thompson, the local County Councillor for Cromer, said that the public consultation about the proposed new hospital had been generally well

received in the locality although disappointment remained that there would be

on endoscopy unit She said that it was important there was no delay in the implementation of the project There was a danger that any delay in approval could result in the loss of some services, given the poor state of public

finances

 Patrick Thompson, Norfolk LINk, said that Members of Norfolk LINk had visited a GP surgery where endoscopy was performed He said that Norfolk LINk remained concerned about the lack of detail concerning the facilities that would be provided in the new building

Committee requested the NNUH continue to work closely with the Cromer Hospital Action Group and the NNUH respond favourably if, in the years ahead, local fundraisers were able to raise enough money to support an endoscopy service at the hospital that met all the relevant healthcare standards

8 Response to the Draft Dementia Strategy Consultation

(Health), that asked Members to agree a response to a draft joint commissioning strategy from NHS Norfolk, NHS Great Yarmouth and Waveney and Norfolk County Council’s Adult Social Services Department, entitled “Living Well with Dementia: Transforming the Quality and Experience of Dementia Care for the People of Norfolk”

Roger Hadingham, Commissioning Officer, Adult Social Services

David Stonehouse, Deputy Chief Executive and Director of Finance, NHS Norfolk

to respond in writing to the Committee’s comments and questions that could be found at paragraph 2.2 of the report It was also suggested that the response of

the joint commissioners should be shared with Members of the Committee

the addition of a comment seeking information from the joint commissioners about those who would diagnose dementia

9 Proposed Changes to NHS Provided Respite Services for Adults with

Learning Difficulties: 3 Mill Close, Aylsham and 4 Park View, King’s Lynn

Support Manager (Health), to a report from the Pooled Fund Commissioners

(NHS Norfolk, NHS Great Yarmouth and Waveney and Norfolk County Council)

on proposals to discontinue NHS provided respite care for adults with learning difficulties at 3 Mill Close, Aylsham and 4 Park View, King’s Lynn

Tim O’Mullane, Head of Learning Difficulties Services, Adult Social Services Bob Mee, Interim Director of Learning Difficulties, NHS Norfolk

Paul Steward, Consultant Project Manager

in respite services for adults with learning difficulties at its meeting in September

2009 and that Members were due to receive a full consultation report about the proposals in March 2010 It was pointed out that this report would include

detailed proposals on alternatives to the current NHS provided respite service, and explain the likely financial implications of each of the proposals for all parties

respite care at Mill Close would have their respite care re-provided with those moving from Lothingland to a new facility at Pinewoods at Repps with Bastwick The existing facilities would not close until the planned care was operational, in around June 2010

parent/carer representatives should be invited to the March 2010 meeting when the Pooled Fund Commissioners would present their full consultation report The Committee asked for the report to include information on how charges were to be introduced for parent/carer representatives, and the overall cost implications for the NHS, Adult Social Services and the individuals concerned

10 Urgent and Emergency Services in Norfolk

Support Manager (Health), to a report from NHS Norfolk about urgent and

emergency health service strategies in light of the rise in emergency admissions

to hospital

Jim Barker, Programme Manager (Unplanned Care), NHS Norfolk

Anne Osborn, Director of Strategy, Planning and Performance, Norfolk and

Norwich University Hospitals NHS FT

Care Programme Board, NHS Norfolk, had intended to attend the meeting but had given his apologies due to illness The Committee agreed to consider the rise in emergency admissions to hospital at this meeting in Dr Heap’s absence, and examine the measures that the NHS was taking to address the current

situation at the March 2010 meeting when Dr Heap would be able to respond to any questions from Members

Committee noted the following:

 It was pointed out that there had been a 16% rise in medical emergency admissions and an 11% rise in A&E attendances at the NNUH in the past year and that there had been a rise in demand for emergency services at the Queen Elizabeth Hospital and the James Paget Hospital, but not to the same extent

 The rise in emergency admissions was attributed to an increase in

self-referrals, inadequacies in the provision of primary care, particularly out-of-hours services, and a perceived difficulty in obtaining GP appointments, particularly amongst migrants living in the west of the county who were

unfamiliar with the working of the NHS

 It was pointed out that there was a strong relationship between the NHS and migrant workers in the Great Yarmouth area and there could be lessons to be learned from this in the NHS Norfolk area

 Emergency admissions increased pressures on the four-hour waiting target

 An Emergency Care Intensive Support Team had been set up to look at care pathways and to make best practice recommendations for reducing demand

on hospital services

 A social marketing “Choose Well” campaign had been launched by NHS Norfolk to ensure people attended the right kind of health service for their treatment and did not go to A&E departments unnecessarily

 Patients with minor ailments who went to the A&E department were being encouraged to see their GP or pharmacist instead This approach to

managing attendance at A&E was being piloted at the Queen Elizabeth

Hospital The pilot was in its infancy and it was hoped to roll it out across Norfolk in due course

 The initiative taken in setting up the Walk-in Centre at Timberhill in Norwich was meant to ease the pressures on the A&E department at the NNUH

 It was important people only accessed emergency help or treatment if it was indeed an emergency Various other NHS services such as GP surgeries and NHS Direct were available so that people could choose the right service for their ailment

 It was considered important for information about how people could access NHS services to go out in different languages and be made available in

places where migrant workers were most likely to read it This was not

necessarily in GP practices

 Patrick Thompson, Norfolk LINk, spoke about the importance of A&E services being “user friendly” and more easily understood by the public

Yarmouth and the NHS hospital acute trusts to give a further report at a later meeting

11 Appointment to Great Yarmouth and Waveney Joint Health Scrutiny

Committee

Conservative Member on the Great Yarmouth and Waveney Joint Health Scrutiny Committee in place of Mrs A Thomas

vacancy

12 Information for the Care Quality Commission

(Health), that sought approval to a method for providing information to the Care Quality Commission

authorities across the south east had attended with representatives from the Care Quality Commission to consider how the Care Quality Commission would regulate all health and social care services in England, whether they were provided by the NHS, local authorities or private companies He said that the Care Quality

Commission had suggested each Health Overview and Scrutiny Committee

should appoint a Member Champion for Care Quality issues

workday with the Care Quality Commission, to be held locally

copied to the Care Quality Commission for information

not being resolved locally would be brought to it’s attention (It was, however, noted that by the time such issues became “persistent” the Committee was more than likely to be following other routes of redress)

13 Regional Joint Health Scrutiny Committees

(Health), that asked the Committee to waive the requirement for political

proportionality on regional and sub-regional Joint Health Scrutiny Committees which were formed on a task and finish basis

Health Scrutiny Committees may waive rules on political balance when appointing Members to Joint Committees

according to the political balance of Norfolk County Council, unless the Council approves otherwise

14 Forward Work Programme

report subject to the following amendments:

Continuing Healthcare Policy to be received at the 4 March 2010 meeting

the 15 April 2010 meeting

The meeting concluded at 13.15pm

CHAIRMAN

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