Agenda and minutes

Apologies of absence were received from Councillor Dawood, Councillor Glover, Councillor Manish Sood (Leicester City Council), Mr. J. G. Coxon, Mr. W. Liquorish, Mrs. J. A. Dickinson, Ms. B. Newton (Leicestershire County Council) and Councillor P. Golden (Rutland County Council).   

Members are asked to declare any interests they may have in the business on the agenda, and/or indicate that Section 106 of the Local Government Finance Act 1992 applies to them.

Members were asked to declare any interests they may have in the business on the agenda and/or declare that Section 106 of the Local Government Finance Act 1992 applied to them.

Councillor Allen declared a personal and non-prejudicial interest, as his wife was in receipt of a care package provided in the City.

Mr. A. Bailey CC declared a personal and non-prejudicial interest, as his son and daughter in law were employees of the partnership trust.

Councillor Hall declared a personal and non-prejudicial interest as he was a member of University Hospitals Leicester (UHL) and Leicestershire Partnership NHS Trusts.

Councillor Gill declared a personal and non-prejudicial interest as he was a Member of the Confederation of Indian Organisations, which was involved in a healthcare project concerned with preventing stroke in South Asian Communities.  

The minutes of the meeting of the Leicestershire, Leicester and Rutland Joint Health Overview and Scrutiny Committee held on 24 November 2008 are attached and the Committee is asked to confirm them as a correct record.

RESOLVED:

                        that the minutes of the meeting held on 24 November 2008 be agreed as a correct record of the meeting.

Jo Yeaman, Director of Marketing, Communications, and Patient & Public Involvement, will give a presentation update on the Next Stage Review.

A copy of the report is attached at appendix B for Members only.  Copies of the report can be viewed at www.cabinet.leicester.gov.uk or from the Customer Service Centre, King Street.

Councillor Allen, with the support of the Committee, opened up the debate by allowing questions to be put to Officers on a number of issues in relation to the Next Stage Review Update – Excellence for All.

Councillor Allen questioned Officers in relation to the ‘Cross Cutting’ issues as detailed in the research evaluation paper provided, and in particular raised concerns about IT Support Systems and the need for better Communication and Information.

Malcolm Lowe-Lauri, Chief Executive Officer, University Hospitals of Leicester (UHL) NHS Trust acknowledged this by stating that there was a need for the better integration of Information Systems, that work was being undertaken with patients to develop clearer expectations about conditions and treatment, and that the UHL Trust was undertaking targeted work to raise the levels of communication with patients.

Jo Yeaman, Director lead for Consultation and Engagement expanded on Planned Care, stating that there was an emphasis in the proposals of the Next Stage Review on:

• Reducing waiting times
• Offering more specialist services in a single place
• Developing a shared electronic patient record
• More local community clinics to avoid unnecessary hospital visits
• Introducing more convenient telephone appointments
• Using day surgery where evidence suggests it be the better choice
• Early access to key services such as physiotherapy
• Shorter hospital stays and a reduced number of visits/stays
• Clear information and proper support provided to patients
• Immediate identification and provision of equipment 

Jo explained further that the proposals had received very strong support, particularly in relation to better follow up care and more information for patients and families.  

Malcolm added that too many people were attending the Leicester Royal Infirmary, Glenfield Hospital and the General Hospital for assessment, diagnosis and treatment. The UHL Local concept was being developed in partnership to address the greater provision of assessment, diagnosis and treatment on a more local basis.

A Member of the Committee queried what systems had been put in place, or were proposed, to address the issue of long waiting times and appointment lists. Further, concerns were also raised about the failings of the Choose and Book telephone appointments booking system.

A Member of the Committee queried whether, in relation to over the phone health assessments, patients would still be able to visit a health professional if they wished. Further, the total number of missed appointments was also requested, as was information about the timescales for achieving the single patient electronic record. 

Jo explained the context of the research evaluation document (Appendix B) and the resulting feedback was to be used to develop a vision to be achieved. The second piece of work was to address the matters raised by the engagement programme.

Malcolm explained that the organisation of outpatient management and the matter of cancellations could be organised better. With the exception of Accident and Emergency and Orthopaedics the median waiting times were 8 weeks. Patients had also been sent to the Nuffield Hospital in an attempt to improve waiting times. On telephone appointments, patients were still able to choose  ...  view the full minutes text for item 36.

Stephen Ward, University Hospitals Trust, will give a presentation on the Getting Into Shape and Next Stage Review.

Tim Rideout, briefly explained the next steps in relation to the Next Stage Review. This included the following:

• A report would be published in Spring 2009 highlighting the results of Phase 1
• The Next Stage Review was concerned with the detail behind changes to services and about identifying exactly what the integrated programme would include

It was also stated that healthcare services were approaching a period of political and financial uncertainty, therefore it was essential that any proposals be resilient and robust.

Malcolm Lowe-Lauri also reported on the progress towards Getting Into Shape. Specifically, consistently low infection rates, improvements to financial governance, the implementation of a new senior staffing structure, and new Committee based governance arrangements were outlined. The results of the Auditors Local Evaluation were also referred to, including the key areas of criticism and how these would be addressed. The organisational priorities for 2009/2010 were also mentioned, where it was stated that there was to be an emphasis on patient experience and valuing and supporting staff.

Members of the Committee raised concerns in relation to the reduction in research monies provided by Government and questioned what action had been taken to account for this reduction in funding. It was explained that the Department of Health were responsible for the allocation of research based funding, that the funding previously provided for research was being phased out under the Best Research Best Health Strategy, that a strategy was in place for replacing lost funding by way of improving the research and development profile of University Hospitals Leicester, and that the funding gap stood at £2m.

Malcolm expanded further on the Nest Stage Review, and in particular on the next steps. It was stated the ‘Darzi’ principle of local where possible, central where necessary was applied when considering any proposed changes to service provision, and that it was important to balance choice and critical mass. Members were also informed of the UHL Central and UHL Local models of service provision. In relation to UHL Local, the intention to develop non-specialist care more locally was outlined. In relation to UHL Central, in some cases UHL were not equipped to provide all aspects of care, particularly in relation to Spinal or Head injuries, and therefore a more strategic outlook was required which involved working in partnership with neighbouring providers in the short term and also developing a plan for longer term provision at UHL sites. 

Members of the Committee raised questions in relation to patient transport and in particular transport to other hospitals outside of Leicestershire and the possible risk to life. Members were informed that the aim of the patient transfer service was to stabilise patients during the journey, but that the demise of the patient during the journey could not be eliminated, although reducing journey time as much as possible reduced the risk to patients.

A Member of the Committee also raised concerns about an instance where a patient had to be transferred to a Nottingham hospital to receive cancer treatment.  ...  view the full minutes text for item 37.

Mark Shepherd, General Manager Patient Transport Services, East Midlands Ambulance Service, will give a presentation on the patient transport service.

Michael Byrne, East Midland Ambulance Patient Transport Service, provided information to Members of the Committee on the following:

·        The patient journey and the different possible types of journey

·        The mobility assessment and how this impacted on the types of vehicles used

·        The resources, staffing and vehicles available

·        The Patient Transport Service Control and how the system was managed

·        Patient transport looking forward, including;

o     The business improvement programme

o     Arranging commerciality and managing projects

o     More joined up working on strategic improvements and planning

o     Improved performance, patient experience, relationships with customers and achieving foundation trust status

A Member questioned whether there was any joined up thinking with the voluntary sector. In response it was confirmed that attempts were being undertaken to strengthen links with the voluntary sector but it is important to remember that the safety of all patients and that the required safety standards of the vehicles be maintained. There was a small car pool of voluntary sector drivers. It was also confirmed that the achievement of Foundation Status was on track.

RESOLVED:

                        that the report be noted.  

The meeting closed 1.06pm.