Agenda item

Tim Rideout, Leicestershire Lead for the Next Stage Review, will introduce the ‘Excellence for All’ vision for Leicestershire, Leicester and Rutland. (This is being launched on 15 July 2008 and further papers will be circulated to Member on that date and copies will be available at the meeting).

Malcolm Lowe-Lauri, Chief Executive of University Hospitals of Leicester NHS Trust, will outline the contribution of the acute sector to the Next Stage Review.

The Committee heard a presentation introducing the ‘Excellence for All’ vision for Leicestershire, Leicester and Rutland, and the Next Stage Review. Presenting the information was Jo Yeaman, Next Stage Review Lead – Engagement and Consultation, Malcolm Lowe-Lauri the new Chief Executive of the University Hospitals of Leicester NHS Trust, and Helen Seth, Deputy Director of Operations (Modernisation). Apologies were given for Tim Rideout who was unable to make the meeting. 

Jo Yeaman stated that  reviews were being carried out across the country as part of the national ‘Our NHS, Our Future: Next Stage Review’, which was being led by Lord Darzi. In Leicester, Leicestershire and Rutland (LLR) NHS organisations had been working jointly on their review called ‘Excellence for All’.  A number of documents had been published to provide information and allow feedback, these were available in leaflet and more detailed forms.

The focus of the LLR review was on improving the health and well-being of people living locally, and based on seven key principles which were outlined in the report.  The vision explained how health services might be delivered in the future which, if undertaken, would change the way the service was provided.  The formal engagement had commenced on 15 July 2008 and would conclude on 5 October 2008.

A Member of the Committee enquired about which committees addressed children’s mental health.  In response Jo noted that this was split between the Children’s and the Mental Health workstreams. A Member of the Committee asked if these nursing services would be based in schools.  Jo acknowledged that the number of school nurses was currently below an adequate level. Funding had been allocated for 8 school nurses and recruitment was underway.

In response to a question regarding emergency care Jo explained that more services needed to directed locally and away from unnecessary hospital treatment.  Helen Seth explained that in addition to this better access would be needed, such as public transport.

A Member of the Committee expressed concern that existing dialysis service users of the Health service had not been consulted.  It was agreed that work needed to be carried out to include this group.

A Member stated that in 2007/08 the NHS organisation within LLR collectively made a surplus and was expected to do so again in 2008/09.  Malcolm Lowe-Lauri reported that the UHL had a current credit  balance of £500,000.  Concern was expressed that the surplus might have come from gaps in the services, as there were many areas  that needed the money, such as building improvements.  Malcolm noted that these areas were covered separately. UHL was investigating how it could access the national capital money previously identified by the Department of Health to begin to address estate concerns within UHL.

Helen Seth explained how the Next Stage Review would fit with the University Hospitals Leicester (UHL) emerging strategy, which would better serve the needs of the patients requiring acute hospital care. Helen reported that there would be work carried out with patients to enable them to access more care locally.  It was anticipated that people using hospitals would be in need of more specialist care.  It was often found that patients entering hospital had  not received the correct initial diagnosis.  The new provision would provide a single front door multidisciplinary access point to help rapidly diagnose symptoms.  This would enable patients to receive the correct care early on and in doing so help save money from unnecessary consultations and admissions.  An example of the importance of this change was identified in acute stroke, where early correct diagnosis could be a matter of life and death.  Additional early diagnosis training in multi stroke would also be given to GPs and publicised to the public.

The next step was for a period of extensive public engagement, and independent evaluation of feedback with the results shared in the autumn that would inform the way forward.  A Member of the Committee asked how the process would develop and how the Committee would fit into the process.  Jo Yeaman reported that this was contained in the next step.  Information would be gathered and evaluated by one of the universities to prevent any bias.  There would also be sub-committee reports from patient groups, work with Councillors and other organisations and 1400 groups would also be contacted over next three months.  Any updates could be brought back to the Committee in the Autumn as no definite timetable was available.

Jo reported that there was to be a ‘Happy Health Day’ to help inform people of services and to be used as part of the engagement programme.  It was hoped that the different services would co-ordinate on events.

There was an extensive amount of work being carried out to enable consultation with hard to reach groups.

A Member of the Committee asked for a definition of the difference between a consultation and an engagement.  In response it was explained that a consultation had a number of legal requirements and at the end of the process decisions needed to be made.  An engagement was to address if an issue needed to be taken forward and would lead to a possible debate and consultation.  If there was an impact on care or change in service delivery a  consultation would be needed.

RESOLVED:

1 that the Committee note the report.

2. that the outcome of the Next Steps consultation be presented

    to the Committee in the Autumn.

3. that a timetable of the process of the Next Stage Review be

    provided to the Committee.

4. That information be provided to the Committee on the scrutiny 

     of children’s mental health issues.