The Monitoring Officer to report on the receipt of any questions, representations and statements of case submitted in accordance with the Council’s procedures.
Minutes:
The Monitoring Officer reported that no questions, representations and statements of case had been submitted in accordance with the Council’s procedures.
The Chair indicated that she had allowed the following questions submitted at late notice by Mr Robert Ball (Campaign Against NHS Privatization) to be received by the Commission:-
1. In proposed reconfigurations elsewhere in England, pre-business consultations have been submitted to the health overview and scrutiny Committee for analysis and discussion as part of the NHS’ statutorily required consultation with the Committee. When will the Better Care Together pre-business consultation case come before a meeting of the Leicester Health and Wellbeing Scrutiny Commission so that the BCT leads have the opportunity to respond to the advice given by the Scrutiny Commission before formal public consultation begins and so that the public have access to up-to-date information? We do not consider any further attempts on the part of Better Care Together leads to provide briefings "in private" to the Commission to be acceptable.
2. What steps are the Better Care Together team taking to avoid misleading the public about the scale of proposed bed closures by referring to care given in patients' own homes as "beds"?
3 How has the Better Care Together team built into its proposals evidence that home delivered care typically does not reduce unplanned hospital admissions and can even increase them, with additional implications for the financial case?
4
Are answers to the questions tabled in the August scrutiny meeting
now available?
The following responses were then circulated to everyone present at the meeting:-
QUESTION 1 - RESPONSE FROM THE PROGRAMME DIRECTOR, BETTER CARE TOGETHER
The pre-consultation business case is presently being reviewed by NHS England and the governing bodies of the BCT partner organisations. Until that process is complete and the CCGs and NHS England give approval for consultation to commence the document remains “work in progress” as it may well change. Once the programme has approval to move to consultation and the document is finalised it will be submitted to all three scrutiny committees. Briefings have already been provided to all three committees and will continue to be so. It will also be published for public information at the initiation of the consultation process. It is not possible to provide a date at this stage when this will take place as the assurance process continues.
QUESTION 2 - RESPONSE FROM THE PROGRAMME DIRECTOR, BETTER CARE TOGETHER
There is no intention to mis-lead and the reconfiguration of inpatients services and the shift to care in the community and home based settings will be absolutely transparent in the PCBC and the public consultation with proposed numbers throughout. The pre-consultation business case will contain a section describing changes in system capacity and will include a description of how provision of intensive community support (ICS) services in peoples own homes will over time replace the requirement for a number of beds in hospitals. The term “beds” is used to make the differentiation to general community care. The ICS ‘beds’ function much more like hospital beds; intensive support, short lengths of stay, defined small groups of patients supported by a small defined nursing and therapy team. The ICS service is already functioning and will be enhanced and as a result will provide the facilities for patients who wish to, to rehabilitate in their own homes where there is evidence they recover quicker. The system will maintain its capacity to care for patients but in a different way.
QUESTION 3 - RESPONSE FROM THE PROGRAMME DIRECTOR, BETTER CARE TOGETHER
BCT has been guided by The Reconfiguration of Clinical Services, an evidence based review by the Kings Fund, which looked at the drivers of reconfiguration and the underpinning evidence. It builds on a major analysis commissioned by the National Institute for Health Research (NIHR) and reviews of service reconfigurations conducted by the National Clinical Advisory Team (NCAT). The Kings Fund report concluded that there is strong patient satisfaction associated with virtual ward programmes and case management programmes. Available evidence points to a positive impact of integrated care programmes on the quality of patient care and improved health or patient satisfaction outcomes. Patients are more satisfied with hospital at home than with inpatient care because it was possible to provide a more personal style of care and staying at home was considered to be more therapeutic. The Kings Fund also found that there is mixed evidence on the capacity of community based initiatives to reduce unplanned hospital admissions and help keep people at home. As such, the expansion of the home based intensive community support service proposed by BCT will be predominantly targeted at step-down from acute hospital and not admission prevention.
QUESTION 4 – RESPONSE
A response to this question from the Chair was sent to Mr G Whittle, Campaign Against NHS Privatization on 22 September 2015. Mr Whittle had asked the question at the August Commission meeting. Mr Ball has been provided with a copy of the response.