Agenda item

The Monitoring Officer to report on the receipt of any questions, petitions, or statements of case in accordance with the Council’s procedures.

The following questions have been received in accordance with Part 4E: Scrutiny Procedure Rules (Rule 10) of the constitution.

Tom Barker

What actions will the committee be taking to scrutinise the detailed calculations underpinning UHL's decision that no additional hospital beds will be needed for the growing population of Leicester, Leicestershire and Rutland for the coming years even though we already don't have enough beds to meet patient need?

Peter Worrall

What plans have the Joint Health Scrutiny Committee for scrutinising the UHL plans for reconfiguration of acute services and how can the committee ensure UHL follows its recommendations, given that the plans have already been drawn up in detail although these details have not been shared with the public?

Katy Wheatley

Will the joint scrutiny committee be examining whether the capacity planning in UHL’s acute reconfiguration proposals adequately take into consideration the growth plans across Leicester, Leicestershire and Rutland and increased numbers of dwellings and residents in the coming years?

Kathy Reynolds

How does the JHOSC plan to collect the evidence that will assure both the JHOSC and the public that STP/UHL plans for reconfiguration involving a capital bid for £367m will meet the future needs of the Leicester, Leicestershire & Rutland community?  I am particularly concerned that at the recent engagement events it became clear that the UHL Plan was reliant on changes within community and primary care to allow it to deliver. However, the Community / Primary Care Plan is not available nor has the associated engagement has taken place, raising questions about the assumptions behind UHL’s Plan. Does the JHOSC have a work plan or are they planning a programme of work to assure the public and can we be appraised of the arrangements?

Additional questions:

Further questions (as attached)  were submitted in accordance with the Scrutiny Procedure Rules (Part 4E) Rule 10 of the Constitution but were received too late to be included on the agenda.  

The following questions had been received in accordance with Part 4E: Scrutiny Procedure Rules (Rule 10) of the Council’s constitution. The Chair advised that she would respond to the questions collectively.

Tom Barker submitted the following question and advised in advance of the meeting that his representative, Mr Steve Score would ask the question on his behalf.

What actions will the committee be taking to scrutinise the detailed calculations underpinning UHL's decision that no additional hospital beds will be needed for the growing population of Leicester, Leicestershire and Rutland for the coming years even though we already don't have enough beds to meet patient need?

Peter Worrall

What plans have the Joint Health Scrutiny Committee for scrutinising the UHL plans for reconfiguration of acute services and how can the committee ensure UHL follows its recommendations, given that the plans have already been drawn up in detail although these details have not been shared with the public?

Katy Wheatley

Will the joint scrutiny committee be examining whether the capacity planning in UHL’s acute reconfiguration proposals adequately take into consideration the growth plans across Leicester, Leicestershire and Rutland and increased numbers of dwellings and residents in the coming years?

Kathy Reynolds

How does the JHOSC plan to collect the evidence that will assure both the JHOSC and the public that STP/UHL plans for reconfiguration involving a capital bid for £367m will meet the future needs of the Leicester, Leicestershire & Rutland community?  I am particularly concerned that at the recent engagement events it became clear that the UHL Plan was reliant on changes within community and primary care to allow it to deliver. However, the Community / Primary Care Plan is not available nor has the associated engagement has taken place, raising questions about the assumptions behind UHL’s Plan. Does the JHOSC have a work plan or are they planning a programme of work to assure the public and can we be appraised of the arrangements?

The Chair responded to the questions raised as follows:

The Joint Scrutiny Committee was committed to continued scrutiny of the Better Care Together (BCT) Plan. The Scrutiny would take place within their meetings but also, with such a large programme of work, be delegated to the separate Local Authority Health and Wellbeing Scrutiny Commissions.

It was agreed at the meeting on 28 September 2018 that the BCT plan would remain a standing item on the agenda and updates are anticipated at every meeting.

The Committee would continue to pursue work around the proposals for UHL reconfiguring and agreed as to the importance of looking at capacity planning alongside population growth plans and forecasts of future health needs both within the UHL reconfiguration plans and the broader BCT plan. She had no doubt that public engagement would be a priority for the CCGs and other NHS services going forward and the Committee would continue to push for assurances that this would remain.

Scrutiny would also fulfil its role as it had been doing in the interests of all residents across its footprint.

With reference to the Peter Worrall’s specific point as to how the Committee could ensure that the UHL followed its recommendation, the reality was that the Committee could not ensure this; they were just recommendations. However, one thing that would come out of this meeting’s discussions was that the Committee would want to see evidence that they were being listened to.

The following questions were also received in accordance with the Scrutiny Procedure Rules (Part 4E) Rule 10 of the Constitution but were received too late to be included on the agenda.  

Questions from Giuliana Foster

At the Special Joint HOSC on 28 September 2018 it was recommended that the CCGs and UHL undertake public consultation before continuing with the proposals to reconfigure Level 3 ICU beds and associated dependent services. Additionally, it was requested that UHL Trust and the CCGs provided further information and regular updates to the JHOSC. 

1. Disappointingly public consultation was not undertaken, what can the JHOSC do to ensure that in future the public will be properly engaged with and consulted when legally necessary? 
2. Has UHL & the CCGs provided the Committee with a detailed project plan for the relocation of services as requested? Can it be put into the public domain?
3. Has UHL & the CCGs provided regular updates on the progress of works and any variations to the plans. Again can it be put into the public domain?
4. Has UHL &/or the CCGs met with the Committee or its representatives to discuss any concerns raised about the implementation of the proposals?
5. Has UHL & the CCGs provided the Committee more detailed information around the sustainability of existing services at the Leicester General Hospital once the Level 3 services have been removed. Again, can it be put into the public domain?
6. Public engagement on the major reconfiguration plans has taken place. Across the city and counties there was disappointment expressed in the content of engagement events also turnout was low at many events. Are the JHOSC satisfied that engagement was adequate?

The Chair stated that she would respond to questions number one and six.  Mr John Adler, Chief Executive UH, then responded to questions numbers two to five.

The Chair’s response was as follows:

Ms Foster rightfully stated that at the meeting on 28 September 2018, the Committee voted to recommend that the UHL and CCGs undertook public consultation, but the Committee also clarified that it was not its position to insist upon this. This stance was taken after the Committee received its own legal advice from the City’s legal team and was explored in the course of the meeting.

The Chair said that she was pleased that following their recommendations, the public conversation / engagement had started again. The Committee had a paper today to discuss the recent engagement sessions and she hoped that these sessions became the norm going forward.

The Committee expected to be kept up to date as plans for the reconfiguration continued and as they had said before, and as UHL and the CCGs had assured members, that when they are in a position to progress plans following funding decisions from NHS England, there would be an expectation that they would go to formal public consultation. The Committee hoped that they would continue to engage with the public and look to the individual authorities for guidance to what good consultation looked like.

Mr John Adler, Chief Executive, UHL responded to the remaining questions as follows:

Q2:  A detailed document of at least 200 pages was presented in public to the CCGs Board in June and July 2018 and was therefore already in the public domain.

Q3:  An update on the project’s progress is taken to the public board meetings every month. The IT project was already under way and he would be happy to provide an update on that during the meeting, if required. Updates could be brought to the Committee if Members so wished.

Q4: The UHL and CCG had not met with the Committee but had been holding briefing sessions as part of their engagement work with Councillors. He appreciated that this was not the same as the formality of a Scrutiny Committee meeting.

Q5: Details were included in the information that went to the CCGs Board meeting, but they would be happy to bring something to the Committee if Members so wished.