Agenda and minutes

Apologies for absence were presented on behalf of County Councillor K Bailey (Chair), Councillors J Jones and A Matthews of Blackpool Borough Council, and Councillor J Robinson of Wyre Borough Council.

*County Councillor AP Jones attended in place of County Councillor R Bailey for this meeting.

Members are asked to consider any disclosable pecuniary and non-pecuniary interests they may have to disclose to the meeting in relation to matters under consideration on the agenda.

County Councillor Michael Welsh disclosed a non-pecuniary interest in item 4 (Vascular Services Review) on the grounds that he was a member of the Governing Body of Lancashire Teaching Hospitals NHS Trust.

The minutes of the Joint Lancashire Health Scrutiny Committee meeting held on the 13 November 2012 were presented and agreed.

Resolved: That the minutes of the Joint Lancashire Health Scrutiny Committee held on the 13 November 2012 be confirmed and signed by the Chair.

The Chair welcomed guest speakers from the NHS:

·  Dr Jim Gardner, Medical Director, Lancashire PCT

·  Mr Simon Hardy, Consultant - Vascular Clinical Lead

·  Kathy Blacker, Network Director (Acting) - Cardiac and Stroke Network

·  Dr Hugh Reeve, Chair of Cumbria Clinical Commissioning Group

·  Mr Salman Desai, North West Ambulance Service

The report explained that at the Joint Health Scrutiny Committee on 24 July 2012 members had been presented with a report outlining proposals for the reconfiguration of vascular services across Lancashire and Cumbria.

The recommendation of the Vascular Clinical Advisory Group of the Lancashire and Cumbria Cardiac and Stroke Network was that one site should be in the north of the region due to geography and travelling distances. It was felt two sites were needed in the south of the network as the population coverage would be just over 2 million. All hospitals within the region were asked to submit bids should they wish to be nominated as a specialist vascular intervention unit working within the proposed vascular network.

Following a procurement process it was recommended that the specialist intervention centres should be located at Carlisle, Blackburn and Preston. These centres would undertake all major inpatient vascular work. Day case work and outpatients would continue in all local hospitals within the region.

Following a discussion at that meeting, members concluded that further information should be requested and a letter was sent to Dr Jim Gardner, Medical Director NHS Lancashire, setting out the information the Committee required for this meeting. The response from NHS Lancashire was attached at Appendix A to the report now presented.

Since the meeting on 24 July, University Hospitals Morecambe Bay Trust (UHMBT), who were unsuccessful in their tender submission, wrote to NHS Lancashire expressing their intention to challenge the procurement decision. A copy of their letter was attached at Appendix B to the report now presented.

A further meeting of this Committee had been planned for 25 September, but was postponed to allow the appeal process undertaken by UHMBT to take place. Details of the outcome of the appeal including further updates since the Committee met in July last year were attached at Appendix C to the report now presented.

Dr Gardner used a PowerPoint presentation which set out:

• what services would be provided through the proposed Vascular Network model;
• from which sites these services would be delivered; and
• the number of people expected to need/access those services over the course of a year.

A copy of the presentation is appended to these minutes.

In delivering the presentation Dr Gardner said that vascular surgery was now a specialism in its own right and that more technologies could be introduced at scale. It was recognised that there had to be a 'trade off' between specialist care and the need for patients to travel to access that standard of care. He drew a comparison with the high standards of specialist heart/cardiac care that were being delivered at Blackpool Victoria Hospital, which was now regarded as the best place  ...  view the full minutes text for item 4.

At the Joint Health Committee on 13 November 2012 officers from the Lancashire Mental Health Commissioning Network Team gave a short presentation about the consultation on dementia care services that was to begin on 3 December 2012 and run to 25 February 2013.

Janice Horrocks, Lancashire Mental Health Commissioning Network Team accompanied by Dr Amanda Thornton, Clinical Lead for the Dementia Case for Change now attended this meeting to provide members with a verbal update on the progress of the consultation on dementia care services, and to discuss the formal 'sign off' process.

She began by drawing the Committee's attention to a document that had been circulated round to them by email from 'Lancaster and Morecambe Mental Health Clinicians for Older People' which was a response to the Dementia Care Services Consultation. Janice Horrocks pointed out it was unclear who the author of the document was, that it contained inaccuracies, and that it was known that some of the team to whom it was attributed were supportive of the proposals for Dementia Care Services. The document itself had not yet been submitted to the Consultation team who had become aware of it via this Scrutiny Committee.

She emphasised that the proposals were about shifting resources away from the provision of hospital beds to support for the provision of specialist assessment and treatment as close as possible to where people were living.

There was some discussion about the two options proposed in the Consultation both of which would cost £15 million to fund:

• Option 1 proposed 30 inpatient beds at the Harbour in Blackpool at a cost of £4m, with £11m for community services;

• Option 2 proposed 20 beds at the Harbour in Blackpool and 20 beds at Royal Blackburn Hospital at a cost of £8m, with £7m for community services. 

The Consultation which set out the options proposed in detail can be accessed via the link below (scroll down to the bottom of the page for the document):

http://www.lancashirementalhealth.co.uk/

The agenda and minutes of JHSC meeting held 13 November 2013 at which an update on Mental Health Inpatient Reconfiguration was presented including an initial presentation about the Consultation can be accessed via the link below:

http://council.lancashire.gov.uk/ieListDocuments.aspx?CId=684&MId=2035&Ver=4

It was reported that there had been just 233 hospital admissions in 2012 and it was expected that the numbers would fall yet further. It was recognised that disruption to a dementia sufferer's routine for as little as two days could lead to a real struggle to then get them back into a routine.

One member raised concern about the ability to predict the need for beds in the future as vascular dementia as well as age-related dementia had to be taken into account.  The Committee was assured that the provision of beds had been "future-proofed" and that the numbers had been very carefully considered. The National Commissioning Advisory Team (NCAT) had also looked very carefully at the proposals and were supportive. This was seen as an opportunity to put money  ...  view the full minutes text for item 5.

An item of urgent business may only be considered under this item where, by reason of special circumstances to be recorded in the minutes, the Chair of the meeting is of the opinion that the item should be considered at the meeting as a matter of urgency. Wherever possible, the Chief Executive should be given advance warning of any Member's intention to raise a matter under this heading.

No urgent business was reported.

To be arranged as and when required.

The next meeting of the Joint health Scrutiny Committee would be scheduled as and when required.