Agenda item

The Health Scrutiny Committee has held a series of meetings to discuss the issues arising from the temporary closure of the Emergency Department at Chorley Hospital.

Further to the meetings held on the 26April and 24 May 2016, this third meeting focussed on the long term sustainability of health services within the county and discussed how the Clinical Commissioning Group and partners would design, consult and deliver new models of care.

The Chair welcomed the following speakers to the meeting to contribute to the discussion:

·  Andrew Birchall, Protect Chorley Hospital against cuts and privatisation campaign

·  Sam Nichol, Healthier Lancashire and South Cumbria Change Programme

·  Jayne Mellor, Head of Planning and Delivery and Matt Gaunt, Finance Officer, Chorley, South Ribble and Greater Preston Clinical Commissioning Group

Andrew Birchall, Protect Chorley Hospital against cuts and privatisation campaign, provided an overview to the Committee on the ongoing campaign concerning the temporary closure of Chorley Hospital A&E Department.

It was reported that campaigning has taken place outside Chorley Hospital every Saturday morning since the temporary closure of the A&E department and would continue until the service was reinstated.  In addition, a recent march for the campaign attracted reported numbers of around 3000 people.

Members were advised that it was understood that the remodelling of healthcare services in the future was required and that it should be driven and shaped by the needs of the community and the most vulnerable.

Members of the Committee commented on their acknowledgment of the campaign were invited to comment and raise questions and a summary of the discussion is set out below:

·  It was reported that the campaign may be ongoing as the focus and remit of the campaign around the cuts and privatisation encompasses the NHS as a whole. 

·  The public meetings would help to shape how this campaign could be moved forward.

·  It was reported that campaign leaders were not forewarned of the temporary closure. 

Sam Nicol, Healthier Lancashire and South Cumbria Change Programme provided a presentation to members to update on the progress of the programme and the next steps around the Case for Change.

The presentation (which is appended to the minutes) included information on the following:

·  From a meeting held with health and care leaders in November 2015, it was agreed that there was a need for a different approach to ensure sustainable health services and to deliver outcomes which addressed the local population challenges on a Lancashire and South Cumbria footprint.

·  There were reported to be a number of improvement plans in place and organisations were keen to understand the consistency, gaps and interdependencies in those plans.

·  Gaps identified included health and wellbeing, care and quality, finance and efficiency.  From these, a number of priorities were determined such as prevention (which would be the main focus), urgent and emergency care and the mental health transformation.

·  The Joint Committee/Programme Board infrastructure would enable solution design, share learning and good practice and engagement with public, staff, elected members and key stakeholders.

Members were informed that there would be engagement with stakeholders and the general public in the next month on the Case for Change and the next steps.

Members of the Committee were invited to comment and raise questions and a summary of the discussion is set out below:

·  It was confirmed that there was a timeline in place and were currently in the strategic planning phase establishing the infrastructure and resources.  The Case for Change would be the final part of that phase.  The solution design phase would then commence but may evolve and continue throughout the implementation phase.  From December onwards, formal consultation would take place if required for commencement in the new financial year.

·  Development around the Health and Wellbeing Partnerships was reported to be continuing with ongoing discussions around proposals for one Health and Wellbeing Board across Lancashire.

·  In answer to the question around prevention of isolation, it was agreed that there was a need for services to be more creative through use of community groups and other mechanisms.  It was felt that the planned engagement with the public, workforce and stakeholders would influence this area of work.

·  Members were assured that there was a robust process for consultation on the plan to engage all stakeholders and the general public.

Jayne Mellor, Head of Planning and Delivery and Matt Gaunt, Finance Officer, Chorley, South Ribble and Greater Preston Clinical Commissioning Group provided members with a presentation (appended to the minutes) on 'Our Health Our Care – Integrated Health System'. 

Highlights from the presentation included:

·  Current status on the Case for Change where it was reported to be recognised that integration was a key requirement and a need for health to work as one economy.

·  Services were reported to be seen as very complex to navigate and fragmented.

·  Key areas within the programme included prevention, early help and self-care, integrated localities and in hospital care.

·  Details were provided on the three integrated localities (Chorley, South Ribble and Preston) and the 10 service planning areas where a mapping exercise of GP practices for registered population numbers had been completed against those planning areas.

·  Next steps would be to understand the demographic population health needs and a redesign of services with engagement from the local communities.

·  The new models of care to then be developed by the end of 2016.

Members of the Committee were invited to comment and raise questions and a summary of the discussion is set out below:

·  It was agreed that there was a need to understand information around services provided through GP practices.  The coproduction and engagement in the remodelling exercise would assist in informing those service requirements.

·  Members were informed that the Integrated Diabetes Service had been built into primary care services and would be implemented this year.

·  In answer to a question on impact to neighbouring health providers, it was agreed that there was a need to engage effectively and would take this suggestion back for further discussion.

·  It was confirmed that the full EU procurement process had been completed for two urgent care centres to support Chorley and Preston A&E's and were currently in the final stages of moderation for the outcome in the next four weeks.

·  In relation to the temporary closure of Chorley A&E, it was suggested that the Chair should write to neighbouring Trusts to ascertain the number of people with 'PR' postcodes now attending their A&E departments compared to the same period last year.

Resolved: That,

  i.  Information presented to the Committee be noted;

  ii.  The Chorley, South Ribble and Greater Preston Clinical Commissioning Group  provide further updates to this Committee on the process of change in relation to 'Our Health, Our Care'

  iii.  Healthier Lancashire provide an update report on the Case for Change to the 26 July 2016 meeting of this Committee;

  iv.  The Health Scrutiny Steering Group produce a draft report on the findings from the information received at the last three Health Scrutiny Committee meetings with recommendations to be ratified at the 26 July 2016 meeting of this Committee;

5. That the Chair of the Committee be requested to write to neighbouring Trusts to ascertain the number of people with 'PR' postcodes now attending their A&E departments compared to the same period last year.