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External Services Scrutiny Committee th Tuesday 15 July 2008 .................... 6.00 pm.* Committee Room 4, Civic Centre, Uxbridge *NB: the Committee will break at 7pm. for 15 mins. Committee Membership: Councillors Mary O’Connor (Chairman) Peter Kemp Shirley Harper-O’Neill (Vice Chairman) Michael White Phoday Jarjussey Contact Officer: David Coombs Telephone: 01895 250 833 Democratic Services Facsimile: 01895 277 373 Civic Centre E-mail: [email protected] High Street Uxbridge, UB8 1UW .................. Members of the public are welcome to attend the meeting and listen to the discussion in Part 1 of the Agenda. This Agenda is available online at http://www.hillingdon.gov.uk/central/democracy/comm_reports/index.php Please ensure that all mobile phones are switched off DESPATCH DATE: 7th July 2008 Lloyd White Head of Democratic Services London Borough of Hillingdon, Civic Centre, High Street, Uxbridge, UB8 1UW www.hillingdon.gov.uk External Scrutiny About this Committee This Committee will scrutinise services provided by non-Council organisations in the Borough including the public, private and voluntary sector. This Committee will also undertake the health scrutiny role required by the Health & Social Care Act 2001. This Committee will have the power to identify areas of concern to the community and instigate an appropriate review process. It will report its findings to Cabinet, highlighting issues of concern for Hillingdon residents. Lloyd White Head of Democratic Services London Borough of Hillingdon, Civic Centre, High Street, Uxbridge, UB8 1UW www.hillingdon.gov.uk EXTERNAL SERVICES SCRUTINY COMMITTEE 15.07.08 AGENDA PART 1 – MEMBERS, PUBLIC AND PRESS i.) Apologies for absence and to report the presence of any substitute members ii.) Declarations of Interest in matters coming before this meeting iii.) Notes of the previous meetings – 17th June 2008 iv.) Exclusion of Press and Public - To confirm that all items marked Part 1 will be considered in public and that any items marked Part 2 will be considered in private 1. Hillingdon PCT’s Provider Services Page 1 a) new governance arrangements b) proposed transfer of services to the Council’s Children’s Centres At the end of item 1 at approximately 6.55 pm the Committee will break to enable the Chairman to present a report on the Healthcare for London Joint Overview & Scrutiny Committee (JOSC) to Cabinet. The Committee will reconvene for the remaining items at approximately 7.15 pm. 2. East & North Hertfordshire NHS Trust Page 4 Application for Foundation Trust status and the implications for Mount Vernon Cancer Centre 3. Work programme 2008/9 Page 6 PART 2 – PRIVATE, MEMBERS ONLY i.) Any Business transferred from Part 1 GLOSSARY FT Foundation Trust JOSC Joint Overview & Scrutiny Committee PCT Primary Care Trust Terms of Reference 1. To undertake the powers of health scrutiny conferred by the Health and Social Care Act 2001, including: (a) scrutiny of local NHS organisations by calling the relevant Chief Executive(s) to account for the work of their organisation(s) and undertaking a review into issues of concern; (b) consider NHS service reconfigurations which the Committee agree to be substantial, establishing a joint committee if the proposals affect more than one Overview and Scrutiny Committee area; and to refer contested major service configurations to the Independent Reconfiguration Panel (in accordance with the Health and Social Care Act); (c) respond to any relevant NHS consultations. 2. To scrutinise the work of non-Hillingdon Council agencies whose actions affect residents of the London Borough of Hillingdon. 3. To identify areas of concern to the community within their remit and instigate an appropriate review process. External Services Scrutiny Committee 17th June 2008 Action Notes Members present: Cllrs Mary O’Connor (Chairman), Shirley Harper-O’Neill, Phoday Jarjussey, Peter Kemp and Michael White. Other Members present: Cllrs Philip Corthorne, Judith Cooper and John Major. NHS officers/witnesses present: • Yi-Mien Koh: Chief Executive, Hillingdon PCT (items 1 & 2) • Kevin Mullins: Director, Out of Hospital Commissioning, Hillingdon PCT (items 1 & 2) • David Searle: Director of Corporate Development, Hillingdon Hospital (item 1 only) • Dr Mitch Garsin: Chair of the Hillingdon Local Medical Committee (item 1 only) LB Hillingdon officer present: David Coombs Declarations of Interest – none Notes of the meeting held on 22nd April 2008 - agreed as an accurate record Exclusion of the press and public – it was agreed that all items of business were considered in public. 1. Developing a strategy for Hillingdon’s health services post Action by: Healthcare for London consultation Yi-Mien Koh outlined the work the PCT is undertaking to develop a strategy for providing health services in Hillingdon. She said that the strategy will follow the themes of Lord Darzi’s Healthcare for London framework, in particular the mantras of ‘centralise where necessary, localise where possible’ and ‘prevention is better than cure’. The strategy will seek to: • Provide a greater proportion of health care in the community than at present. • Improve partnership working between the PCT and Council, both in terms of closer working between ‘health’ and ‘social’ care and on the wider ‘health and well-being’ agenda (i.e. encouraging people to lead healthier lifestyles). • Address health inequalities in the Borough and ensure services are focused on areas with greatest need. - 1 - In response, Dr Garsin said that GPs support many of these aims, including the greater integration of primary and secondary care, and the provision of more health care in the community. However, Action by: GPs have deep concerns about ‘polyclinics’. Dr Garsin highlighted a recent survey undertaken by the Local Medical Committee (LMC) which demonstrates high public satisfaction (over 80%) with the service Hillingdon GPs currently provide. GPs believe these results question the public’s demand for longer GP opening hours. In addition, extending GP opening hours could encourage more people to visit thier GP instead of self-managing their condition as at present. This could place unaffordable pressures on primary care. Dr Garsin added that the extent of public support for the BMA’s petition to oppose polyclinics provides a better indication of public opinion than the much smaller number of responses to the Healthcare for London consultation. Dr Garsin said that the public and GPs are worried that polyclinics could undermine the personal relationship with a ‘local’ GP, particularly if private sector organisations are awarded contracts to operate polyclinics. Dr Garsin stated that there has been limited investment in Hillingdon’s GP surgeries in the last four years and expressed concern that GPs in ‘decaying’ surgeries could be pressured into moving to new polyclinics. In response, Kevin Mullins stated that the PCT is sensitive to the views of GPs and key partners such as Hillingdon Hospital and the Council. He said that the PCT is committed to engaging stakeholders prior to a strategy being finalised for consultation. The Chairman offered the opportunity for the representatives of Hillingdon Hospital and the Council to comment. David Searle said that the Hospital agrees with the PCT that patients must be treated in the most appropriate setting, and the Trust is already working with the PCT on a number of initiatives including the Urgent Care Centre and CATS. He added that any strategy for the future of Hillingdon’s health services must consider the implications for the whole Hillingdon health economy. Cllr Corthorne said that it is hard for the Council to comment until further detail is available but welcomed the opportunity to bring health and social care services closer together. He added that the PCT must engage elected Members in the process of developing the strategy. Members supported the proposal to bring health and social care closer together and highlighted that in the past the Council or PCT had sometimes taken decisions in isolation. - 2 - Members highlighted that the public are supportive of their local GP services and any strategy for improving Hillingdon’s health services should focus on supporting existing good practice rather Action by: than starting from the opposite angle of imposing a set solution (polyclinics) that could undermine existing strengths. Following Dr Garsin’s earlier comments, Members sought further information on the quality of GP surgeries in Hillingdon. Dr Garsin responded that approximately 5-10 surgeries are located in poor quality premises which cannot be modernised. However, he believes the remaining 80-90% of GP surgeries in Hillingdon could be retained and physically improved so that they are equipped to provide excellent services. Kevin Mullins added that the PCT will be examining the condition of GP surgeries in Hillingdon as part of the work to develop the healthcare strategy. Members reminded the PCT of the importance of ensuring primary care accommodation meets access requirements. Members stated that it would be important to continue to monitor the quality of care provided across GP services in Hillingdon, particularly if a variety of organisations were to run polyclinics. It was noted that the PCT is continuing to develop methods for performance managing independent contractors, but services may differ slightly across the Borough in response to local need. Dr Garsin added that GPs working together under a federated model would be more preferable than polyclinics; closer working in a ‘federation’ would enable GPs to maintain links with the local community whilst reducing some of the concerns around the service provided by single-handed GPs. Members noted that Healthcare for London is only a vision and proposals for developing health services in Hillingdon will need to consider where the capital and revenue funding to deliver new services will come from. In response to the issues raised above, Yi-Mien Koh said that the concept of polyclinics is not new: there are already health centres in Hillingdon which house a number of GPs and provide a range of additional primary care services.

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