Councillors and committees

Agenda and minutes

Venue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN. View directions

Contact: Leah O'Donovan 

Items
No. Item

1/13

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

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    Minutes:

    Apologies were received from Alan Young and Nicky Lee.

2/13

MINUTES OF THE PREVIOUS MEETING: pdf icon PDF 54 KB

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    To agree the minutes as a true record of the meeting.

    Minutes:

    The minutes were agreed as an accurate record of the meeting.

3/13

DECLARATIONS OF INTEREST

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    To receive any declarations of disclosable pecuniary interests from Members in respect of any item to be considered at the meeting.

     

    Notes:

    ·    In line with the Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012, declarations may relate to the interest of the member, or the member’s spouse or civil partner, or a person with whom the member is living as husband or wife, or a person with whom the member is living as if they were civil partners and the member is aware they have the interest.

    ·    Members need only disclose interests not currently listed on the Register of Disclosable Pecuniary Interests.

    ·    Members must notify the Monitoring Officer of any interests disclosed at the meeting so they may be added to the Register.

    ·    Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest.

    Minutes:

    No declarations

4/13

QUESTIONS AND PETITIONS

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    To receive any questions or petitions.

     

    Notes:

    1.  The deadline for Member’s questions is 12.00pm four working days before the meeting (Friday 18 January 2013).

    2.  The deadline for public questions is seven days before the meeting (Thursday 17 January 2013).

    3.  The deadline for petitions was 14 days before the meeting, and no petitions have been received.

    Minutes:

    None received

5/13

CHAIRMAN'S ORAL REPORT

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    The Chairman will provide the Committee with an update on recent meetings he has attended and other matters affecting the Committee.

    Minutes:

    Southwest London JHOSC

    The Southwest London joint Health Overview & Scrutiny Committee met on 12 December to discuss the inclusion of Epsom Hospital into the Better Services, Better Value review following the halting of the merger that we will be looking at in-depth today. NHS southwest London is looking again at all options and will report back to the JHOSC in due course with its preferred option. The aim was to begin consultation after Easter but as this will be during the purdah period it may have to be pushed back to after the election. I will keep you updated on the timetable.

     

    BSBV Stakeholder Event

    On 15 January I attended a stakeholder consultation event for BSBV at Epsom Downs. The proposals still include only three A&Es across now five hospital sites, with one site without an A&E hosting a planned care centre. I, along with other key stakeholders, provided important feedback to the BSBV programme on the concerns we have for the residents of Surrey should the option to remove the A&E from St Helier and Epsom be the preferred one. Colin and I will continue to voice these concerns during the upcoming JHOSC meetings.

     

    Visits to SECAmb Headquarters

    On 4 and 15 February there are visits scheduled to SECAmb’s headquarters in Banstead. The purpose of these visits is to show those that have not seen how vehicles are managed and dispatched or for those that have, to have a refresh. This is to ensure that we are well-informed when they attend our March meeting to discuss their performance in more detail. I would encourage you to attend one of these visits if you have not been to their HQ before.

     

    CQC Inspections

    In November, two of the Council’s own residential homes for older people were inspected by the Care Quality Commission. They did not receive favourable reports and an enforcement notice was served at Cobgates, Farnham, in relation to keeping accurate care records. I sought assurances from the Strategic Director of Adult Social Care about the matter and she has responded. There is a management plan in action to resolve these issues and the Directorate continues to strive for excellent services. Another unannounced CQC inspection took place in the beginning of January and Cobgates was deemed compliant.

6/13

REVIEW OF EPSOM HOSPITAL MERGER pdf icon PDF 43 KB

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    Purpose of report: Scrutiny of Services

     

    The Committee will scrutinise the failed merger of Epsom Hospital with Ashford & St Peter’s Hospitals NHS Foundation Trust.

    Additional documents:

    Minutes:

    Declarations of Interest:

     

    None.

     

    Witnesses:

     

    Matthew Hopkins, Chief Executive, Epsom & St Helier University Hospitals NHS Trust

    Jan Sawkins, Independent Chair, Epsom & St Helier Transaction Board

    Peter Cook, Programme Director, Epsom & St Helier Transaction Board

    Bob Peet, Director of Special Projects, Ashford & St Peter’s Hospitals NHS Foundation Trust

    Miles Freeman, Chief Officer, Surrey Downs CCG

    Karen Parsons, Chief Operating Officer, Surrey Downs CCG

    Diane Hedges, Better Services Better Value lead for Surrey Downs CCG

    Rachel Tyndall, Senior Responsible Officer, Better Services Better Value Programme

     

    Key Points Raised During the Discussion:

               

    1.    The Chairman began by setting out the concern of the Committee about the failed merger between Epsom Hospital (“Epsom”) and Ashford & St Peter’s Hospitals (“ASPH”) and its wish to understand why this had happened.

     

    2.    The Independent Chairman of the Transaction Board reported that it had not anticipated when the Transaction Board last updated the Committee that the merger would fail.. In outlining the history of the transaction it was explained that obtaining Cooperation and Competition Panel (CCP) approval at stage 1 on 12 September 2012 had been a very significant achievement.  After this Deloitte had continued their investigations and concluded their work on the merger. It was emphasised that stakeholder support for the proposed merger especially that of Surrey residents could not have been stronger.

     

    3.    Subsequent to stage 1 approval ASPH had also engaged in further financial work. This work resulted in a reduction in their proposed synergies downwards at year 5 from £14.0m to £10m (£8.8m at the five year point) and a projected increase in on–costs from £1.2m at year 5 to £5.m (due mainly to the inclusion of capital costs). At around this time there was also uncertainty concerning Surrey Downs CCG and its commissioning intentions whilst the Better Service Better Value (BSBV) preferred option made public in  August 2012 included the repatriation of south west London orthopaedics from the Elective Orthopaedic Centre at Epsom Hospital (“EOC”) to St Helier Hospital. .It was noted that the impact of this BSBV option on Surrey residents was a concern for Members.

     

    4.    In conclusion four factors were identified as having led to the failure to agree a credible financial case for approval of the merger, the size of the deficit at Epsom which was £5.4m at the five year point after transitional funding, the reduction in ASPH synergies and increased costs, uncertainty over Surrey Downs CCG commissioning intentions and the potential impact of BSBV. It was explained that NHS South of England (NHSSoE) had considered the requirement for transitional funding too great whilst BSBV was now delayed pending further discussion between NHS South West London (NHSSWL) and Surrey CCG’s These factors had together led to the decision of NHS London on 25 October 2012 to halt the merger with urgent discussions to follow to progress matters.

     

    5.    Members raised questions concerning the allocation of the deficit between Epsom and St Helier Hospital and whether the Trust felt that the Deloitte’s figures were accurate in this regard and  ...  view the full minutes text for item 6/13

7/13

PERFORMANCE AND QIPP UPDATE pdf icon PDF 36 KB

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    Purpose of report: Scrutiny of Services

     

    The Committee will scrutinise performance against QIPP savings targets and national performance indicators.

    Additional documents:

    Minutes:

    Declarations of Interest:

     

    None.

     

    Witnesses:

     

    Justin Dix, Acting Director of Governance, Transition and Corporate Reporting, NHS Surrey

    Malachy McNally, Director of Finance, NHS Surrey

     

    Key Points Raised During the Discussion:

               

    1.    The Acting Director of Governance, Transition and Corporate Reporting apologised to Members that no recent performance Report was available due to staffing problems and stated that information would be sent to the Scrutiny Officer for circulation. A brief outline was given at the meeting and it was reported that performance is good against QIPP and performance targets. There were some difficult issues to deal with such as Norovirus ( East Surrey Hospital in particular has had problems with this  which were being addressed) and the recent snow but transport arrangements had been good and very well supported with the assistance of the volunteer 4x4 drivers.

     

    2.    The Performance function was now passing to CCG’s and they were becoming engaged and were establishing good relations with acute services.  It was reported that there did not seem to be any impact on performance during the transitional period.

     

    3.    Members were informed that it was anticipated that The Francis Report which was due to be published on 5 February 2013 would be very important to the future management and expectations as far as care quality is concerned. The implications of this Report would be discussed at the final NHS Board meeting in March 2013.

     

    4.    Members asked whether there were any financial issues they should be aware of which may affect the ability to meet savings targets and if they were not met what the impact of this would be. It was reported that there was some slippage and concern in some areas (for example at the Ashford & St Peter’s A $ E) but that it was hoped the CCG’s would deliver and it was considered that they have developed clear, robust plans to do so. It was explained that the CCG’s have had a 2.3% uplift to their budgets but levels of inflation and growth meant that this is sometimes seen to be a reduction in budgets. Members were concerned as to the impact on services that may arise from meeting savings targets. It was stated that each plan had implications and choices would have to be made with budget allocations but that CCG’s were collaborating together as a Surrey wide group which was encouraging for Surrey residents.

     

    Recommendations:

     

    1.    The witnesses were thanked for their attendance today and their assistance to Members.

     

    2.    Members were supportive of all efforts made to seek to meet QIPP targets and performance objectives but were keen to ensure services to Surrey residents were appropriately. maintained during the transitional period and beyond and that all  efforts were sustained to meet  challenging objectives.

     

    3.    Members to be provided with a guide to the measures on infection control required by hospitals and noted that there is much agreement on best practice.

8/13

RECOMMENDATION TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 34 KB

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    Purpose of report: Scrutiny of Services

     

    The Committee is asked to monitor progress on the implementation of recommendations from previous meetings, and to review its Forward Work Programme.

    Additional documents:

    Minutes:

    Declarations of Interest:

     

    None.

     

    Witnesses:

     

    Leah O’Donovan, Scrutiny Officer, Democratic Services

     

    Key Points Raised During the Discussion:

     

    1.    The implications and issues arising from The Francis Report to be included in the Work programme for future consideration.

     

    2.    A series of meetings has been arranged with the new CCGs. The intention is for the Chairman or Vice Chairman to attend in each case with Members attending the meeting of the CCG for their division

     

    3.    Members should make any other comments on the Work programme or recommendation tracker to the Scrutiny Officer by email.

9/13

DATE OF NEXT MEETING

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    The next meeting of the Committee will be held at 10.00am on 14 March 2013.

    Minutes:

    Noted that the next meeting of the Committee would be held on 14 March 2013.