Agenda and minutes

Adults and Health Select Committee OLD - Monday, 4 September 2017 10.00 am

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

Contact: Andy Spragg, Scrutiny Officer 

Items
No. Item

8/17

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

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    Minutes:

    Apologies were received from Angela Goodwin, Graham Ellwood and Sinead Mooney. Angela Goodwin was substituted by Fiona White.

     

9/17

MINUTES OF THE PREVIOUS MEETING: 14 JULY 2017 pdf icon PDF 136 KB

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    To agree the minutes of the previous meeting as a true and accurate record of proceedings.

    Minutes:

    The minutes of the previous meeting were approved as a true and accurate record of proceedings.

10/17

DECLARATIONS OF INTEREST

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    All Members present are required to declare, at this point in the meeting or as soon as possible thereafter:

          I.        Any disclosable pecuniary interests and / or

        II.        Other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting

     

    NOTES:

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

    ·         As well as an interest of the Member, this includes any interest, of which the Member is aware, that relates to the Member’s spouse or civil partner (or any person with whom the Member is living as a spouse or civil partner)

    ·         Members with a significant personal interest may participate in the discussion and vote on that matter unless that interest could be reasonably regarded as prejudicial.

    Minutes:

    David Mansfield informed the Committee that he worked for Central and North West London NHS Foundation Trust in a non-clinical role. He withdrew from the room.

     

11/17

QUESTIONS AND PETITIONS pdf icon PDF 234 KB

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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 (Tuesday 29 August).

     

    2.    The deadline for public questions is seven days before the meeting (Monday 28 August)

     

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

    Additional documents:

    Minutes:

    There were five questions submitted to the Committee for response. The questions and their response are attached to the minutes as Annex 1.

    There were four supplementary questions asked.

     

    1)    We are now being told that patients at the Blanche Heriot Unit with genital skin conditions and genital pain fall outside of the integrated Surrey contract for sexual health & HIV services and that these services will continue to be provided by Ashford & St Peter’s Hospitals NHS Trust. These patients, which I understand to be around 3,000 in number, have always been treated by the Blanche Heriot Unit as part of its specialist genitourinary medicine service and funded, since responsibility and funding for commissioning GUM transferred with Public Health to local authorities in 2013, by Surrey County Council. Will Surrey County Council transfer funds, presumably from the integrated sexual health & HIV services contract, to enable the North West Surrey Clinical Commissioning Group to fund these services at St Peter’s Hospital going forward?

    asked by
    Sheila Boon

    2)    Michael Devine noted his disappointment at the answer, and expressed the view that there appeared to be a lack of detailed capacity planning for the transfer of services from the BHU and surrounding clinics to the Buryfields clinic. He asked whether an environmental impact analysis and capacity planning for expected attendances had been undertaken, and whether the commissioners were prepared to share this information including number of  daily attendances expected, number of consulting rooms, seating capacity of waiting area and the maximum occupancy insurance limit?

    asked by
    Michael Devine

    3)    One of the great strengths of the Blanche Heriot Unit is its very experienced clinical team who provide responsive, thorough and valuable support to GPs allowing direct interaction with a leading specialist. GPs are very concerned about the break-up of this team and the loss of expertise. What steps are the Council and NHS England, as the co-commissioner of the sexual health & HIV services contract, taking to ensure that GPs will continue to have direct access to such expertise and be able to refer patients direct to a specialist level 3 service?

    asked by
    Nigel Glynn

    4)    Steven Fryett praised the staff and the experience at the Blanche Herriot Unit, and asked how he could be expected to go online to access advice and support when the new provider had no knowledge of his specific needs.

    asked by Steven Fryett

     

    The supplementary questions were responded to in full prior to the meeting. The responses are attached in full as Annex 2.

     

12/17

RESPONSES FROM THE CABINET TO ISSUES REFERRED BY THE SELECT COMMITTEE

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    There were no rsponses made from Cabinet.

    Minutes:

    There were no responses issued from Cabinet.

13/17

REFERRAL BY HEALTHWATCH pdf icon PDF 95 KB

14/17

SURREY INTEGRATED SEXUAL HEALTH SERVICES pdf icon PDF 336 KB

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    Purpose of the report: To provide a summary of the process undertaken to commission an Integrated Sexual Health Service for Surrey

     

    Additional documents:

    Minutes:

    Witnesses:

    Members

    Helyn Clack, Cabinet Member for Health

    Speakers

    Matthew Parris, Deputy Chief Executive Healthwatch
    Stephen Fash, Resident and representative of the Blanche Heriot Group
    Cliff Bush, Co-Chair - Surrey Coalition of Disabled People

    Commissioners

     

    Helen Atkinson, Strategic Director for Adult Social Care and Public Health

    Ruth Hutchinson, Deputy Director - Public Health

    Lisa Andrews, Senior Public Health Lead

     

    Steve Emerton, Delivery Director South East, NHS England

    Fiona Mackison, Service Specialist, Specialised Commissioning, NHS England

     

    Providers

     

    Stephen Tucker, Deputy Service Director, Central and North West London NHS Foundation Trust

    Simon Edwards, Clinical Director, Sexual Health and HIV Services, Central and North West London NHS Foundation Trust

     

    Ashford and St Peter’s Hospital

     

    Tom Smerdon, Director of Operations, Ashford and St Peter's Hospitals NHS Foundation Trust

    Declarations of Interest:

    David Mansfield informed the Committee that he worked for Central and North West London NHS Foundation Trust in a non-clinical role. He withdrew from the room.

    Key points raised during the discussion:

    1. The Committee heard representation from the Deputy Director of Healthwatch, Surrey. It was noted that representatives of Healthwatch had attended several feedback events regarding the change in service offered by Central and North West London (CNWL) NHS Foundation Trust. They expressed the opinion that there was a lack of explanation of the services being offered by the new provider. Healthwatch also felt that there was inadequate consultation work with regard to the changes undertaken by the commissioners and providers. Healthwatch noted that, since the referral has been made, there has been more evidence of consultation made available. Healthwatch questioned whether the communication and consultation undertaken was wide enough and whether patients with chronic disabilities would still be able to adequately access services.

    2. The Committee heard representation from a member of the Blanche Heriot Unit Group (BHUG). He expressed the opinion that patient support needs were significant for the services. He stressed that the Blanche Heriot Unit (BHU) serviced a large population in North West Surrey and that there was a higher than average demand for the services. It was also noted that the unit was used as a training resource for staff working with sexual health issues. The representative of the BHUG suggested that BHU patients were not sufficiently involved in consultation during the re-commissioning of services. He noted that the commissioners decision to reduce the overall spend of the provision for sexual health services was a primary reason for the former provider being unwilling to bid to provide the service and that this limited competition. There were also concerns raised regarding CNWL‘s ability to provide the service, noting that the provider was running at a budget deficit and that they could become overstretched and unable to provide services effectively in Surrey.

    3. Representatives questioned the quality of CNWL’s current offer of Sexual Health Services, noting that there were some concerns regarding the emphasis on phone and email contact, rather than face to face services currently offered. The phone services were also deemed by “Mystery Shoppers” commissioned by the BHUG  ...  view the full minutes text for item 14/17

15/17

SUSSEX AND EAST SURREY SUSTAINABILITY AND TRANSFORMATION PARTNERSHIP CLINICALLY EFFECTIVE COMMISSIONING pdf icon PDF 137 KB

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    Purpose of the report: To review the Surrey and East Sussex Sustainability and Transformation Partnership’s plans for commissioning of services and make recommendations as appropriate.

    Additional documents:

    Minutes:

    Witnesses:

    Samantha Stanbridge, Director of Commissioning, East Surrey CCG

    Declarations of Interest:

    None

    Key points raised during the discussion:

    David Mansfield left the meeting at 11.36am

    1. Witnesses explained that the Commissioning plan was intended to set common criteria across Sussex and East Surrey for treatments, including clinical procedures and the prescription of drugs.

    2. Witnesses noted that the East Surrey commissioning was reviewed alongside other Surrey CCGs to ensure there were a common Surrey-wide criteria for treatments. There was not expected to be any changes to these as a result of the work being undertaken regarding the Sussex and East Surrey Sustainability and Transformation Partnership (STP). It was highlighted that Sussex would be subject to significant change in line with the desire to ensure greater consistency in treatment across Surrey.

    3. Members queried to what extent the commissioning plan would reduce waste and release resources. Witnesses commented that East Surrey CCG was performing well in this area, and expressed the view that there were not significant efficiencies to be identified in this area.

    4. Witnesses stressed that the STP needed to maintain a uniform approach to commissioning. It was highlighted that there could not be differing thresholds for Sussex and East Surrey and that Sussex CCGs would need to establish the extent of this through a gap analysis.

    Resolved:

    1.        That the Committee notes the Clinically Effective Commissioning plan proposed by the Surrey and East Sussex STP.

     

     

16/17

RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 147 KB

17/17

DATE OF THE NEXT MEETING

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    The next public meeting of the committee will be held 9 November 2017 at County Hall.

    Minutes:

    The Committee noted that its next meeting would be held on 9 November 2017 at County Hall.