Tim Rideout, Chief Executive, Leicester City Primary Care Trust, will be in attendance to address the Committee with regard to the PCT Local Health Services Review. A representative from the University Hospitals of Leicester will also be in attendance to provide background information relating to the decision not to continue with the Pathways project.
Prior to discussion on this item the Chair read out two brief statements that related to the recent retirement of Peter Reading that conveyed the best wishes of the Chair, Vice-Chair and members of the Joint Health Overview and Scrutiny Committee.
Mandy Ashton, Director of Quality Assurance/Deputy Chief Executive, Pauline Tagg, Acting Chief Executive, and Martin Hindle, Chairman of the Leicester City NHS Primary Care Trust attended the meeting.
Members were informed that, due to greatly increased costs of some £200m, the Pathway Project was felt by the Trust to be no longer value for money for both the Trust and the public. The options available to the Trust were to press on with the Project or to pull out, the Trust opted to pull out. Since this decision had been taken support had been received from Trust staff, doctors, nurses, unions, media and the public.
Members were informed that the Trust had £70m available to undertake post Pathway works to buildings. Work was being carried out with the Trust Board and the Facilities Team, together with colleagues in Primary Care on the Next Steps Review and to identify what work was required in the short term to buildings.
A brief presentation on the Next Steps Review was given that illustrated the principles for developing the vision through to the engagement and the consultative process.
The general principles for developing the Partnership for the next 5, 10, 15 years were outlined. The first part of the process was described in the Project structure and would comprise eight separate groups, each concentrating on a specific area of work, and each group comprising the best specialists available from within the PCT’s and UHL. Each group would be responsible for the consultation process between the specialists and the public. The eight groups would report to a Project Executive that would report to the Project Board.
The engagement process would be initially in two stages. The first stage would take place between September 2007 and January 2008 and would comprise the eight groups meeting to undertake engagement and pre-visioning work. The second phase would take place between February 2008 and March 2008 and would comprise pre-consultation on the vision and values. Formal consultation would be carried out over a 12 week period between April and June 2008. Analysis of the responses and preparation of the recommendations would be carried out in July 2008.
At this point questions were invited from Members.
1) The move to community care was welcomed, together with additional funding. However there were concerns as to whether adequate skills were in place across the community.
Assurances were sought that sufficient time and funding would be allocated to ensure that the necessary skills were in place in the community to ensure that the required levels of care could be given. It was essential that Leicester had excellent acute care facilities.
Mandy Ashton stated that currently excellent facilities within the City had been provided, or were being provided, as part of the Local Investment Finance Trust (LIFT) project. Within the County hospital establishments existed that were well equipped to take services from UHL. Regarding available skills, this was subject to legislation and training had been put in place. As an example there used to be 4 Community Matrons, now there were 21. There was also talk of skilled nurses going out into the community to train community nurses, brought about because, over time, hospitals would downsize with fewer staff and beds being required.
Martin Hindle stated that he was aware of the short term issues and of the shrinking of hospitals, however UHL would continue to provide terciary and appropriate care. UHL were developing centres of excellence, the basis for which were already in place. UHL were to ensure that the hospitals it was providing were the best available for the people across Leicestershire, Leicester and Rutland.
2) It was stated that it seemed as if the point had been reached whereby something had to be done and there was talk of involving a wide sector of the community. From an elected member point of view the electorate were at the point of losing confidence regarding health provision locally. To restore this confidence a lot of detail needed to be provided on the proposals being outlined. Staffing of certain existing hospitals was also an area of concern, with part of the facility at Hinckley being closed for some time.
Mandy Ashton stated that she sympathised with the comments and stated that timescales were terribly short. A lot of the detail was already in place from the previous several years of consultations. Currently the Mental Health Review and the Community Hospitals Review were moving on swiftly and the Out of Hours Service Review was also progressing. From frequent travel on public transport it was apparent from comments overheard that UHL faced a lot of work to rebuild confidence. By getting the Partnership and the Leadership right and also the commitment of where UHL wanted to go would form the basis of restoring confidence.
Martin Hindle stated that regarding integrated care, eight areas had been outlined earlier and consultants had been moved into these areas to provide clinician input. UHL were anxious to move forward on obtaining Foundation Trust status which would bring greater freedoms.
3) It was stated that there were currently some very good practices being carried out within communities and assurances were sought that UHL would be building on these.
Mandy Ashton stated that there were indeed a number of examples of good practice in the community. Who was to provide care had yet to be determined but there was a need to get the specification and pathways right before services were commissioned.
On behalf of the Patient and Public Involvement Forum (PPIF) –UHL Trust, it was stated that it was important that comments were received and it was apparent that the public were fed up with the divisions in the service and of the loss of confidence. The Forum would next meet on 19th October 2007. What was causing most concern at the present time was the ‘Darzy’ review of hospitals and of the questions being asked as to why this area of the East Midlands had 3 major hospitals plus the facilities at Derby and Nottingham. It was felt that it was time for the local authorities in this area to lobby the Strategic Health Authority stating in the strongest possible terms the requirement for top class hospitals in this area.
Martin Hindle stated that he had spoken with Prof. Darzy and outlined the aims of UHL and of the liaison and co-operation with other major hospitals in the area.
In concluding the Committee stressed that health was very important to the people of Leicestershire, Leicester and Rutland and expressed the view that they would welcome the recommendations from UHL in July 2008 and urged UHL to work to bring back the faith of the public that had been lost.