Meeting documents

Also present at the invitation of the Chairman

Ms Amanda Brown (Locality Director, NHS North Yorkshire and York) – for Item 5

Ms Alyson Elder (Ingham Play Park Committee) – for Item 6

Mr James Hayward (Director of Facilities, Scarborough and North East Yorkshire Healthcare Trust) – for Items 4 and 5

Mr Mike Proctor (Deputy Chief Executive, York Teaching Hospital Foundation Trust and Interim Chief Executive, Scarborough and North East Yorkshire Healthcare Trust) – for Items 4 and 5

Dr Marcus Van Dam (GP, Danby Surgery) – for Item 5

Ms Lisa Ward (Ingham Play Park Committee) – for Item 6

Ms Sarah Wyatt (Whitby Hospital Action Group) – for Item 5

Members are reminded of the need to consider whether they have a personal or prejudicial interest to declare in any of the items on this agenda.  If so, the nature of the interest must be declared at the start or as soon as the interest becomes apparent, of the meeting.  In addition, the attached form must be completed and passed to the Committee Administrator.  The Officers will be pleased to advise, if necessary, and any request for assistance should be made, in the first instance, to the Committee Administrator whose name appears at the end of this agenda.  Ideally, such advice should be sought before the day of the meeting so that time is available to consider any uncertainty that might arise.

Councillor Abbott declared a personal interest in agenda item 5, Future of Whitby Hospital since he was a member of Whitby Hospital Action Group.

Councillor Mrs Turner declared a personal interest in agenda item 5, Future of Whitby Hospital since she was a member of Whitby Hospital Action Group.

Councillor Lawn declared a personal interest in agenda item 6, Ingham Play Park, Sleights - Councillor Call for Action since his father-in-law's firm Wilf Noble tendered for the works.

To approve as a correct record and sign the Minutes of the meeting held on 27 July 2011.  (Minutes attached).

RESOLVED that the minutes of the meeting held on 27 July 2011 be approved as a correct record and signed by the Chairman.

Public questions of which due notice has been given and which are relevant to the business of the Scrutiny Committee.

The Chairman reported that no public questions had been submitted.

To receive a joint presentation by Mike Proctor (Deputy Chief Executive, YTHFT and Interim Chief Executive, SNEYHT) and James Hayward (Director of Facilities, SNEYHT)

The Committee received a verbal progress report by Mike Proctor, the Deputy Chief Executive of York Teaching Hospital Foundation Trust (YTHFT), and the Interim Chief Executive of Scarborough and North East Yorkshire Healthcare Trust (SNEYHT) on the integration of both organisations.  Members were reminded that because of Government requirements to become a Foundation Trust and SNEYHT’s long standing financial difficulties and problems in clinical performance, the SNEYHT had approached YTHFT to consider the the acquisition of SNEYHT by YTHFT.  On its own, YTHFT was a break even organisation, and SNEYHT a deficit organisation, therefore additional financial support would be needed to make the acquisition a success.  Mr Proctor believed that in clinical terms, the benefits would be enormous, by pooling the expertise of both organisations, thereby making services more sustainable, and introducing stability into the management.  This was not about centralising services in York, since York Teaching Hospital was already at capacity.  Foundation Trust status would also engender greater accountability through patient and staff representation on the Board of Governors.  The Integration Plan, Integrated Business Plan and Long Term Financial Plan for the new organisation would be submitted to the independent financial regulator, Monitor by October, and then Monitor would hold a meeting with the YTHFT Board in January 2012.  Both Boards of the existing organisations would then take a final decision following the outcome of the Monitor meeting.  Subject to the above, the new single organisation would come into being in April 2012.  Various questions were then put to Mr Proctor:

Q: What are the threats to the integration not going ahead?

A: The YTHFT Board may reject the proposal because of the financial consequences, but he believes the acquisition is the way to secure the long term future of both hospitals.  The larger the organisation, the more viable it becomes.

Q: Will the recent Mascie-Taylor review and the recommendation to reduce the number of hospital beds across North Yorkshire and York by 200 have implications for the integration? 

A:  How to manage the recommended reduction in hospital beds has yet to be decided, but if beds are to be lost, these should be in acute hospitals, not community hospitals, which he believes have a bright future.

Q: Why is YTHFT trying to acquire SNEYHT given its historical debt, critical Care Quality Commission reports, and problems with hospital acquired infection?  And what is being done about the hospital acquired infection?

A: YTHFT has a track record of delivering quality services and can improve healthcare delivery in Scarborough and the surrounding area.  SNEYHT has previously struggled because of the healthcare system, but York has resources to help Scarborough.  However, given the levels of debt, this cannot be achieved without financial support from the centre.  Hospital acquired infection statistics have shown improvement.  There has been only one MRSA bloodstream infection this year at Scarborough Hospital and the Trust is on course to achieve its target of under 40 C. Difficile cases.  However, he recognises that the Trust is  ...  view the full minutes text for item 4.

To receive a presentation by Simon Cox (Associate Locality Director, North Yorkshire and York Primary Care Trust)

The Committee considered a verbal report by Amanda Brown, Locality Director, NHS North Yorkshire and York (NHSNYY), in respect of the future of Whitby Hospital. Ms Brown referred to a briefing and list of questions which had been previously circulated to members of the Committee.  The briefing stated that the clinical model of Enhanced Community Teams (ECT) or ‘Hospital at Home’ was piloted at Whitby Hospital in 2010, leading to the temporary closure of Abbey Ward from November 2010 to July 2011.  The objective of the pilot was to ensure that unnecessary hospital admissions were avoided, with quicker discharge and better coordinated follow-up care for people who are admitted to hospital.  Earlier in the year, the National Clinical Advisory Team (NCAT) undertook a review to form part of the overall evaluation of the pilot.  They endorsed this model of care, but viewed it within the context of a new wider strategic vision for community hospitals based on intermediate care (including rehabilitation and palliative care), outpatient services, diagnostics and minor injuries.  However, they saw GP support for the new clinical models as pivotal, and advised against full implementation of the ECT and closure of the ward because of lack of local stakeholder support, and in particular of GPs.  The NCAT also referred to the poor estate of Whitby Hospital and that any capital planning should flow from the future strategic direction agreed for the hospital.  NCAT’s findings and recommendations were further reinforced by Professor Mascie-Taylor’s Independent Review of Health Services in North Yorkshire and York which concluded in August 2011 that community hospitals such as Whitby should be reviewed and redesigned as part of a wider strategy for improved community services.  They should provide ‘step-up’ care for patients from the community and ‘step-down’ care for patients from acute hospital settings, so that care was matched to patient need and was provided in the right place.  Mascie-Taylor specifically referred to the Whitby ECT pilot as a model which should be considered.  Mascie-Taylor provided a stark assessment of the North Yorkshire and York health economy, estimating that the efficiency savings required in North Yorkshire in the next four years would be in excess of £230 million.  To meet this challenge he called for a radical solution and a shift in how healthcare is provided, including

• redesigning the model of care so that patients are treated according to their level of need
• reducing hospital inpatient beds, while increasing activity
• shifting care from the hospital to the community sector, and significantly developing community services

Ms Brown then provided further information to supplement the briefing.  She reported that earlier this year the York/Scarborough Trust had taken over community services in the area including Whitby Hospital, and GPs representing the Whitby area had joined the Clinical Commissioning Group for Hambleton and Richmondshire.  Mascie-Taylor’s recommendations to provide more integrated healthcare services also needed to be seen in the context of radical changes in the way healthcare was to be commissioned  ...  view the full minutes text for item 5.

To consider a report by the Overview and Scrutiny Manager (attached)

The Committee considered a report by the Overview and Scrutiny Manager which set out the terms of a Councillor Call for Action initiated by the Chairman, Councillor Lawn in respect of how the Council supported Ingham Play Park Committee (IPPC) to deliver the new play park in Sleights.  Councillor Lawn explained that although this project had been an undoubted success, and could not have been realised without the support of the Borough Council, the IPPC had encountered many frustrations when dealing with the Council.  Today’s review therefore set out to identify what these frustrations were, if there were any weaknesses in the way the Council supported community groups to deliver such projects, and what lessons the Council could learn from Ingham Play Park in order to improve the way it supported community groups.  Ms Alyson Elder of IPPC then addressed the Committee.  Ms Elder explained that in 2006, with help from Eskdaleside-cum-Ugglebarnby Parish Council, a group was set up with the intention of redeveloping the derelict and disused play ground off Ingham Close.  By April 2007 the group was formally constituted as Ingham Play Park Committee.  This group consisted entirely of Sleights residents.  Throughout, two members of the Parish Council attended all their meetings.  The Parish Council paid for room hire at the local institute allowing them to meet as a group and to arrange meetings with outside bodies, and to obtain advice and direction from other organisations and funding bodies.  To underline this support and add credibility, the Parish Council provided an initial grant of £2000.  Due to funding body requirements (Lottery and Leader) the IPPC was required to finalise schemes for:

(i) the lease of the site,

(ii) maintenance of the equipment and also the green areas of the site,

(iii) regular safety inspections (with the Parish Council to meet the costs of these)

(iv) insurance 

(v) an Accountable Body to handle the grants (Scarborough Borough Council).

A formal agreement with SBC (as landowners) was negotiated to enable the group to prepare and submit bids for funding.  By the end of 2009 it was agreed that SBC would appoint a project manager to work with the group.  The IPPC was successful in its bids to the Lottery and Leader – the Lottery being a 2 stage process over 18 months which supported the successful Leader bid.  Over £135K of funding was obtained to enable the creation of an impressive play park at Ingham Close.  Ms Elder added that to achieve this project they needed to negotiate their way through a labyrinth of hoops.  Although the project was complete, she commented that there were questions they needed to ask the management of SBC, in order (i) to improve the IPPC’s understanding of why parts of the administrative system of SBC made it difficult to achieve their aim and (ii) to enable the IPPC to support and pave the way for other community groups experiencing difficulties in their dealings with the systems of SBC.  The Head  ...  view the full minutes text for item 6.

To review progress of the Work Programme 2011/12 (Reference 11/397 attached)

The Committee considered a report by the Head of Legal and Support Services (Reference 11/339) to assist Members in planning the committee’s work for 2011/12.  In addition to the new items agreed under minutes 4, 5 and 6, Members agreed to invite a representative of Yorkshire Ambulance Service Trust to the next meeting on 23 November, to speak to the current consultation on YAS’s plans to become a Foundation Trust.

RESOLVED that, subject to the above amendments, the report be received.