NORTH YORKSHIRE COUNTY COUNCIL

17 February 2021

STATEMENT OF CHAIRMAN OF THE SCRUTINY OF HEALTH COMMITTEE

The Scrutiny of Health Committee has a responsibility to review any matter relating to the planning, provision and operation of health services in the County.  A key part of that responsibility is requiring NHS bodies to consult health scrutiny on proposals for substantial developments or variations to the local health service provision.  One of the powers that the committee has is, in specific circumstances, to refer contested proposals for change to the Secretary of State for Health.

The committee met formally and in public on 18 December 2020 using Microsoft Teams for a live broadcast.  At that meeting, committee members received detailed presentations on: the proposed changes to the Healthy Child Programme; proposed and actual changes to Stroke services, Oncology, and Urology at Scarborough hospital; developments in community and in-patient mental health services; NHS pandemic recovery planning; and covid-19 infection rates and the roll out of the vaccination programme.

A Mid Cycle Briefing was held using Microsoft Teams on 29 January 2021.  The Mid Cycle Briefings offer the Chair, Vice Chair and Group Spokespersons an opportunity to develop the committee work programme and determine how proposed changes to NHS services locally can best be scrutinised.  At the Mid Cycle Briefing, there was a detailed discussion about the provision of and access to NHS dental services in the county.  The outcome of this is that a number of lines of enquiry will be followed up with NHS England, including: details of the funding formula for NHS dentistry and how that is applied to North Yorkshire; the number of dental practices that provide NHS services, where they are located and how this has changed over time; the role of the Integrated Care Systems in the commissioning of NHS dental services; and the covid-19 recovery plan for NHS dental healthcare provision.

Outlined below are some areas that the committee has been looking at in-depth.

Scarborough Hospital

The committee continues to scrutinise the actual and proposed changes to some specialist services at Scarborough hospital.  The driver for these changes have been workforce shortages and the numbers of people being treated falling well below the clinically safe recommended levels.  There are concerns locally that Scarborough hospital has lost a number of smaller and more specialist services over time and this has then creates considerable worry and anxiety about what the plan is for the hospital and what services it will deliver.  There are real concerns that people will have to travel to York and Hull to access services that they would normally access in Scarborough.

Of particular concern is the change to hyper acute stroke services.  Instead of an initial assessment being undertaken at Scarborough hospital, people who exhibit the symptoms of a stroke will bypass Scarborough and are taken directly to York or Hull for specialist treatment.  The committee heard that the most important thing for a patient with a suspected stroke is that they are rapidly assessed and then taken to the right treatment centre as soon as possible.  This prompted some considerable debate regarding the relevance of the ‘golden hour’, that period of time following a serious and life threatening injury during which there is the highest likelihood that prompt access to specialist treatment will significantly improve patient outcomes.  At the March meeting, the committee will be receiving a more detailed report on the treatment of hyper acute stroke, the times taken to receive specialist treatment and what the clinical impact can be.

Over the past 18 months, the committee has scrutinised the proposed and actual changes to some specialist services at Scarborough Hospital.  During the course of this scrutiny and also reviews undertaken by the Scarborough and Whitby Area Constituency Committee, it has become apparent that NHS commissioners and providers have been unable to successfully articulate a vision for the future of Scarborough hospital.  At committee, we have been told by commissioners that new funding has been secured, the site will be modernised, that there will continue to be an Emergency Department, there are opportunities to establish new services and that the aim is for Scarborough to become a high quality District Hospital.  It is of note, however, that this seemingly positive news has yet to be conveyed to residents of Scarborough and the surrounding area.

Development of mental health services

Over the past 3 years, the way in which mental health services have been commissioned and provided has changed.  The focus has moved away from the use of in-patient beds to greater use of enhanced forms of community mental health services.  This has seen the construction of a new, purpose-built mental health hospital at Foss Park in York, the construction of a community mental health hub at Northallerton, and the consolidation of community mental health services onto one site in Selby.  Considerable time, effort and money has been invested in these changes and the committee continues to scrutinise the developments and the impact of these changes upon patient outcomes.

At the December meeting, the committee heard that the pandemic and the series of lockdowns has led to more people seeking help from mental health services.  This increase in demand and the plans for the recovery of mental health services from the pandemic will be something that the committee monitors over the next 12 months.

Joint work with Area Constituency Committees

The committee is working more closely with the Council’s six Area Constituency Committees (ACC).  Building upon the work that the Skipton and Ripon ACC has done in leading the scrutiny of the re-development of the Castleberg Hospital at Giggleswick, the following proposed development to local health services have been referred to the local ACC:

· Richmond (Yorks) ACC – the development of the Catterick Health Campus

· Thirsk and Malton ACC - project that is being set up across health and social care to look at developing primary care and ancillary services in and around Easingwold.

As previously indicated, the Scarborough and Whitby ACC is also taking an active role in reviewing proposed and actual changes to services at Scarborough hospital and also the development of services at the Whitby hospital site.

NHS pandemic recovery

An ongoing piece of scrutiny is the review of the NHS response to the pandemic and what this has meant for the delivery of NHS services.  In particular, the impact upon access to primary care, routine outpatient appointments and elective surgery.  The committee receives regular updates on the roll out of the vaccination programme and the spread of the covid-19 infection and its variants.  Over time, the committee will look at the implication for health and social care services of the emergence of the condition known as ‘long-covid’.

Committee meeting on 12 March 2021

The next meeting of the committee will be at 10am on 12 March 2021.  At this time, the items for consideration at that meeting are as follows: the NHS response to the pandemic, in particular the progress being made with the vaccination programme; further information on the extent of hospital acquired covid-19 infections, management of waiting lists for routine treatments and elective surgery, and staff sickness; the transfer of hyper acute stroke treatment from Scarborough to York and Hull and the response times and outcomes linked to hyper acute stroke provision; the development of the Whitby hospital site and the impact that will have upon services provided there.

COUNTY COUNCILLOR JOHN ENNIS

Chairman of the Scrutiny of Health Committee

2 February 2021