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Overview and Scrutiny Committee: 24th August 2006
NORTH DEVON DISTRICT COUNCIL
Minutes of a meeting of the OVERVIEW AND SCRUTINY COMMITTEE held
at the Civic Centre, Barnstaple on Thursday 24th August 2006 at 7.00 p.m.
PRESENT:
Members:
Councillor Mrs Shapland (Chairman)
Councillors Brailey, Mrs. Carter, Mrs Clark, Greenslade, Mrs
Gubb, Mrs. Lewis, Mrs McCormack-Hole, Mullen and Pagram.
Councillors Cook, Harrison, Haywood, Lucas, Macbeth, Mrs.
Manuel, Tucker and Wilsher attended the meeting in
accordance with Standing Order 9 (3) (b).
Officers:
Assistant Chief Executive (Legal and Democratic), Diversity
Officer and Member Services Co-ordinator (JG).
Also Present:
Nikki Kennelly – Acting Director of Clinical Services – Primary
Care Trust
Maureen Bignall – Director of Human Resources – Primary
Care Trust
Jo Gibbs – Director of Operations, North Devon District
Hospital
Paul Masters – Officer at North Cornwall County Council
Councillor Mrs. Jenkins, Devon County Council
Councillor Mike Nicholls, Chair of Cornwall
County Council Overview and Scrutiny Committee
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MINUTES
RESOLVED that the minutes of the meeting held on 13th June
2006 (circulated previously) be approved as a correct record
and signed by the Chairman.
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DECLARATIONS OF INTEREST
There were no declarations of interest announced.
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VERTICAL INTEGRATION AND NDDH TURNAROUND
The Chairman announced, as a matter of information and update, that the
new Chairman of the Devon Primary Care Trust was David Radford former
Chief Exec of Somerset County Council. Steps would now be put in place
to appoint a Chief Executive.
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Overview and Scrutiny Committee: 24th August 2006
Nikki Kennelly, Acting Director of Clinical Services (Primary Care Trust)
began by reporting on the proposed vertical integration.
She stated that with effect from 1st October 2006, the Northern Devon
Primary Care Trust would no longer exist, and that prior to the new Devon
PCT taking over, the North Devon Primary Care Trust was seeking to
transfer some of the services such as therapy services, district nursing
and family planning to the Northern Devon Healthcare Trust.
A decision as to whether or not the services would be transferred would
be taken by both Boards on 13th September 2006.
The reason for the transfer was to retain local services within the North
Devon focus and to improve the critical mass of the Northern Devon
Healthcare Trust. It was proposed that services would be transferred in
their current format.
Maureen Bignell, Director of Human Resources (Primary Care Trust)
provided feedback on the proposals.
She stated that the proposals had been subject to consultation, which
began in mid June, and approximately 500 members of staff (including all
hospitals in all localities) were invited to comment.
The outcome indicated that staff were very supportive of the proposals
once they had understood that the proposals meant retaining health
services in North Devon.
The consultation process ended last week and no formal objection to the
proposals had been submitted.
It was noted that General Practitioners were in favour of District Nursing
being transferred to the Northern Devon Healthcare Trust.
The transferred services would establish a clear division of provider and
commissioner and would be subject of a Service Level Agreement against
which the Healthcare Trust would be held accountable.
Although there was initial concern raised from Social Services, Jac Kelly
(Chief Executive of the Northern Devon Primary Care Trust – leading on
the Turnaround Plan), had met with David Johnson, Director of Social
Sevices, Devon County Council and he had given his supoort to vertical
integration proposals.
The Patient and Public Involvement Forum had a Member on the Vertical
Integration Workshop and was supportive of its proposals and the services
remaining in North Devon.
Jo Gubb, Director of Operations (North Devon District Hospital) reported
on the Turnaround Plan for the Northern Devon Healthcare Trust.
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Overview and Scrutiny Committee: 24th August 2006
She informed the Committee that an £8.8million deficit for the 2006/07
financial year had been agreed and signed up to. The Plan was to reach a
break-even position by 2007/08 financial year on the basis of the
following ongoing projections and new projects: Ongoing Projects: 




Operating Theatre Utilisation
Bed Configuration Project
Clinical and Support Service Project
Outpatients Project
Administration and Clerical Project
New Projects: 


Procurement in our facilities
Clinical Coding
Tactical Group
She stated that linked with all projects were workforce reductions of 60
full time equivalents, 50% of which would be front line nursing staff
proportionate to the reduction in beds and by means of utilising resources
more efficiently based on the clinical need of the patient. It was intended
that these reductions would be met from natural turnover.
There should be significant cash savings next year leaving a £3.8million
gap which was being addressed by seeking to maximise income and
provide further proposals to the November Board meeting focussing on
efficiency savings mostly in working practices. Vertical Integration had not
been built into the Turnaround Plan as yet.
Questions
The Chairman with the agreement of the Committee allowed persons
whom were not Members of the Overview and Scrutiny Committee to ask
questions.
The following points were clarified: Children’s Services such as School Nurses, Special needs etc would not
join the Northern Devon Healthcare Trust.
There would be a continuation of community services in accordance with
specifications. Delivery of the services would be monitored and there
would be a management of the integrated system.
To confirm there would be a Director of Community Services, an Associate
Medical Director, a General Practitioner who would have a seat and
attendance at the Board, and Social Services together with the
Partnership Trust would be invited to the Joint Board and Operational
Management Trust.
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Overview and Scrutiny Committee: 24th August 2006
Reducing the number of in-patient beds would and had already been
addressed by reducing the length of stay in hospital by improving
efficiencies.
Investments in Community Services have been kept in line with reduction
of beds.
Jo Gibbs, Director of Operations (North Devon District Hospital) advised
on the Medications Management:




The drug regime would automatically continue
There would be more senior nurses prescribing
There would be more pre-packaging of drugs
There would be a specialist pharmacist to help ward staff
There would be a consultant physician of the day to deal with complex
drug issues and get patients moving through the systems more
speedily
It is important that the Clinical opinion is clear and shared with the patient
and relatives and that lessons from the past are learnt. There was no
question of driving medical staff to discharge patients before they are
ready and there were no plans to change specialist surgeries in North
Devon.
The Acute Services Review Report (DURROW REPORT) had not made any
final recommendations but referred to the future of the Hospital in a 5-10
year period whereas Vertical Integration related to the next 1-3 years.
The Northern Devon Healthcare Trust could learn a lot from the financial
turnaround of the Primary Care Trust.
The Committee considered that there was a need for greater
communication with the public to provide assurances that the quality of
healthcare would be preserved within the proposals.
The Chairman thanked Nikki, Maureen and Jo for their full and frank
presentation to Committee.
She also thanked Members of North Devon District Council for attending
the meeting, together with those representing other authorities. She
advised that they would be kept fully informed of future developemnts.
RECOMMENDED:
(a)
that the Committee continues to support the Primary
Care Trust and Northern Devon Healthcare Trust for
the quality services they delivered to the people of
North Devon;
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Overview and Scrutiny Committee: 24th August 2006
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(b)
that the Committee welcomes and supports the move
to ensure that health provision, whether acute or
community is protected and continues to be provided
in North Devon, as close to residents as possible;
(c)
that the Primary Care Trust and Northern Devon
District Hospital be invited to report back to a future
meeting of the Overview and Scrutiny Committee
within an appropriate monitoring period to keep the
Committee up to date on the progress of both areas of
work;
(d)
that the DURROW report be brought to a future
meeting of the Overview and Scrutiny Committee for
a detailed presentation at the appropriate time;
(e)
that the Committee seeks, as a primary aim, to allay
the fears of the public concerning possible loss of
services. The Chairman would make immediate
contact with Nick Harvey MP and request that he seek
an early meeting with the Minister of Health to ensure
that the long term future of the hospital is guaranteed
so that the delivery of the Turnaround plan could be
implemented.
(f)
that North Devon District Council and or the Councils
concerned, contact their respective MP’s as indicated
above; and
(g)
that a letter of thanks be sent to Mrs. J. Kelly, Chief
Executive of the Northern Devon Primary Care Trust,
for keeping the Committee involved and informed on
the proposals.
HEALTH AND SAFETY POLICY AND HEALTH AND
SAFETY ORGANISATION DOCUMENT
The Committee considered a report by the Health and Safety Adviser in
relation to the Health and Safety Policy Statement and associated
organisation document (circulated previously).
The Assistant Chief Executive (Legal and Democratic) requested that
owing to staff and resource issues, the matter be referred to the
daytime meeting of the Policy Panel for further detail and scrutiny.
RESOLVED, that the new Health and Safety Policy and
Organisation Document be referred to the Policy Panel of the
Overview and Scrutiny Committee for consideration.
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Overview and Scrutiny Committee: 24th August 2006
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COMMUNITY CONSULATION FRAMEWORK
RECOMMENDED, that Executive adopt the Community
Consultation Framework subject to the following
amendments: (a)
Page 3: Objectives - move number 9 to number 2 in
the list;
(b)
Page 3: Public Consultation - 2nd sentence - change
"them" to "the public";
(c)
Pages 4 and 5: Paragraph 4.1 - ensure that the same
demographic figures that were included in the
Community Strategy be included within this section of
the framework;
(d)
Page 10: "Identify stakeholders and hard to reach
groups" - that this also include speaking to the local
community that the consultation will affect;
(e)
Page 11
(i)
"Seek opportunity for joint working" - 3rd
sentence be amended to "Joint working will get
public credibility";
(ii)
"Identify ways to increase participation" - fourth
paragraph - be amended to "... reimbursements for
travel should be considered";
(f)
Page 13
(i)
Team";
"SMT" be amended to "Senior Management
(ii)
That a box be added to state that the
consultation programme will be included within the
Corporate Business Plan;
(g)
That reference be made in the Framework as to how
Members will be involved in each stage of the
consultation process;
(h)
Page 15: "SMG" be amended to "Strategic
Management Group";
(i)
Page 16: "Communicate the Consultation" - that
reference be made to Members being informed and
involved in the planning of consultation at an early
stage;
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Overview and Scrutiny Committee: 24th August 2006
(j)
Page 22 - paragraph 9.4 - delete the sentence
beginning with "Wish Lists" need to be avoided.........."
(k)
Page 23
(i)
Paragraph 9.7
(A)
1st sentence - change "weary" to "wary";
(B)
4th sentence - "Joint initiatives between
Council
services
or
other
organisations
including partners i.e. health, police,
statutory and non-statutory bodies can also
help to alleviate this problem;
(ii)
Paragraph 9.8 - that reference be made to the
community consultation calendar including consultation
events taking place at venues such as the North Devon
Show;
(l)
Page 24
(i)
Paragraph 9.10 - 3rd paragraph - be amended
to ".....reimbursements for travel should be
considered.";
(ii)
Paragraph 9.11 - that the paragraph be moved
to page 11 of the Framework and be incorporated into
the heading "Identify stakeholders and hard to reach
groups"
(m)
Page 26: Paragraph 9.2 - 4th paragraph - be amended
to "be established. This will aid monitoring......";
(n)
Page 28: Paragraph 9.2 - list of examples of hard to
reach groups be expanded;
(o)
Page 30
(i)
Paragraph 9.5 - that the "Data Protection fair
obtaining statement" clause also be used in any
consultation carried out by partners and that reference
to this clause be included within other appropriate
sections within the Framework;
(ii)
Paragraph 9.6 - 2nd sentence be re-worded;
(p)
Page 32 - question be included asking "What are the
opportunities for working with partners?";
(q)
Page 36 - be deleted;
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Overview and Scrutiny Committee: 24th August 2006
(r)
Page 37 - Appendix 5 - include a list of acronyms used
within the Framework and also at the beginning of the
Framework;
(s)
Page 39 - consider the wording of the questions to
ensure that they were plain english.
(t)
That reference be made within the Framework to the
work that had already been carried out with the
community by the Community Development Unit and
how this work would be supported;
RECOMMENDED, that terms "strategy", "policy" and
"framework" be defined and how they link together.
RECOMMENDED, that Executive adopt the implementation
plan for the Community Consultation Framework subject to
the following amendments:
(a)
1st page - "Set up of new process and roles" and "role
of members" objectives completion dates be changed
to a later date;
(b)
2nd page - "hard to reach groups" objective be
amended to include the "voluntary sector" as a
partner;
(c)
2nd page - "freedom of information" objective
completion date be changed to a later date;
(d)
3rd page - "recruiting" objective completion date be
changed until after the District Council elections had
been held in May 2007;
(e)
3rd page - "training programme" objective completion
date be changed until after the District Council
elections had been held in May 2007 and that the
training programme be incorporated within the
Members Induction Programme;
(f)
4th page - "additional support to consultors" objective 3rd key activity be changed from "FAQs" to "Frequently
Asked Questions".
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Overview and Scrutiny Committee: 24th August 2006
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INFORMAL MEETING OF THE OVERVIEW AND
SCRUTINY COMMITTEE AND EXECUTIVE MEMBER
COUNCILLOR PROWSE
The Committee considered and noted the report of the informal meeting
of the Overview and Scrutiny Committee and the Leader of the Council
held on 24th July 2006 (circulated previously).
RESOLVED, that the impact of the Local Area Agreements be
included in the Overview and Scrutiny Committee work
programme for review.
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INFORMAL MEETING OF OVERVIEW AND SCRUTINY
COMMITTEE AND EXECUTIVE MEMBER COUNCILLOR
MRS. WEBBER
The Committee considered and noted the report of the informal meeting
of the Overview and Scrutiny Committee and the Executive Portfolio
Holder for Housing held on 8th August 2006 (circulated previously)
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REVIEW OF CALL-IN PROCEDURES
The Committee considered a report by the Assistant Chief Executive
(Legal and Democratic) in relation to the Overview and Scrutiny Call-In
mechanisms identified by the Policy Panel (circulated previously).
RESOLVED, that the report be noted.
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WORK PROGRAMME
The Committee considered the Committee's Work Programme for 2006/07
and agreed the scoping papers in relation to the review of deprivation
indicators and the review of the policy framework (circulated previously).
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EXEMPTIONS FROM CONTRACT PROCEDURE RULES
The Committee considered and noted the exemptions from Contract
Procedure Rules (circulated previously):
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DEVON COUNTY COUNCIL HEALTH
OVERVIEW/SCRUTINY COMMITTEE
Councillor Mrs. Shapland had nothing to report.
Chairman
The meeting ended at 8.53 p.m.
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