Agenda and draft minutes

To confirm the minutes from the previous meeting

The minutes of the meeting on 14 September 2016 were confirmed by the members present and then signed by the chairman.

To receive any apologies for absence

Apologies for lateness were received on behalf of Councillors Cllr Maddern and an apology for absence from R Trigger.

To receive any declarations of interest

A member with a disclosable pecuniary interest or a personal interest in a matter who attends a meeting of the authority at which the matter is considered -

(i)            must disclose the interest at the start of the meeting or when the interest becomes apparent

and, if the interest is a disclosable pecuniary interest, or a personal interest which is also prejudicial

(ii)           may not participate in any discussion or vote on the matter (and must withdraw to the public seating area) unless they have been granted a dispensation.

A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Members’ Register of Interests, or is not the subject of a pending notification, must notify the Monitoring Officer of the interest within 28 days of the disclosure.

Disclosable pecuniary interests, personal and prejudicial interests are defined in Part 2 of the Code of Conduct For Members

[If a member is in any doubt as to whether they have an interest which should be declared they should seek the advice of the Monitoring Officer before the start of the meeting]

Councillor Guest declared a personal interest due to the fact that she is a practicing Community Pharmacist for another Health Authority.

Cllr Taylor gave an update on how the issues that had been identified in Minute No. OS/222/16 had been dealt with and the negotiations that had taken place to bring Health issues forward for consideration at a future meeting of the Council.

An opportunity for members of the public to make statements or ask questions in accordance with the rules as to public participation

E Glatter, of the Dacorum Patients Group began by drawing attention to what she considers the lack of acute care in HH. She then went through the points raised in the Dacorum

She then went on to list suggestions from local people for services they would like to see in HH including more community beds and acute services. She continued that bringing together services on one site is laudable but the money involved could be better spent on further services and towards new hospital in Hemel Hempstead.

David Law, Chief Executive Hertfordshire Community NHS Trust D Laws responded that the proposals include the retention of community beds and this may be in Hemel. He admitted that the increase in money for community services is welcome and he would like to see more as he supports a greater move towards community care. This service involves a restructuring of the current services to allow those involved to work with the other services in the area to provide primary care and community services.

Councillor Guest asked Mr. Law directly:

Is it intended that there will be acute beds in Hemel Hempstead Hospital. In the future; and

Will there be MRI and CT scanners on the site.

David Evans (DE), Programme Director for ‘Your Care, Your Future’ replied that they not looking at beds for planned or acute care but at more flexible beds around Herts sites including Hemel. The Trusts are looking at estates options at the moment and different options for future health provision.

Helen Brown (HB), Director of Strategy & Corporate Services, West Hertfordshire Hospitals NHS Trust added that the other options are not planned for Hemel in the near future. She said that the planned care center being proposed for Hemel will include an MRI scanner but that the HH plans do not involve complex diagnostics.

Councillor Hicks said that the community based approach in Your Care Your Future did not satisfy the bed need and that the people in Tring feel under siege because of reduction in service. In his opinion this approach will not keep people out of hospital.

While DL pointed out that there will be services provided in Tring, Cllr Hicks responded that elderly people will have to travel to Hemel Hempstead to visit their relations. DL was of the opinion that the need to provide safe and resilient staffing triggered the closure of Gossoms End and recent reviews have refocused the funds moving the beds into the social care category.

B Harris countered that she felt community beds and care in your own home are a good idea but district nurses are now under too much strain to support this service and make it viable - there will not be the staff to offer the service. DL then added that the restructure will draw staff from different segments of the staff resources; they are recruiting different people from a broader base of service staff.

Cllr Guest asked if a district nurse need different training from  ...  view the full minutes text for item 232.

Acute Hospital Care in West Herts

An additional Health in Dacorum meeting has been called to discuss Acute Hospital Care In West Hertfordshire.

David Law, CEO Herts Community NHS Trust will attend to update on community care in west herts.

D Evans, Programme Director, Your Care Your Future (DE) introduce slides setting out the process they went through to allocate resources to provide the care needed in West Herts with the aim of providing the most appropriate access to healthcare for young and old of the area. He drew attention to the fact that 2007 saw the consolidation of acute healthcare in west Herts in Watford Hospital. Essential to this was the promotion of more prevention; moving care closer to home; collaboration to provide a more effective approach. This would result in a reduction in the demand for Hospitals – He stressed that demand is not the same as need – backed up by processes such as placed based commissioning.

The outstanding issue is still the provision of specialist care and planned care and DE went through the most recent proposals on how to centralise acute care – if the conditions are favorable.

The various options were considered by various user groups and ‘Panel’s and he went on to outline how these operated and the results produced – specifically the financial elements and the travel time conclusions. The panels considered factors such as the new road networks around the current hospital site in Watford and the possibility of new Underground station links.

The Deliverability Panel had to consider the likelihood of realising the various options. They had to take into account that NHS England will always ask ‘what if you stick with the services you have and do nothing?

Councillor Maddern arrived at 20:12.

Cllr Taylor stated that the timeframe given suggested that two years ago they started the building of the road and railway links to try to address the serious delays experienced by those trying to access the Watford site. If we factor in the tendering and commissioning processes then this scheme commenced years ago. Consequently those suggesting alternatives feel hoodwinked and that the decision has already been made.

H Brown, Director of Strategy & Corporate Services, West Hertfordshire Hospitals NHS Trust (HB) added that the decision was taken five years ago to redevelop the Watford site. The recent road and rail developments were part of that decision - emergency care would be at Watford. This year the commitment was to relook at a number of options including the further development of the Watford site.

Councillor Taylor stated that in his opinion there has been a great deal of financial aid given towards maintaining and developing the Watford site.

E Glatter, Dacorum Patients Group (EB), asked why Dacorum could not be the site of a planned diagnostic centre. She added that as far as the Community Care approach is concerned the service provision in the east of the county is not as good as it is being made out to be, and she gave two examples to illustrate this.

She then said she is upset about what has been said regarding the proposed green field site which she felt was the better option.

The discussion then  ...  view the full minutes text for item 233.