Agenda and minutes

The minutes from the previous meeting will be circulated and considered at the December meeting of the committee.

The minutes of the meetings on 21 September will be circulated at a later date.

To receive any apologies for absence

Apologies for absence were received on behalf of DrFernandes, E Glatter and T Gallagher.

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]

None.

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

None.

H Brown to provide clarification regarding the process surrounding access to a GP out of hours at the West Herts Medical Centre.

The meeting returned to the issue of ‘out of hours’ services in the Urgent Care Centre in Hemel Hempstead. H Brown (HB) outlined the extent of the hours of service and the difficulties in providing a service all night for a service that is underutilised. She maintained that the telephone 111 service was constantly available and if you have to see a GP then an appointment can be arranged or a home visit organised.

Cllr Birnie suggested that the service is being provided by a qualified nurse and not a GP and consequently access to a GP is restricted. HB drew attention to the outline of the service she provided in her briefing note submitted to the committee.

Cllr Birnie asked her to confirm that there is no walk in GP service available in Dacorum after 10.00 pm. HB advised that there is no walk in GP in Dacorum overnight and cllr Birnie concluded that the situation is that any resident of the largest conurbation in Hertfordshire is unable to access a doctor during the night without going to Watford. Cllr Timmis pointed out that the withdrawal of an all night service was supposed to be a temporary measure and is now permanent. HB responded that the number of patients accessing the service at night was low and keeping the service open all night is not sustainable.

Councillors are invited to raise any issues within their Ward.

No issues were raised at this meeting.

Phil Bradley, acting Chief Executive Officer, accompanied by Diane Brent (Head of Estates), to provide an update from. Hertfordshire Community NHS Trust.

Diane Brent, Hertfordshire Community NHS Trust, Head of Estates (DB) provided an update on the current situation and proposals for the possible future use of the property.

Last year the in-patients facility was closed leaving vacant space (approx. 300 sq metres) in a good quality building. At the moment there are two doctors’ practices struggling in the vicinity and the proposal is to have three GP practices operating from this premises. Additional services are being considered but there are some funding difficulties to be addressed before this can happen. They are trying to source some funding in an improvement grant from NHS England. She maintained they are confident the building can absorb the three practices.

Cllr Timmis expressed some doubt that there would be enough parking at the site as the current parking is restricted. DB suggested that they could buy additional parking from the adjacent nursery. They are also looking at other alternatives.

Cllr Timmis asked if the sale of the other practice sites would fund part of the cost but was advised that this depended on the ownership of the other sites.

Cllr W Wyatt-Lowe asked if Gossoms End would be using a discharge to assess model. Phil Bradley (PB) advised that on this model patients are currently seen at home and this is not proposed for Gossoms End.

DB advised that the aim is to make this a GP hub which will attract other services and providers. This will mean that patients will not have to go to hospital and can be seen for different services on different days.

Cllr Taylor confirmed that these proposals are only at the feasibility stage. DB advised that there is some sensitivity as the GPs will have to consult their patient lists.

Cllr Hicks felt that it was a backward step closing down the step-down bed facility but welcomed the proposal for a GP hub.

The committee requested that the Health professionals return with an update early in the New Year.

Herts County Councillor Richard Roberts to provide an update on the most recent progress.

Herts County Councillor Roberts addressed the committee on the subject of health and the contribution of the voluntary sector.

Cllr Roberts expressed the view that we can avoid the extremely costly provision of tertiary care (e.g. taking a child into care), if the County and Boroughs develop and share good universal type, primary services and encourage secondary type services such as encouraging and enabling residents to give up on unhealthy activities e.g. smoking.

The above can be achieved with signposting services; CAB advice; to assist with prevention through persuasion empowerment and support.

Cllr Tindall asked if a Strategic Transferable Partnership (STP) is part of this view. Cllr Roberts suggested that the STP brings forward a multi-county approach. As far as he is concerned we have to assist those who are trying to intervene earlier to prevent Homelessness/debt/mental health issues and to provide support.

Cllr Roberts listed areas such as age, diabetes, obesity, vulnerable elderly, diet which should be the main focus of the efforts. He recommended the HCC Health Strategy Adopt Healthy Lifestyles as a blueprint for action.

To provide members with an update since last meeting.

As there was no representative at the meeting it was agreed to defer this item to a later date.

Councillor W Wyatt-Lowe to provide an update since the last meeting.

The committee considered issues surrounding the provision of Adult Care Services.

Cllr Tindall stated that in his opinion Adult Care Services are grossly underfunded, being cut significantly and are in a desperate situation.

K Minier suggested that we need more home care provision to avoid patients having to go to Hospital.

Cllr Timmis sought reassurance that the scheme to provide ‘flu-jabs’ has sufficient uptake. It was suggested that it was not advertised widely enough. Cllr W Wyatt-Lowe agreed to seek some more information at his meeting next week. He felt that the scheme as it operated this year made it difficult to keep track of who had and had not had the vaccination.

Cllr Taylor explained that the front line staff in Dacorum had been offered vaccinations and those who had taken it up were offered a voucher to go to Lloyds Pharmacy for the service.

Councillor Birnie to provide an update since the last meeting.

Cllr Birnie reported on recent meetings that he had attended.

He hinted that the Herts and the West Essex trusts are making progress despite the fact that Watford and the Princess Alexandra are still in special measures.

He gave a brief update on the recent review of Ambulance Services. The categories of call have been reduced from 6 to 4 and the despatchers have a series of questions to ask to try and reduce the number of vehicles responding to minor ailments.

Waiting time while handing over patients at A&E is still an issue but places like the Lister have introduced ‘discharge plans’ almost at the point of admission and this approach has been effective.

He reported that the Annual Finance Scrutiny meeting has been postponed until March 2018. Cllr W Wyatt-Lowe asked if it was likely that there would be any scrutiny of providers from outside the health area. Cllr Birnie was of the opinion that these services would not form part of the scrutiny.

The work programme for the committee was considered.

It was suggested that the following be included in future agenda:

·         HCC Adult Care Services (update provided by Cllr Guest) – December onwards

·         Gossoms End update – in March 2018

·         Update on CQC Inspection report  - to the February or March meeting

·         H Brown and D Evans to update on CCG strategic outline case for development of Hemel.

·         Delayed Discharges  - March 2018

The date of the next meeting is on 13 December 2017.

The meeting ended at 21.30pm