Agenda and draft minutes

To confirm the minutes from the previous meeting

The minutes of the meeting on 5 July 2016 were confirmed by the members present and then signed by the chairman.

To receive any apologies for absence

Apologies for absence were received on behalf of Councillors Brown and Guest; Betty Harris, and CouncillorW Wyatt-Lowe.

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.

Ward issues from other Councillors (Minute 120). There is no record of the letter to NHS England being produced. Cllr Timmis informed the committee that the matter is now being pursued through alternative means and the direct intervention of Dacorum Borough Council Chief Executive.

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

There was no public participation.

Councillors have been invited to raise any issues within their ward

Cllr Ritchie addressed the committee regarding the closure, last October, of twenty intermediate care beds in Gossoms End, Berkhamsted. The reason given for the closure at that time was patient safety and that it was a temporary arrangement while the service provision was assessed. This has now been confirmed as a permanent decision by D Law,the Chief Exec of the CCG.

Cllr Ritchie informed the committee that Berkhamsted Town Council feel that the staff from Gossoms End have been deployed to other units and Gossoms End seems to have been sacrificed in favour of services outside Dacorum borough.

Cllr Ritchie added that the beds are to be replaced by Quantum care and that their intention is that only two beds will be provided in the borough. The borough is being poorly served by the NHS and Cllr Ritchie gave figures to back up his view that the provision now is half of 20 years ago. He added that in the same period Luton and Dunstable Hospital have increased their beds – the UK average for bed provision is 2 beds per 1000 population: in the Luton & Dunstable it is 2.1.

The committee then heard that Watford General is grossly overcrowded and that booking is difficult and stressful for staff, patients and relatives. Cllr Ritchie suggested that the Borough Council ought to take a lead in making an issue of this.

Cllr Maddern suggested that the local health authority’s behaviour is reminiscent of that towards the SCUBU unit in the 2000s – the aim appears to be to close down services, for example taking away the few 'step-down' beds in Dacorum.

Cllr Timmis agreed that she felt the Health authority is getting rid of staff. She added that the Step-down beds are a great intermediate phase between the home and a hospital stay: Berkhamsted demographics would suggest this resource is particularly necessary there.

Cllr Hicks returned to the difficulties experienced by relatives who can’t get to see their relatives resulting in slower recovery times.

Cllr Taylor said in his opinion Gossoms End is a 'constructive closure'. He added that this is the first he has heard of Quantum Care being involved in possibly running Gossoms End. Dr Fernandes added that the 20 beds at Gossoms End did not fall in to the “beds per 1000 of the population” equation. Cllr Taylor added that as far as Hospital facilities are concerned that the approach is ‘divide and conquer’; on a variety of fronts at the same time and that this is part of a larger problem.

Dr Fernandes then gave the facts as he understands them. He pointed out that those

examining the issue need to separate acute and re-hab beds: patients are handled

differently now and there is more efficient control over the length of peoples stay in hospital. The evidence as he understands it goes against lengthy stays in a bed based scenario. He went on to say he cannot comment on the detail of proportions  ...  view the full minutes text for item 222.

To provide Members with a Herts Valleys Clinical Commisioning Update since the last meeting held on 5 July 2016.

Dr Fernandes began by reiterating much of what was said in the previous item. He added that much is complained of Watford General Hospital but stressed that they are in fact hitting many of their targets and providing good care in areas such as cancer and 'strokes', that metrics have improved, and that mortality rates have improved. He admitted that A&E is an issue but felt that they are trying to address this.

He acknowledged that the administration of care often frustrates patients but pointed out that this is being looked at through improving the IT and identifying trends and patterns that can be taken up with the Trust.

The fact is that NHS Finances are tricky – he believes that the trust is £7m overspent at 3 months - mainly through people ending up in hospital care unnecessarily. NHS policy is that no hospital should end the year in deficit.

Cllr Timmis asked if the Care Quality Commission have finished their investigations and reported yet. Dr Fernandes said they came in last week; produced an action plan of hundreds of points; and that these are being examined actioned and monitored. The final report will be in a couple of months.

Cllr Timmis then raised the issue highlighted in recent press exposure of hospitals giving out equipment - e.g. zimmer frames - and advising patients to throw it away when they have recovered. Dr Fernandes mused that standards of hygiene may be the reason for not cleaning and re-using old equipment.

Cllr Maddern recounted that patients are being asked to use Stoke Mandeville and the L&D to allow Watford to clear its backlog – she enquired if ambulances being asked to do this as well and gave the example of her father in law being transported elsewhere for care. Dr Fernandes replied that the advice to ambulances is if it is acute then it is the nearest hospital but elective procedures, and planed, routine surgery is being farmed out.

Councillor W Wyatt–Lowe to provide Members with an update since the last meeting.

Deferred.

Deferred.

To consider passing a resolution in the following terms:

That, under s.100A (4) of the Local Government Act 1972 Schedule 12A Part 1 as amended by the Local Government (Access to Information) (Variation) Order 2006 the public be excluded during the item in Part II of the Agenda for this meeting, because it is likely, in view of the nature of the business to be transacted, that if members of the public were present, during this item there would be disclosure to them of exempt information relating to the financial or business affairs of any particular person (including the authority holding that information).

Resolved:

That, under s.100A (4) of the Local Government Act 1972 Schedule 12A Part 1 as amended by the Local Government (Access to Information) (Variation) Order 2006 the public be excluded during the item in Part II of the Agenda for this meeting, because it is likely, in view of the nature of the business to be transacted, that if members of the public were present, during this item there would be disclosure to them of exempt information relating to the financial and business affairs of a particular person.

See the Part II minutes No. OS/225/16, Get, Set, Go Dacorum.

The next meeting is scheduled for 7 December 2016.

The date of the next meeting is on 7 December 2016.

The work programme for the next meeting was amended to include the two items deferred from this meeting.