Health & Adult Social Care

Adult Social Care

Introduction

The Health and Social Care Act 2001 introduced the specific power of health scrutiny for English local authorities with a social service function. This enables local authorities to scrutinise the operation of the health services in its area and make reports and recommendations to NHS bodies.  Typically, the committee undertakes reviews of health issues and considers and responds to inquiries, considers proposals by the NHS to develop or vary services, responds to national consultations.

Funding

Under the County Council service cut programme entitled Transformation 2017, the following savings are going to be found;-

  • £9.7m by April 2016
  • £36m by April 2017
  • £43.1m by April 2018

Hampshire County Council is to use special new powers to hike council tax up 3.99% in April 2016.  To provide some protection for care funding, Chancellor George Osborne included a 2% “social care precept” in his autumn Spending Review, which will bring in another £10m, but 90% of this will be taken up on inflation and  paying staff the living wage.  See the Independent piece, “Nine in 10 English councils to use special new powers to impose council tax hikes”.  In addition, “The Government must take responsibility for the elderly”.

Working on a greatly reduced budget means that the council is having to derive a model for people to support themselves in a greater way than they would have previously.

Proposals to Develop or Vary Services

Committee members must be alerted to the fact that the NHS or providers of health services are proposing to make changes to health services provided to people living in Hampshire.  However this is undertaken within several policy documents or frameworks.  The principal document, the NHS Outcomes Framework sets out the outcomes and corresponding indicators that will be used to hold NHS England to account for improvements in health outcomes.  Another policy document, the Public Health outcomes framework 2013 to 2016 concentrates on increased healthy life expectancy and reduced differences in life expectancy and healthy life expectancy between communities.  Yet another, the Adult Social Care Outcomes Framework (ASCOF) measures how well care and support services achieve the outcomes that matter most to people.

Minor Injuries Unit (MIU) in Andover War Memorial Hospital (AWMH)

It is through the guidelines provided by these documents that councillors scrutinize health provision, which is how the subject of Hampshire Hospitals NHS Foundation Trust: Andover War Memorial Hospital Minor Injuries Unit – Temporary Change to Operating Hours, came to committee.  Hampshire Hospitals NHS Foundation Trust (HHFT) provides a Minor Injuries Unit (MIU) in Andover War Memorial Hospital (AWMH) which is usually open seven days a week, from 8.30am until 10pm, complementing the two major hospital sites of Basingstoke and Winchester, which both have 24/7 Emergency Departments.  Emergency Nurse Practitioners (ENPs) lead the service and are part of a larger staff rotation which includes all three hospital sites (Andover, Basingstoke and Winchester), in order to help maintain services, and skillsets.  In March 2016, a combination of staff sickness and absence resulted in an insufficient number of ENPs available to provide safe staffing levels at all three hospital sites.  As a consequence, Hampshire Hospitals NHS Foundation Trust took the decision on 15 March 2016 to temporarily reduce the operating hours of the MIU at AWMH to 8am to 6pm, Monday to Friday, in order to ensure that safe services could be offered at all three hospital sites for those seeking urgent care.  It is estimated that by the end of June 2016 everything will be back to normal.  However Councillors were given the opportunity to have their say about how this situation arose and what if anything should be done about it.

West Hampshire Clinical Commissioning Group: Friarsgate Practice – Kings Worthy Branch Surgery Closure

West Hampshire Clinical Commissioning Group (CCG) notified the scrutiny officer of proposed changes to several primary care services in its region in January 2016. One of these proposals centred on the proposed closure of the Kings Worthy branch surgery operated by the Friarsgate Surgery, which is a multi-branch surgery primarily based in Weeke, Winchester.  The reason given for the closure was the low usage of the facility.

The Care Quality Commission’s inspection report on Portsmouth Hospital Trust’s Accident and Emergency Department

In particular, the committee will evaluate the response times of South Central Ambulance NHS FT (SCAS) South East Coast Ambulance NHS FT (SECAMB).

The Quality Care Commission ratings for Queen Alexandra Hospital are;-

  • Overall rating for this hospital, Inadequate
  • Urgent and emergency services, Inadequate
  • Medical care (including older people’s care), Requires improvement

The Care Quality Commission (CQC) re-inspection of services Southern Health NHS FT

This has been a very high profile issue for several years.  Southern Health acknowledge that there is more work to be done to improve services and say that they are moving quickly to address this.