Burngreave Area Panel Minutes 11th December 2003

BURNGREAVE AREA PANEL


Meeting held 11^th December, 2003 at Pitsmoor Methodist Church

PRESENT:		Councillors Jackie Drayton (Chair) and Steve Jones.

		Also in attendance:-
		Kieron Williams	-	Area Co-ordinator

		Dr. Jeremy Wight	)
		Gary McCulloch	)	Sheffield North Primary Care Trust

		Heather Drabble	-	Sheffield Teaching Hospitals NHS Trust

		Maria Duffy	)
		Shanza Hussain	)	Development Services

		John Clark	)
		Magda Boo	)	Burngreave New Deal for Communities

		John Turner	-	Committee Secretariat

There were approximately 20 local residents and representatives of local community groups in attendance.

…………….

1.	APOLOGIES FOR ABSENCE FROM MEMBERS OF THE PANEL
	An apology for absence was received from Councillor Ibrar Hussain.

2.	PARKWOOD LANDFILL SITE HEALTH IMPACT ASSESSMENT – SUMMARY
	Dr. Jeremy Wight, Sheffield North Primary Care Trust (PCT) gave a presentation on the results of the Health Impact Assessment carried out in respect of the Parkwood Landfill Site, which had been undertaken in response to concerns expressed in recent years by local residents. The PCT had recognised that it was vital that local residents and other interested groups, including the site operators, should be consulted over the design and implementation of the assessment, and as part of the process, a Steering Group had been established which comprised representatives from the Landfill Site operator, local Councillors, Council officers, Impact, the Chemical Incident Response Service and the Environment Agency. Dr. Wight reported that there were three elements to the Health Impact Assessment, which included a review of research undertaken elsewhere, a health survey and an analysis of routine cancer, congenital anomaly, low birth rate and stillbirths data, and the assessment focused on the area within four kilometres of the centre of the Parkwood Landfill Site, which was divided into four zones, created by concentric circles, and a map showing this was displayed at the meeting. The health survey was designed to find out whether people reported more ill-health if they lived closer to the landfill site than if they lived further away, and the questionnaire, of which 900 were sent to residents living within each of the four zones, was eight pages long and contained 37 questions, covering various health problems, including respiratory symptoms, skin, nasal or eye irritation, anxiety or depression, neurological symptoms and liver problems, such as jaundice. There were also questions relating to smoking, age, gender, length of time individuals had lived in the area, employment status, occupational history and causes of worry or stress. The overall response rate to the survey was 58.6%, which was considered a reasonably high response rate for a survey of this nature.
	Following an analysis of the questionnaires received, it was found that there was a significant increase in the number of self-reported symptoms close to the landfill site, and this was particularly noted for bronchitis, chronic obstructive pulmonary disease, skin, nasal and eye irritation and neurological symptoms. The increase in reporting of anxiety, depression and asthma-like symptoms was less clear-cut and liver problems were more commonly reported by respondents who lived further away from the landfill site.
	Dr. Wight referred to the results of the survey relating to each of the various health problems, and how prevalent they were in each of the four zones, and which showed that the majority of the health problems were more prevalent in zone one.
	Following an analysis of routine data, over the 12 year period from 1990 to 2001, it was found that there had been no increase in cancers among people living near to the site, as compared with people living further away from the site and that between 1997 and 2002, it had been found that there had been no overall increase in congenital anomalies close to the landfill site. It had also been found that there had been no increase in low birth weight babies close to the site. The number of stillbirths in the same time period under study was too few to draw any firm conclusions about differences in rates between the different zones.
	Dr. Wight reported that the review of research from elsewhere had been inconclusive and that the analysis of cancer and congenital anomaly data was reassuring, in that it showed no increases close to the site. However, the health survey had revealed increased reporting on certain symptoms. Dr. Wight made the point that it was important to note that the survey simply revealed an association between certain self-reported symptoms and residents close to the landfill site, and that the survey did not inform what the cause of this association was. There were a number of possibilities for this; firstly, it was possible that there was a genuine casual link between the landfill site and ill-health in the population living around the site, secondly, it may be that there was an alternative cause of these symptoms affecting people who lived close to the landfill site, such as alternative sources of industrial waste and thirdly, it was possible that these results were due to increased sensitivity to symptoms in people who lived close to the site, and whilst the PCT was not suggesting that people living near the site had deliberately misrepresented their symptoms, people living near the landfill site may be more aware of particular symptoms, or have a lower threshold for identifying themselves as having the symptoms. Both explanations would make residents more likely to report symptoms than people living further away, even though the actual level of ill-health could be the same.
	Dr. Wight reported on the next steps to be undertaken, which included attempting to distinguish between the three above-mentioned possible causes, which would include three further pieces of work. Firstly, the records of GPs would be examined to see if they backed up the increased level of self-reported symptoms, secondly, the PCT would carry out a further examination of alternative sources of environmental pollution and undertake a re-analysis of data and finally, the PCT would undertake more sophisticated modelling of exposure, taking into account, wind and weather data. Dr. Wight concluded by stating that although there was increased reporting of ill health, the PCT could not say at this stage, that the landfill site was the cause, and that further studies were needed to understand why more ill health was reported in the area. He added that the PCT was committed to ensuring that these studies are undertaken, and would report back on the results to the local community.
	The following questions were asked and responses given:-

	Q. There appeared to be some air quality monitoring equipment at Firs Hill Primary School - when will the results of this monitoring become publicly available?

	R. The Environment Agency should be aware of all the air quality monitoring being undertaken in areas surrounding the site and they are keeping those residents involved, in meetings of the Parkwood Landfill Liaison Group, aware of all issues relating to the landfill site. It was not clear who was undertaking the air quality monitoring at Firs Hill Primary School.

	Q. Was the information as to exactly what was being dumped on the site publicly available?

	R. The Environment Agency should have this information, and as it was a public body, the information should be made publicly available. Viridor, the company which operates the site, also attend meetings of the Parkwood Landfill Liaison Group, so they could be questioned at these meetings by local residents.

	Q. With regard to the application made to the Environment Agency for the dumping of toxic waste on the landfill site to cease - was there any indication as to when the decision would take effect and who had made the application?

	R. The application to the Environment Agency was made following a resolution passed by the Parkwood Landfill Liaison Group at its meeting held on 13^th November, 2003. The decision was made by the Liaison Group, following representations from local action groups and local residents, who made representations at this and previous meetings. It was believed that the decision to stop dumping on the site would become effective in approximately two to three months.

	Q. The PCT must be aware that the effects of the toxic waste could result in an increase in people living near the site suffering various forms of cancer, and that it could take decades for the cancer to materialise - had the PCT taken this into consideration with regard to potential health problems in the future?

	R. The PCT was aware of this possibilty, but could only analyse the data on cancers to date. The PCT itself had no way of predicting what effects the toxic waste might have on the health of residents in 10 years time.

	Q. The air quality monitoring being undertaken at Firs Hill Primary School was quite a distance from the site - wouldn't it have been more effective to have the equipment nearer the site?

	R. It was accepted that Firs Hill Primary School was a distance from the landfill site, but other air quality monitoring had been undertaken at various locations nearer the site.

	RESOLVED: That (a) the information now reported as part of the presentation, together with the questions asked and responses provided, be noted;
	(b) the thanks of the Area Panel be conveyed to Dr. Jeremy Wight for the presentation now made; and
	(c) in the light of the concerns of local residents expressed at this meeting, as well as other public meetings, representations be made from the Area Panel, to the Environment Agency, to support the decision taken at the Parkwood Landfill Liaison Group, to ensure that the dumping of toxic waste on the site ceases with immediate effect.

3.	SHEFFIELD NHS TEACHING HOSPITALS TRUST - OUR PROPOSALS: TAKING OWNERSHIP OF OUR HOSPITALS
	Heather Drabble, Foundation Trust Project Director, Sheffield Teaching Hospitals NHS Trust, gave a presentation on the Trust's proposals with regard to the Trust gaining Foundation Trust status. Ms. Drabble reported that the Trust would still remain within the NHS and provide care free of charge, but that the proposals offered an opportunity to look at how the Trust could be run in the future. The main changes would be that local residents and patients would have an influence on how decisions were made with regard to the day-to-day running of the Trust.
	Ms. Drabble reported that a Governors' Council would be established, comprising members of the public elected by the communities in which they resided, patients elected from the patient community, staff elected from the staff community and a number of stakeholder representatives. A Board of Directors would be responsible for the day-to-day operational running of the Trust. The Trust would still be accountable to the relevant Primary Care Trusts and other NHS bodies and would be held to account by the National Health Service Foundation Trust (NHSFT) Regulator. Membership of the Trust would be open to staff, patients and public constituencies, it would be free to join and easily accessible to all, members would be able to vote in order to elect representatives to the Governor's Council, members would be able to stand for election to the Governor's Council and provide feedback and opinion on all issues relating to health care.
	With regard to eligibility, public members members should be residents of Sheffield and patient members should be patients or their designated carers in the last five years. Staff members would be expected to have 12 month contracts or equivalent, or honorary contracts.
	In connection with the Governors Council, Ms. Drabble reported that Governors would be democratically elected from staff patients and public members, they would be joined by nominated stakeholder representatives and the Council would be expected to oversee the hospital's strategic direction and service development and ensure the views of staff patients and public members were taken into consideration. For continuity reasons, the existing structure of the Board of Directors would be expected to remain, with the Board providing strategic leadership to the Trust, working with the Governors’ Council to set vision, priorities and strategy, oversee the day-to-day running of the hospital and have responsibility for the delivery and fulfilling a role almost identical to the present role of the Trust Board.
	The Governors’ Council would comprise 19 patient and public governors, five staff governors and 13 stakeholder governors, and would hold the Board of Directors to account. Of the 19 patient and public governors, 12 would be residents of Sheffield, and seven would be patients who may be from outside Sheffield. With regard to the Stakeholder Governors, it was proposed that there would be one from each of the Sheffield Primary Care Trusts, one each from the Sheffield and Hallam Universities, two from Sheffield City Council, two from the South Yorkshire Strategic Health Authority, one from Voluntary Action Sheffield, one from Sheffield First and one from NORCOM (South Yorkshire, North Derbyshire and Bassetlaw Commissioning Consortium).
	Ms. Drabble summarised the new proposed Governance arrangements, indicating that it comprised a new way of running the hospitals, there would be local accountability and involvement of local people, staff and stakeholders in planning issues, there would be open elections to Governor roles, there would be true partnership working and it would offer a chance for people to work with the Sheffield Teaching Hospitals NHS Trust. The new proposals would provide an opportunity for the Trust to work more closely with local communities which would involve communities being more engaged through membership and Governors, allow for the Trust to work more closely with the Area Panels in an attempt to help tackle health issues in the City, it would involve key stakeholders at a formal level and would help to build on the work undertaken by Sheffield First for Health.
	The following questions were asked and responses given:-

	Q. Those members of the public who would be willing to become members of the Trust would need to be clear exactly what would be required of them - would the Sheffield Teaching Hospitals NHS Trust be able to provide such information?

	R. The Trust would welcome the opportunity of talking to any prospective members and Governors.

	Q. Was there any training provision in place for members, particularly those elected on the Governors Council?

	R. There will be training sessions available for prospective Governors, with some sessions being held in the local community. There would also be additional training for those members, once elected to the Governors’ Council.

	Q. If and when the hospitals gain Foundation Trust status, will the Trust be able to remunerate its employees as it so wishes?

	R. All Trusts were required to offer nationally set pay and conditions next year. NHS Foundation Trusts may then subsequently look at local pay and conditions, but only if it was supported locally. Sheffield Teaching Hospitals already have a large number of staff on a local payscale.

	Q. There was a potential for local companies to benefit from the work of the Trust, by forming links with the Trust – was there any indication of which companies would benefit?

	R. The University of Sheffield were one body that was interested in forming links with the Trust, to look at research exploitation through start-up companies. There was also the opportunity of using local companies as suppliers, which could benefit from the present spending of approximately £130m a year on supplies, which the Trust was currently tied in to national contracts in many cases.

	Q. How long would members be elected to serve on the Governors Council?

	R. The term for the elected members would be three years, with each member being able to be elected for a maximum of two consecutive terms. At the first elections, the terms of appointment would be staggered in order to ensure that the whole of the Council would not have to step down at the same time in future years. For those members appointed for a period of one or two years from the outset, this would not be classed as a term.

	Q. Would the new Trust take into consideration the health inequalities in some areas of the City, such as Burngreave, and channel additional resources into such areas?

	R. There will be a strategic change as regards how the Trust viewed its responsibilities with regard to inequalities and regeneration, and by working more closely with the local community, it was hoped that health inequalities in certain areas could be identified and addressed more easily.

	Q. Would those members elected onto the Governors’ Council be paid for their services?

	R. The legislation stated that members of the Governors Council cannot be renumerated, but could receive expenses with regard to travel and subsistence.

	RESOLVED: That (a) the information reported as part of the presentation, together with the questions and responses provided, be noted; and
	(b) the thanks of the Area Panel be conveyed to Heather Drabble for the presentation now made.

4.	SHEFFIELD NORTH PRIMARY CARE TRUST - UPDATE ON HEALTH PROJECTS IN BURNGREAVE
	Gary McCulloch, Health Development Manager, Sheffield North Primary Care Trust (PCT), gave a presentation and provided an update on health projects organised by the PCT in Burngreave.
	Mr. McCulloch referred to the work being undertaken with children and young people in the area, including details of work being carried out in partnership with Sure Start relating to supporting families. Reference was also made to the work being undertaken with adults, specifically relating to the provision of health information, and work with older adults, with regard to supporting people to remain independent in their own homes.
	Mr. McCulloch also referred to the involvement of patients and members of the public in the work of the PCT, indicating that the PCT had patient representatives as members of its various Working and Planning Groups, which meant that patients were involved in hearing about proposals, plans and problems. They could also advise the PCT with the decisions it made and the plans it developed, which also helped the PCT to be accountable to the community, its services and ensured the openness of its decision-making process. The PCT attended various local events and festivals and carried out surveys to seek the community's views about local NHS services. The PCT often consulted with local residents when it was introducing proposals with regard to new services, and this was done by attending public meetings, holding special meetings and carrying out surveys.
	The PCT supported and worked with two patients' groups in the area, the Community Health Advisory Group and the Black and Ethnic Minority Health Group. These groups were made up of local people with an interest in health issues and met locally to advise the PCT about related issues and to be informed about service developments.
	Mr. McCulloch referred to the work of the other partners and stakeholders in the area who had assisted the PCT in its work, including residents, local community groups, Burngreave New Deal for Communities, the Area Panel's Area Co-ordinator and other groups in the area, such as the Community Health Advisory Group, Black and Minority Health Group and Burngreave and Fir Vale Sure Start, and thanked all the individuals and groups for their co-operation.
	The following questions were asked and responses given:-

	Q. In the light of the high levels of unemployment in Burngreave, and following the recruitment of nurses from abroad to work in hospitals across the country, could there be a programme of recruiting local people from black minority ethnic groups to work in the hospitals in Sheffield?

	R. Yes, the PCT were exploring initiatives such as this.

	Q. One of the problems of recruiting nurses was that the bursaries offered to them were so low - could these be increased?

	R. The PCT would investigate this.

	Q. It appeared that as part of the drives to recruit local people to work in the hospitals, such people were only appointed to service or lower paid administrative jobs - could it be possible to recruit them to higher posts, as many had the relevant skills and experience?

	R. The PCT would investigate this and report back.

	Q. As part of the drive to recruit local people to jobs in the hospitals in the City - could a system be introduced whereby those people who had the basic skills required to undertake certain jobs to be able to attend top-up courses to regain any necessary skills?

	R. The PCT would look at this issue and report back.

	Q. Due to the high rate of heart-related illnesses in Burngreave - could there be a system of regular cholesterol level testing in GPs’ surgeries in Burngreave and who would make the decision on providing funding for this facility?

	R. This was a very complex issue in that there was only a limited amount of funding available, and the PCT had to make decisions as to where such funding should be targeted. Whilst the idea of having a facility for routine cholesterol level testing for all, in local doctors surgeries was attractive, it would prove to be very expensive and therefore such a facility would not be justified. There was a need to channel resources into targeting those people most at risk from heart-related illnesses which meant that GPs would have to look at various factors when assessing the need for cholesterol testing, such as their age, sex, blood pressure and whether they smoked. This would enable resources to be used in a way which delivered most benefits. It was acknowledged that there was a high rate of heart-related illness in Burngreave and if GPs assessed people who they thought required treatment to lower their cholesterol levels, they would write out prescriptions for relevant treatment on this basis. The PCT has been doing a lot of work with GPs in Burngreave, and was well aware of the levels of heart-related illness.

	Following the questions, a number of comments were made by Members, members of the public and stakeholders, and it was noted that (a) the facility whereby residents could have their blood pressure taken at Lloyds Chemist, Ellesmere Road, was welcomed by residents in the surrounding area, (b) in connection with the recruitment of local people to work in the City's hospitals, Sheffield First for Health had recognised that Sheffield Teaching Hospitals NHS Trust were the biggest employers in the City, and would be working with relevant groups and organisations to undertake more work to look at what could be done to benefit local people, (c) New Deal would be interested in looking at the possibility of providing funding in respect of contributions to bursaries for those residents in the New Deal area who were interested in taking jobs in one of the City's hospitals, (d) members of the public felt that there should be a facility at local doctors' surgeries for routine cholesterol level testing, and that it would be an effective way of identifying those people with potential heart-related illnesses and could possibly, save the NHS money in the long-term and (e) there were still major issues with regard to inequalities in health across the City, and more particularly, in Burngreave; whilst the Council, as part of its "Closing the Gap" initiative, was taking action and targeting funding in order to reduce the inequalities between different areas of the City, there were still major inequalities with regard to health, and that senior officers within the Sheffield North PCT and the Sheffield Teaching Hospitals NHS Trust need to give this serious consideration.
	RESOLVED: That (a) the information reported, the questions asked and responses given, be noted; and
	(b) the thanks of the Area Panel be conveyed to Gary McCulloch for the presentation now made.

5.	MINUTES OF LAST MEETING
	The minutes of the meeting of the Area Panel held on 13^th November, 2003, were approved as a correct record, and arising therefrom, the Chair reported that officers in Development Services were looking at options with regard to the temporary closure of Grimesthorpe Road, and would be consulting on the proposals with local residents, which would include a public meeting and sending questionnaires to residents seeking their views.

6.	PUBLIC QUESTIONS AND PETITIONS
	There were no questions asked or petitions submitted from members of the public.

7.	DATE OF NEXT MEETING
	It was agreed that the next meeting of the Area Panel would be held on Thursday, 5^th February, 2004 from 6.30 p.m. to 8.30 p.m. at a venue to be arranged.

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