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Health and Community Care Scrutiny and Policy Development Board Minutes 25th June 2007
HEALTH AND COMMUNITY CARE SCRUTINY AND POLICY DEVELOPMENT BOARD | ||
Special meeting held 25th June, 2007 | ||
PRESENT: | Councillors Clive Skelton (Chair), Ian Auckland, Jane Bird, Vic Bowden, Mike Davis, Jackie Drayton, Pat Fox, Gill Furniss, Keith Hill, Robert MacDonald, Pat Midgley and Helen Mirfin-Boukouris. | |
………………….. | ||
1. | APOLOGIES FOR ABSENCE FROM MEMBERS OF THE BOARD | |
There were no apologies for absence received from Members of the Board. | ||
2. | DECLARATIONS OF INTEREST AND PARTY WHIP | |
There were no declarations of interest or party whipping received. | ||
3. | PUBLIC QUESTIONS AND PETITIONS | |
There were no questions raised or petitions submitted by members of the public. | ||
4. | YORKSHIRE AMBULANCE SERVICE - DEVELOPING ACCESS AND RESPONSE SERVICES | |
The Board gave consideration to proposals of the Yorkshire Ambulance Service NHS Trust to close its Rotherham Access and Response 999 Communications Centre and relocate the service to an expanded centre in Wakefield. | ||
The Yorkshire Ambulance Service (YAS) was conducting a 12-week public consultation exercise upon the proposals, ending on 27th July, 2007, and the results of the consultation would then be submitted to the Trust's Board who would make a decision on whether to proceed with the proposed closure. A consultation document produced in respect of the proposals had been circulated with the agenda for the meeting. | ||
John Darley (Director of Operations, YAS) gave a presentation upon the Trust's plans to develop access and response services and in particular (a) commented on the policy environment pertaining to ambulance services, (b) stated that the Trust proposed to develop, over time, two large Access and Response 999 Communications Centres which include expanded emergency and urgent care services for the public and other health service providers and, with a view to achieving that aim, proposed to close the facility in Rotherham and relocate its service to an expanded centre in Wakefield with an estimated completion date of Spring 2008, (c) outlined the benefits to be accrued from implementing such proposals, (d) commented on the rationale for selecting the Rotherham Centre for closure and (e) outlined the impact of the proposals upon the local Ambulance Service and on the staff at the Rotherham Centre. | ||
Members of the Board asked questions and commented upon the presentation and consultation documentation, to which responses were made by John Darley, assisted where appropriate by Nick Varey (Chairman, YAS) Trevor Baldwin (Assistant Director, Access and Response, YAS) and Anne Dale (Access and Response Consultation Co-ordinator, YAS) and these included:- | ||
· The service provided by the emergency care practitioners would be unaffected by the proposals. This local service was commissioned directly by the Sheffield Primary Care Trust at a cost of £1.8m and was proving very effective in service and value for money terms. The Yorkshire Ambulance Service would wish to continue the operation of the emergency care practitioners in Sheffield and also look to extend the initiative to other areas of the region. | ||
· As regards the impact of the recent reorganisation of ambulance services in the region on performance in Sheffield, performance in South Yorkshire immediately prior to the merger on the key measure of performance relating to percentage of emergency calls responded to within eight minutes was 79% and the current level of performance after merger was also 79%. The Service would be introducing 24 hour standby points within South Yorkshire during this financial year in order to further improve performance on response times. | ||
· On the issue of the impact on service delivery of the loss of the local expertise and knowledge provided by the staff of the Rotherham Centre, whilst local knowledge and expertise was beneficial, the information technology systems used by the Service's Access and Response 999 Communications Centres provide detailed information about any local area. The ambulance crews would be unaffected by the proposals to close the Rotherham Centre, so there would be no loss of local knowledge on the ground. The information technology system for processing and responding to calls to the Service accurately identifies callers' locations and locates the nearest appropriate crew to respond. The satellite navigation systems suggest a route to be taken by the crews but they would use their local knowledge and take an alternative route if they deemed it appropriate. | ||
· The Trust was of the opinion that the operation of two Access and Response 999 Communications Centres was the best way for the Service to meet its future aims and objectives. Call volumes and patterns were analysed to determine staffing levels within the Centres and deployment of road crews and the command and control systems used by the Service enabled emergency calls to be redirected between Communications Centres should there be an unexpected peak in demand at any one of them. | ||
· Approximately 50% of calls made to the Service were handled by the Wakefield Communications Centre and the remaining 50% was split equally between the Centres in York and Rotherham. | ||
· In response to a query as to whether the Trust had considered establishing a Communications Centre in Sheffield, possibly in conjunction with other emergency services, this had not been pursued for risk and resilience reasons. Police and Ambulance Services operated different response systems and problems had been experienced with some combined Police, Fire and Ambulance Communications Centres piloted in some areas of the Country. Although combined operations may be a viable option in the longer term, the Trust was of the opinion that the potential risks were too high at the present time. The Trust wished to operate two communications centres as this offered greater resilience and business continuity benefits over a single call centre. | ||
· As regards the consultation exercise upon the proposals, the Trust was adhering to Department of Health guidance in relation to consulting on proposals for organisational change and it was deemed that the recommended minimum consultation period of 12 weeks would be sufficient to enable all relevant stakeholders to be consulted upon the proposals. A preferred option had been selected by the Trust following consideration of the viability of the options of doing nothing, reducing from three centres to two or reducing from three centres to one, and the Trust now wished to discuss its proposals with its stakeholders in order to ensure that no issues had been overlooked. | ||
· A detailed options appraisal had been undertaken in relation to the Trust's plans to develop its access and response services and showed fairly conclusively that reducing from three communications centres to two and closing the Rotherham Centre was the option providing the greatest benefits to the Service. The requirement for significant financial investment to be made in the Rotherham Centre and its lack of capacity to expand, either as a larger communications centre or to manage an expanded emergency care practitioner service, were key considerations. | ||
· As regards the views of stakeholders upon the proposals, the trades unions were opposing the proposals and whilst there had been resistance expressed by some staff during informal one to one interviews undertaken in relation to the proposals, many staff acknowledged the rationale for the closure and were keen to explore the opportunities being made available to them in terms of relocation or redeployment in other roles within the Service. The Trust had given a guarantee to the Rotherham staff that their terms and conditions would be protected. The views of the local Primary Care Trusts were being sought and this would be the method by which the views of general practitioners and other health professionals would be obtained, but the Trust was guaranteeing to continue to deliver its contractual obligations with the Primary Care Trusts in relation to levels of performance. | ||
· The performance of the Yorkshire Ambulance Service in 2006/07 had been affected by the levels of performance in the West Yorkshire region which had skewed the overall score for the Service. A significant reorganisation of the service in that region had been implemented and had resulted in significant improvements to levels of performance. All constituent areas of the Service were now achieving performance levels of over 75% in relation to time taken to respond to emergency calls. A further indicator of service performance was the fact that the Service had retained its contracts in respect of patient transport services. | ||
· Along with many other NHS Trusts, the Trust had financial recovery plans in place and was required to balance its finances. As part of those arrangements, management costs had been reduced, whereas operations had been protected. The savings accruing from the proposed closure of the Rotherham Centre would be used partly to assist the financial position of the Trust but also to support improved operations. | ||
· The communications centres in Wakefield and York had capacity to expand, whereas there was no scope for expansion at the Rotherham Centre. There had been a 6% increase in the number of life threatening calls made to the Service in the past year and this had been managed through expansion and new staffing rotas to meet peaks in demand. The Trust had a strategy to enhance its communications centre services and facilities and it was anticipated that this would be implemented in two to three years time. In order to improve its response to demand and need for the service, the location of pick-ups was recorded and analysed by the Service and the location of high levels of demand was identified and used to inform decisions in relation to the location of stand-by points for ambulance crews. The Service was also endeavouring to develop its responses to requests for ambulance services through categorisation of calls and enhanced care pathways. | ||
RESOLVED: That (i) the representatives of the Yorkshire Ambulance Service NHS Trust be thanked for their attendance and contribution at the meeting; | ||
(ii) consideration of the Board's response to the Trust's proposals to close its Rotherham Access and Response 999 Communications Centre be deferred to the meeting of the Board to be held on 16th July, 2007; and | ||
(iii) in order to further inform the Board's response in that regard, arrangements be made for the Trust's detailed options appraisal with regard to the development of its Access and Response Services, and the views of the trades unions upon the potential impact of the closure of the Rotherham Centre upon the delivery of access and response services in the South Yorkshire area, to be circulated to all Members of the Board. | ||
5. | WORK SCHEDULE 2007/08 | |
The Board gave consideration to the schedule of items proposed to be considered by the Board during 2007/08. | ||
RESOLVED: That (a) the work schedule for the Board in 2007/08 now submitted be approved; | ||
(b) dignity and respect for older people be identified as a possible topic upon which to conduct a detailed scrutiny exercise during 2007/08 and a decision as to whether or not to proceed with such exercise be taken following consideration of the report to be submitted to the meeting of the Board on 15th October, 2007, in relation to that topic; and | ||
(c) on future occasions where the Board is giving consideration to health care providers' proposals to reconfigure services, arrangements be made for the Board to consider the views of trades unions and staff upon such proposals. | ||
6. | MINUTES | |
The minutes of the meeting of the Board held on 14th May, 2007, were agreed as a correct record subject to the addition of the name of Councillor Jane Bird to the list of Members present at the meeting. | ||
7. | NATIONAL BLOOD SERVICE | |
The Board gave further consideration to its response to the presentation made by the National Blood Service upon the National Health Service Blood and Transplant Service Strategy 2006-10, considered by the Board at its meeting held on 11th June, 2007. | ||
RESOLVED: That in the light of the information made available, this Board (a) views with grave concern the proposals outlined by the National Blood Service to re-organise the Service in England and Wales without sufficient evidence of the need to re-organise the Service and particularly with regard to the impact of the re-organisation proposals in the City, (b) believes that these proposals could result in Manchester being the nearest Testing and Processing Site to the City and serving the whole of the North of England and Wales and the transfer of blood storage and distribution facilities in the City to Leeds, thereby putting at risk the availability of blood and blood products in the City, particularly in emergency situations; (c) views with disquiet the lack of clarity as to whether or not the Strategy was formulated in consultation with medical experts and laboratory managers from local hospitals and if the strategy has the support of these professionals; (d) notes with concern the fears expressed by the trades union and others that the proposals would have a severe impact upon the ability of the Children's Hospital to continue its internationally renowned work on children's leukaemia, the training arrangements for Consultant Haematologists in the City, the immediate availability of specialist blood components and the carrying out of specialist research and development activities such as stem cell research, which are presently supplied by the Sheffield Centre; (e) does not accept the premise put forward by the National Blood Service that the NBS Centre in Sheffield was "not fit for purpose" when the Centre has recently under gone several major refurbishment projects and, in the opinion of managers, is now fit for purpose for at least another 10 years; (f) would wish to express its dissatisfaction at the apparent lack of accurate costings for the proposals including transportation costs thereby not giving the Board any opportunity to reach “judgment” on the economic veracity of the proposals; (g) is of the view that the underlying philosophy behind the proposals is driven by economic consideration rather than service improvements particularly as no information regarding costings and deployment was made available to the Board; (h) is concerned that this matter was brought to the attention of the Board in the first instance by the trades unions representing employees of the NBS in the City and not by the NBS and would urge the Secretary of State for Health to remind the Health bodies of their responsibility to engage in meaningful and comprehensive consultations with Local Authorities and other parties regarding proposals for service change and also to request in the strongest possible terms to examine closely the processes for disseminating information and engaging in consultation so as to ensure that substantial systemic improvements are made to prevent this situation arising again; (i) believes that at a time when all agencies are committed to taking positive steps to reduce the environmental impact of road travel there would be every possibility of an adverse environmental impact through increased transportation of blood products to the City together with the concomitant dangers of inaccessibility to the City in adverse weather conditions; (j) whilst recognising that it is not within its remit to become involved with or comment upon the possible adverse economic impact of the proposals upon the City's regeneration would nevertheless urge the Leader of the City Council, the Cabinet Member with responsibility for Economic Regeneration, Culture and Planning and the Chief Executive to pursue this aspect of the proposals with the utmost vigour; (k) requests that further proposals about this re-organisation be reported to the Board as a matter of urgency; and (l) requests that copies of this resolution be forwarded to the Sheffield Members of Parliament, the Secretary of State for Health, the Core Cities and the other South Yorkshire Authorities. | ||
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