PAPER A

NOTES OF EVIDENCE

Meeting	Policy Commission for Care Trust Delivery and Health Scrutiny
Ref	He.PC.16/11/05
Date	16^th November 2005
Time	18.00hrs
Place	Committee Room 1, County Hall, Newport
Purpose of meeting	Formal public meeting
Attendance	Commission	Cllrs Erica Oulton (Chairman), Roger Mazillius, Colin West, Win McRobert and David Whittaker Co-opted Members Mr Robert Jones – Vice Chairman, Primary Care PPIF Mr David White – Vice Chairman, Healthcare PPIF
	Cabinet	Cllrs Dawn Cousins, Andy Sutton
	Secretariat	Cllr David Pugh, Cllr Alan Wells
	Other Councillors	Cllr Mike Cunningham, Deborah Gardiner and George Brown
	Officers	Ms Louise Biggs - Overview and Scrutiny (O&S) Team Mr Andrew Shorkey - O&S Team Ms Sandy Weller, Acting Director of Social Services
	Stake holders	Mr Graham Elderfield, Joint Chief Executive, Isle of Wight Healthcare Trust and Primary Care Trust Mrs Jane Wilshaw, Director of Nursing and Patient Care, Isle of Wight Healthcare NHS Trust (IWHNHST)
	Apologies	Cllrs Geoff Lumley, Margaret Webster
Agenda Items
1. To agree the notes of evidence arising at the extraordinary meeting held on 26 October 2005	The notes of evidence were agreed.
2. Declarations of Interest.	None
3. To receive an update on the current status and future work on the joint financial recovery plan	Service targets: · After 6 months, 98% of patients presenting A&E were being either admitted, discharged or transferred within 4 hours of arrival. This was despite a busy summer period. · The ambulance service met the target of reaching 75% of life-threatening calls within 8 minutes, throughout the year. · The trust is on target to achieve its target of a maximum 6 month wait for elective surgery. · The trust is currently meeting its target of all patients having an outpatient appointment within 13 weeks of GP referral. · The challenging targets are now the cancer wait targets · The choose and book system in use by General Practioners (GPs) is working well Workforce targets: · The trusts have losing posts within this current year as part of the financial recovery plan. After 6 months on target and are 11 posts ahead of schedule. · 12 organisational change papers have now all been discussed and agreed with staff and will be implemented over the next few weeks. · The number of staff posts that are reducing are coming down in line with the target. The predicted number of posts to be lost will be in excess of 200, be made up of non-clinical staff and reflect a change of skills rather than staff reduction. Most of the posts will be cut through existing vacancies and staff turnover. It is not considered that this will have a detrimental effect on recruitment in the future. Financial: · After 6 months the PCT has reached financial balance although the IWHNHST is still 1.2 million overspent. Action will be put in place to correct this. · Staff costs have been higher over the first 6 months due to an increase in elective surgery over the first half of the year. · There has been an under-spend on prescribing in primary care has been seen this year and the PCT has already met targets set at the beginning of the year. A small number of patients have complained that drugs are changing more frequently in line with increased generic prescribing to reduce costs. · The IWHNHST is seeking advice on Herceptin (which is currently unlicensed) for the treatment of breast cancer. · The trusts are moving away from salami slicing the budgets and instead focussing upon reworking the whole health system to create efficiency savings. · The overspend is not reducing as quickly as expected. This has been caused by higher than anticipated agency costs for Doctors and also the costs associated with Agenda for Change (the introduction of new pay scales for the majority of NHS staff) and an underachievement in CRES. · Theatre productivity is improving and can contribute to savings · Peaks and troughs of demand are difficult to predict and can cause problem in achieving target, and can be somewhat alleviated by contingency planning has taken place for this winter. · The Isle of Wight’s NHS trusts predict that they will in recurrent financial balance prior to integration with the Council’s Adult services in 2007. · The key to future savings will be from practice-based commissioning, whereby patients are cared for within a primary care setting rather than at St Mary’s hospital. · The estimated growth money for next year will be £12/13 million although this figure was originally predicted to be £15 million.
4. To receive evidence from Mr Elderfield on his response dated 26 October 2005 to the Policy Commission’s letter dated 3 September 2005	· St Catherine’s ward has been altered to take Shackleton House which will not move until this is complete. This is still on track to be completed by March 2005. · The increase in the number of patients being treated at home for mental health problems will lead to a reduction in admissions to 7 Acres and the number of inpatient beds will be reviewed in December. · More long term work is required to provide more care provision outside of hospital in conjunction with the Isle of Wight Council, which is currently under progress. · The Channel Islands wish to use the Manor House or another facility in Southampton. The PCT in conjunction with the Channel Islands and Southampton University hospitals are investigating whether this service can be provided more cheaply. · The Trust is now looking at ways to reduce bed occupancy figures. These include moving more surgery to a day basis, creating a better system of tracking patients who have been delayed waiting for a care package and also treating more people in the community.
Issues raised by the Patient and Public Involvement Forum	· Independent Complaints & Advocacy Service - communication and feedback form this organisation has been limited and this was of concern to the PPIF · Hospital signage – Mr Elderfield had written to the chairman on this issue which was referred to the Policy Commission by the PPIF. The Trust have offered for the PPIF to develop the signage plans in conjunction with the PPIF.
Further discussions	· Cllr Cousins updates Members on the recent conference on adult health and social care and commented that the national direction of travel reflected the Island’s plans to integrate health and social care.
Actions	1. Information to Members on the Platinum points scheme to be sent through 2. The regional ICAS office to be contacted.	Overview and Scrutiny Team / IWHNHST Overview and scrutiny Team