PAPER A

NOTES OF EVIDENCE

Meeting	Policy Commission for Care, Health and Housing
Ref	He.PC.28/06/06
Date	28^th June 2006
Time	18.00hrs
Place	Committee Room 1, County Hall, Newport, Isle of Wight
Purpose of meeting	Formal public meeting
Attendance	Commission	Cllrs Erica Oulton (Chairman), Roger Mazillius, Win McRobert, Margaret Webster and Colin West
	Cabinet	Cllr Dawn Cousins
	Secretariat	Cllr David Pugh
	Other Councillors	Cllr Gill Kennett (Member Champion for Housing)
	Officers	Ms Louise Biggs - Overview and Scrutiny (O&S) Team Ms April West - Overview and Scrutiny (O&S) Team Leader Mr Andrew Williamson, Interim Director of Adult and Community Services
	Stakeholders	Mr Graham Elderfield – Chief Executive of the Isle of Wight Healthcare NHS Trust / Primary Care Trust (PCT) Mr Paul Bingham – IW Director of Public Health Ms Anita Cameron-Smith – IW smoking cessation service Ms Carol Foley –IW Smoking Cessation Service
	Apologies	None
Agenda Items
1. To agree the notes of evidence arising at the meeting held on 17^th May 2006	Agreed
2. Declarations of Interest.	None
3. To receive a presentation from Mr Graham Elderfield – Isle of Wight Healthcare NHS Trust on the financial recovery plan.	3.1 Last year, the Healthcare Trust met its A&E 4 hour wait target, 8-minute 999 response time target, cancer wait targets and 6 month routine surgery wait targets. 3.2 There have been 4 cases of MRSA (in blood) since 31^st March 2006, against an allowance of 15 cases – this equates to a very low rate. There have been no fatalities. It is also important to remember that where the numbers are low, fluctuations may not necessarily be statistically significant. 3.3 The workforce has been reduced by 63 rather than the target of 224 as set by the Strategic Health Authority. (SHA). Bank, agency and overtime staff costs have been reduced. 3.4 Last year, the Healthcare Trust broke-even but did not achieve the targets of £11.7 million specified in the financial recovery plan. 3.5 Last year, the PCT overspent by 6.5 million. The Island as a whole did not achieve its financial plan 3.6 The Local delivery Plan for the year ahead has just been signed off. There will be £195 million of funds allocated for IW Healthcare. There will be £90 million for the PCT and he Healthcare Trust will receive £105 million of this to deliver services. 3.7 The target for financial recovery for this year was £12.9 million. £5 million has been found, leaving a gap of £7.9 million 3.8 The focus for this financial year: 3.8.1 There is workforce reduction target of 96 whole time equivalents (WTE). The current reduction stands at 47. The workforce reductions include all sections of staff: administrative, managerial and clinical. Last year’s target was carried forward to this year. 3.8.2 There have been changes to Island Line: the contact with NHS Direct has been cancelled and the controllers are now based in St Mary’s Hospital. This delivers a better service and saves money. 3.8.3 Since the beginning of April, 40 beds have been closed across St Mary’s Hospital and Shackleton in Ryde (4 beds). Some had to be re-opened due to pressures such as the Isle of Wight Festival. This had some impact upon the budget but was necessary for patient care. 3.8.4 Prescribing costs will be reduced by a target of 1.8 million. 3.8.5 Long term care was re-designed to save money and so people can be cared for in the most appropriate setting. 3.8.6 Of the debt to be found, a significant amount was non-recurrent. The Island’s health organisations are currently in discussion with the SHA as to how this could be paid back over a longer period of time. The outcome of this will be in September. 3.8.7 The contract for cataract treatment was negotiated nationally. This contract means that Island patients travel to Portsmouth for treatment, although the trust is concerned with this arrangement. In future it is hoped that the independent sector treatment centre may be able to provide some services on-Island. 3.9 Island healthcare is close to maintaining recurrent financial stability. 3.10 Better use could be made of the Healthcare Trust’s and Primary Care Trust’s estate. 3.11 The Island’s NHS have not made any consultants redundant, and there is still as shortage of GPs. 3.12 Attention is also being focused upon means of income generation, e.g. increasing the use of the Mottistone Suite.
4. To receive a presentation from the Public health team on smoking cessation – enquiry H3/06 – from Dr Paul Bingham, Ms Anita Cameron-Smith and Ms Carol Foley	4.1 The scoping proforma was agreed for this enquiry with the following amendments: Tourism should be added to the list of stakeholders, along with Island licencees and the Chamber of Commerce. It was also felt that some reference to the economic factors as a result of smoking should be included within the review. 4.2 Smoking is the single biggest health inequality. The national rate of smoking is 26% and 31% amongst manual workers. The island average is 27% 4.3 The ‘choosing health’ white paper aims to reduce these rates. 4.4 The cessation service offers drop-in assistance, group and individual support for quitting. They also provide prisoners with help in quitting, work closely with school nurses and advise companies smoking policies. 4.5 There are dedicated work place advisors to reduce the number of routine / semi routine. 4.6 The IWC is not yet no-smoking. 4.7 Schools are difficult areas to tackle as it is hard to motivate young people to quit. However, the Island’s service does run drop-in sessions at schools and encourage the closure of staff smoking rooms. 4.8 There is a higher level of smoking amongst teenage girls than boys. Recent advertising has concentrated on the effects of smoking upon a person’s physical attractiveness, rather than just health effects in an attempt to reach a younger audience. 4.9 Women still smoke more than men and there has been an increase in the number of woman with lung cancer. 4.10 Levels of cigarette smuggling are high, and Government tends to focus on the revenue lost rather than the health implications of smoking. 4.11 The new legislation is very good for Public Health. There will be a total ban on smoking within enclosed public places, and a ban on areas which are more than 50% enclosed. 4.12 Smoking on the St Mary’s Hospital site has been banned and bed-side quitter’s packs are provided for patients and staff. The smoking cessation service can go into see patients if wanted. 4.13 Anecdotal evidence suggested that smoking is not as expensive as assumed - some users of the service have said that the cost of smoking is not significant motivator to quit. 4.13 The sale of tobacco to under 16s is of concern and Trading Standards are tackling this. 4.14 Each quarter, the cessation service must send off a 4-week quitter’s return to the Department of Health.
5. To agree the scoping documents for new commission enquiries	5.1 Continuing Care enquiry H1/06. 5.1.1 Under ’Terms of Reference’, ‘National and regional criteria for continuing care’, add ‘define’ to the beginning of the sentence. 5.1.2 Under ‘key stakeholders’, differentiate between nursing and residential care homes 5.2 Affordable Housing enquiry H2/06: 5.2.1 Under ‘Terms of Reference’, move ‘to clarify the definition of affordable housing’ to bullet point one. 5.2.2 Add to the terms of reference mention of the financial situation regarding the provision of affordable housing (e.g. grants) 5.2.3 Ensure that a case-is provided for members on an affordable housing development, as part of this enquiry. 5.3 Smoking cessation H3/06: 5.3.1 It was agreed that Cllr Win McRobert would lead on this enquiry.
Actions	1. To invite the Chief Executive of the Healthcare Trust / PCT and the Project Director of the Transition Team to the meeting on 27^th September 2006 2. Amend scoping documents H1/06, H2/06 and H3/06		LB LB