Core Strategy Implementation: PCT

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					                      Core Strategy Implementation: PCT
                                 30 July 2008

                                                                               Action
1.   Christine Winstanley Head of Capital and Estates, PCT
     David Proctor        Forward Planning Group Leader BwD
     Elizabeth Dixon      Principal Planner BwD

2.   PCT involvement in Planning:
     CW raised concern regarding current PCT involvement in planning
     and development control. PCT had been unaware of the level of
     increase in population from the proposed redevelopment of the
     Infirmary area. This is an area which is currently undoctored; they
     suggested s106 as an option for the developer to pick up the cost of
     providing facilities for the new residents, but it was too late to be
     considered.

     CW confirmed that any large development in an area will have an
     impact on the provision of health facilities.

     The PCT (Public Health Department) were sent a copy of the
     Preferred Options Core Strategy document as part of the formal
     consultation period. But we received no comments back.
     CW confirmed she would ensure the document and relevant sections
     are flagged up to Public Health – particularly the housing figures and    CW
     approach to development locations/development types, and see if
     they wish to raise any issues.
     DP confirmed we are happy to take comments even though we are
     not in a formal consultation period.

     CW queried whether there was an existing ‘Forward Planning’ Group
     for partner discussions of major applications/plans etc.
     DP confirmed that the best way to ensure a suitable approach was
     taken in planning applications was to get it written into policy.
     DP confirmed that the Environment Forum was the main Group
     which has ownership of the LDF development.

     CW suggested there should be a mechanism to link developments –
     for example – the college and the PCT working together on the town
     centre site happened almost by ‘accident’. But partnership working
     benefits include possible options such as a joint approach to/pool
     resources for cycle storage/ recycling points provision etc.

3.   Health Facilities Provision in Blackburn with Darwen:
     CW confirmed that the PCT work to the following standard
     benchmark:
         1 whole time GP to 1,500 population

     BwD currently operate to 1 GP to 1,900 population. In some areas
     the number of population per GP is smaller than this and in others it’s
     much larger: e.g. Shear Brow – 1 GP to 2,300 pop.

     The PCT have pledged 12 new GPs with the contract being awarded
     in December this year. These will be concentrated into 3 areas which
     have been identified as the most in need:
      Bentham Road area (the redevelopment of an existing old facility
        which currently has no GPs. The refurb. will be carried out over
        12/18months, and is a joint venture between Health and
        Education)
      Whitebirk (a premises had been identified, but has since been
        withdrawn: was Accrington Road Community Centre)
      Shear Brow area (haven’t been able to identify anything suitable.
        DP queried the new provision in the town centre and whether that
        would satisfy this need).
     Need is identified through analysis of data including: public health
     data/ deprivation/ GP list lengths/ distance of journeys each patient
     travelled to access health facilities/ etc.
     This data is looked at to see which areas there is the greatest need
     for intervention.

     Currently the BwD PCT is the 28 bottom performing PCT in the
     country; and has one of the worst gaps of GP per population in the
     country.

     CW agreed to provide information on the number of PCTs in the
     country.                                                                  CW

     In terms of health ranking – nationally we went from being the 36th
     worst to the 17th worst. This is based on the multiple deprivation
     index.

4.   Provision of New Health Facilities in Blackburn with Darwen:
     With respects to the Infirmary a business case is being prepared to
     put to the Board in November; likely to submit a planning application
     in November/December. They have secured funding for this
     internally.

5.   PCT Plans/Programmes:
        Estates Strategy: 5 year Plan
        Strategic Service Plan: 10 year Plan

     The PCT redrafted the 10 year Plan last year, but due to changes, is
     going through a further redraft. The current one is on the PCT
     website. The new one is likely to be drafted by Autumn. CW
     confirmed it was unlikely to change much in relation to the movement
     of services and how the PCT are intending to move forward. CW
     considered the current draft would be sufficient for our purposes to
     make reference to and consider as part of our process.

     Have requested population projections from Corporate Policy relating
     to changes in population for age/ ethnicity etc. – all of which has an
     impact on the types of health facilities they need to plan for and
     provide.

     They are aware there is an aging population, and in particular there is
     likely to be a growing aging Asian population – which will have
     different implications for service requirements since they have
     different health needs and demand for some services will increase;
     these are services we don’t currently provide and most of our
     residents have to travel to Preston for such treatment. Without the
     population projections it’s not possible to make the case for use of
     resources.

     PCT figures estimate a borough population of 160,000 – this is
     different to that we understand in planning (Core Strategy Preferred
     Options document states a population of 142,200 in approximately
     55,000 households).

     For every sample of population there are core services which they
     need to have access to: GP/Maternity/Pathology-bloods/
     Elderly/Sexual Health/Family Planning/Substance Misuse/etc.

     The PCT breakdown this, and target provision in different wards to its
     particular needs. Some services are similar right across the borough,
     while others are provided in those areas with the highest need – to
     be centred on where the issue actually is (i.e. substance misuse).

6.   Main Areas of Core Strategy with Implications for PCT:
         Attracting and Retaining Families
         Town Centre Living

     For every development there will be core services needed to be
     provided. This will be different depending on the type of development
     being proposed.

     The level of detail the PCT need to get involved was discussed – e.g.
     site allocations and actual planning applications will provide a clearer
     understanding of population increase, whether this will come from
     within the borough (existing residents) or new, and what type/age of
     household will be attracted to the development, or where a bus route
     would be diverted which may impact on the use of a particular
     existing building/site/ service. The Core Strategy doesn’t provide this
     level of detail, but will form the basis that the local decisions are
     made.

     DP confirmed that we would need to contact Corporate Policy for the
     development of the Core Strategy into its submission document; he
     confirmed that if we receive anything which we can share with CW
     we will.

     DP confirmed that the Core Strategy was taking the assumption that
     there will be an increase in families in the inner urban areas of the
     towns. Whilst there would remain a limited number of people within
     the town centres, this would also experience some increase, and in
     particular the types of people being attracted would be hoped to be
     ‘young professional’ types.

     There was discussion regarding the villages. CW confirmed that the
     BwD PCT doesn’t cover Belmont, Chapeltown, Edgworth – these are
     all covered by the Bolton PCT. Nothing south of Darwen.
     DP confirmed we would need to have a discussion with Bolton PCT
     regarding these areas.
                                                                                DP/ED
     CW confirmed she would be interested to know if Bolton assumed
     BwD PCT provided services to these villages or if Bolton plan for
     them.
     CW agreed to find a contact for Bolton PCT.
                                                                               CW
     CW was unsure as to provision in Hoddlesden.

     CW confirmed they covered Tockholes and Pleasington.

     CW also confirmed that they provided a service in Mellor – whilst this
     is outside the borough boundary it does serve BwD population.

     CW agreed to provide ED with a map of the area BwD PCT covers.

     DP queried whether there would be a move towards ‘poly clinics’ –
     i.e. moving towards larger service provision in key locations, and less   CW
     small individual practices.
     CW confirmed there was nothing planned of this scale after the town
     centre development has been completed. The town centre facility has
     been future proofed – built in capacity for outpatients, care in the
     community, walk in centre, etc.

     Any new development will be on a smaller scale for local provision.

     However, the GP practice provision is a national issue. There are a
     lot of GPs who are co-locating to be able to provide the hours cover
     required by national policy.

     CW suggested DP contact the Local Medical Council (LMC) who are
     the body representing GPs. The query would be a general, national
     one, at a higher level, rather than borough specific, to set the scene.
     CW agreed to provide contact details. The PCT work closely with           CW
     Clinical Care and GPs.

7.   PCT Funding:
     Strategic Capital Funding streams run for the financial year (April-
     March). By Christmas each year plans need to be submitted for the
     following year’s funding bid.

     Plans are prepared for 3year cycles, but funding is allocated on a
     12month basis. Previous to this year it was possible to carry over
     remaining funding, but this has been stopped since April 2008. Now
     the PCT have to have spent all allocated funding and completed the
     schemes by the March.

     This funding is received from the Treasury and is very fixed. The PCT
     must list the developments intended to pursue over the 3 years and
     put which year funding will be allocated in. They are only then
     informed for each 1 year allocation whether this funding has been
     agreed.

     The capital projects are decided based on the PCT’s own working to
     understand the needs/demands/gaps for the area.

     There isn’t the mechanism to move the funding about within the
cycles priorities – otherwise it would result in a slip in other priorities.

LIFT development is different; this is revenue-based funding. The
PCT are given operational money to run from year to year – which
pays for everything (wages etc.). As part of that LIFT is paid for –
similar to a mortgage. East Lancs Building Partnerships is the body
which owns the assets which are used for LIFT. This is made up
from: Government body/BwD PCT/ Eric Wright Group.
The PCT can commission LIFT to develop anything for BwD PCT.
The building in the town centre, for example, will cost £17-20m,
which the PCT don’t have, but they will pay back monthly through the
revenue.

There is therefore the possibility of any money received from s106
funding to be used to offset some of the balance of a LIFT project –
which would mean a developer wouldn’t have to pay for a facility
which is beyond the means of the development (can be in scale and
kind to the development triggering the need, but used as match
funding if required).

				
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