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									                                                                     Item No 1

                                DURHAM COUNTY COUNCIL

At a Meeting of the Health Scrutiny Sub-Committee held at the County Hall,
Durham on Monday 29 March 2004 at 10.00 a.m.

                              COUNCILLOR PRIESTLEY in the Chair.

Durham County Council
Councillors J Amstrong, Carroll, Cordon, Howarth, E Hunter and Ord

Chester le Street District Council
Councillor Harrison

Easington District Council
Councillor Burnip

Derwentside District Council
Councillor Agnew

Durham City Council
Councillors Simmons

Teesdale District Council
Councillor Mitchell

Sedgefield Borough Council
Councillors Crosby and Gray

Wear Valley District Council
Councillor Lee

Other members
Councillor Blenkinsopp and Thompson

Apologies for absence were received from Councillors Armstrong, Harker,
Marshall, Porter, Pye, Raine, Stansfield

A1       Minutes

The Minutes of the meeting held on 12 January 2004 were agreed as a correct
record and signed by the Chairman. The notes of the presentation held on 16
January 2004 were noted


A2       Declarations of Interest

There were no declarations of interest.




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A3       Annual Report

The Sub Committee considered the Annual Report (for copy see file of
Minutes).

Resolved:
That the report be approved.


A4       County Durham and Darlington Acute Hospitals NHS Trust

The Sub Committee received a presentation from Edmund Lovell and Louise
Robson of County Durham and Darlington Acute Hospitals NHS Trust.

The Trust was formed in 2002 following the merger of the North Durham and
South Durham Hospital Trusts. The Trust employs 5,700 and manages 1,500
beds. The three main hospitals are

        Bishop Auckland General Hospital
        Darlington Memorial Hospital
        University Hospital of North Durham.

The Trust is also responsible for a number of Community Hospitals.

During 2002/03 the Trust has dealt with 372,600 outpatients, 27,000 day cases,
81,000 inpatients and Accident and Emergency (A&E) treated 138,500 cases.

In terms of waiting lists, the waiting time of inpatients has been reduced. The
Trust was on target for no one to be waiting more than 9 months and were
cutting the number of people waiting over 6 months. The performance on
outpatients has also improved and they are on target for no one to wait longer
than 17 weeks for an appointment with a consultant. The number of people
waiting more than 13 weeks is also being cut. Louise confirmed that work is
commissioned with the private sector as and when necessary.

In relation to A&E performance the 90% target for dealing with patients within 4
hours was met across the Trust. An action plan will be put in place at each
hospital to meet the target of 98% from January 2005. In response to
questions, Edmund explained that the A & E admissions at University Hospital
were under pressure in early January. A decision was taken to redirect GP and
ambulance admissions to other hospitals. Any one reporting directly at A & E
was offered treatment as were all those who were seriously ill. In addition on
another occasion, after a chemical incident A & E was temporarily closed.

Changes to services are proposed at Homelands Hospital, South Moor Hospital
and specialist urology services. Approximately 1600 urology patients will be
treated at Sunderland as a result of increased specialisation, an increase in
cancer treatment standards and the European Working Time Directive.
Responding to Members concern about the provision of transport for patients
and their families, Louise explained that more specialised clinics will be
arranged at local hospitals and only those requiring specialised major
procedures will have to travel to Sunderland.


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It was confirmed tha t the Health Scrutiny Sub Committee will be formally
consulted at a later stage.


A5       Tees Review - Presentation

The Sub Committee received a presentation from Melanie Fordham and Anne
Donnan about the Tees Review consultation process (for copy see file of
Minutes).

Ian Mackenzie explained that the Tees review covered a wide geographical
area of which parts of Easington and Sedgefield Districts are affected. The
Health Scrutiny Committee has representation on a Joint Committee
considering the review.

Ian reminded the Sub Committee that the effect on Easington is likely to be
significant and that transport will be a major issue. The formal consultation
process has yet to commence.

Councillor Burnip stressed the importance of the formal consultation being
perceived as open and genuine if it is to be supported by the residents of
Easington.

Resolved:
That the presentation be noted.


A6       Homelands Hospital

The Sub Committee received a presentation from Andrew Kenworthy, Chief
Executive of Durham Dales PCT, on the proposals for Homelands Hospital
Crook.

Andrew explained that at the present time Homelands Hospital has 20 beds
used for the care of the elderly. The fabric of the building is very poor and only
a small part of the building is actually used. Whilst the level of care provided by
staff is considered excellent, it is felt to be an inappropriate facility in the modern
NHS.

Currently the beds are used for up to 12 patients for recovery and respite care.
At the present time there are no delayed discharges and use is reducing.
Andrew stated that the funding used for Homelands would be reinvested into
other community services including therapy, extra support, admissions into
residential homes and alternative beds.

In response to a question about the provision of a new community hospital,
Andrew explained that with a new general hospital at Bishop Auckland there
was no demand and in any case it would divert funding away from other
services.

A formal consultation exercise will be undertaken in the near future.




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Resolved:
That the presentation be noted.


A7       Other Primary Care Trust Issues

Wynn Griffiths Chief Executive of Derwentside Primary Care Trust (PCT) gave
the Sub Committee an update on issues within the Derwentside and Durham
and Chester le Street PCT’s.

Resources are being invested in A & E and cardiac services. Following the
introduction of the new GP contract on 1 April 2004 the PCT’s will be
introducing new local enhanced services. Approximately £1.1m of extra money
will be spent in Derwentside. As a result of improvements to primary services it
was expected that patients would be able to see a GP within two days and have
access to a nurse or physiotherapist within one day.

The Sub Committee was reminded that the position with the out of hour’s
service has to be resolved by December 2004. The present GP co-operative
arrangements will end on 1 July 2004 and the PCT’s will take over
responsibility. New shift patterns will be introduced from 1 September and a
mixed skill arrangement will be used (ie doctors/nurse practitioners) to provide
the out of hour’s service.

Wynn Griffiths referred to the proposals for South Moor Hospital and Stanley. A
meeting had recently taken place with Derwentside District Council to discuss
the future of South Moor Hospital. At the present time South Moor Hospital
provides local X-ray facilities, outpatient clinics and 20 beds, 15 of which are
funded by the Social Services Department for clients awaiting residential care or
a nursing home. The care is considered excellent but the environment is not
considered to be appropriate. It was proposed to provide a new facility close to
the centre of Stanley. This will provide existing GP services, a new X-ray
facility, space for a walk in centre and a GP special interest local centre. This
will need a large building and at present 15 sites are on the shortlist close to the
centre of town.

Responding to a question about the use of the beds at South Moor Hospital to
prevent bed blocking, Wynn Griffiths explained that most of the beds were
currently being used for patients who had been physically ill and were
recovering. Alternative provision in nursing home accommodation could be
used if there is demand. He advised that public consultation will take place in
the future and the Sub Committee will be formally consulted.


A8       Consultation – Closure of GP Sessions at Quarrington Hill

The Sub Committee considered a report of the Head of Overview and Scrutiny
about the outcome of a consultation exercise undertaken by the Durham and
Chester le Street PCT about the proposed closure of GP sessions at
Quarrington Hill Community Centre (for copy see file of Minutes).




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Resolved:
That the report be noted.


A9   Development of Adult Mental Health Services in the North of
Durham

The Sub Committee considered a report of the Head of Overview and Scrutiny
about the development of adult mental health services in the north of Durham
(for copy see file of Minutes).

Harry Cronin updated the Sub Committee on the consultation process and
advised that all the public consultation meetings had been completed. It was
expected that a fully functioning crisis resolution service would be operational by
April 2005. Wynn Griffith advised that patients would prefer the location of the
new centre to be close to a general hospital. In response to members concerns
about the loss of a local service, Harry Cronin explained that the Allensford Unit
would not be closing but its use will change. Patients who are referred will
receive their initial treatment at the new facility and will be transferred to their
local centre at the appropriate time.

A further presentation about the consultative process will be given to the Sub
Committee.

Resolved:
That the report and update be noted.


A10 Minding the Gap: Mental Health Provision for 16-25 Year Olds and
Their Carers – Scrutiny Report

The Sub Committee considered a report of the Head of Overview and Scrutiny
and a presentation from Councillor E Hunter about the Scrutiny Report ‘Minding
the Gap: Mental Health Provision for 16-25 Year Olds and Their Carers’ (for
copy see file of Minutes).

Harry Cronin advised that the report had been discussed by the County Durham
and Darlington Priority Services Trust and they were considering how to
implement the reports recommendations. Councillor Hunter informed the Sub
Committee that a conference on mental health issues is to be held at County
Hall on 11 May 2004.

Resolved:
That the report and                recommendations be             submitted to Cabinet for
consideration.




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A11 The Wanless Report: Securing Good Health for the Whole
Population

The Sub Committee considered a report of the Head of Overview and Scrutiny
about the Wanless Report: Securing Good Health for the Whole Population (for
copy see file of Minutes).

Resolved:
That the report be noted.


A12      Government Consultation on Public Health - Choosing Health ?

The Sub Committee considered a report of the Head of Overview and Scrutiny
about the Government Consultation on Public Health - Choosing Health ? (for
copy see file of Minutes).

Members asked that the information detailed within the fact sheets be given
further publicity.

Resolved:

1.       That the report be noted.

2.     That the Head of Overview and Scrutiny be authorised to respond on
behalf of the Sub Committee


A13      Complaints about the National Health Service

The Sub Committee considered a report of the Head of Overview and Scrutiny
about how complaints against the National Health Service should be handled
(for copy see file of Minutes).

Members asked that the Commission for Patient and Public Involvement be
invited to a future meeting to give feedback on their work.

Resolved:
That the report be noted.


A14      Centre for Public Scrutiny

The Sub Committee considered a report of the Head of Overview and Scrutiny
about the first meeting of the Scrutiny Practitioners Forum (for copy see file of
Minutes).

Resolved:
That the report be noted.




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A15      Scrutiny Projects and Work Programme

The Sub Committee considered a report of the Head of Overview and Scrutiny
about the work programme of the Sub Committee (for copy see file of Minutes).

Resolved:
That the work programme be noted.




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