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					                                                                                                      AGENDA ITEM ..................6..........................



                                                                                                              HOSC/05/05
Committee Essex Health Overview and Scrutiny
Date            4 March 2005
Report by Josie Godfrey, Health Research Manager
__________________________________________________________________________________________________________________

Suggestions for Future Work Programme 2005-06

The following table sets out suggestions for future scrutiny studies received from Public and Patient Involvement Forums and District Councils.
Members are asked for initial comments on the proposed topics, which will be considered in more detail In May/June.

Some topics may be more suitable as an agenda item at the main Health Overview and Scrutiny Committee rather than as detailed scrutiny
studies.

Some topics could be suitable for an action learning project [See HOSC/06/05].

Topic                        Rationale/Comments                                                                      Organisation
24/48 hour access            Concern about equity of access to a GP appointment in mid-Essex.                        Witham, Braintree &
                             This is likely to form part of the planed Primary Care study.                           Halstead PPI Forum
Extend cancer drug study     Concern about levels of prescribing/access to drugs.                                    Maldon & South
to look at all drug usage.                                                                                           Chelmsford PPI Forum
Respite beds for dementia    Concern that there is inadequate supply of beds                                         Maldon & South
patients.                                                                                                            Chelmsford PPI Forum
Stroke services              Concern that these do not meet the needs of service users                               Maldon & South
                                                                                                                     Chelmsford PPI Forum
Waiting Lists                Concern that some elderly people may be offered a course of physiotherapy               Mid-Essex PPI Forum
                             instead of being put on the waiting list to see a consultant and it is only after       North Essex mental Health
                             this course of treatment that they are put on the waiting list, which builds in a
                             delay.                                                                                  Partnership Trust PPI




                                                                                                                                                             1
Topic                     Rationale/Comments                                                                Organisation
                          Concern that there are “waiting lists for waiting lists”.                         Forum
Health & Safety in NHS    Concern that there may be insufficient attention given to patient safety in NHS   Mid-Essex PPI Forum
hospitals                 hospitals. E.g. issues such as falls from beds, MRSA.
Diagnosis of Cancer       We would like to see earlier diagnosis of Cancer and subsequent fast track        Mid-Essex PPI Forum
                          treatment, which is not always carried out.
Hospital cleanliness      We are concerned at the lack of cleanness of our hospitals, which leads to        Mid-Essex PPI Forum
                          infections such as diarrhoea and sickness, and worse infections such as
                          MRSA, which can kill people even if they have recovered from their original
                          complaint.
Respite care coverage,    Concern that respite care for the benefit of carers is not adequately provided    Tendring PPI Forum
especially for mental
health
Collaboration with        Concern that there could be better co-ordination with the voluntary sector.
voluntary sector          Members may feel this is a policy issue that should be taken up by ECC
                          officers in there partnership working arrangements.
Vulnerable Adults         Concern that since the abolition of the New Possibilities NHS trust and the       Chelmsford PPI Forum
                          move into the community of adults with learning disabilities, who independently
                          assesses the standard of care and facilities provided by the private care
                          companies and nursing and care homes for the elderly?
                          This is a question that could be answered without a study given the role of
                          ECC as contractor and CSCI as the independent inspector. It would seem to
                          be a topic more appropriate for consideration by the Community Care PDG.
Community and             Concern about the provision of community and intermediate care services           Chelmsford PPI Forum
Intermediate Care         given there are no plans for a community hospital in Chelmsford. Will plans
Services                  adequately address the needs of an aging population?
Hospital cleanliness      Concern about how this is being tackled locally with particular reference to      Chelmsford PPI Forum
                          service level agreements and contracts, auditing/monitoring arrangements and
                          meeting MRSA targets.
                          PPI Forums have been invited to take on cleanliness inspections and it may be
                          more appropriate at this stage to advise them to seek central advice with the
                          possibility of looking at reports form each Trust at a later stage.
Diagnostics               Concern that there may not be enough local facilities to ensure proper            Chelmsford PPI Forum
                          diagnoses are made. Are primary and secondary care organisations
                          addressing this issue together, and if so how and what progress is being
                          made?
Older people’s services   Colchester DC is currently looking at older people’s services in partnership      Colchester District Council




                                                                                                                                          2
Topic                          Rationale/Comments                                                                  Organisation
                               with the NHS because of a concern that there is a lack of co-ordination in the
                               delivery of services and a lack of strategic overview.
Determine the incidence of     Neurological conditions are not readily categorised and may straddle                South Essex Partnership
neurological conditions in     boundaries of local healthcare responsibility. There is anecdotal evidence that     Trust PPI Forum
South Essex and the            these illnesses entail major penalties for sufferers, carers and society yet they
impact of these conditions     are not well documented and receive little exposure in SHA action plans.
including the social and       Determination of the size and severity of the issue in South Essex is a
economic consequences          prerequisite for informed discussion and action planning for this neglected
for patients, families,        area.
carers and the wider
community.
Hospital acquired              Concern about levels of hospital acquired infections, particularly MRSA             Rochford District Council
infections
Nutrition for older and        Concern that patients unable to feed themselves are not receiving adequate          Rochford District Council
vulnerable people in           levels of nutrition/hydration during hospital stays.
hospitals
The funding and                Preventative programmes are likely to be considered as part of the diabetes         Harlow District Council
effectiveness of               project. A study looking at health promotion activity may be a suitable topic for
preventative ill-health        an action learning study.
programmes
Access to NHS dentistry        Concern about levels of access.                                                     Harlow District Council
                               Dentistry is not expected to form part of the Primary Care study and changes
                               may occur following the introduction of a new contract for NHS dentists.
The implications for users     PCTs and GPs will need to change the medication regimes of many patients            Braintree District Council
of co-proxomol if it is        and there may be concerns about how effectively this is done and the impact
withdrawn;                     such a change may have on patients.




The process of allocation      Concern about the fairness and transparency of this process.                        Braintree District Council
of new digital hearing aids;
Out-of-hours services.         Concern that the transfer of responsibility for out-of-hours services to PCTs       Braintree District Council
                               may result in a reduction of service.




                                                                                                                                                3
Topic                        Rationale/Comments                                                                 Organisation
                             This should be addressed as part of the Primary Care study.
Children’s mental health     Concern that these services are marginalized and inadequate.                       Epping Forest District
services                                                                                                        Council
Children’s services,         Relevant following the National Service Framework.                                 Billericay, Brentwood and
particularly the interface                                                                                      Wickford PPI Forum
with social care and
education
Smoking cessation                                                                                               Princess Alexander Trust
services                                                                                                        PPI Forum

In addition to this list, Members have already mentioned a number of possible areas for future studies/action learning projects:
         Children’s services;
         Older People’s services;
         Mental health care;
         Learning disabilities services;
         Drug and alcohol abuse services;
         Early intervention for children (e.g. vaccination, speech therapy); and
         Voluntary sector involvement in health provision in Essex.

Members are asked to note the suggested topics and to offer initial comments on which topics they would like to be considered in
more detail at the next Committee meeting.

Proposals from members that are not tabled by 4th March 2005 will not be considered for the 2005-06 programme of scrutiny studies.

In considering the future work programme, Members may wish to consider why potential topics are of importance to Essex residents and how
they may relate to the work of Policy Development Groups in their new scrutiny role.




Josie Godfrey
Health Research Manager




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