Apologies for absence were received from County Councillor Dr R Moore (Essex County Council) and County Councillor S Robinson (Essex County Council). Councillor P Reid attended as substitute for Councillor Moore.

The following interests were made:

(a)  Councillor Nevin – non-pecuniary – 2 children work at MEHT; step sister works at Basildon Hospital; previous association at Southend and MEHT Hospitals; NHS employee in Trust outside area;

(b)  Councillor Habermel - non-pecuniary – brother is a paramedic with London Ambulance Service; sister is a nurse and works at Southend Hospital; nephew is a physiotherapist at Southend;

(c)  Councillor Borton - non-pecuniary – daughter is a nurse at Rochford Hospital;

(d)  County Councillor Egan - non-pecuniary – ECC nominated governor – Castle Point & Rochford CCG; and code interest as her cousin is Managing Director at Basildon Hospital – however she believed that this did not prejudice her consideration of the public interest and that she was able to speak and vote on the matter;

(e) County Councillor Reid – non pecuniary – son-in-law works at Basildon
      Hospital.

That the Minutes of the meeting held on Wednesday, 6th June 2018, be confirmed and signed as a correct record.

Members of the public attending the meeting and who wish to make a statement at the meeting must notify the clerk of their intention by close of business on the working day prior to the meeting (contact details above), and should provide their name and contact information. Each person speaking shall be limited to a maximum of 3 minutes. If speaking on behalf of a group / body, a spokesperson must be appointed. The period for statements from members of the public at the meeting will be at the Chairman’s discretion and normally will not exceed 15 minutes in total. No response will be provided at the meeting.

There were four statements from the public and were circulated following the meeting. At the invitation of the Chairman the STP representatives confirmed that they would seek to address the issues raised in them during their subsequent presentation and update.

The Joint HOSC Chairman opened the item by clarifying that the remit of the Joint HOSC was to consider proposals from the STP for changes to services that had cross border impacts and subsequent implementation. However, powers of referral to the Secretary of State did not reside with the Joint HOSC and remained with the participating local authorities.

The Joint Committee considered a report setting out the framework for the ongoing working relationship between, and the distinguishing the roles of, the Joint HOSC and the health scrutiny committees at each of the three participating local authorities. It was anticipated that this would bring greater clarity and transparency to the respective roles for the general public and the NHS.

In defining the role of the JHOSC it was confirmed that it would continue its deliberations and hold meetings during the implementation of STP plans.

Resolved:-

(i)            That there would be three substantive meetings scheduled by the end of the financial year with each meeting having a core theme.

(ii)           That officers from each participating Local Authority approach their respective Directors of Public Health, or other appropriate senior officer, for their input into the process.

(iii)          That some JHOSC members meet separately with their local Healthwatch and report back to the JHOSC.

(iv)         That the JHOSC undertake a review/evaluation of its work at the end of the 2018/19 municipal year i.e. after the cycle of meetings proposed in (i) above.

Thereafter the following were welcomed to the meeting:

Jo Cripps, Programme Director, Mid and South Essex Sustainability and Transformation Partnership;

Tom Abell, Deputy Chief Executive of the three hospitals in Mid and South Essex.

At a meeting on 6th July 2018, the Joint Committee of 5 CCGs had agreed STP plans to reconfigure some acute and/or specialist services in line with proposals communicated as part of the public consultation “Your Care in the Best Place” earlier in the year. The STP representatives present at the meeting briefly outlined those decisions taken.

Resolved:-

That the decisions taken by the Joint Committee of 5 CCGs on 6th July 2018 be noted.

The STP representatives gave a presentation which included:

·         How the decisions of the Joint CCG Committee had been communicated;

·         The Governance processes being put in place for the continued oversight and implementation of the decisions made;

·         The Membership and Terms of Reference for the Implementation Oversight Group;

·         The establishment of a People’s Panel for on-going engagement with residents on the service changes in relation to Orsett Hospital and to provide an independent view on service relocation. Members of the Panel will be representative of groups within the community;

·         The Transport Working Group for patient, family and a carer transport (which had been established during the consultation) continuing its detailed work looking at existing transport links, and opportunities to enhance access between urban centres and hospital sites;

·         Work had commenced with ECC Integrated Passenger Transport Unit to engage with transport operators to look at the amendment of existing public transport routes to facilitate improved access between hospital sites, and consideration of the development of a shuttle service to run between the three hospitals;

·         A single workforce strategy which was now agreed across the three trusts. An example of the work going on across the three hospitals to resolve workforce shortages was the significant focus being placed on the training and use of apprentices.

The Committee asked the representatives of the STP a number of questions and points of clarification arising from the presentation:-

Stroke services

It was confirmed that the proposals for stroke services were not following the national model and approved pathway. Instead, all patients would be scanned and assessed initially at their local A&E and be eligible for thrombolysis delivered in A&E as was currently done. Once that treatment had started and the patient stabilised they would be transferred to Basildon Hospital for specialist treatment and care before being transferred back to their local hospital in due course if the specialist treatment was successful.

Members asked for reassurance about quality of treatment being maintained for stroke services that were to be relocated. It was confirmed that the project lead for the relocation was the lead clinician at Southend Hospital. Some locums were currently being used and future sustainability of services would be assisted by bringing the stroke teams together at one location.

Clinical transfers

Existing transfers of patients between mid and south Essex’s acute hospitals were believed to be at least 14 per day (primarily cardiology, burns, maxillofacial, burns and ENT patients) and the 15 anticipated additional patients being transferred would increase the total number to 29. An initial 24-hour audit of new transfer numbers had been undertaken. A further two-week audit was now being planned for September.

The STP were exploring an option for a pilot treat and transfer service which could be subsequently refined although timing for the pilot had not been finalised yet. Treat and Transfer would have its own dedicated service with a single command centre for the three hospitals to identify bed need and allocate beds in a timely manner so that  ...  view the full minutes text for item 7.

A report was considered detailing an Opposition Business Motion supported at a meeting of the Full Council of Southend-on-Sea Borough Council (SBC) on 19 July 2018. The Motion reiterated concerns previously outlined in SBC’s Full Council’s response to the STP’s proposals earlier in the year and further expressed concern at the public consultation process and how it had reached only a small fraction of the population within the STP footprint.

Resolved:-

(i)            That the JHOSC noted the request from SBC that JHOSC take full account of SBCs continued objections to the STP.

(ii)           That the JHOSC noted that SBC’s Full Council had requested SBC’s People Scrutiny Committee to give due consideration to a referral to the Secretary of State, taking into account the SBC’s continued objections to the STP, and the progress made by the STP regarding SBC’s objections.

Resolved:-

That the next meeting of the Joint Scrutiny Committee would be arranged for late September or October 2018. Future meetings would be theme-based.