Hampshire County Council
Councillors:
78
Wards:
76
Committees:
49
Meetings (2025):
165
Meetings (2024):
156
Meeting
Health and Adult Social Care Select Committee - Hampshire
Meeting Times
Scheduled Time
Start:
Tuesday, 3rd September 2024
10:00 AM
Tuesday, 3rd September 2024
10:00 AM
End:
Tuesday, 3rd September 2024
12:31 PM
Tuesday, 3rd September 2024
12:31 PM
Meeting Status
Status:
Confirmed
Confirmed
Date:
03 Sep 2024
03 Sep 2024
Location:
Ashburton Hall - HCC
Ashburton Hall - HCC
Meeting Attendees
Independent Group Spokesperson
Co-opted Member
Councillor Cynthia Garton
Eastleigh Borough Council
Apologies
Liberal Democrats Deputy
Councillor Adrian Collett
Not required
Liberal Democrats Deputy
Councillor Dominic Hiscock
Not required
Agenda
0
NHS Hampshire and Isle of Wight Integrated Care Board - Renewed Ambition/Strategy
To receive a report and presentation from NHS Hampshire and Isle of Wight Integrated Care Board outlining their ambitions to improve health outcomes for local residents.
Attachments:
- Document 6a. Hampshire IoW Renewing Our Ambition. 23 Aug 2024
- Document 6a. Renewed_Ambition_-_summary 23 Aug 2024
0
Project Fusion Update
To receive a report providing an update on the new ‘Hampshire and Isle of Wight Healthcare NHS Foundation Trust’ delivering Mental Health and Learning Disabilities services for Hampshire and the Isle of Wight.
Attachments:
- Document 6d. HIOW Healthcare Update Project Fusion 23 Aug 2024
- Document 6d. HIOW Healthcare Update Project Fusion appendix 1 23 Aug 2024
0
Dental Services Update
To receive a verbal update.
0
Primary Care Update
To receive a report providing an update on patient access to primary care health services.
Attachments:
- Document 6b. Improving Access to Primary Care 23 Aug 2024
0
PROJECT FUSION
Minutes
In the absence of a presenting officer, a written statement had been submitted to the Select Committee to provide an update on the formation of the ‘Hampshire & Isle of Wight Healthcare NHS Foundation Trust’ and developments since the last update to the HASC in May 2024.
The Chairman of the Select Committee had extended an invitation to the Chief Executive of Hampshire & Isle of Wight Healthcare NHS Foundation Trust to attend the next meeting in October.
RESOLVED:
The Committee noted the update and requested a further presentation at the October meeting of the Select Committee.
The Chairman of the Select Committee had extended an invitation to the Chief Executive of Hampshire & Isle of Wight Healthcare NHS Foundation Trust to attend the next meeting in October.
RESOLVED:
The Committee noted the update and requested a further presentation at the October meeting of the Select Committee.
0
HAMPSHIRE AND ISLE OF WIGHT INTEGRATED CARE BOARD: RENEWED AMBITION
Minutes
The committee received a report and the Chairman welcomed Caroline Morison of Hampshire and Isle of Wight Integrated Care Board (H&IW ICB), to make a presentation which provided an update on the recent publication of their ‘renewed ambition’ document which summarised the key priorities and actions NHS partner organisations were taking to achieve their ambition.
The document included five key statements to more clearly state the difference the H&IW ICB want to make:
We will make a shift towards proactive and preventative care and support. We will deliver person-centred care led by the needs of the whole person and underpinned by a community-centred approach to wellbeing. We will develop and maximise our pathways of care based on clinical outcomes, evidence and data. We will maximise the use of the resources in our system building on models of collaboration, partnership and integration. We are a learning system
The Select Committee focused on areas of local and national policy, access and delivery of NHS services which included:
The ICB’s response to the increase in the local population and the rise in patients with complex needs. Officers reported that working with partners they felt in a good position to actively support the new and changing population. The fundamentals of out of hospital care were unchanged, keeping people well with a focus on prevention. The Director of Public Health working alongside NHS colleagues looked at the JSNA to identify trends to assist with predictions of future health models.
The Director of Public Health confirmed that work in conjunction with NHS colleagues had focused on specific health outcome and unhealthy risk factors which included smoking, vaping, (with no suggestion that vaping had progressed to smoking) obesity (working with colleagues in Planning to monitor numbers of fast food outlets) etc. Support in the management and prevention of obesity included targeting groups of high instances of obesity, reviewing community pathways which helped with weight management particularly in children, a recognition of what could be achieved outside the clinical environment, safe open spaces, looking at the public health transport plan to encourage walking and cycling to school.
The Committee supported children’s wellbeing and wanted to ensure that mental health issues was not forgotten. Discussion included the excessive waiting times for initial CAMHS consultation, diagnoses and treatment. The ICB reported that the focus was on diagnoses and treatment but there was support for young people at the early stages while the young person awaits the CAMHS referral.
The Committee were interested to hear more about the primary care access recovery plan. ICB explained that this involved matching the right types of access to the patient and the clinical need which includes, in person, virtual, same day appointments, planned and more urgent care appointment. etc.
RESOLVED:
The Select Committee noted the update and requested a further update outlining the ICB’s renewed ambition action plan, including detail of key aspects with outcomes.
The document included five key statements to more clearly state the difference the H&IW ICB want to make:
We will make a shift towards proactive and preventative care and support. We will deliver person-centred care led by the needs of the whole person and underpinned by a community-centred approach to wellbeing. We will develop and maximise our pathways of care based on clinical outcomes, evidence and data. We will maximise the use of the resources in our system building on models of collaboration, partnership and integration. We are a learning system
The Select Committee focused on areas of local and national policy, access and delivery of NHS services which included:
The ICB’s response to the increase in the local population and the rise in patients with complex needs. Officers reported that working with partners they felt in a good position to actively support the new and changing population. The fundamentals of out of hospital care were unchanged, keeping people well with a focus on prevention. The Director of Public Health working alongside NHS colleagues looked at the JSNA to identify trends to assist with predictions of future health models.
The Director of Public Health confirmed that work in conjunction with NHS colleagues had focused on specific health outcome and unhealthy risk factors which included smoking, vaping, (with no suggestion that vaping had progressed to smoking) obesity (working with colleagues in Planning to monitor numbers of fast food outlets) etc. Support in the management and prevention of obesity included targeting groups of high instances of obesity, reviewing community pathways which helped with weight management particularly in children, a recognition of what could be achieved outside the clinical environment, safe open spaces, looking at the public health transport plan to encourage walking and cycling to school.
The Committee supported children’s wellbeing and wanted to ensure that mental health issues was not forgotten. Discussion included the excessive waiting times for initial CAMHS consultation, diagnoses and treatment. The ICB reported that the focus was on diagnoses and treatment but there was support for young people at the early stages while the young person awaits the CAMHS referral.
The Committee were interested to hear more about the primary care access recovery plan. ICB explained that this involved matching the right types of access to the patient and the clinical need which includes, in person, virtual, same day appointments, planned and more urgent care appointment. etc.
RESOLVED:
The Select Committee noted the update and requested a further update outlining the ICB’s renewed ambition action plan, including detail of key aspects with outcomes.
0
PRIMARY CARE UPDATE
Minutes
The Chairman welcomed James Roach, Director of Primary Care, H&IOW ICB to present his report to the Select Committee. Discussion included issues identified at the HASC meeting in May 2024.
The issues raised included the following
- Understanding patient needs at the local level
- Levels of access to appointments, emergency and same day
- Time allocated to individual appointments ie. Recent reduction from 9
mins to 6mins per appointment.
- Family and friend test used as one of the ways to influence future service
provision
- Specific issues and limited capital investment impact on the estate
- Supporting local practices experiencing contracting and financial issues
The Committee discussed the Primary Care Access Reference Group and its membership of GPs, Hampshire ICB, Public Health and an invitation to any Councillors that would like to sit on the Group. The Chairman confirmed that the Select Committee would need to review any terms of reference in advance of County Council representation.Councillors North and Taylor expressed an interest in sitting on the Reference Group.
Officers agreed to provide more detailed and accurate data in terms of the several aspects of the paper, reasons for patients attending appointments, as the figures reported were unclear and difficult to determine what was driving patient access. The table of deprivation did not reflect an accurate picture of key areas and had been missed, hot spots in Basingstoke and Dean were not recorded. The Director of Public Health acknowledged the importance of accurate recording and would continue to work with the Trust to support this.
Access to a clinician related to the increased practice of one medical issue per appointment, Members were specifically concerned that mental health and wellbeing issues were being overlooked. In addition to the longer wait times for a routine appointment, figures suggest that 19% of patients in parts of Basingstoke had waited over 28 days for an appointment with no comparisons reflected in the paper therefore making it difficult to draw a conclusion.
The Committee responded to information provided around recruitment and retention of GPs, the report showed that there was a culture shift away from become a partner in a practice to operate on a salaried basis. The Trust were looking at how to recruit more GPs, to add variety and support their development.
Members discussed the impacts of the continued reduction in resources against the increase in housing figures and what the Trust’s planned response would be, new GP buildings had not materialised as part of recent new builds, and asked how the Trust would ensure that GPs practices were incorporated. The officer confirmed that internal discussions and planning had taken place to achieve the 5 – 10-year vision of future growth. Data from the JSNA and public health would inform this. The Trust had been in talks with developers and partners and were confident that the 600 new homes that have come online can be accommodated within existing GP provision.
Councillors requested further information related to the National recovery plan, as the report had each action recorded as “a plan in place” with no reference to delivery or future evaluation. The officer confirmed that NHS England had provided the risk register and its categories gave assurances in terms of progress and how the Trust are moving forward. The information and data would be subject of discussions with the Reference Group. The Chairman made a request to see the data as residents looked to their elected members when seeking answers.
RESOLVED:
The Select Committee
· Noted the update with concern with an expectation that a future update would provide details of the necessary action plans, milestones and an understanding of the action being taken
· Agreed to the establishment of a Joint Reference Group to include Frimley ICB, to report back to the HASC in March 2025. Terms of Reference for the Group to be provided to the HASC Chairman.
· Recommend the Director of Primary Care work with the Director of Public Health to review the relevant JSNA data to produce a public health response.
The issues raised included the following
- Understanding patient needs at the local level
- Levels of access to appointments, emergency and same day
- Time allocated to individual appointments ie. Recent reduction from 9
mins to 6mins per appointment.
- Family and friend test used as one of the ways to influence future service
provision
- Specific issues and limited capital investment impact on the estate
- Supporting local practices experiencing contracting and financial issues
The Committee discussed the Primary Care Access Reference Group and its membership of GPs, Hampshire ICB, Public Health and an invitation to any Councillors that would like to sit on the Group. The Chairman confirmed that the Select Committee would need to review any terms of reference in advance of County Council representation.Councillors North and Taylor expressed an interest in sitting on the Reference Group.
Officers agreed to provide more detailed and accurate data in terms of the several aspects of the paper, reasons for patients attending appointments, as the figures reported were unclear and difficult to determine what was driving patient access. The table of deprivation did not reflect an accurate picture of key areas and had been missed, hot spots in Basingstoke and Dean were not recorded. The Director of Public Health acknowledged the importance of accurate recording and would continue to work with the Trust to support this.
Access to a clinician related to the increased practice of one medical issue per appointment, Members were specifically concerned that mental health and wellbeing issues were being overlooked. In addition to the longer wait times for a routine appointment, figures suggest that 19% of patients in parts of Basingstoke had waited over 28 days for an appointment with no comparisons reflected in the paper therefore making it difficult to draw a conclusion.
The Committee responded to information provided around recruitment and retention of GPs, the report showed that there was a culture shift away from become a partner in a practice to operate on a salaried basis. The Trust were looking at how to recruit more GPs, to add variety and support their development.
Members discussed the impacts of the continued reduction in resources against the increase in housing figures and what the Trust’s planned response would be, new GP buildings had not materialised as part of recent new builds, and asked how the Trust would ensure that GPs practices were incorporated. The officer confirmed that internal discussions and planning had taken place to achieve the 5 – 10-year vision of future growth. Data from the JSNA and public health would inform this. The Trust had been in talks with developers and partners and were confident that the 600 new homes that have come online can be accommodated within existing GP provision.
Councillors requested further information related to the National recovery plan, as the report had each action recorded as “a plan in place” with no reference to delivery or future evaluation. The officer confirmed that NHS England had provided the risk register and its categories gave assurances in terms of progress and how the Trust are moving forward. The information and data would be subject of discussions with the Reference Group. The Chairman made a request to see the data as residents looked to their elected members when seeking answers.
RESOLVED:
The Select Committee
· Noted the update with concern with an expectation that a future update would provide details of the necessary action plans, milestones and an understanding of the action being taken
· Agreed to the establishment of a Joint Reference Group to include Frimley ICB, to report back to the HASC in March 2025. Terms of Reference for the Group to be provided to the HASC Chairman.
· Recommend the Director of Primary Care work with the Director of Public Health to review the relevant JSNA data to produce a public health response.
0
DENTAL SERVICES UPDATE
Minutes
The Committee received an update from James Roach of the Hampshire and the Isle of Wight Integrated Care Board.
It was acknowledged that accessing an NHS dentist remained an issue both locally and across the country. The National Plan and National Framework highlighted the current shortfall in those joining the profession. Discussions around the introduction of “golden hellos” and the removal of the requirement for an additional year of study, would be suggested as positive ways to increase numbers of dentists.
During questions of the officer, Members learned the following:
· The Mobile dentist units had received a larger cohort of patients, circa 700 people that had been seen across 73 clinics, 200 visitors required dental work and also received cancer screening. Officers agreed to provide an update and further breakdown at the next meeting.
· The promise of combined dental practices in a shared space with GP surgeries had not materialised. As NHS England are the governing body responsible for delivering new surgeries, the officer agreed to follow up on this query
· Increased communications in terms of access to dental care for service men and women was raised. Officers agreed to take this point away as an action.
RESOLVED:
The Sub-Committee noted the update and welcomed the opportunity to review the services again and receive an update in November.
It was acknowledged that accessing an NHS dentist remained an issue both locally and across the country. The National Plan and National Framework highlighted the current shortfall in those joining the profession. Discussions around the introduction of “golden hellos” and the removal of the requirement for an additional year of study, would be suggested as positive ways to increase numbers of dentists.
During questions of the officer, Members learned the following:
· The Mobile dentist units had received a larger cohort of patients, circa 700 people that had been seen across 73 clinics, 200 visitors required dental work and also received cancer screening. Officers agreed to provide an update and further breakdown at the next meeting.
· The promise of combined dental practices in a shared space with GP surgeries had not materialised. As NHS England are the governing body responsible for delivering new surgeries, the officer agreed to follow up on this query
· Increased communications in terms of access to dental care for service men and women was raised. Officers agreed to take this point away as an action.
RESOLVED:
The Sub-Committee noted the update and welcomed the opportunity to review the services again and receive an update in November.
1
APOLOGIES FOR ABSENCE
To receive any apologies for absence.
Minutes
Apologies were received from Councillor Patricia Stallard, Councillor David Harrison, Councillor Andy Tree and Co-opted member Councillor Cynthia Garton.
2
DECLARATIONS OF INTEREST
All Members who believe they have a Disclosable Pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to Part 3 Paragraph 1.5 of the County Council's Members’ Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore all Members with a Personal Interest in a matter being considered at the meeting should consider, having regard to Part 5, Paragraph 4 of the Code, whether such interest should be declared, and having regard to Part 5, Paragraph 5 of the Code, consider whether it is appropriate to leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with the Code.
Minutes
There were no declarations of interest.
3
MINUTES OF THE PREVIOUS MEETING
To confirm the minutes of the meeting held on 19 June 2024.
Attachments:
- Document Minutes , 19/06/2024 Health and Adult Social Care Select Committee 23 Aug 2024
Minutes
The minutes of the meeting held on 19 June were approved as a correct record.
4
CHAIRMAN'S ANNOUNCEMENTS
To receive any announcements the Chairman may wish to make.
Minutes
Savings Programme 2025
Members were reminded of the additional meeting of the HASC on 17 September, which had been convened to allow the Committee to scrutinise SP25 proposals under Adults Health and Care alongside the report detailing the findings and recommendations of the Working Group. Any questions relating to the SP25 programme were submitted in writing to officers.
Update on the ‘Hampshire Together’ JHOSC
The Joint Health Overview and Scrutiny Committee met on 22nd of July and considered the programme ‘Hampshire Together’ regarding potential service model changes and a new Acute Hospital for the Mid Hampshire Area. The Joint Committee were informed about the thorough public consultation and engagement activity that Hampshire Hospitals NHS Trust and Commissioners had undertaken on the proposals.
The Joint Committee were satisfied that the consultation had exceeded what is required and provided feedback to NHS commissioners. The Committee highlighted areas raised in the feedback that should considered further.
The Joint Committee would meet again in the Autumn prior to further decisions being made by Commissioners.
Update on the Frimley JHOSC
The Joint Health Overview and Scrutiny Committee considering the proposal to replace Frimley Park Hospital were due to meet for a second time on Friday 6 September, with a further meeting planned for October. Members of the HASC to be kept updated by the Chairman.
Central government royal commission on future of social care
It was reported in the press in July that the Government intended to launch a cross party Royal Commission on the future of social care. The Committee welcomed the initiative and would monitor developments.
Central government NHS Performance Review
The Government also announced in July that there would be a NHS Performance Review, with findings due to be reported in September 2024.
MPOX Update
The World Health Organisation (WHO) declared a public health emergency of international concern due to the rapid spread of a mpox virus strain, clade 1, after its emergence in the Democratic Republic of the Congo (DRC) last year, and the potential for the virus to spread further across countries in Africa and outside the continent.
The UK Health Security Agency (UKHSA) is working with the NHS, local authorities, and other government departments to ensure we are ready to respond to any cases we see in the UK and help prevent transmission.
Suicide Prevention Training Session
Members were reminded of the session due to take place on 10 September, the Director of Public Health encouraged Members to attend as it was a worthwhile session.
Members were reminded of the additional meeting of the HASC on 17 September, which had been convened to allow the Committee to scrutinise SP25 proposals under Adults Health and Care alongside the report detailing the findings and recommendations of the Working Group. Any questions relating to the SP25 programme were submitted in writing to officers.
Update on the ‘Hampshire Together’ JHOSC
The Joint Health Overview and Scrutiny Committee met on 22nd of July and considered the programme ‘Hampshire Together’ regarding potential service model changes and a new Acute Hospital for the Mid Hampshire Area. The Joint Committee were informed about the thorough public consultation and engagement activity that Hampshire Hospitals NHS Trust and Commissioners had undertaken on the proposals.
The Joint Committee were satisfied that the consultation had exceeded what is required and provided feedback to NHS commissioners. The Committee highlighted areas raised in the feedback that should considered further.
The Joint Committee would meet again in the Autumn prior to further decisions being made by Commissioners.
Update on the Frimley JHOSC
The Joint Health Overview and Scrutiny Committee considering the proposal to replace Frimley Park Hospital were due to meet for a second time on Friday 6 September, with a further meeting planned for October. Members of the HASC to be kept updated by the Chairman.
Central government royal commission on future of social care
It was reported in the press in July that the Government intended to launch a cross party Royal Commission on the future of social care. The Committee welcomed the initiative and would monitor developments.
Central government NHS Performance Review
The Government also announced in July that there would be a NHS Performance Review, with findings due to be reported in September 2024.
MPOX Update
The World Health Organisation (WHO) declared a public health emergency of international concern due to the rapid spread of a mpox virus strain, clade 1, after its emergence in the Democratic Republic of the Congo (DRC) last year, and the potential for the virus to spread further across countries in Africa and outside the continent.
The UK Health Security Agency (UKHSA) is working with the NHS, local authorities, and other government departments to ensure we are ready to respond to any cases we see in the UK and help prevent transmission.
Suicide Prevention Training Session
Members were reminded of the session due to take place on 10 September, the Director of Public Health encouraged Members to attend as it was a worthwhile session.
5
DEPUTATIONS
To receive any deputations notified under Standing Order 12.
Minutes
No deputations were received.
6
ISSUES RELATED TO THE PLANNING, PROVISION AND/OR OPERATION OF HEALTH SERVICES
To consider a report on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.
Minutes
The Committee received a report (item 6 in the minute book) which provided Members with information about the issues brought to the attention of the Committee which impacted upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population as follows:
a. Hampshire and Isle of Wight Integrated Care Board: Renewed Ambition
b. Primary Care Update
c. Dental Services Update
d. Project Fusion
a. Hampshire and Isle of Wight Integrated Care Board: Renewed Ambition
b. Primary Care Update
c. Dental Services Update
d. Project Fusion
7
UPDATE TO THE FRAMEWORK FOR ASSESSING SUBSTANTIAL CHANGE IN NHS PROVISION
To consider and agree the updated ‘Framework for Assessing Substantial Change in NHS Provision’.
Attachments:
- Document 2024-09-03 HOSC assessing substantial change protocol 23 Aug 2024
- Document Appendix 1 - HOSP Framework for Assessing substantial variations 2024 update.doc 23 Aug 2024
Minutes
Members felt that as a Scrutiny Committee that their position had been weakened, but appreciated that the facility remained to allow requests to the Secretary of State for Health to call in a proposal. It was noted that no referrals had been made by Hampshire County Council to the Secretary of State in the past.
RESOLVED:
That the Select Committee agree the updated Arrangements for Assessing Substantial Change in NHS provision (revised June 2024).
</AI11>
<AI12>
RESOLVED:
That the Select Committee agree the updated Arrangements for Assessing Substantial Change in NHS provision (revised June 2024).
</AI11>
<AI12>
8
WORK PROGRAMME
To consider and approve the Health and Adult Social Care Select Committee Work Programme.
Attachments:
- Document 7. HASC Work Programme 03 09 2024 23 Aug 2024
Minutes
The Select Committee considered the current Work Programme and agreed to receive a presentation with further updates and progress from the Chief Executive of Project Fusion.
Dental Services would remain a feature in the work programme with the Select Committee looking forward to receiving a helpful update from officers at the meeting scheduled in November.
RESOLVED:
That the Health and Adult Social Care Select Committee discussed and agreed potential items for the work programme that can be prioritised and allocated by the Chairman of the Health and Adult Social Care Select Committee in consultation with the Director of Adults’ Health and Care.
Dental Services would remain a feature in the work programme with the Select Committee looking forward to receiving a helpful update from officers at the meeting scheduled in November.
RESOLVED:
That the Health and Adult Social Care Select Committee discussed and agreed potential items for the work programme that can be prioritised and allocated by the Chairman of the Health and Adult Social Care Select Committee in consultation with the Director of Adults’ Health and Care.
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