Agenda and minutes

*O&S(E) 21               

Apologies for absence were received from Cllrs D W Cloke, A F Leech, J Sheldon and L Watts.

*O&S(E) 22    

The minutes of the Meeting held on 2 August 2016 were confirmed and signed by the Chairman as a true and correct record.

Members are invited to declare any personal or disclosable pecuniary interests, including the nature and extent of such interests they may have in any items to be considered at this meeting.

If Councillors have any questions relating to predetermination, bias or interests in items on this Agenda, then please contact the Monitoring Officer in advance of the meeting.

*O&S(E) 23    

Members and officers were asked to declare any interests in the items of business to be considered during the course of this meeting, but there were none made.

A period of up to 15 minutes is available to deal with issues raised by the public.   

*O&S(E) 24    

The Chairman informed that since the issue that had been raised by Mr Kevin Eady at the previous Committee meeting had not been addressed at that time (Minute *O&S(E) 14 refers), it had been deferred for consideration at this meeting (as below).

Issue raised by Mr Kevin Eady:

“The out-of-hours GP clinic at Tavistock hospital is to cease from the 1st October 2016. This decision was taken in such a way that practically no-one in Tavistock knew about it before the decision was announced. Even the announcement was easy to miss. None of the GP surgeries in Tavistock, Yelverton, Bere Alston and Lifton were directly consulted by the CCG. Nor were the trades unions of the workforce involved.

The staff discovered their intended redundancy on-line, not even in a face-to-face meeting with anybody. The general public were, and most still are, completely unaware of what was being proposed.

Similar proposals are being rolled out across Devon, in Okehampton, Bideford, Tiverton, Honiton and elsewhere. This is all being carried out with the same degree of secrecy and subterfuge. The pretence may be that of increased efficiency and streamlined services, but we all know that the underlying reason is simply lack of funding from central government. The reality will be that many patients will either present themselves for treatment later than they should, fail to present at all, have great difficulty in attending clinics in either Okehampton or Plymouth, or may find the cost prohibitive or punitive. The knock-on adverse health effects are impossible to quantify accurately, but can be imagined.

The NEW CCG may think it has followed the letter of the law in terms of consultation, but a quick stroll through Tavistock talking to passers-by would soon convince you that any supposed consultation was complete sham. Or maybe it was merely overlooked by busy people.

Is there any justification for the way in which these decisions have been arrived at, for the lack of accountability and for the underhand nature of the decision-making process?”

Having read his question, Mr Eady proceeded to inform that he had organised a petition that had seen 1,500 signatories put their name to it urging for the out of hours clinic to be retained.  The petition had been submitted to the Northern, Eastern and Western (NEW) Devon Clinical Commissioning Group (CCG) and, at the time of this meeting, he was still awaiting a response.

At this point, the Chairman informed that Ms Elaine Fitzsimmons (Associate: Northern Locality, NEW Devon CCG and Mr Jerry Clough (Chief Operating Officer, NEW Devon CCG) were in attendance at this meeting in accordance with agenda item 7 below (Minute *O&S(E) 26 below refers).  As a consequence, it was the Chairman’s intention for these issues to be raised under agenda item 7 and, at that point of the meeting, she would enable Mr Eady a further opportunity to address the Committee.

If any Member seeks further clarity, or wishes to raise issues regarding any future Hub Committee agenda item, please contact Member Services before 5.00 pm on Thursday, 22 September 2016 to ensure that the lead officer(s) are aware of this request in advance of the meeting.

*O&S(E) 25    

The most recent (published August 2016) Hub Committee Forward Plan was presented for consideration.  Whilst not directly linked to the Forward Plan, the Head of Paid Service informed the Committee of the intention for a Special Council meeting to be convened on 26 January 2017 to consider an agenda item relating to the Joint Local Plan.

*O&S(E) 26    

As highlighted in the Public Forum session (Minute *O&S(E) 24 above refers), Ms Fitzsimmons and Mr Clough were in attendance at this meeting to address the Committee and respond to Member questions. 

In her introduction, the Chairman informed of her intention to divide this agenda item into two separate discussions.  The first item would be led by Ms Fitzsimmons and would relate to the out of hours and 111 services and the second item would be introduced by Mr Clough and would specifically focus on the CCG’s Sustainability Transformation Programme

(a)    The Out Of Hours and 111 Services

In her address, Ms Fitzsimmons raised the following points:-

-         The 111 telephony service had been introduced with the ability of being able to offer a range of services (e.g. from calling an ambulance on behalf of the patient to offering self-care advice) whilst streamlining and simplifying the system;

-         The Devon Doctors service had been commissioned to work in partnership with a national organisation called ‘Vocare’ who would provide the 111 service.  Whilst the two services were working together in partnership, Ms Fitzsimmons acknowledged that there were still further improvements that could be made in this respect;

-         Specifically regarding the out of hours service, approximately 60% of the contacts made were resolved through an initial telephone consultation.  In the remaining instances, the Committee was informed that the GP would determine (when speaking to the patient) whether or not they believed that they would need to complete their consultation with a face to face assessment;

-         Assurances were given to Members that, from the perspective of the patient, they would see no difference to the out of hours service;

-         It was felt that the 111 service would result in improvements by way of advice still being given to patients whilst there would be additional Doctors and nurses involved in the process, who would be available to provide and offer faster solutions;

-         Whilst there was a perception that the changes had been implemented to save money, it was in fact confirmed that the contract value was the same as before;

-         The development of an integrated 111 and out of hours service was attempting to reduce the confusion around the urgent care model;

-         There was now clarity around the specification for the out of hours service.  This specification had been developed with the involvement of Healthwatch, with 13 GPs and 6 volunteers involved in the process.  Whilst there was representation from rural areas during this process, it was acknowledged that no individuals from the West Devon area were involved.  One of the conclusions reached by Healthwatch was that a reasonable travel distance to access an out of hours service was 30 minutes by car;

-         It was noted that Devon Doctors had won the bid to provide the service following a competitive dialogue process.  In its submission, Devon Doctors had concluded that, due to the relatively close proximity to Derriford  ...  view the full minutes text for item *O&S(E) 26

(a)  CAB; and

(b)  CVS

O&S(E) 27     

The Chairman of the Partnership Task and Finish Group introduced this item and made specific reference to the extensive and comprehensive business plans that had been received by both the Citizens Advice Bureau and the Council for Voluntary Service.

In particular, the Chairman highlighted evidence in both business plans that illustrated the extent of the value for money that the Council was obtaining from these partnerships.  It was therefore his strong recommendation to the Committee that the levels of funding allocated by the Council to both partners for 2017/18 should be retained at the same level as they were for 2016/17.

In the ensuing debate, reference was made to:-

(a)    the submitted business plans.  In wishing to thank both partners, a number of Members echoed the view that the business plans had provided an insight into the work that they undertook;

(b)    working more closely together.  Officers advised that there was a recognition that, in certain instances, there was an identified duplication of work that was being undertaken by the Council and both partners.  As a result, all parties were committed to working more closely together in the future in an attempt to reduce this duplication.

It was then

RECOMMENDED

That the Hub Committee RECOMMEND to Council that the funding allocated by the Council to the CAB and CVS for 2017/18 should be retained at the same level as it was for 2016/17 (£32,900 and £8,500 respectively).

*O&S(E) 28    

The latest version of the Committee decisions log was presented to the meeting.

With no debate or questions being raised on the log, it was then:

RESOLVED

That the published Decisions Log be noted.

*O&S(E) 29    

The Committee considered its draft 2016/17 Work Programme and made reference to the following comments, additions and amendments:-

Following the discussions under agenda item 7 (Minute O&S(E) 26 above refers), the Chairman reminded the Committee that a progress update had now been requested from the CCG and Devon Doctors at the meeting on 7 March 2017.