Apologies were received from Councillors Cyril Baily, Abigail Lock and Roger Thistle. 

a)  The Committee are to nominate and agree a Chair for the municipal year 2008/09.

b)  The Committee are to nominate and agree a Vice Chair for the municipal year 2008/09.

Councillor Stuart Gordon-Bullock was nominated and seconded as Chair of this committee for the municipal year 2008/09.

Councillor Mary Angell was nominated and seconded as Vice Chair of this committee fro the municipal year 2008/09.

To note that members have declared the following interests in the Clinical

Services Review:-

Councillor Gilli Lewis-Lavender declared a person interest as an

employee of St George’s NHS Trust.

Councillor Jayne McCoy declared a personal interest as the Vice Chair of

Sutton, Epsom & District Branch of The National Childbirth Trust.

Members will be asked to confirm their interests, or any change thereto, at the meeting.

Resolved: To note that the following declarations of interest were made:

Ÿ        Councillor Sheila Knight declared a personal interest as an employee of Merton MIND.

Ÿ        Councillor Gilli Lewis-Lavender declared a personal interest as an employee of St George’s NHS Trust.

Ÿ        Councillor Jayne McCoy declared a personal interest as a member of Sutton, Epsom & District Branch of The National Childbirth Trust.

The minutes of the Joint Extra Ordinary Meeting of the Better Healthcare Closer To Home Joint Health Scrutiny and the Epsom and St Helier Financial Recovery Plan Committee held on 8 April 2008 were agreed as a correct record.

The draft Terms of Reference, as amended and proposed by the Better Healthcare Closer to Home Joint Scrutiny Committee and the Epsom and St Helier Financial Recovery Plan Committee, to be agreed.

Indicative time 10 minutes

Resolved: That the Terms of Reference for this committee were agreed. 

Bill Gillespie, Chief Executive, Sutton and Merton PCT and Stephen Waring, BHCH Programme Director, to give a progress report and to present the BHCH Outline Business Case.

Indicative time 60 minutes

Resolved: (i) The Chair explained that because the slide presentation was received very late that this item be deferred to the next meeting in October. 

(ii) That an informal briefing be set up for Bill Gillespie and Stephen Waring to speak with members of the committee prior to the next meeting.

(iii) That members refer any queries on the report through to the Committee Manager.

The Committee are inviting Bill Gillespie, Chief Executive, Sutton and Merton PCT, Samantha Jones, Chief Executive, Epsom and St Helier University Hospitals NHS Trust and Chris Butler, Chief Executive, Surrey PCT to report on:

Ÿ         progress of the review,

Ÿ         the approach to stakeholder engagement,

Ÿ         the project timeline, and 

Ÿ         issues for each PCT/borough

Indicative time 60 minutes

Stephen Evans, Interim Project Director, introduced his report.  The scope of the review included Epsom and St Helier Hospitals, obstetrics and paediatric services.   There were two drivers for the review: sustainability of clinical services especially with regard to European Working Hours Directive and National, as well as local, directions around commissioning standards i.e. improving care and outcomes.  Governance issues and stakeholder involvement were explained as in the report.  It was hoped to be able to take viable options to the Project Board by late August.

Following member questions it was reported that:

Ÿ         Following the Project Board discussion of the options in August the business case would then be put together. 

Ÿ         A health impact assessment as well as an equalities impact assessment would be commissioned externally. 

Ÿ         A company by the name of Jacobs has been commissioned for a transport assessment and they will be working with Transport for London to look at public transport accessibility.  There were grave concerns expressed by the public and other stakeholders around some of the assumptions made in the original transport survey carried out under the original Better Healthcare Closer to Home Programme.

Ÿ         The data source for population information was information from the Greater London Authority and data from the Office of National Statistics.

Ÿ         The midwife led unit at St Helier option had been developed as part of a service development over the last few years and was not linked in any way to the Women’s and Children’s Services Review.  There is concern about the stand-alone midwife led unit being so close to the obstetrics and labour units at St Helier and there are very strong views both ways but the debate continues.

Ÿ         In terms of Royal College of Nursing Guidelines, Samantha Jones explained that services are delivered at the standard which the PCT wish to commission them.  Both Chris Butler and Bill Gillespie explained standards being evidence based and due regard is given to them.

Ÿ         Samantha Jones explained that clinical service reviews were emotive for not only the professionals but for the public.  Differences in opinion will not be swept under the carpet in that the models of care document explained that consensus has not been reached. 

Ÿ         It was reiterated that Local Care Local Needs review was not about clinical services but about organisational structure.

Ÿ         It was recognised that there are significant differences between Surrey and south London that was one of the reasons for this review and whatever the outcomes from the review they must be sustainable and financially viable.

Ÿ         A report following a stakeholder event, held in April, was available on the website.

Ÿ         Samantha Jones confirmed that the Houghton judgement, and others, was being taken into consideration.

Ÿ         Consultation arrangements would be proportional to the complexity of the options.  A draft consultation plan would be discussed with this committee if it was felt that a full and wide-ranging consultation was needed.

Ÿ         It was confirmed that GP practices would be consulted and that schools could also be included.  Discussions about the best form of consultation  ...  view the full minutes text for item 7.

Draft information received from Stephen Waring:

It is RECOMMENDED that the Merton, Sutton and Surrey Joint Health Scrutiny Committee set dates to meet on:

Ÿ         Thursday 18 September 2008, and

Ÿ         Thursday 26 March 2009

Indicative time 10 minutes

Stephen Waring, Programme Director, had provided draft timetable information, which was published on the agenda.  It was reported that the timings have changed.  The Outline Business Case would not be going forward to the Boards until the 18 September.  Therefore it was suggested that the next meeting of this committee be put back from the date suggested on the agenda.  

Resolved: (i) To request that the Committee Manager liaises with the Trusts on the next two proposed dates for future meetings (2 October 2008 and 26 March 2009) of this committee.

(ii) To request that Bill Gillespie make the Gateway Review recommendations available to the members of this committee for information.

Including that of members, brought forward at the direction of the Chair, who has approved the reason for urgency.

The Chair invited the Chief Executives of the PCTs and NHS Trust to make their announcements, of recent reviews taken place, at their request.

Bill Gillespie, Chief Executive Sutton and Merton PCT, explained that now the PCTs had consulted on models of care they were now looking at how best to organise themselves to deliver on this and take forward.  They were considering scale and structures to maximise ability to deliver and working in partnership to enhance relationships.  Various options were being considered i.e. should PCTs merge or collaborate in a different way or share services.  A committee of chairs of PCTs and chief executives was overseeing the work, in southwest London.  It was hoped to present their preferred option to NHS London but there would not be a formal decision at this stage.  It was stressed that this was not about service change but about the best way to deal with decision-making on service change or the functions needed to support any change.  The Chair requested that Sutton, Surrey and Merton Councils each have a representative on the review group and that Councillors Mary Angell, Gilli Lewis-Lavender and Stuart Gordon-Bullock to have observer status. 

Samantha Jones, Chief Executive Epsom and St Helier NHS Trust (ESH), explained that ESH Trust had launched a review called ‘Local Needs, Local Health’ which looked at the way the organisation is managed.  It was not about clinical services and the terms of reference were still to be agreed.  The review will look at a range of options including, and not inclusive, remaining with status quo, both hospitals working in closer partnership with other hospitals/trusts and establishing the feasibility of the Epsom and St Helier Hospitals de-merging to become separate entities.  The review is supported by the PCTs the Southeast Coast Strategic Health Authority and NHS London.  It is hoped that by the end of August the terms of reference for the review, governance process for it and how it will be taken forward.  The Chair requested that Sutton, Surrey and Merton Councils each have a representative on the review group and that Councillors Mary Angell, Gilli Lewis-Lavender and Stuart Gordon-Bullock to have observer status.

Resolved:  (i) That Bill Gillespie would forward the request for membership and observers, on the review group, back to the Southwest London Committee.

(ii) That Samantha Jones would forward the request for membership and observers.