Agenda item

Representatives of the Board have been invited to the meeting to discuss the proposals contained within the consultation document, a copy of which is attached.

 

The Board have been notified that the Council's particular areas of concern are as follows:

 

(1) Home Enhanced Care Service;

(2) The Deeside Mold Hub;

(3) The Future of Flint Community Hospital and plans for a primary care centre;

(4)  Cross-border services, notwithstanding the reference to this in page 15 of the consultation document and

(5) Transport.

 

A short presentation will be given by the Board representatives after which  Members will be able to ask questions.

 

(a)       That the presentation be noted; and 

 

(b)       That the BCUHB submit written responses to the questions shown in Appendix 1 of the minutes prior to a formal response being considered at a special meeting of the County Council on 24 October, 2012

The Chair welcomed Members, the Betsi Cadwaladr University Health Board (BCUHB) representatives and members of the public to the meeting.  She explained that some questions had been prepared in advance, copies of which were circulated before the start of the meeting.  Members would be given the opportunity to ask supplementary questions during the meeting. 

 

                        The Chair invited the Chief Executive, Director of Community Services and Councillor C.M. Jones, Cabinet Member for Social Services to speak before the BCUHB representatives gave their presentation.

 

            The Chief Executive reported that he had requested that the presentation to be given by the BCUHB representatives be extended to include specific information on the proposals for Flintshire and the following particular areas of concern:-

 

·         Home Enhanced Care Service;

·         The Deeside Mold Hub

·         The Future of Flint Community Hospital and plans for a primary care centre;

·         Cross-border services, notwithstanding the reference to this in page 15 of the consultation document; and

·         Transport

 

A special County Council meeting would be arranged prior to the deadline for responses to the consultation document to allow the Council to submit its formal response.

 

The Director of Community Services outlined the actions taken together with the Cabinet Member for Social Services following publication of the consultation document.  He said that there was a need to ensure that the proposals contained within the document would not create an additional financial burden to the Council whilst still supporting residents within the context of the Social and Health Care Wellbeing Strategy.  He commented on the need for further detailed information on future budgets and said that if the proposals were agreed these should be in place before the decommissioning of other services.     

 

Councillor C.M. Jones, Cabinet Member for Social Services, said that Members wanted to ensure that the proposals would be safe for all residents in Flintshire and said that she shared the concerns outlined by the Director of Community Services on preventing an additional financial burden to the Council in the future.

 

Mr. Geoff Lang, Executive Director of Primary Care, Community and Mental Health Services gave a presentation which covered the following areas:-

 

·         Why change?

·         More Care closer to home

·         What isn’t changing

·         Our proposals for change

·         Neonatal Intensive Care Service – our proposals

·         Vascular Services – our proposals

·         Older persons Mental Health – our proposals

·         Enhancing Care in the Community

·         Hospital Hubs

·         Enhanced Care at home

·         What the proposals mean for your local area – Flint

·         Cross border issues

 

Members raised a number of concerns around the proposals for the Neonatal Intensive Care Service, the proposals for Mold Community Hospital and Flint Community Hospital, the current shortage of hospital beds at Glan Clwyd Hospital, the level of funding allocated to meet future transport needs, enhanced care at home, that the proposals would be safe for the residents of Flintshire, cross-border issues and dementia care. 

 

Councillor I.B. Roberts highlighted a recent local press article from Dr. Eamon Jessup who had raised concerns around the shortage of beds at Glan Clwyd Hospital following the loss of beds at the Royal Alexandra Hospital in Rhyl and asked whether the closure of Flint Community Hospital would add additional pressures to Glan Clwyd Hospital in the future.  He also quoted Dr. Jessup’s comments on the Enhanced Care at Home Scheme (HECS), which he said offered poor value for money, cost a small fortune and would not fill the gap left by shutting Community Hospitals.  He commented on past reviews of Flint Community Hospital which were similar to the proposals outlined during the presentation which had been rejected by the former Health Minister.  He sought assurance that the BCHUB representatives were listening to the concerns of residents in Flint.

 

Councillor R.C. Bithell raised concerns on the proposals to close the minor injuries and x-ray departments at Mold Community Hospital and asked whether it was financially viable to remove this established facility to Deeside Community Hospital where this service currently did not exist.  He also raised concerns around future transport links and the possible increase in cost to residents having to travel to Deeside.  Councillor M. Bateman raised similar concerns on the proposals and asked if the removal of these facilities was due to the need to update the equipment.  She commented that the Mold League of Friends should be contacted to assist with funding the upgrade of such equipment if necessary. 

 

Councillor S. Jones asked for clarification on the care assessments and costs to residents when leaving hospital and what were the proposals to deal with patients who need continued care after the 14 day care package ends.  She also asked what measures would be taken to address the current shortage of staff within the NHS. 

 

Councillor M.J. Peers sought assurance that residents in Flintshire would continue to access health services at Hospitals in England and asked if an update on the proposed primary health care centre in Buckley could be provided.

 

Councillor A.P. Shotton, Leader of the Council said that there were clear concerns around the proposed enhanced care at home.  He said that there was a lack of detailed information around funding at this stage and asked why a detailed business plan had not been shared with the Council.  He asked whether GPs were supportive of the proposals and whether the BCHUB were confident that Deeside Community Hospital would have the capacity to meet future need.  Councillor H.J. McGuill asked how much it would cost to create minor injuries and x-ray departments at Deeside Community Hospital and whether the current site was big enough.

 

Councillor L.A. Sharps asked how many x-rays and blood test were carried out annually at both Mold and Flint Community Hospitals and what affect the expected increase in population in the future would have on the proposals for Deeside Community Hospital and could it cope with the increased housing projections.

 

Councillor R.B. Jones raised concerns that the proposed savings to the NHS would result in additional costs to vulnerable people across Flintshire.  He asked for detailed information around the rationale for closing the minor injuries and X-ray departments at Mold Community Hospital and whether the future demographic of the County, transport links and the affect the proposals would have on the vulnerable had been taken into account.

 

Councillor C.A. Ellis vacated the Chair while she raised a number of concerns around the lack of clarity on the proposals and the consultation process commenting that a public meeting has not been held for residents of Buckley. 

 

The Chief Executive summed up the concerns and questions raised by Members and suggested that there be a 10 minute adjournment before responses were given to the questions. 

 

Following the 10 minute adjournment, the BCHUB representatives responded to the questions raised by Members.

 

Enhanced Care at home

 

Mr. Geoff Lang reported that there was evidence elsewhere that enhanced care at home with the support of GPs would benefit residents.  Extensive consultation had been carried out with GPs who were supportive of the proposals and this would reduce the demand for beds in hospital 

 

Carers

 

Mrs. Jill Galvani explained that the BCUHB were driven by the Welsh Government Carers Measure Legislation and that she was the lead in developing a Carer Strategy which would identify future resources.  The Carer Strategy would impact health and work was continuing around developing this Strategy. 

 

Neonatal and Intensive Care

 

Mr. Geoff Lang reported that Clinicians had undertaken work on the proposed changes to Neonatal and Intensive Care Services.  To continue this service at Glan Clwyd and Wrexham Hospitals would not be viable for the future, therefore it was proposed that this service be delivered from Arrow Park to ensure that future health standards were met. 

 

Capacity in Hospitals

 

Mrs. Jill Galvani explained that work was on-going to address the concerns around people waiting in ambulances to go into Glan Clwyd Hospital with the Welsh Ambulance Service.  Consideration was also being given to improving the Accident and Emergency area at Glan Clwyd Hospital.  Work was also being undertaken to improve access to GPs which should reduce the amount of people visiting hospital unnecessarily.  An update on this could be provided to Members in due course.   

 

Cross border relationships

 

Mr. Geoff Lang explained that residents in Flintshire would continue to be able to access services at the Countess of Chester Hospital together with specialist services available at a number of hospitals across England. 

 

Transport

 

Mrs. Jill Galvani said that the concerns raised by Members on the allocated funding for future transport links would be taken back to the BCUHB.  She said that more work could be done with voluntary sectors to ensure that there would be heavy investment in future transport. 

 

Flint and Buckley Primary Health Care Centres

 

Mr. Geoff Lang reported that the BCUHB had been engaged in discussions around the Flint Masterplan as a stakeholder.  A site for the proposed primary health care centre in Flint had not been identified but the BCUHB were committed to providing this centre.  Work was on-going around providing the primary health care centre in Buckley with the planning application being submitted shortly.  This work should be completed in the next 15 months.   

 

Population change and demand

 

Mr. Geoff Lang explained that a great deal of work had been carried out to identify future population projections and demand with further work still to be completed.  Experience elsewhere had also been considered together with expected spells in hospital.  He said that he was confident that the proposals would address future population change and demand. 

 

Financing

 

Mr. Geoff Lang reported that the proposals would generate resources but would also enhance care across North Wales and the additional resources would allow the BCUHB to invest further in Flintshire in the future. 

 

 

 

Care assessment and cost

 

Mr. Geoff Lang reported that the enhanced care service would be funded by the health service until a patient was well enough to leave enhanced care.  Work would continue with social services to develop a care package once a patient had been released from hospital. 

 

Mold Community Hospital

 

            Mr. Geoff Lang explained that when considering the proposals for Mold Community Hospital, a number of factors had been taken into account, including, clinical benefit, efficiency and community transport.  The concerns raised by Members would be taken back the BCUHB. 

 

            Following the responses to the questions, Members were given the opportunity to ask a supplementary question.  It was agreed that a written response to the questions would be provided by the BCHUB representatives prior to the special County Council meeting on 24 October, 2012 to enable the Council to prepare a formal response before the end of the consultation process on 28 October, 2012.

 

            A copy of the supplementary questions raised by Members is attached at Appendix 1 of the minutes. 

 

            The Chair thanked Mr. Geoff Lang and Mrs. Jill Galvani for their attendance and for answering the questions from Members. 

 

RESOLVED:

 

(a)       That the presentation be noted; and 

 

(b)       That the BCUHB submit written responses to the questions attached at Appendix 1 of the minutes prior to a formal response being considered at a special meeting of the County Council on 24 October, 2012