Agenda item

Purpose:  To receive information from Beverley Searle (Director for Partnerships and Commissioning – NHS Berkshire West) of the changes to services planned as part of the ‘Care for the Future’ reforms and to determine the impact on West Berkshire residents.

April Peberdy (Head of Partnerships for West Berkshire, NHS Berkshire West) attended as a substitute for Beverley Searle (Director of Partnerships and Joint Commissioning) she described that “Care for the Future” was a transformational programme to reform service and enable the NHS to keep up with the increased demand on health services, whilst still improving quality and driving down costs. 

The changes included transferring hospital care to the community setting wherever possible and she explained that comments were being sought by 31^st October 2010.  Mrs Peberdy explained how generally patients preferred receiving care closer to home as this prevented the need to journey to acute hospitals.

Mrs Peberdy described that Specialist Services would be delivered in particular hospitals as centres of excellence.  She described that patient choice was a significant consideration as well as educational measures to allow patients the ability to manage their own conditions better.  This was particularly important for those with Chronic Obstructive Pulmonary Disease (COPD) in order to prevent frequent hospital admissions.   

Members asked about the “Choose and Book” policy of the NHS and how this might influence services in relation to “Care for the Future”. 

Members welcomed the introduction of the Community Matron role but enquired about the timescales, the need for training of staff and the risk to patients unless all agencies involved in health and social care were working efficiently together and provided a seamless service.  It was noted that the system sometimes fails the patient and that the changes presented a particular challenge to achieve joint working by 2012.

Mrs Peberdy described the work underway mapping patient pathways in order to improve the patient experience and clarify all the constituent parts of the healthcare system that had to identified and work properly together. 

Members asked whether there would be greater investment within community services, including small General Practitioner (GP) surgeries in the rural areas.  It was described how preventing acute hospital admissions should save a significant sum of money as costs of acute hospital beds were in the region of £2-3k per patient per week.  It was further explained that GPs in the future would have a far greater service commissioning role and would receive money to support this service delivery.

Treatment at local GP surgeries was also seen as advantageous in terms of preventing the need to travel and causing less stress for the patient.

Members described certain hospital centres which were already acknowledged for their specialist services; including Royal Berkshire Foundation Trust for cardiology services and the John Radcliffe in Oxford for burns, neurology and cancer care.

Members discussed the need for large enough GP surgeries to be available to undertake additional treatment procedures.  A concern was raised that delays might occur as a consequence of the planning process.

Mrs Peberdy explained that although the overall funding to the NHS was increasing this was not keeping up with the increase in demand for services. 

Members raised a point about how the new GP commissioning arrangements might work and if former NHS Berkshire West employees would be employed to undertake the commissioning functions.  Mrs Peberdy explained it was not clear how the new structures would work, as yet, but that within a set allocation of money it was still possible to drive up performance. 

Members were concerned about the natural linkages with Buckinghamshire area as they argued there were quite different urban and rural areas within this geographical boundary. 

A point was also made in relation to previous mergers with Buckinghamshire for example when South Central Ambulance Trust formed.  This resulted in an overall drop in performance than when Berkshire was a separate Ambulance Trust.  Concerns were raised as to the potential risk of the same negative impact on performance occurring. 

The fact that NHS patients occasionally received treatment at non-NHS Trusts within the area was also made.  

It was requested that in the New Year a progress report to keep abreast of the key milestones be brought to the Committee. 

RESOLVED that:

(1)       The “Care for the Future” debate at this meeting becomes the basis of the Healthier Select Committee’s submission to the NHS Berkshire West. 

(2)       An update be provided in the new year on the progress of the “Care for the Future” proposals.