Agenda item

Health & Scrutiny (Standing Item) (Agenda Item 8)

To receive an update from Maureen Orr, Scrutiny Support Manager (Health) Norfolk County Council, on the way the Health Scrutiny process has changed.



Maureen Orr, Scrutiny Support Manager (Health) Norfolk County Council gave Members a presentation on the Health Scrutiny Process.


The Norfolk Health Overview & Scrutiny Committee (NHOSC) was made up of eight Norfolk County Councillors and seven District Councillors (one from each Local Authority).  It met every six weeks and examined healthcare issues raised by Councillors, Healthwatch and others as well as responding to consultations.


NHS funded organisations were required to:


  • Provide information
  • Attend scrutiny meetings and answer questions
  • Consult on plans for substantial changes to services
  • Respond to scrutiny reports and recommendations within 28 days


The Committee had powers to:


  • Make reports and recommendations to health service bodies
  • Refer substantial changes to the Secretary of State for review


The Health Scrutiny relationships with Providers, NHS Commissioners, Local Authority Commissioners, other scrutiny partners and the public were explained.  All NHS funded providers were required to consult NHOSC on any substantial changes they proposed to make.  The criteria for referring matters to the Committee were wide ranging and very open. 


The current work programme of the Committee included:



         Access to NHS dentistry

         Same day admissions to hospital

         Ambulance turnaround times at the N&N

         Wheelchair provision

         Use of the Liverpool Care Pathway for the dying


         Radical redesign of mental health services

         Dickleburgh branch surgery


The Health and Wellbeing Board was an official Committee of Norfolk County Council with high level membership.  It was a mixed Member / Officer Board with voluntary and community sector representatives.  The first meeting of the Board would be held on 1 July 2013. 


The Board’s operating framework was explained.  The Board would produce strategy based on evidence and identify priorities for focus on issues where a difference could be made.  A one year strategy for 2013/14 had already been produced and had three strategies:


         Unplanned care/emergency admissions

         Improving Access to Psychological Therapies (IAPT)

         Creating good developmental/learning outcomes for Children and Young People


The Board would also hold a watching brief over issues already being dealt with by other agencies and receive detailed reports.


Councillor Gilbert asked whether the Committee’s remit included looking at individual surgeries and was advised that since 1 April 2013 GP surgeries were within the Committee’s remit.  However, guidance was awaited and it was expected that the Committee would look at overarching issues such as the appointments systems.


Councillor Kybird asked Members to bear in mind that the NHS was a very large employer with a £1.6 billion budget.  The Committee had to focus on high level issues and complaints about surgeries should be made to Health Watch Norfolk in the first instance.


Councillor Bambridge asked if there was a good spread of rural and urban Councillors on the Committee and whether recent changes to the political makeup of the County was reflected on the Committee.  He was advised that the majority were Councillors from rural areas and the Committee had four Conservative, two UKIP, one Labour and one Liberal Democrat member.  The overall Committee was not politically balanced due to the District membership.  The Committee did not operate in a political way and Members worked very well together.


Councillor Matthews who was also the Chairman of Breckland Older People’s Forum noted that it could be frustrating trying to get information about people who paid for their own care due to confidentiality issues.


Councillor Irving asked whether the Committee would look at A&E waiting times, the 111 service and charity hospices, as well as NHS hospices.


Mrs Orr said that A&E was a big part of the Committee’s remit and was already being looked at.  The 111 service was a good subject which would be worth looking at.  Hospices in receipt of NHS funding were also within the Committee’s remit.


Councillor Richmond said he had enjoyed listening to the presentation.  He attended a patient participation group and the Practice Manager and Doctor usually attended but had been too busy since the changes.  He was also concerned that people might have to travel longer distances to access care.


Mrs Orr acknowledged that there was a lot of work to be done and the services were under a lot of pressure to make savings and to commission care with less money.  Commissioning groups would be contacted and told that they needed to consult NHOSC if they were planning to make major changes.


Councillor Richmond asked whether mental health support would still be available and was advised that the Committee was looking at mental health services.  A local service would still be available but the change meant that access to those services would be handled through a central point.


Councillor Byrne wondered how decisions were ever made when so many different agencies had to be consulted.  He was also concerned that the change to out of hours services was causing problems at A&E departments.


Mrs Orr said there was a lot of debate about what was causing the problems at A&E.  She confirmed that despite the consultations decisions were being made and the services took on board what Health Scrutiny said and welcomed responses from people that knew the service.


The Chairman thanked Mrs Orr for her presentation.