Agenda item

(To receive a report by Simon Evans (Health Scrutiny Officer) which invites the Committee to consider its' work programme for the coming months.  The report also sets out the Committee's final responses to two consultations)

Consideration was given to a report by the Health Scrutiny Committee for Lincolnshire which gave the Committee the opportunity to consider its work programme for the coming months and also provided the Committee's final response to two consultations.

The consultations referred to were in relation to the merger of Peterborough and Stamford Hospitals NHS Foundation Trust with Hinchingbrooke Health Care NHS Trust; and the Medicines Management Consultation.

In relation to the merger of Peterborough and Stamford Hospitals NHS Foundation Trust with Hinchingbrooke Health Care NHS Trust, the Committee established a working group, on 21 September 2016, to draft and finalise the response of the Committee to the Full Business Case.  The deadline for the response was 7 November 2016 and the response of the Committee would be reported to both Trust Boards at their meetings in November 2016.

On the basis of the information received, the Committee supported the full business case for the merger and was reassured that the outcome of the merger would not impact directly on Lincolnshire patients.  In addition, in the event of a significant change of service in the future, the Committee would seek to be involved in any consultation on service change, led by the appropriate commissioners.

The full response of the Committee could be found at Appendix B to Agenda Item 11 on pages 113/114 of the agenda pack.

A working group was also established, on 26 October 2016 to draft and finalise the response of the Committee to the Medicines Management Consultation which was being undertaken by the four clinical commissioning groups in Lincolnshire.  The response of the Committee on the proposals put forward are noted below:-

·       Proposal 1 – To restrict providing over the counter/minor ailment medicines for short term, self-limiting conditions – the Committee supported the principle of self-care for very minor ailments but noted that some medicines, such as paracetamol or ibuprofen were cheap and widely available in supermarkets, etc.  Some over the counter medicines, including cough syrups, thrush creams or child paracetamol, however, were not as cheap nor readily available.  The Committee recorded its concerns that this may have an impact on low income families;

·       Proposal 2 – To restrict the prescription of gluten-free foods – the Committee supported the proposal to limit prescribing of gluten-free foods to loaves of bread, bread-flour and bread mixes (in accordance with Coeliac UK's recommended quantities).  However, GP's should be advised to take account of the impact of these arrangements on particular individuals and allow discretion in exception circumstances to prescribe additional products;

·       Proposal 3 – To restrict prescribing of baby milks and specialist infant formula – the Committee noted that specialist baby milks and infant formulas may cost up to four times as much as standard milk and formulas.  The Committee expressed concern about the potential impact on low income families and believed that GPs should be allowed to use discretion in these circumstances;

·       Proposal 4 – To restrict prescribing oral nutritional supplements -  the Committee strongly supported the "food first" approach for those with low appetites or a degree of malnourishment.  Concern was noted that some care homes relied too much of nutritional supplements when they should encourage residents to eat food.  The Committee was mindful that there may be exceptional circumstances and the need for GPs to take account of the impact on low income families; and

·       General Comments

o   the Committee noted that each proposal included the word "restrict" rather than "discontinue" as this provided an element of reassurance that discretion would be applied by GPs;

o   Concern was raised that a six week period of consultation had been too short although the Committee acknowledged the pressures on the four clinical commissioning groups to reduce expenditure during the remainder of the 2016/17 financial year;

o   The Committee was concerned that the consultation document had not been widely circulated due to some GP practices choosing not to make the document available in their waiting rooms;

The full response of the Committee could be found at Appendix C to Agenda Item 11 on pages 115/116 of the agenda pack.

The Committee made no comments on the content of the work programme but agreed that an item on Lincolnshire Health and Care (LHAC) and the Sustainability and Transformation Plan (STP) be added to the work programme for the December meeting, on the assumption that the STP would be published on 12 December 2016.

RESOLVED

1.    That the Work Programme, with the addition noted above, be agreed;

2.    That the response of the Committee to the Full Business Case for the Merger of Peterborough and Stamford Hospitals NHS Foundation Trust with Hinchingbrooke Health Care NHS Trust be noted; and

3.    That the response of the Committee to the Medicines Management Consultation, undertaken by the four clinical commissioning groups in Lincolnshire, be noted.

The Chairman advised that an attendance analysis for the Committee had been done and expressed disappointment at the attendance from two District Councils.  The Committee was asked to ensure that apologies were submitted and to provide a substitute member wherever possible.