(a)

concerns regarding staff shortages, staff skills, recruitment and staff retention within the NHS, specifically the four hospitals linked to the review, and how this would be managed effectively;

(b)

the impact upon adult social care resources and future budgets linked to stroke rehabilitation and the clinical discharge of patients from hospital to care provided at home or within the community;

(c)

the importance of GP retention in Plymouth and efforts made to encourage increased trainee numbers;

(d)

the feasibility of recruiting from a hospital consortium to help alleviate workforce issues and aid in career progression.

(a)

the delivery model of Accountable Care Organisations and how smaller organisations would contribute and be managed within this model;

(b)

the importance of accountability, collaboration, responsibility and governance linked to the Accountable Care Delivery System; what was the democratic process linked to the new system and what financial arrangements were in place?

(c)

the current crisis with primary care and General Practices in Plymouth as well as workforce retention within the NHS and how the Accountable Care Delivery System would have an impact upon these issues.

1.

to note the update on the Accountable Care Delivery System;

2.

that the business case would be provided to the Wellbeing Overview and Scrutiny Committee to scrutinise once properly developed.

(a)

proposals for the Paediatric SARC to be based in Exeter; there were concerns that this location was not accessible and should instead be based in Plymouth as it was the largest city southwest of Bristol;

(b)

proposals for Plymouth to have an Acute Response SARC only; there were concerns that Plymouth was in need of a fully operational SARC as the figures suggested that rape and sexual assault incidents recorded were increasing;

(c)

clarification if other agencies had been involved  with the commissioning of the service, if a needs assessment had been undertaken and if the proposals indicated had been tried and tested in other areas with a similar demographic to the South West/ Plymouth;

(d)

how was the consultation process surrounding these proposals undertaken?

(e)

as a result of speaking to victims of sexual assault it was highlighted to Members that the was preference was to only have to recount their experiences once – Members questioned how this would be achieved with so many organisations involved;

(f)

concerns that if the current proposals were implemented there would be a reduction in service provided in Plymouth;

(g)

Members raised concerns that despite the numbers of sexual assault and rape increasing, attendance at the SARC were low in comparison.

1.

that it is minded to view these proposals as a substantial variation of service provision. This is based on - 

·          

the proposed service delivery model not having been tried and tested across a similar geography;

·          

reduction in local accessibility, particularly as the proposals indicate adverse travel implications for the public;

·          

the proposal has a seemingly counter intuitive case for change (reduction in local accessibility for potential service users);

2.

that the Committee, under powers conferred by the NHS Act 2006 (as amended) recommends to NHS England that the consultation methodology and results, final service model, and service specification are subject to a Joint Health Scrutiny Committee by Local Authorities in the area to enable this the service specification is not put out for tender in September;

3.

to direct the lead officer to work with colleagues across the peninsula to convene a Joint Health Scrutiny Committee to consider the detailed plans for the variation of service provision.

·          

adult mental health needed to be added to the work programme to be scrutinised

·          

the primary care select review was a priority however due to procurement exercises affected three surgeries it was necessary to wait until after 21 August 2017 until this review could be considered – the planning document also needed to be completed;

·          

Torbay children services was listed on the work programme and would be arranged shortly;

·          

select review request forms for End of Life Care and Dementia Friendly City had been submitted and it was hoped that these reviews would be scheduled before December 2017.