Agenda and minutes

Cumbria Health Scrutiny Variation Sub-Committee - Thursday, 23rd June, 2016 1.30 pm

Venue: Grand Jury Room - The Courts, Carlisle, CA3 8NA. View directions

Contact: Lynn Harker  Email:

No. Item


Apologies for Absence

To receive any apologies for absence.



Apologies for absence were received from Ms C McCarron?Holmes and Ms G Troughton.




Disclosures of Interest

Members are invited to disclose any disclosable pecuniary interest they have in any item on the agenda which comprises


1.         Details of any employment, office, trade, profession or vocation carried on for profit or gain.


2.         Details of any payment or provision of any other financial benefit (other than from the authority) made or provided within the relevant period in respect of any expenses incurred by you in carrying out duties as a member, or towards your election expenses.  (This includes any payment or financial benefit from a trade union within the meaning of the Trade Union and Labour Relations (Consolidation) Act 1992.


3.         Details of any contract which is made between you (or a body in which you have a beneficial interest) and the authority.


            (a)       Under which goods or services are to be provided or works are to be executed; and


            (b)       Which has not been fully discharged.


4.         Details of any beneficial interest in land which is within the area of the authority.


5.         Details of any licence (alone or jointly with others) to occupy land in the area of the authority for a month or longer.


6.         Details of any tenancy where (to your knowledge).


            (a)       The landlord is the authority; and


            (b)       The tenant is a body in which you have a beneficial interest.


7.         Details of any beneficial interest in securities of a body where


            (a)       That body (to your knowledge) has a place of business or land in the area of the authority; and


            (b)       Either –


(i)                 The total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body; or


                        (ii)        If that share capital of that body is of more than one class, the total nominal value of the shares of any one class in which the relevant person has a beneficial interest exceeds one hundredth of the total issued share capital of that class.




A “disclosable pecuniary interest” is an interest of a councillor or their partner (which means spouse or civil partner, a person with whom they are living as husband or wife, or a person with whom they are living as if they are civil partners).



There were no disclosures of interest on this occasion.




Exclusion of Press and Public

To consider whether the press and public should be excluded from the meeting during consideration of any item on the agenda.



RESOLVED,    that the press and public be not excluded from the meeting for any items of business.




Minutes pdf icon PDF 49 KB

To receive the minutes of the last meeting held on 12 November 2015 (copy enclosed).



RESOLVED,    that the minutes of the last meeting of the Sub-Committee held on 12 November 2015 be agreed as a correct record and signed by the Chair.





To consider reports by the Chief Executive and Cumbria Clinical Commissioning Group (copies enclosed).


Additional documents:


The Sub-Committee received a report which contained a submission from the Cumbria Clinical Commissioning Group outlining a proposal to make a permanent variation in service at Helme Chase Midwife-Led Maternity Unit.


Members were informed that Helme Chase was a standalone midwifery-led unit at Westmorland General Hospital.  It was explained that women who were assessed as having a low risk pregnancy were able to give birth at Helme Chase which was staffed by experienced midwives and clinical support workers.


The Sub-Committee noted that an interim change had taken place at Helme Chase in December 2014 which meant that the unit operated an on-call service overnight, during weekends and bank holidays.  It was explained that during those times staff did not stay on the unit unless they were caring for a woman in labour, but were at home and would meet women at the unit to provide care as required.  It was noted that the unit was staffed during the day to provide a range of services.


Members were informed that following the introduction of the interim arrangements more than 3,000 clinical hours had been freed up.  The Helme Chase midwifery staff were able to work flexibly across the Trust, which enabled them to gain experience of working in busier units and, therefore, retain their skills and competencies.  It was noted that whilst there had been a reduction in the number of deliveries at the unit since the interim change was made this was a trend that was already happening.


The Trust had also been working with the CCGs on a programme of work following the independent review of maternity services across Cumbria and North Lancashire by the Royal College of Obstetricians and Gynaecologists which had focused on the actions necessary to sustain consultant-led units at both Royal Lancaster Infirmary and Furness General Hospital.  It was explained that as part of those activities there had been a significant amount of engagement with local women and the Maternity Services Liaison Committees to inform service developments and this was now an embedded way of working.


It was emphasised to members that the interim arrangements at Helme Chase had not impacted negatively on recruitment there were indications that it was a more attractive proposition for applicants.  Furthermore, an inspection by the Care Quality Commission in 2015 which had been undertaken a year after the implementation of the interim arrangements gave a rating of good in all areas.


The Trust and the CCGs felt that the interim change at Helme Chase should be made permanent.


The Sub-Committee held a detailed discussion and members raised questions regarding the social media campaigns which had been launched promoting the restoration of 24 hour inpatient services.  It was explained that a dialogue had been established with campaign organisers and positive communication was ongoing.


The Sub-Group then discussed the programme of engagement which had been undertaken.  Concerns were raised regarding the previous engagement and it was felt that those in the local area were not afforded sufficient opportunity to express their  ...  view the full minutes text for item 5.



To consider a report by the Chief Executive and presentation from the Cumbria Clinical Commissioning Group (copies enclosed).


Additional documents:


The Sub-Committee received a report which outlined a process which the NHS Cumbria Clinical Commissioning Group (CCG) intended to use to undertake a review of the configuration of adult in?patient mental health provision across Cumbria. 


Members received a detailed presentation which included vision and context, governance, process and timeline.  It was noted that the process was to determine the best way of providing in?patient care and from a long list a short list would be determined to endeavour to have a preferred option. 


A discussion took place regarding the proposal and it was


RESOLVED,    that the Committee treat the options consultation as a substantial variation for the purposes of applying the variation protocol.





To consider a report by the Chief Executive (copy enclosed).


Additional documents:


The Sub?Committee received a report from the Chief Executive which contained a submission from the Practice Manager at the Castlegate and Derwent Surgeries, Cockermouth with a proposal to merge the patient lists of the two Practices.


Members were informed that in April 2015 Derwent House Surgery received resignations from two GPs which left it with a patient population of circa 6,700 with only 18 GP sessions.  The Derwent House Surgery was incapacitated, therefore, consideration had to be taken as to the best way to proceed.  It was explained that recruitment of GPs in Cumbria was difficult, therefore, it was felt that the best solution was to approach Castlegate Surgery to merge or collaborate.  It was noted that a merger position was embraced and it was an obvious solution to both surgeries.


The Sub-Committee discussed the proposals and


RESOLVED,    that the proposal does not constitute a substantial service variation.