Agenda item

Neil Kennett-Brown, Director of Transformation for Newham, Tower Hamlets and Waltham Forest CCGs will present on the Transforming Services Together programme (report attached).

The Director of Transformation overseeing the Transforming Services Together (TST) project explained that the Newham, Tower Hamlets and Waltham Forest Clinical Commissioning Groups (CCGs) had been working with Barts Health and neighbouring Trusts to respond to the case for change. The combined population of the three boroughs named was predicted to rise by 270,000 over the next 15 years and it was therefore important health services were altered in order to cope with this.

Prevention was an important issue and the TST team felt that the Health Service should be seen as less of an ‘illness service’. Work was therefore also being undertaken with Health and Wellbeing Boards, including the Board covering Redbridge. Out of hospital care also needed to be considered and the TST project was supportive of the Vanguard project that had recently been launched in Outer North East London. Similar work was also being undertaken in Inner North East London. The NHS 111 service would also be further developed.

In hospital care, it was planned to develop elective surgical wards that would include a higher volume of work at either Newham or Whipps Cross Hospitals. Acute care hubs would be established at each site allowing a more proactive approach to unplanned care. More hot clinics would be used in order to reduce numbers of overnight hospital stays.

It was also planned to increase numbers of low risk births taking place at midwife led units as these facilities had been shown to improve outcomes for low risk births. The programme would also look to improve pathways for brain injuries treated at the Royal London hospital. Work would also take place across the system to improve outpatients, end of life care and diagnostics.

It was accepted that Whipps Cross Hospital was an old site that required fundamental redevelopment as part of the TST programme. The populations of Redbridge, Waltham Forest and West Essex would be involved in development of these plans. A public document outlining the proposals would be available from December 2015 and it was confirmed that a period of public engagement on the plans would follow this.

The predictions for healthcare demand had been based on the Greater London authority population and planned housing data. It was accepted that there were large health inequalities across North East London. Investment needed to be made in GP practices so that people, regardless of language spoken etc, understood how the healthcare system worked.

It was anticipated that an outline business case for the TST proposals would be published in April 2016 and this would be followed by a period of public consultation. Engagement would also continue in the meantime and officers would shortly be attending a meeting in the Epping Forest area to discuss the plans.

Officers agreed that investment was also required in out of hospital care. A shift towards having more consultations by Skype or telephone would result in savings although it was emphasised that investment would also be increased. Barts Health was also continuing to invest in midwifery services.

A pilot of hot clinics at Whipps Cross had been very successful and had saved 50% of non-elective activity. Work was ongoing to remove any disincentives and to ensure that the costs to Barts Health of establishing hot clinics were covered. While some services such as e.g. arthroscopy could be moved to a different site, it was emphasised that outcomes were expected to improve. Officers added that there were unlikely to be large increases in travelling distances from any change of service location.

A Member requested approximate cashflow figures for the proposals but officers emphasised that work had to be carried out in a different way and look for savings from increased productivity etc. There was not the finance available to build a further hospital in North East London and it was therefore necessary to try to transform existing services and ways of working.

The TST programme was looking to change the primary care model and be more proactive. As regards prevention, the programme wished to use schools more in child health and to work with Council public health leads in order to improve areas such as sexual health services.

Information systems had been shared with the GP EMIS system now linked with the system used by Barts Health, allowing the sharing of patient records electronically. Officers would confirm if systems had also been linked with those used in West Essex.

It was accepted that there was a big case for change in primary care but there were no plans to merge the primary and secondary care sectors. Officers also felt that Public Health had a critical role in the TST plans. Work was undertaken with the Barking, Havering and Redbridge University Hospitals’ Trust (BHRUT) via the North East London Advisory Group and Outer North East London was also represented on the Commissioning Strategy Group.

The Committee NOTED the position.