To receive an update from officers on the current position on the Transforming Services Together project for health services in North East London.
Minutes:
Officers explained that the TST programme was a partnership between Barts Health and the Newham, Tower Hamlets and Waltham Forest CCGs. This was in response to the increasing population in these areas, the variable quality of care and workforce issues. It was emphasised that there were no proposals to close any A & E or maternity units.
The main aims of the programme were to bring care closer to home and to establish strong, sustainable hospitals working across organisations. Engagement and project planning had been undertaken and the project was now at the point of decision making.
The engagement process had included advertisements and articles on the proposals in local newspapers and a dedicated website. Documents were also available in libraries, hospitals and Council offices and there had also been a programme of engagement with staff on the proposals. Drop-in sessions for staff and the public had been held at the hospitals and representatives of the project had attended patient meetings, health and wellbeing boards and overview and scrutiny committees. A feedback and challenge event had been held in June 2016 and comments on the proposals would be collated in the engagement report.
Given the likely rise of 270,000 in the population covered by the proposals over the next 15 years, it was accepted that a lot of new health facilities were needed and officers wanted to be ambitious with the plans. Responses to the proposals had been supportive overall but some concerns had been expressed about the distances to travel in order to have surgery. People were also broadly in favour of care being delivered closer to home, again with some reservations.
The proposals aimed to maximise surgical capacity across the three Barts Health sites and it was acknowledged that concerns had been raised over transport, patient choice and pre and post-operative care. Under the TST proposals, some colorectal and neurosurgery would move to Newham Hospital and some urology surgery would move to Whipps Cross Hospital.
The final report on the proposals would be submitted for decision to Barts Health and the CCGs in September 2016.
It was accepted that some transport issues were not easy but services would be centralised if this would benefit patients. There were reasonable transport links to Barts Hospital and there were also hospital patient transport services available in some cases. It was a challenge to ensure people e.g. moved from Newham to Whipps Cross Hospital for urology surgery rather than to a central London hospital but it was felt that evidence of better patient outcomes would persuade people to stay with the Trust under the choose & book system. It was also hoped that IT improvements would allow the availability of x-rays, blood test results etc on a single system.
It was noted that pressure groups had felt that the proposals constituted a threat to overnight surgery but officers emphasised that this was not the case. The current arrangements sometimes meant that tests were often duplicated if previous results could not be accessed if these were held on a separate system. Testing could also be increased if necessary. It was also confirmed that the TST proposals would be incorporated into the Sustainability and Transformation plan that covered the whole North East London area.
As regards home births, it was wished to increase this to around 5% of the total number of births in the area covered by the proposals, compared with less than 1% of births as present. More use would also be made under the proposals of integrated models of care such as the introduction of physician’s associates. It was also planned to make more use of telecare with more consultations undertaken by phone and alternative methods.
Efficiency savings would come from a number of different areas including A & E and IT systems although it was accepted that the savings targets in the proposals were very challenging. Current targets also included the requirement to make 2-3% efficiency savings across all service lines. New financial modelling was also currently being undertaken.
The total planned capital spend was £352 million over 5 years and £663 million over 10 years and the anticipated drop in these funds as part of the TST programme was anticipated to be £72 million. The thirteen initiatives detailed in the programme had been selected as likely to have the highest impact on the programme’s aims and officers added that many were already in progress. There had been some IT successes with portals etc but officers agreed that this work was evolving with the overall aim of developing shared care records and having all three hospital sites using the same versions of IT. It was confirmed that the TST programme also had links with West Essex CCG.
The Committee NOTED the update.