Agenda item

To receive and consider the latest position re the North East London Sustainability and Transformation Plan (STP). Update paper and presentation attached.

Note: The Committee will also be addressed on this issue by a representative of Save Our NHS.

Save Our NHS Group

The Joint Committee was addressed by two representatives from the Save Our NHS group. The group’s view was that the Sustainability and Transformation Plan (STP) aimed to close the A&E department at King George Hospital where 115 acute beds had been removed since 2011. The group was concerned the closure of acute beds would lead to overcrowded A&E departments and hence to more acute deaths.

The group did not feel that the STP would be appropriately resourced to make the proposed changes successful and that the STP had been drawn up in secret with a lack of democratic accountability. In the view of Save Our NHS, key financial details of the STP were being withheld.

It was also felt by the group’s representatives that there needed to be better public engagement around the STP. The group was also concerned that the predicted population growth in London over the next 15 years had not been accounted for as no additional hospital was being proposed and it was still planned to close the A&E at King George. The representatives felt that the STP would be devastating for the Ilford South area where a lot of new housing had been proposed but no details had been given of where new health facilities would be located.

There were also concerns that surgeries were forming into larger networks but that there were insufficient GPs to support this. The group felt that the public wished to have care close to home and to trust health professionals.

Presentation from STP team

The STP officers accepted that there been challenges in the STP process. There were a total of 44 STPs across the UK. In North East London, the STP aimed to support local delivery systems.

Work had been undertaken with Local Healthwatch and Community Council organisations and it was accepted that the current health system was not giving the right outcome for patients. The STP aimed to create a new way of working based on a partnership model. It was hoped that North East London would become a place where people wished to live and work. The STP would also seek to establish a career pathway for staff.

Questions and discussion

Councillor Zammett from the London Borough of Redbridge addressed the Committee and felt that the shortfall in NHS beds would not be sustainable in the future. He also asked when bed forecast reconciliation figures would be provided. Officers responded that the decision to close the A&E at King George had been made by the Secretary of State rather than BHRUT. Bed modelling data was likely to be available by the end of April but officers would confirm the timescale for this.

Members asked for clarity over what services would be retained on the King George site if A&E was closed. It was felt important that A&E continued to provide the required standards in terms of both skills and staff numbers.

Other concerns raised by Members included the rising demand on NHS services and how the public could be educated to use other facilities rather than A&E. It was also raised that some 95,000 residents of South west Essex used health services in North East London but there had been little work undertaken with Local Authorities in Essex concerning the STP.

Officers accepted that there had been a lack of engagement with Essex and this would be addressed in the next phase of the STP work. A representative from the Princess Alexandra Hospital in Harlow was on the maternity working group for the plans. Councillor Pond would report these responses back to the chairman of the Essex Health Overview and Scrutiny Committee.

A representative of Healthwatch Havering raised concerns that Queen’s Hospital, with one of the busiest A&E departments in London, would not be able to cope if the A&E at King George was closed. Officers agreed that Queen’s A&E was already extremely busy and a lot of capital would be required to improve and expand the department at Queen’s. Some 50-60% of current A&E cases at King George could still be treated at a planned enhanced urgent care centre on the site where blood tests, x-rays etc could be carried out. Work to expand the A&E at Queen’s would take over a year and this depended on capital availability.

The renal dialysis unit at Queen’s was currently located next to A&E and there were no plans to close this. It was possible that the facility could move to an alternative site in the local area in order that A&E could be expanded.

Revised figures for population growth in the local area would be factored into the STP plans. The effect of the Private Finance Initiative process for Queen’s Hospital would be fed into an estates strategy that was in the process of being developed. As regards housing for hospital staff, capital receipts received for NHS land were not in the control of the STP and this could be part of a London-wide approach. The linking of prescribing pharmacists with GPs was under consideration.

Officers recognised the crisis in primary care and wished to use the STP to bring key components together in order to work differently. The STP team were also starting to meet with different consultant bodies including the British Medical Association.

Officers accepted that health services were not currently delivering best outcomes and the STP was therefore needed in order to develop a different way of working. The impact on Whipps Cross on any closure of A&E at King George would also be considered.

Members felt that the current STP documents were not clear or accessible and that concern about STPs was shared by Councillors across London. Issues such as the expected 18% rise in the population of North East London in the next 15 years had not been taken into account nor had the NHS financial deficit locally or the shortage of GPs and social care facilities. A national march concerning the NHS was planned for 4 March.

In response, offices felt that the STP could be implemented and a more accessible document would be produced saying what differences the STP would make.

The Chairman thanked the STP and Save Our NHS representatives for their input. The Committee NOTED the position.