To receive an update on implementation of the programme from Heather Mullin, Health for North East London.
Minutes:
Senior officers from Health for North East London (H4NEL) and BHRUT gave an update on implementation of the H4NEL plans. BHRUT was represented by Nick Hume who was working on how care that was currently provided in hospital could be safely provided in the community. He felt that one third of patients in hospital beds at any one time did not need to be there. The officers felt however that clarity was needed as soon as possible around BHRUT’s clinical strategy in order that the amount of resources needed to provide care in or near people’s homes could be gauged more accurately.
The H4NEL process had been running for three years and the project lead confirmed that the current plans were to relocate the existing King George Hospital A&E department to Queen’s Hospital from around November 2013. It was emphasised that an urgent care centre would remain operating at King George. The sexual health service at Queen’s would have to be relocated in order to allow the building of a larger A&E at the hospital. Half of all current users of A&E at King George would still be seen there by GPs in the Urgent Care Centre.
It was planned for there to be midwifery-led units at each hospital and Cornflower A ward at Queen’s had recently been closed in order to start construction on the midwifery-led unit there. It was anticipated that the current maternity unit at King George Hospital would close by mid-2013. Cases would be then be seen at Queen’s, Whipps Cross or the Barking Birthing Centre. No closure of King George maternity would take place however until the quality of the alternative facilities had been successfully demonstrated.
The King George site would contain an elective treatment centre, polyclinic, the urgent care centre, a renal dialysis unit and rehabilitation beds. Havering and Barking & Dagenham had a combined total of 176 beds but there were still often issues and delays in the care pathway. As such, an integrated care pathway was being developed jointly by the three local Councils and Clinical Commissioning Groups. GPs were also keen to redesign the frail elderly pathway.
A representative of Havering LINk felt that officers should consider the recent LINk report on hospital discharge. The LINk was also now looking at the issue of domiciliary care and had made a difference by working in partnership with the Overview and Scrutiny Committee, something that was often not seen in other boroughs. The H4NEL lead responded that she had read and responded to the report and agreed that the report contained a number of quick and simple measures that could improve patient care.
The health officers confirmed there were no current plans for changes to the Ambulance Service. The polyclinic at King George Hospital was expected to be open by the end of 2012 and existing local GP practices who were operating from premises in poor condition would move in. The polyclinic would also have access to other facilities on site at King George such as blood testing.
Checks on people giving care at home would be more the responsibility of the Council’s Adult Social Care directorate. It was not possible to entirely guarantee continuity of care but efforts were being made to base care teams around GPs and hence meet more of people’s care needs at home.
There was currently insufficient space at Queen’s to include a polyclinic at the site although GPs did work in A&E in order to stream out cases not requiring emergency treatment. It was possible the introduction of a polyclinic could be reconsidered when the other changes at Queen’s had been completed. The business case for the work required at Queen’s would be developed by the end of July and initial discussions had started with the hospital’s PFI partner.
Members expressed concern about the practice of using cook-chill food at Queen’s that had been transported from Wales and it was agreed that comments on this could be included in the response to the BHRUT Quality Account. The issue could also be raised with the relevant director at BHRUT. Members felt that the food at Queen’s Hospital was nutritionally very poor and health officers agreed that very few Trusts got hospital food right.
Plans for St. George’s Hospital would be included within the NHS NELC estates strategy which would be brought to the Committee once finalised.
The Committee noted the update and agreed that the officers should come to future meetings and give further reports on the implantation of the H4NEL plans.