To receive a presentation from officers on the work of the Commissioning Support Unit covering Outer North East London.
Minutes:
The Chairman explained that she had agreed to take as part of this item an update on the position with the review of services urological cancer.
Commissioning Support Unit (CSU)
Officers that the CSU would support the work of Clinical Commissioning Groups (CCGs) in Inner and Outer North East London as well as North Central London, once the CCGs started formally on 1 April. It was clarified that commissioning of primary care would be undertaken by the NHS Commissioning Board in order to avoid any conflict of interest for the CCGs. The CSU wished therefore to provide a high quality service to allow CCGs to commission well.
Services to be provided by the CSU included information on how many people are using health services, finance, support for service redesign, procurement and provider management/quality of care issues.
It was confirmed that CCGs could commission mental health services from other provides if they wished. The CSU chief operating officer also agreed to supply a list of services provided by Public Health England and of those public health services that would now be provided by Councils.
It was suggested that the Committee could meet jointly with the Inner and North Central London equivalent committees in order to scrutinise the work of the CSU or other matters of joint concern. It was explained that CCG budgets were set but the National Commissioning Board and not allocated by the CSU. The CSU would however report to the CCGs on how much money they were spending.
As regards governance, the CSU reported to the National Commissioning Board and its staff were employed by the NHS Business Services Authority. The accountable officer for the CCGs in Barking & Dagenham, Havering and Redbridge was Conor Burke who could talk through how the CCGs were being set up. Similar governance arrangements existed for Waltham Forest CCG.
It was uncertain at this stage what level of financial savings would result from the introduction of CCGs. Officers added that Redbridge CCG faced the biggest financial challenge from its allocation. It was suggested that the financial challenges facing CCGs could be scrutinised in more detail at a future meeting.
Urological Cancer
Officers explained that services for urological cancer were complex to commission and this had led to delays in the publication of the case for change for these services. A lot of work was however being undertaken with Hospital Trusts as part of the London Cancer Partnership. This was an integrated cancer system among Hospital Trusts in Outer North East London, North Central London and West Essex.
Of 1,900 cases of prostate and bladder cancers in this area each year, only around 350 required complex surgery. Surgery was currently carried out at four hospitals in the sector including King George and Whipps Cross although more cases were now seen at UCH. The case for change was likely to recommend further consolidation of complex surgery procedures onto fewer sites in order to give better outcomes. It was accepted that which hospitals would offer urological cancer services would be a contentious issue. It was aimed to have 1-2 outstanding for urological cancer in this area.
Pre-consultation meetings were planned for January/February and the Joint Committee could then decide if it wished to see any level of formal consultation on the proposals.
Members asked for details of the criteria for how the centres of excellence would be judged in the future. It was AGREED that an update on the situation should be taken at the Committee’s next scheduled meeting in April. It was further AGREED that scrutiny Members from the affected boroughs in Inner North East and North Central London should also be invited to this meeting and that the Committee’s wish to explore joint meetings with these boroughs in the future should also be fed back to the boroughs concerned.