Agenda and minutes

The Chairman gave details of the arrangements in case of fire or other event requiring evacuation of the meeting room.

Apologies were received from Councillors Sanchia Alasia, Barking & Dagenham and Stuart Bellwood, Redbridge. Apologies were also received from Jilly Mushington, scrutiny officer, London Borough of Redbridge.

Healthwatch representatives present:

Mike New, Healthwatch Redbridge

Joan Smith, Healthwatch Havering

Health officers present:

John Hine (JH) Consultant Surgeon, Whipps Cross

Neil Kennett-Brown (NKB) London Cancer

Mike Gill (MG) Director of Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT)

Nicole Millane, North East London Commissioning Support Unit

Scrutiny officers present:

Anthony Clements, Havering (notes)

Glen Oldfield, Barking & Dagenham

Corrina Young, Waltham Forest

Farhana Zia, Waltham Forest

Two members of the public were also present. 

There were no disclosures of interest.

To approve the minutes of the meetings held on 8 January and 13 February 2013 (attached) as a correct record.

The minutes of the meetings held on 8 January and 13 February 2013 were agreed as a correct record and signed by the Chairman.

To receive an update from health officers on the proposals for changes to services for urological cancer in the Outer North East London area.

JH explained that he chaired the urology pathway board which aimed to make treatment better for patients in North East and North Central London as well as West Essex. The principal drivers for change were to ensure better outcomes for cancer patients in terms of both survival and patient experience. It was also important to promote more clinical trials in order to improve outcomes for some types of cancer.

The overall proposals were to keep less complex surgery at the existing hospitals while there would be a single centre for complex prostate and bladder cancer surgery and a separate single centre for complex kidney surgery.  Diagnosis and follow up treatment would still be undertaken locally and health officers stated that only a very few patients would need to travel for their operations.

Working groups drawing up the proposals included patients and GPs and had recommended specialist centres in order that surgeons could perform as many as 50 complex urological operations per year. Each centre would have approximately six surgeons attached to it.

There were not enough patients in the region to make two centres viable and research had shown that functional outcomes in terms of reduced incontinence or erectile dysfunction were better in a single centre. Better facilities such as access to Da Vinci robots would also be available in a single centre.

It was emphasised that the vast majority of patients would still receive their care locally and fewer than 1 in 5 would need to receive care at a specialist centre. It was estimated that around 225 patients in the sector would need complex surgery for bladder/prostate cancer and around 270 would need such surgery for kidney cancer. In terms of the ONEL boroughs and West Essex, numbers for complex bladder/prostate surgery ranged from 19 per year in Barking & Dagenham to 49 per year in West Essex. For kidney cancer, the equivalent figures varied from 14 in Barking & Dagenham to 29 in West Essex.

The patient pathway would see patients returned to local care as soon as possible after having their operation in a specialist centre. Emergencies would also be treated locally. In some cases, recipients of complex surgery would only need to stay in the specialist centre for one night. The only visits needed to the specialist centres in most cases would be for one pre-op appointment and for the operation itself. The proposed locations for the specialist centres were UCLH for bladder/prostate surgery and the Royal Free Hospital for kidney surgery. Further information on the proposals and the recommendations reached was available on-line.

Engagement on the surgery proposals was taking place from January to April and meetings would also be taking place with patient groups and local CCGs. Additional clinical information and a video on the proposals were available on the website.

Officers felt that the benefits of the clinical outcomes of the proposals outweighed any travel difficulties. It was accepted however that travel concerns were the main issue in Outer North East London and West  ...  view the full minutes text for item 35.

Report of the Clerk to the Committee (attached).

The Committee AGREED unanimously to co-opt one representative from each of the Local Healthwatch organisations for Barking & Dagenham, Havering, Redbridge and Waltham Forest.

Initial discussion by Members.

In addition to an update on the urological cancer proposals in six months, the Committee also agreed to take an update on the maternity situation as soon as possible. The Committee also requested a presentation on the NHS 111

telephone service. It was felt that scrutiny of the performance of CCGs could best be carried out at a local level.  

To consider any other item of which the Chairman is of the opinion, by means of special circumstances which shall be specified in the minutes, that the item shall be considered at the meeting as a matter of urgency.

Dates and venues of future meetings were AGREED by the Committee as follows (all 3.30 pm start):

Tuesday 2 July (Barking & Dagenham)

Tuesday 1 October (Havering)

Tuesday 7 January (2014) (Redbridge)

Tuesday 1 April (Waltham Forest)