Agenda and draft minutes

Joint Health Overview & Scrutiny Committee - Tuesday, 11th February, 2020 7.00 pm

Venue: Stratford Town Hall, 29, The Broadway, London, E15 4BQ

Contact: Anthony Clements  Email: 01708 433065

No. Item



The Chairman will announce details of the arrangements in case of fire or other events that might require the meeting room or building’s evacuation.


The Joint Chairmen (Councillors W. Vaughan, LB Newham and N. Zammett, LB Redbridge) welcomed attendees and explained that the meeting was a simultaneous meeting of members of the INEL JHOSC and ONEL JHOSC to enable a discussion on matters relevant to both bodies, as such there were minor variations in the agendas for each Joint Committee. They led introductions around the table and explained the emergency evacuation arrangements.





Apologies were received from Councillors S. Bellwood (LB Redbridge, who was substituted by Councillor H. Chaudhry); Councillors N. Dodin and C. White (LB Havering) Councillor U Alli (LB Waltham Forest who was substituted by Councillor R Sweden) and Councillor A. Lion (Epping Forest District Observer Member).




Members are invited to declare any interests in any of the items on the agenda at this point of the meeting. Members may still declare an interest in an item at any point prior to the consideration of the matter.


There were no disclosures of interest.



The Joint Committee is asked to note and, where appropriate, respond to questions submitted by the public relating to items on the agenda.



Ms C. Ackroyd, representing North East London Save Our NHS (NELSON) spoke in relation to the NHS Long Term Plan indicating that, whilst a positive development, the Plan did not contain sufficient information on resources, financial projections and the location of services, in order to support the proposed initiatives.


Regarding financial balance by 2023/24, Ms Ackroyd expressed concern regarding NHS deficits that the potential implications on local authority social care budgets, particularly regarding the anticipated reduction in the number of people being treated in hospital and the resources required to support care in the community.


Ms R. Mykura, representing North East London Save Our NHS (NELSON), spoke in relation to the NHS Long Term Plan and asked the following question:


“What steps have local authorities taken, locally and nationally, to understand the additional caring impact and financial implications of this transfer to local authority budgets and individuals, and to address these issues?”


A member of the INEL JHOSC requested further information from ELHCP either during the presentation on the NHS Long Term Plan or in due course in relation to the reference to the transfer of local authority budgets.


With the Chairman’s permission, Ms C. Ackroyd, also spoke in relation to the issue of overseas patients and charging by Barts NHS Trust, particularly regarding maternity services, indicating that this created a hostile environment with the community and calling on both Committees to issue a joint statement to NHS England and NHS Improvement to this effect.


The Chairmen thanked the speakers for their contributions and indicated that a response would be submitted to them on behalf of the two Committees in due course.


(The Committee agreed to vary the order of business and take item 6 ahead of item 5).






Report attached.

Additional documents:


At the request of the Committees, an update was provided in relation to population health management, urgent and emergency care, primary care networks, cancer, mental health, workforce and estates, which was initially scheduled for the meeting held on 6 November 2019.

Jane Milligan (ELHCP Accountable Officer), Dr Jagan John (Chair Barking and Dagenham CCG) and Simon Hall (ELHCP Director of Transformation) introduced a detailed presentation which outlined a background to the NHS Long Term Plan; selected workstreams, ongoing work to develop an integrated care partnership for North East London, the role of the acute collaborative group, and projected delivery and next steps.

The Plan was published in January 2019 setting out a vision for the NHS over a 10-year period including the development of a number of work programmes. It was submitted to NHS England and published on the ELCHP website in November 2019.

Jane Milligan made reference to the questions received from the members of the public and explained that a single CCG (NEL Integrated Care System) was in development across north east London to remove barriers to integration, improve governance structures and speed up decision making in key areas, and Marie Gabriel was due to commence in her role as Chair on 1 April. 

The final plan was due to be submitted to NHS England / Improvement in March 2020 and ELCHP would continue its boroughwide engagement with local authorities and NHS provider organisations as well as the JHOSCs, particularly as services are redesigned.

Questioning outlined the following:

-       The Accountable Officer acknowledged the importance of co-production across the various partner organisations to deliver integrated care health and social care for north east London and the constraints of national policy and welcomed further developments in national policy, such as the Green Paper. 

-       Resources would be made available to support the transformation of services in north east London, particularly in relation to Primary Care Networks and workforce development, and work programmes would build on the learning from previous transformations, in terms of integrated working and engagement, such as maternity services and mental health.

-       An Acute Collaboration Group exists which worked across acute providers to share good practice.

-       Joint commissioning arrangements were a work in progress and both the Plan and a move to a single CCG would aid decision-making and the alignment of resources.

-       The Accountable Officer acknowledged the challenges regarding A&E waiting times and explained that Marie Gabriel would be undertaking a governance review. The Director of Transformation clarified that the Plan included ongoing work to develop workforce initiatives including the offer of apprenticeships and collaborative work with partner organisations.

-       The Chair Barking and Dagenham CCG explained that the transformation plan across the CCGs aimed to ensure that people could access the right services in the right location and nearer to home and reduce A&E activity, particularly at BHRUT which was seeing a rise in activity relating to access and workforce, and to create a more stable system. He acknowledged  ...  view the full minutes text for item 34.



Report attached.

Additional documents:


The report outlined that Barts Health NHS Trust, Lewisham and Greenwich NHS Trust, and Homerton University NHS Foundation Trust hospitals were working to develop a joint NHS pathology network in order to improve the quality, efficiency and sustainability of pathology services.


Ralph Coulbeck, Director of Strategy, Barts Health NHS Trust and Tracy Fletcher, Chief Executive, Homerton University Hospital NHS Trust introduced the report and explained that the proposed clinical model was based on the creation of a network of laboratories, centralising laboratory testing where clinically appropriate and reflected the changing needs of an ageing population and the emergency of new diagnostic tests and an increase in demand and potential benefits, to be reflected over time; this included improved quality, faster response time, reduced variation in standards, improved training opportunities for staff and increased strategic alignment between partners.


The Outline Business Case for the partnership had been approved by all three trust boards through November and December 2019 and work had commenced on the Full Business Case, due to be completed by end of March 2020.


Questioning outlined the following:

-       The proposed changes would best utilise available resources and experts in the field and each hospital site would be able to undertake urgent / fast turnaround testing where required.


-       The development of a network would not have a significant impact on the current organisation of clinical services or pathology services across the Barts Health hospitals. Barts is the proposed host for the network and the Royal London site is the proposed location for the ‘hub’ laboratory.


-       Each Trust would be able to specify a list of ‘Reserved Matters’ where a trust may wish to reserve a right of veto over partnership decisions and an example of such a matter was given as extending the partnership at a future date beyond the founding partners.


-       Further detail regarding potential staffing changes and performance monitoring of turnaround times would be included a part of the full business case and any potential savings over the four-year transition period would be reinvested among the three organisations.


-       The choice of provider organisations related to expressions of interest and did not preclude the likelihood of additional partnerships at a future date.


It was agreed that officers would continue to keep the Committees briefed on developments prior to the Final Business Case being completed.





The next meeting of the Outer North East London Joint Health Overview and Scrutiny Committee will be on Tuesday 28 April at 4 pm at Havering Town Hall, Main Road, Romford, RM1 3BB.


The next meeting of the ONEL JHOSC will be on Tuesday 28 April at 4pm at Havering Town Hall, Main Road, Romford RM1 3BB.