Presentation by Simon Williams
Minutes:
The Board received a presentation from a representative of NHS England on Specialist Commissioning who welcomed the opportunity to address the Havering Health and Wellbeing Board. The representative went on to address a number of points that Board members had raised.
The Board were informed of the NHS England organisational and geographical structure and that Specialist Commissioning was divided into the following groups:
· Mental Health
· Internal Medicine
· Cancer and Blood
· Trauma
· Women and Children
Although Specialised Commissioning covered 10 area hubs within England, the structure in London would be more integrated with a single regional team covering the three areas within London; North West, South and North/North East. Nationally NHS England had also established an Independent Review Panel to look into issues of public concern and the Children’s Cardiac Services reconfiguration was given as an example.
The Board were advised that there were no definitive recommendations yet as to whether some specialised services should be centralised to central London, but that there was no immediate NHSE agenda for centralisation. The focus of NHSE is on the provision of equitable access to specialist services at the right standard of care. The London Specialised Team would be tasked with providing the means of assuring access to all services and that certain service specifications would need to be met.
In the list of NHS England’s service priorities, for example, the University College London Partners (UCLP) Cancer and Cardiovascular programme, Trusts had to meet with service standards and if they fell below that standard, a plan would be put in place to deliver those standards. In addition, any service changes amounting to a reconfiguration would be subject to public scrutiny, including those relating to specialised cancer and cardiac services.
The Board were advised that NHS England had no model currently in place for consulting populations but a process was under rapid development.
Members were advised that Screening Children’s Hearing came under direct commissioning, (not specialised commissioning).
An observation was made that the structure of NHS England, the Clinical Commissioning Group and Public Health was very confusing and that the centralised culture of NHS England could clash with local organisations including the Trusts. NHS England responded that they were very conscious of this and were looking at how they could work with the Clinical Commissioning Groups as well as Local Authorities and that any helpful advice would be gratefully received.
In response to a further observation that there were no Health Visitors listed within the Children’s Sector on the list of Priorities, the Board were advised that Health Visitors were part of direct commissioning and that across London there was currently a shortage of 150 Health Visitors.
In summary, NHS England affirmed that it was one of their priorities to understand local ways of thinking and to understand Local Authorities. NHS England had sufficient resources to deliver effectively and there was no agenda to pull specialist services into Central London.
Several members observed that they had concerns about what was going to happen locally and did not feel reassured. Further comment was made as to the lack of definition and focus on the presentation which made it very difficult for the Board to challenge.
NHS England responded that the organisation was only three months old and that processes would become clearer. Further activities would be reported at Clinical Commissioning Group level but not to the Local Authority.
NHS England affirmed that there were no plans now or in the future to move services out of Queens Hospital, Romford.