APPENDIX A
Joint Three
Boroughs
Meeting of Health
Scrutiny
Chairmen
MEETING NOTES
Joint Meeting of Health Scrutiny Chairmen and Officers
Hammersmith Town Hall, London W6 9JU
23 June 2010
IN ATTENDANCE
LB Hammersmith & Fulham (LBHF)
Councillor Andrew Johnson, Chairman, Housing, Health and Adult Social
Care Select Committee (Chairman of the meeting)
Councillor Peter Tobias, Assistant (Health) to the Cabinet Member for
Community Care
Sue Perrin, Committee Co-ordinator
RB Kensington and Chelsea (RBKC)
Councillor Christopher Buckmaster, Chairman of the Health Scrutiny
Committee
Central London Community Healthcare
Jane Clegg, Director of Operations
Claire Holloway, Managing Director
Murray Keith, Director of Strategy and Business Development
Imperial College Healthcare NHS Trust
Ewan Mathieson, Stakeholder Relations Manager
1.
WELCOME AND INTRODUCTIONS
Councillor Johnson welcomed Ms Holloway, Ms Clegg and Mr Keith to
the meeting.
2.
APOLOGIES FOR ABSENCE
Councillor Sarah Richardson and Simon Lewis, Westminster City
Council.
3.
NOTES FROM PREVIOUS MEETING
The notes from the meeting held on 21 April 2010 are to be circulated.
Action: RBKC (Gavin Wilson)
4.
CENTRAL LONDON COMMUNITY HEALTHCARE (CLCH)
CLCH tabled a paper entitled ‘CLCH’s Development Plans and update
on Foundation Trust Application’.
Ms Holloway stated that the current challenges were:
•
•
The Coalition Government’s commitment to ‘reduce duplication and
the resources spent on administration, and redirect these resources
to front-line care’.
CLCH’s commitment to maintain and improve quality and
effectiveness against the backdrop of:
(i) A £18.6 million three year cost reduction target, including £8.2
million in year.
(ii) An additional 15% reduction in management costs in-year,
equivalent to £1.1 million of additional savings.
Ms Holloway responded to a query that CLCH currently had an annual
turnover of £147 million, and management costs of £13.8 million in the
previous year.
Ms Holloway stated that the new clinical model would move away from
the provision of services on the basis of professional grouping, and
would be organised around the patient journey. CLCH would work with
Imperial College Healthcare NHS Trust and GPs to provide improved
joined up care.
The commissioning of services would move from PCTs to GPs. Some
GPs had experience of fund holding, but not of the commissioning of a
broad range of services, which would include emergency as well as
elective services and the wider remit of public health and well being.
Councillor Johnson queried whether the transfer of commissioning to
GPs would realise savings. Ms Holloway responded that
commissioning would need to be undertaken by larger practices or a
consortium of GPs, as they would have little bargaining power on their
own, and gave the example of one patient requiring intensive care to
highlight the impact of changes in demand on small practices.
PCTs would be working with GPs to provide acute care in the
community rather than in hospitals which currently accounted for
around 50% of their budgets.
Ms Holloway addressed the specific concerns raised at the previous
meeting in respect of the plans for restructuring some children’s
community health in Kensington and Chelsea on a regional basis, by
outlining the following benefits for children’s services applying the key
principles of the new clinical model:
•
Expert clinical leads with access to children best practice
knowledge to meet local requirements.
•
A dedicated safeguarding nurse.
•
Quicker, more responsive and adaptable children’s service to
address children matters.
•
A named senior manager specialising in children’s services.
•
A dedicated senior borough/relationship manager.
Initially CLCH had been managed on the basis of three boroughs, but
Ms Clegg had now been appointed as Director of Operations,
responsible for all clinical operations across the three boroughs.
Children’s services had not moved away from borough structures, but
plans for restructuring in order to deliver higher quality services in
future were being informally consulted upon with staff. Patients were
being asked about the important aspects of their care pathways and
the aspects which were not so good. The proposed model would then
be consulted upon. CLCH would consult at all stages.
Ms Holloway outlined the views of CLCH services as obtained from a
recent survey of existing patients, which produced 5,000 responses.
Ms Holloway explained service specific PROMs (Patient Reported
Outcome Measures) and PREMs (Patient Reported Experience
Measures) to track the ongoing quality of service delivery and the
patient experience, in addition to finance and performance targets`.
Ms Holloway then outlined CLCH’s journey to achieve NHS community
trust status by 1 October 2010, with consultation on NHS foundation
trust status in 2011. It was intended that there would be an open
culture, with CLCH holding its meetings in public.
In response to a query by Councillor Buckmaster, Ms Holloway stated
that initially accountability would be to the SHA, and after abolition of
the SHA, to the regional office of the NHS Commissioning Board.
Monitor would remain as the financial regulator and the role of the
Care Quality Commission would be strengthened in respect of
registration and quality of service delivery. Additionally, penalties and
improvement notices could be issued in respect of services and
ultimately, withdrawal of the contract.
There was likely to be competition from acute providers, GPs
undertaking more services themselves and polysystems, for example
NHS Kensington & Chelsea and the London Medical Associates were
in partnership to deliver GP led services to St. Charles Urgent Care
Centre, and Chelsea and Westminster Foundation Trust was providing
care in the community for specific services.
In response to queries in respect of funding of the new structure, Ms
Holloway stated that the CLCH was currently funded by the PCTs, but
this would transfer to GP commissioners.
5.
IMPERIAL COLLEGE HEALTHCARE NHS TRUST (ICHT)
Ewan Mathieson met the councillors to informally discuss the quarterly
meetings with ICHT. The changes to the scrutiny structures within the
boroughs were outlined. Councillor Buckmaster stated that significant
changes to the health remit were anticipated at RBKC.
Ewan Mathieson stated that ICHT would be pleased to host an
induction event for members of health scrutiny committees.
6.
WORK PROGRAMME
It was agreed that the North West London Commissioning Partnership
be invited to attend the next meeting.
Action: LBHF (Sue Perrin)
7.
DATE OF NEXT MEETING
Wednesday 13 October 2010, 9.30am at Kensington Town Hall.