Agenda and draft minutes
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Contact: Fiona Abbott
Apologies for absence & substitutions
Apologies for absence were received from Councillor Holloway (Thurrock Council), Councillor Collins (Thurrock Council) and Councillor Fish (Thurrock Council).
Declarations of Interest
The following interests were made:-
(a) County Cllr Beavis – non-pecuniary - ECC nominated governor – Mid Essex CCG;
(b) County Cllr Egan – non-pecuniary - ECC nominated governor - Castle Point and Rochford CCG;
(c) Councillor Nevin – non-pecuniary - 2 children work at MEHT; step sister works at Basildon Hospital; previous association at Southend and MEHT Hospitals; NHS employee in Trust outside STP area (Royal London & Barts) which was mentioned in presentation on transport; sister works in Yorkshire in health field which was mentioned during the meeting;
(d) Councillor Habermel – non-pecuniary - brother is a paramedic; sister is a nurse & works at Southend Hospital;
(e) Councillor Jones – non-pecuniary – knows a Nurse Prescriber as close friend;
(f) Councillor Salter - non-pecuniary – husband is consultant surgeon at Southend Hospital and holds senior posts at the hospital; son-in-law is a GP; daughter is a doctor at Broomfield Hospital;
(g) Councillor Moyies – non-pecuniary - Governor of Essex Partnership University NHS Foundation Trust.
Appointment of Chairman and Vice Chairman
1. That Councillor Arscott be appointed as Chairman of the Joint Scrutiny Committee.
COUNCILLOR ARSCOTT IN THE CHAIR
2. That County Councillor Beavis and Councillor Snell be appointed as the two Vice Chairmen of the Joint Scrutiny Committee.
That the Terms of Reference of the Joint Scrutiny Committee be agreed.
- Report of Jo Cripps, Programme Director STP and presentation by representatives from STP
On behalf of the Committee, the Chairman welcomed the following representatives from the Mid and South Essex Sustainability and Transformation Partnership (STP) to the meeting:-
· Jo Cripps – Programme Director, STP
· Dr Celia Skinner – Medical Director, STP
· Caroline Rassell – Senior Responsible Officer, STP
· Claire Hankey – Director of Communications and Engagement, STP
· Clare Panniker – Chief Executive of the 3 hospitals in Mid and South Essex
The Committee considered an update briefing paper from the Mid and South Essex Sustainability and Transformation Partnership (STP) Programme Director on the public consultation which formally commenced on 30th November 2017 and runs to 9th March 2018. The representatives also gave a presentation which provided information of the public consultation to date, the emerging feedback and next steps and the proposed timeline (for discussion and agreement).
The Programme Director confirmed that although the proactive consultation activity will end as planned on 9th March, the STP will continue to accept feedback (including the questionnaire) through until 20 March.
As well as acute reconfiguration the STP are encouraging more self-care, utilising voluntary sector, utilise local services - especially community pharmacists - and look to offer a wider range of services at GP practices and ultimately looking to make services in the community more joined up.
There are five principle for future hospital services:-
· Majority of care will remain local
· Certain more specialised services should be concentrated in one place and get better patient outcomes (e.g. cardiothoracic at Basildon Hospital, burns at Broomfield, radiotherapy and oncology at Southend Hospital)
· Access to specialist services should be available via local A&E
· Separate planned care from emergency care
· Some services should be provided closer to home
A number of services will remain available at all three hospital sites. However the STP proposals are recommending:-
· Intensive care aspects of stroke services to be centred at Basildon Hospital although initial triage and treatment could be undertaken locally
· Specialised gynaecology (including cancer) in Southend
· Planned orthopaedic operations to be in Southend and Braintree
· Complex urology at Southend
· Complex lung, vascular, heart and kidney at Basildon
By reconfiguring the acute trusts as proposed they expect the acute trusts to be able to operate within the financial envelope given. Substantial £118m of transformation monies had been provisionally awarded for capital investment for buildings, technology and transport. However, this was not guaranteed and was dependent on the outcome of the consultation process.
The STP are committed to producing a transport plan which will be a key part of the final documentation for decision. This would include provision for clinical transfers and a patient and visitor bus service between hospitals.
1. That the update report be noted.
2. That the STP timeline be noted and that the STP will continue to accept feedback (including the questionnaire) through until 20 March.
Statements from members of the public
Mr Fieldhouse, a resident of Southend and spokesman for ‘Save the NHS – Southend’, made a statement which focussed on the clinical evidence put forward by the STP for specialising some services in one specific location. He made reference to international evidence that better outcomes are not automatically achieved by operating from fewer larger centres. He suggested that much of the data relied on by the STP was dated and urged the Committee to check the pertinence and veracity of the data.
Questions from the Joint Committee on the presentation given by the STP; responses by the STP
The Committee asked the representatives of the STP a number of questions which were responded to as follows:-
Numbers on patient flows and estimated numbers on those impacted by the proposals for acute services were based on current activity.The plan was predicated on managing the future demographic and demand growth by expanding primary care and other community services.
It was also confirmed that many of the numbers quoted in the consultation were averages and that further refinement of numbers would be done as actual figures were validated against modelling assumptions.
Under the proposals Basildon Hospital would have limited planned care (e.g. cardiothoracic, vascular but relatively small numbers for each). A far greater proportion of planned care would be at Southend Hospital and Mid Essex Hospital Trust and the STP believed that, as a result, they could manage patient flows through the hospitals better than now. The Hospitals already do winter planning and will continue to make those seasonal adjustments.
The STP were proposing a variation to national specification due to local feedback.The STP stressed that there was strong international evidence that good outcomes could still be achieved by undertaking a local assessment and provide clot busting medication before transfer to a specialist service (model being used in Scarborough and York) and that this was shown to be no worse in terms of outcomes compared to immediate transfer for treatment.
Action: The JointCommittee to be provided with the numbers of people suffering a stroke by CCG area over last 5 years.
Clinical changes had been developed by the relevant local clinical teams and had not imposed from 'top down'. The STP argued that the reconfiguration proposals would bring clinical teams together and enable critical mass and provide more 7 day services, and help with recruitment gaps. It was also considered by the STP that consolidation of some services would create a better training environment to help recruit and retain staff and create research capacity opportunities.
Despite this some members felt that there needed to be more clinical evidence to support the proposed changes and that greater assurance was needed about better outcomes.
Responses received to date were weighted slightly in favour of the Southend area and comprised slightly older demographic. In recognition of that the STP had arranged an event next week at SE Essex College (after having already held an event at ARU).
A concern was expressed that the terms of engagement had not been good in the Thurrock area. Some members considered that the consultation period needed to go on for longer whilst others doubted extending consultation by another few weeks would make any significant difference and that there would be other opportunities to communicate and engage as the plans and implementation progressed.
Some members referred to an oversubscribed event in Southend and a further session was also now fully booked and queried whether this meant there was full opportunity for everyone to take part. The STP ... view the full minutes text for item 7.
Date of next meeting
– the next meeting of the Joint Committee will be held on 13th March 2018, beginning at 7.30 pm and will be held at County Hall, Duke Street, Chelmsford
The next meeting of the Joint Scrutiny Committee will be held on Tuesday 13th March 2018 beginning at 19.30 and will be held at County Hall, Chelmsford.