The Committee received a report from N Abbott (Interim Managing Director, Care Group 5 at Mid and South Essex NHS Foundation Trust), which provided an overview of the proposal and rationale to redesignate the status of the neonatal unit at Southend Hospital from a Level 2 Local Neonatal Unit (LNU) to a Level 1 Special Care Baby Unit (SCBU).

The proposal from the MSE NHS Foundation Trust had been through and supported at the relevant MSEFT meetings and Committees. It has also been supported at the Mid and South Essex Local Maternity and Neonatal System Board. The proposal was discussed at the East of England Specialised Services Joint Commissioning Committee on 31 January 2024 where the outcome was for referral to the Health Overview and Scrutiny Committees (HOSCs).

Members of the Committee raised a number of concerns regarding the redesignation of the status of the neonatal unit at Southend Hospital, as summarised below:

·         That paediatric care was being conflated with neonatal care.

·         Concern that the proposed redesignation could exacerbate the safety and quality concerns already identified. 

·         That the proposed redesignation could potentially put additional pressure on the ambulance service to transport patients and parents to Basildon, and the safety and stability of care of patients in any such transfer.

·         The impact of the proposed redesignation on the Neptune Ward and Children’s Emergency Department; it was queried whether there was any future reduction in these services planned in the same way as the Local Neonatal Unit (LNU).

·         It was felt that there had been a lack of coproduction, consultation and engagement with local stakeholders before the pilot had been initiated.

·         That the proposed redesignation could negatively impact upon the City and its residents.

·         The longer travelling time for parents to visit their baby at Basildon Hospital, the potential prohibitive costs of this and difficult public transport options.

·         That a public consultation had not been undertaken to accumulate the views of local residents who would be affected by the proposals.

·         That the challenges around the recruitment and retention of staff at Southend Hospital needed to be addressed.

A motion was proposed by Councillor L Hyde to reject the report and suggested an alternative proposal to call upon the MSE NHS Foundation Trust:

a)    To pause the proposal to redesignate the status of the neonatal unit at Southend Hospital from a Level 2 Neonatal Unit (LNU) to a Level 1 Special Care Baby Unit (SCBU); and,

b)    To instead secure the investment required to address the safety issues as soon as possible.

c)    To develop a recruitment drive focussed on Southend and once all options had been exhausted to look at whether the right balance had been achieved.

The motion proposed by Councillor L Hyde was seconded by Councillor D Jones.

The Chair explained that she understood that the report provided would be considered as part of the consultation process, but observed that the Committee was only being asked to note the contents of the report and consider the recommendation set out in 4.13 that:

The Essex Health Overview and Scrutiny Committee is asked to approve the redesignation of the Southend Neonatal unit as a level 1 SCBU as described and proposed in this paper with effect from 1 April 2024.

The Chair highlighted the typographical error that the report referenced ‘Essex’ rather than ‘Southend’ and explained that under regulation 22 of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 enabled local authorities and committees to make reports and recommendations to NHS bodies and health service providers.

The Chair of People Scrutiny Committee felt that it was not appropriate to endorse the proposed downgrade and suggested a motion to reject the report and:

Following consideration of the paper, the Committee request that Mid and South Essex NHS Foundation Trust:

1.    To provide a report to either the Southend People Scrutiny Committee or to the Southend and Essex Joint Health Overview and Scrutiny Committee, detailing further information regarding the modelling of other sites for the proposed downgrade as well as improved data analysis, feedback from external partners such as EEAST and local authorities.

2.    To provide full details and parameters of their proposed consultation with patients, staff and other key stakeholders across the Mid and South Essex footprint regarding the proposed changes.

3.    To provide data on the budgetary impact of this proposal on Southend Hospital and across the Trust.

4.    To provide information on what has been considered in terms of staffing ratios, recruitment, retention, staff satisfaction in Southend and the outcome of these investigations.

5.    Arrange a site visit for members of the People Scrutiny Committee/Joint HOSC to speak with staff and patients across the Southend and Basildon sites.

The above motion proposed by Councillor T Cowdrey and seconded by Councillor K Murphy.

The Chair (Councillor T Cowdrey) asked Councillor L Hyde and Councillor D Jones whether they would accept incorporating their motion into her own proposed motion to form a new substantive recommendation.

Councillor L Hyde and Councillor D Jones indicated their agreement, and the new motion was unanimously agreed by the Committee as set out in the resolution below.

On behalf of the Committee, the Chair thanked N Abbott for their informative presentation.

Resolved:

That the Southend People Scrutiny Committee reject the report in its current format

to redesignate the status of the neonatal unit at Southend Hospital from a Level 2 Local Neonatal Unit (LNU) to a Level 1 Special Care Baby Unit (SCBU) and request that Mid and South Essex NHS Trust:

1.    To pause the proposal to redesignate the status of the neonatal unit at Southend Hospital from a Level 2 Local Neonatal Unit (LNU) to a Level 1 Special Care Baby Unit (SCBU); and,

2.    To secure the investment required to address the safety issues as soon as possible.

3.    To provide a report to either the Southend People Scrutiny Committee or to the Southend and Essex Joint Health Overview and Scrutiny Committee, detailing further information regarding the modelling of other sites for the proposed downgrade as well as improved data analysis, feedback from external partners such as EEAST and local authorities.

4.    To provide full details and parameters of their proposed consultation with patients, staff and other key stakeholders across the Mid and South Essex footprint regarding the proposed changes.

5.    To provide data on the budgetary impact of this proposal on Southend Hospital and across the Trust.

6.    To provide information on what has been considered in terms of staffing ratios, recruitment, retention, staff satisfaction in Southend and the outcome of these investigations in addition to any details on a Southend focussed recruitment drive.

7.    To arrange a site visit for members of the People Scrutiny Committee/Joint HOSC to speak with staff and patients across the Southend and Basildon sites.