Agenda and minutes

There were no apologies for absence.

There were no declarations of interest on matters coming before this meeting.

RESOLVED:  That all items of business be considered in public.

RESOLVED:  That the minutes of the meeting held on 15 September 2021 be agreed as a correct record. 

Ms Jessamy Kinghorn, Head of Partnership and Engagement at NHS England / Improvement (NHSEI) - East of England, advised that the report provided Members with a brief update on the Mount Vernon Cancer Centre (MVCC) strategic review.  Following the independent clinical review, it had been proposed that a new cancer centre be located in Watford with a chemotherapy centre at Hillingdon Hospital and a satellite radiotherapy centre in the north of the catchment area. 

Although having the expertise under one roof at Watford was welcomed, concern was expressed that a catchment area with a 2.4m population seemed high.  Ms Kinghorn advised that MVCC covered three NHS regions and that a 2.4m population was not excessively large. 

An expression of interest had been submitted for the new cancer centre to be considered as one of the eight new hospital schemes which would added to the Government’s health infrastructure plan.  It was thought that this would be the best opportunity to secure capital to fund the project.  The long listing of the expressions of interest would be undertaken in the autumn with a decision expected in the spring of 2022.  In the meantime, NHSEI would continue to work on the busines case. 

A significant amount of patient engagement activity had been undertaken and support for the MVCC proposals had been received from clinicians and the East of England Senate.  Insofar as Hillingdon was concerned, there had been good engagement from local residents in the focus group activity with a mixed response.  During the engagement activity, concern had been expressed that some patients had a 100 mile round trip for blood tests or chemotherapy.  As a direct result, it had been proposed that blood tests be made available in primary care settings closer to home (where possible) and that a chemotherapy centre be established at Hillingdon Hospital.  Enhancing capacity at Hammersmith Hospital would also be included as part of the plan. 

Mr Richard Ellis, Joint Borough Director at NWL CCG, advised that, since the pandemic had started, all GP practices were now providing blood tests either individually or providing a shared service with other practices.  This had been well received by patients and would reduce the number of routine blood test appointments needed at MVCC.  However, urgent blood tests would continue to be undertaken at MVCC. 

With regard the creation of a chemotherapy centre at Hillingdon Hospital, it was thought that around 356 patients would be able to use this service each year (this equated to 3-5 chairs per annum).  It was thought that some tumours (such as some lung tumours) were so rare that they would need specialist treatment elsewhere to ensure that these patients received the best possible care.  In addition, some Hillingdon patients were likely to choose to go to Northwick Park or one of the Imperial sites rather than travel to Watford. 

It had been recognised that the MVCC catchment area included significant areas of deprivation.  Luton was an area of deprivation and had been identified as having some  ...  view the full minutes text for item 29.

The Hillingdon Hospitals NHS Foundation Trust (THH)

Ms Tina Benson, Chief Operating Officer at THH, advised that, despite the pandemic, the Trust had received a number of awards and accolades.  To build on achievements from the previous year, the Quality Priorities for 2021/2022 had included improvements to patient discharge. 

In the week commencing 18 October 2021, an event had been planned whereby consideration would be given to hospital discharge.  Safer Care Bundles would be available for discharges from an acute site within 24 hours.  It was noted that if no action was taken to improve the efficiency of discharge, the hospital would be 88 beds short of the number needed in January 2022.  Even with the proposed action, it was thought that there would still be a shortage but that it was workable. 

Ms Claire Eves, Associate Director of Outer London Services at Central and North West London NHS Foundation Trust (CNWL), advised that progress over the last year had resulted in a more positive position to fully integrate the discharge team.  Daily discharge monitoring had been undertaken to unblock any problems as they arose and improved communications and regular touchpoints had helped to reduce delays.  The good relationship between THH, CNWL and Hillingdon Health and Care Partners (HHCP) had helped to improve hospital discharges.

Therapy had been integrated into the discharge process.  Brunel University trained a range of therapists so action had been taken to attract them into Hillingdon Hospital.  Action had also been taken to join community and hospital therapy services which had been helped by Discharge to Assess.  Use of the service was monitored as well as the availability of step down beds and rehabilitation beds in the community and the length of stay. 

Mr Richard Ellis, Joint Borough Director at NWL CCG, advised that twice daily discharge monitoring meetings were undertaken at Hillingdon Hospital, six days each week.  There had been a particular focus on Fridays and Saturdays to ensure that discharges could still be undertaken over the weekends.  This work had resulted in improvements to the safety of discharges and documents could be produced at any time of day.  It would be important to continue to learn from past experience and implement improvements to the discharge process.  Ms Benson would provide the Democratic Services Manager with statistics on the number of failed discharges at THH going back as many years as was available. 

With regard to winter planning, Ms Benson advised that the Trust anticipated a challenging period ahead.  During the summer months, the demand for all services had increased to levels similar to those seen in the winter.  Primary care surge hubs had been set up through the Primary Care Networks (PCNs) and the Rapid Response Team was available from 8am to 8pm.  Members were advised that these services would be required of all Integrated Care Partnerships (ICPs) by April 2022 so Hillingdon was ahead of the curve. 

Activity at Hillingdon Hospital’s Accident and Emergency (A&E) department had already increased to winter levels.  ...  view the full minutes text for item 30.

Consideration was given to the Committee’s Work Programme.  It was noted that the Chairman would be presenting the Committee’s final report on children’s dental health to Cabinet at its meeting on 14 October 2021. 

Concern was expressed that the waiting times for a CAMHS assessment still appeared to be too long.  During this time that they were waiting for professional intervention, the child’s/young person’s mental health was likely to be deteriorating and the parents were having to deal with this as well as things like having their child sectioned.  It was agreed that the Committee hold a focussed discussion in relation to CAMHS as its first meeting in the 2022/2023 municipal year.  The Chairmen of any of the Council’s other relevant Select Committees would be invited to attend this meeting.  As with the children’s dental services review, if the there was more scrutiny needed following the meeting, this could be scheduled into the Committee’s Work Programme. 

RESOLVED:  That:

1.    CAMHS be added to the Work Programme for the meeting in June 2022; and

2.    the Work Programme be agreed.