Verbal update from NHS North West London.
Minutes:
Ms Susan La Brooy, North West London NHS advised that a lot of work was being carried out with regard to ‘shaping a healthier future’. The public, OSC, LA’s and other organisations were involved in the consultation of strategic re-configuration.
Health and clinical standards had been agreed and it was noted there was a large out of hospital component that needed to be considered. There were 2 large events with clinicians and the public which evaluated various options and combinations of the emergency services at hospitals in North West London.
The organisation was not looking to close any hospitals but was looking at the emergencies services in North West London hospitals and possible pairings. Northwick Park and Hillingdon Hospital emergency services would remain unaffected. The distance between the two hospitals was quite far, whereas as the other hospital were quite close together.
An evaluation criteria had been used to produce at least three combination plans, and included every hospital having an option on whether to stay as an acute hospital. A consultation was going out at the end of June/beginning of July 2012; this would end in October 2012. This consultation would then go to the Secretary of State, before the possible implementation through new CCG’s.
There was a large communication element to this. Ms Brooy reminded Members that although Hillingdon Hospital services were not threatened that they will be affected by the changes. As hospitals around North West London changed then this would cause a shift of change. Ms Brooy stressed that out of hospital care was important to consider. In addition the quality of services needed to be maintained.
Members asked what management was being used for the placement of patients. Ms Brooy advised that any changes would take 3 – 5 years and that if there was change then capacity would need to increase. North West London NHS had a grant of £12million for emergency care. Changes would be built into a financial model.
Members commented it was important to increase the amount of care to patients at home, in the right setting and with value for money. Members noted that three A & E’s will close but urgent care centres would be in place of those A & E’s that close. An urgent care centre run by GP’s will deal with injury and illness which was severe. It was expected around 50% of patients would go to an urgent care centre instead of A & E.
Members spoke about emergency need in a large scale if required, for example for emergencies on the motorway or at the airport. Ms Brooy explained that there were Pan London plans to deal with this and would be used if there was a need.
Members asked for clarification on urgent and minor centres, how will patients know which to attend or will they be advised. Ms Brooy explained that it was most important that patients got the best care and were not messed about. At hospital the person who triages the patient would tell the patient where to go for appropriate care. It was also for the ambulance to decide, if they were called. It was noted that there would also be specialist centres to deal with strokes, vascular care (for example) and patients would get transferred as required.
Travel time was discussed and Ms Brooy explained that a lot of work had been done with regard to looking at travel times. There was very little difference and this difference was not a critical element. North West London had a number of centres in accessible distance for residents.
The ratio of people per A & E was discussed. Currently it was 1 A & E per 200,000 and would be 1 per 400,000 after the changes in North West London. This was a better ratio in comparison to the rest of the UK.
Mr Trevor Begg, LINk, spoke about LINk’s heavy involvement as they had been on the Programme Board. Mr Begg stated that Hillingdon hospital A & E was not a concern as the A & E hospital configuration was broadly positive for Hillingdon hospital. Out of hospital had potential to be positive for Hillingdon. He had concerns around out of hospital strategy and elective care. The strategies were not in enough detail for Mr Begg to give a view. In Hillingdon there needed to be a focus on the potential impact on the quality of care, especially with people moving for care.
Dr Friedman stated that the basic strategy appeared to be correct. There were 30% more beds in North West London than the national average. Overall there should be no doubt outcomes for patients will be better. Fewer and more specialist hospitals was the right way forward. The amount of planning provisions was robust enough to take up the slack. The effect on social care spending needed to be looked at in detail. If Ealing A & E closed the exact changes that would result to Hillingdon hospital needed to be looked at and Dr Friedman has not seen a model flow of this. Locally, more detail was required.
The Committee thanked Ms Brooy for her presentation and answering Members questions.
RESOLVED: That the presentation be noted.