Agenda item

Members expressed concern that there appeared to be no good reason for NHS England's (NHSE) proposal to stop commissioning congenital heart disease (CHD) services from Royal Brompton and Harefield NHS Foundation Trust (RBH).  It was suggested that a representative from NHSE be invited to attend a meeting with the External Services Scrutiny Committee to establish the reasoning behind the proposals.  Mr Nick Hunt, Director of Service Development at Royal Brompton and Harefield NHS Foundation Trust, agreed to provide the Democratic Services Manager with the details of the most appropriate NHSE representative/s to invite to the meeting.

Mr Hunt advised that the NHSE consultation would end on 17 July 2017 and that the results would not be reported until Christmas at the earliest.  RBH had received a lot of support from, amongst others, MPs.  He noted that there had been regular personnel changes at NHSE.  It was suggested that the proposals could have arisen for a number of reasons such as: the process could not be stopped without NHSE losing face; and the possible realisation of the estate value.  Members were keen to test the assertions made in the consultation document with NHSE representatives. 

Mr Hunt stated that the Hillingdon Medical Director had highlighted the impact that closure of RBH CHD services would have on Hillingdon patients, especially those using the maternity services.  Concern was expressed that, if the RBH Paediatric Intensive Care Unit (PICU) closed, there was no capital investment available to bolster the service in other hospitals to cope with the resultant increase in demand.  It was suggested that the exercise was more about the cost of care rather than the quality of care.  Furthermore, NHSE was seemingly under the misconception that, if the proposals went ahead, RBH staff would just move to a different Trust.  The reality was that RBH staff had been recruited from all over the world and it was likely that they would return to their country of origin and the UK would lose this expertise completely.  If implemented, the proposals would be hindered by a lack of funding and would result in a lack of expertise in the remaining centres. 

Although RBH was still able to recruit medical staff, the proposals had impacted on the recruitment of nurses.  This had resulted in an increase in agency staff costs which was now being brought under control. 

Mr Hunt acknowledged that RBH did not have an in-house gastroenterologist.  However, this service was contracted with the Chelsea and Westminster Hospital NHS Foundation Trust which was located next to the Royal Brompton Hospital.  This arrangement worked seamlessly. 

Members were advised that 80% of RBH work was cardiothoracic and 20% was complex respiratory.  The proposals would result in the withdrawal of PICU and CHD services and would impact on the transplant service at Harefield Hospital.  The foetal echo service at Hillingdon Hospital would be withdrawn and the training provided for Hillingdon Hospital staff by RBH would also be damaged, resulting in a loss of expertise in respiratory issues.  Furthermore, Hillingdon would lose the transitional care services for cardiac patients.  Dr Imran Devji advised that he would liaise with the Chief Executive at The Hillingdon Hospitals NHS Foundation Trust to establish the Trust's formal position on the NHSE proposals.  It was also suggested that consideration be given to speaking to the Health Scrutiny Committee in Ealing for their perspective. 

RESOLVED:  That:

1.    Mr Hunt provide the Democratic Services Manager with contacts from NHSE to invite to a future meeting;

2.    Mr Devji liaise with the THH Chief Executive to clarify THH's formal position on the proposals;

3.    the Democratic Services Manager contact Ealing for their thoughts on the proposals; and

4.    the discussion be noted.