Agenda item

The Chairman welcomed those present to the meeting.  He noted that the Committee had last met to discuss the closure of Michael Sobell House on 28 February 2019.  At this meeting, agreement had been gained from all partners to reopen the inpatient unit: Hillingdon Clinical Commissioning Group (HCCG) would undertake a commissioning exercise which East and North Hertfordshire NHS Trust (ENH) would be involved in. 

However, it had recently become apparent to Members that progress had not been as forthcoming as had been hoped.  It was noted that it was still the aim of the Committee to see Michael Sobell House (MSH) reopened – this aspiration had the full backing of the Council.  As such, the Chairman had been involved in a number of informal meetings outside of the Committee meetings where he stressed the frustration that had been caused and the importance that partners move much more quickly.  He had established that a significant number of organisations had been involved in the process which had slowed progress down significantly.  The labyrinthine sequence of events had also made the process more complicated than it needed to be. 

Ms Caroline Morison, Managing Director at HCCG, advised that HCCG had confirmed its commissioning intentions in February 2019 and had written to ENH accordingly.  HCCG had then embarked on a governance process and, following OJEU procedures, Harlington Hospice had been awarded the contract.  It was at this point, where mobilisation was due to commence, that a number of meetings to progress the process had been cancelled by ENH at short notice.  The issue was escalated to ENH’s Chief Operating Officer and to East and North Hertfordshire CCG (ENH CCG).  ENH had advised that it would need to seek clarity from all of the service commissioners to ensure that they were happy with the proposed changes. 

Members were advised that Hillingdon accounted for approximately 44% of the activity undertaken by ENH on this contract.  Herts Valley CCG was the second highest user of the service; other commissioners included Ealing and Harrow.  A meeting of the commissioners was due to take place on Thursday 11 July 2019 to discuss a way forward.  Ms Morison confirmed that written representations from the Committee and MSHC might be helpful for this meeting with commissioners as ENH had questioned the public involvement in the process undertaken by HCCG.  She advised that she had asked that the following be included on the agenda for that meeting:

·         Timings and next steps;

·         ENH’s intentions regarding the MSH building; and

·         Viability and sustainability of the specialist palliative care service in the context of proposals relating to Mount Vernon Cancer Centre (MVCC) and MSH.  It was noted that there had been a recent review of services at MVCC.  As those present had not yet been privy to the outcome of the review, it would be important to ensure that they received clear guidance from ENH about the interdependencies. 

Mr Steve Curry, Chief Executive at Harlington Hospice (HH), advised that he had been involved in several meetings and had been working closely with key partners to reopen MSH.  He had met with the architects’ team at Hillingdon Hospital and Mr Michael Breen and Mr Ian Chandler from Michael Sobell Hospice Charity (MSHC) to identify what work was required to put the building into an adequate state to provide a safe service.  The two charities’ Boards had also met and agreed working arrangements; HH had appointed a Medical Director and healthcare assistants were ready to start.

Mr Curry noted that relations with ENH had appeared fine before HH had been awarded the provider contract.  Since then, there had been significant challenges in working together and concern was expressed that there could be an unintentional negative impact on some staff TUPE transferring to the new provider.  That said, Mr Curry believed the biggest current blocker was the building. 

It was noted that Mr Chandler had been working with Ms Julia Wright at HH to progress the reopening of MSH.  Mr Chandler advised that the work required at MSH was minor: redecoration, moving some doors, additional wash rooms and toilets, etc.  Timing for the work continued to be a challenge.  A contractor to undertake the work on a cost only basis was on standby and, once started, the work was likely to take approximately six weeks to complete. 

Mr Michael Breen, Chairman of MSHC, noted that the charity already owned a lot of the equipment needed to run the inpatient unit but that it was currently spread around the Mount Vernon Hospital site.  He advised that the MSH building had been extended in the past with the use of charitable donations and that the extended part of the building was now being used by ENH for matters unrelated to the hospice.  MSHC needed to re-establish a right to access the buildings that it had funded.  It also needed to access the buildings to enable the charity to undertake its own independent costings for the work. 

Mr Breen had been trying to arrange a meeting with The Hillingdon Hospitals NHS Foundation Trust (THH) estates team but there had recently been significant management changes and disruption.  It was noted that Mr Breen had tonight spoken to Mr Tahir Ahmed, THH’s Executive Director of Estates and Facilities, who had agreed to arrange a meeting.  It was noted that, as the leaseholder, ENH would need to give permission for HH or MSHC to access the building. 

Mr Breen noted that MSHC continued to need to fund raise as it cost £420k per annum to run the day centre which was still operational from the site.  Although Ms Sarah Lucy James at ENH had confirmed that it would be a “smooth and positive transition” to a new provider, this had not been borne out.  It had been more than a year since the MSH inpatient unit had been closed and four months since the Committee’s last meeting where ENH had made the commitment to help with the transition to a new provider.  This had resulted in a number of excellent staff leaving to seek alternative employment.

Fundraising by MSHC had reduced by £80k during 2018/2019.  Although income was substantially down, costs were also significantly down as the inpatient unit was not functioning from MSH.  MSHC had received two legacies in the last two weeks totalling £123k which would help the charity’s finances.  However, it would be important to get some movement so that the charity didn’t lose support from the public.  Mr Breen advised that MSHC had been jointly fundraising with HH and that the charity’s biggest fundraising event, Ladies in the Night Walk, would be taking place on 20 September 2019. 

Concern was expressed that ENH’s handling of the whole situation had been farcical.  Although alternative arrangements were in place, action could not yet be taken to restart the service from MSH and ENH had occupied a resource building for its own purposes even though the building had been funded by MSHC for the provision of inpatient palliative care services.  Concern had also been expressed in the community that the land was being earmarked for a £32m luxury property development and that ENH had requested a financial stake in the land. 

It was noted that Crown Princess Katherine of Serbia had been monitoring developments in relation to the reopening of MSH.  Princess Katherine had worked with Dr Elaine Laycock to develop three hospice units in Serbia based on MSH.  It now seemed ridiculous that there were three MSH units running in Serbia and none in Hillingdon. 

Mr Ahmed confirmed that THH was the landowner and that there were undocumented tenancies relating to ENH.  These unwritten leases were much more difficult to manage.  Mr Ahmed had met with Ms Wright at HH to determine how occupancy could be expedited.  Consideration could be given to having a direct covenant with HH but this would need a formal discharge from ENH.  Once ENH had discharged its interest, a new heads of terms could be agreed with HH relatively quickly. 

It was noted that Wards 10 and 11 had been closed for refurbishment.  This work had now been completed and patients had been moved back onto the Wards. 

It was recognised that the MSH building had about 18-24 months of useful life left in it.  As such, consideration was being given to the future end of life care service provision and delivery needed and wanted by Hillingdon residents. 

Because this issue needed to be resolved as quickly as possible, it was suggested that, if there was no acceptable resolution at the commissioners’ meeting on Thursday, the Committee should arrange a meeting with all of the parties involved. 

RESOLVED:  That:

1.    Ms Morison be provided with written representations from the Committee and MSHC; and

2.    the presentations be noted.