Agenda item

Councillor Turner arrived during this item.

Richard Dale and Yasmin Peiris from the Transforming Services, Changing Lives Programme (TSCL) Team presented the report and explained the inception of the clinical transformation programme and its aim to consider how best to ensure safe, effective and sustainable hospital services at Bart’s Health Hospitals in the context of challenging financial changes and the need to find more than £400m savings in the next five years.  The work programme was launched in February 2014 and was expected to run until October 2014, following which a baseline assessment of the drivers for change for the local health economy would be drawn up in order to inform further discussions about the scope, scale and speed of change that would be needed.  The introduction of NHS111, integrated care and personal health budgets were just some of the changes to the health economy that had occurred recently.  The principles of the Francis Report together with national and international best practice would be at the heart of developing the case for change. 

The governance arrangements for the programme had been established and this included a Programme Board, Clinical Reference Group and its six working areas and Public and Patient Reference Group.  The full details together with the engagement and consultation that the TSCL intended to undertake were set out in the report and the ‘Interim Case for Change’ could be viewed at the web address provided in section two of the report.  Comments could also be made via that link.

The health challenges across the boroughs and the 34% population growth that was anticipated made planning for both treatment and preventative health an issue for all stakeholders, which may require adapting and delivering services in a different way.  Staff also needed to be engaged in the process and empowered to make changes.

There was an acknowledgement that there are some excellent services but they are not always consistently provided across the borough.  The health estate and technology systems also needed to be upgraded to enable different and efficient ways of working.

Helen Jenner, Corporate Director of Children’s Services drew the Boards attention to the need for clarity as the report seemed to be more about inner east London and the Bart’s NHS Trust and not the whole of East London or LBBD provision. 

Anne Bristow, Corporate Director of Adult and Community Services, pointed out that the report was NHS focused and did not seem to exhibit the integration thrust that is being required under the Better Care Fund, Care Act, Children and Families Act, Department of Health Policy and Barker Commission report .

Marie Kearns raised the issue of access and transport and the additional resources that would be required from the Ambulance Service.  The Chair supported the concerns about transport links and said that real life travel issues from LBBD to King George’s site caused genuine difficulties for both patients and visitors.

Councillor Carpenter questioned whether there proposals in the report would result in sufficient drive to address the mental and physical health inequalities in funding and service provisions.  The TSCL team response was that this has been identified as an issue but potential solutions were still being looked into.

The Board was advised that the LBBD Health and Adult Services Select Committee will be scrutinising proposals, and the public would be able to attend that meeting. 

The Board noted that at this stage recommendations were not being set out and accordingly

The Board commented:

(i)  Improved clarity was required in the appendix to the report as only some of East London is included, as some of the sections / services in the report LBBD are not included or only part of LBBD is included. 

(ii)  References to the safeguarding needs and practices, following the Francis report, need to be more pronounced.

(iii)  Concerns were raised around the accessibility and quality of transport links for residents of LBBD when travelling to clinics or visiting patients. 

(iv)  Due to the lack of parking around, St Bartholomew’s, The Royal London, Homerton and London Chest hospitals, more patients would require ambulance transport, as patients own transport would not be feasible.  The journey times for LBBD residents would be longer.  This would have resource implications for the Ambulance services.

(v)  The document seemed to be a stand alone NHS document, which did not seem to equate with the drive for integration under the Better Care Fund, Care Act, Children and Families Act, Department of Health Policy and the Barker Commission report, which had been published last week. 

(vi)  There needed to be recognition that a ‘one size fits all’ approach is not appropriate and what may be suitable for a neighbouring borough, or even a borough of similar make up, does not always work in LBBD.

(vii)  The need to ensure parity of treatment and funding to achieve a holistic approach to mental and physical heath.

(viii)  In regards to the £400m savings it should be reworded to reflect improved quality and productivity savings. 

(ix)  There needs to be more data and analysis to back up the statements in the report.  A number of broad brush statements were being made but they are not being expanded to deal with peoples experience, for example young people’s experience of the health service is not good.