Agenda and minutes

The minutes of the meeting held on the 16 May 2012 be approved.

Apologies for absence were received from Councillor Braun.

None.

None.

The Chairman announced a variation in the order of the agenda.  Item 6 (Joint Health Overview and Scrutiny Committee Minutes) would be considered after Item 7 (Service Provision and Implementation Updates from Health Partners).  In relation to Item 7, Item 7e (Maternity Services) would be considered after Item 7a (BEH Clinical Strategy Update).

The Committee considered a report which detailed service updates from NHS partners in relation to the Barnet, Enfield and Haringey (BEH) Clinical Strategy, Primary Care, Clinical Commissioning Group (CCG) Implementation, Urgent Care Pathway in Barnet and Maternity Services.

Siobhan Harrington (BEH Clinical Strategy Programme Director) and Mark Easton (Chief Executive of Barnet and Chase Farm (BCF) Hospitals NHS Trust) delivered a presentation on Better Healthcare in Barnet, Enfield and Haringey.

The Committee were informed that NHS London had approved the BCF Hospitals NHS Trust Outline Business Case for capital investment.  Detailed business planning was taking place to achieve Full Business Case approval by the end of November 2012.  Members were advised that there were four ongoing workstreams.  It was highlighted that the workforce changes workstream would be particularly significant.   It was noted that as part of the workforce changes workstream, a Reference Group and Chase Farm Vision Group, chaired by Dr Atish Patel (Chairman of the Enfield Clinical Commissioning Group), had been established to ensure that key stakeholders had an input into the development of proposals. 

The Committee noted that an additional workstream relating to transport had also been established and this was being chaired by Mark Easton.  In response to questions from the Committee, Mr Easton reported the following:

·         that a previous Transport Study was being revisited and refreshed in the context of the BEH Clinical Strategy;

·         that an additional 202 car parking spaces would be provided at the Barnet Hospital site to deal with the current demand and anticipated future demand following the transfer of Accident & Emergency (A&E) and Maternity services from Chase Farm Hospital; and

·         that the Transport Group would be working with Transport for London regarding the reconfiguration of bus routes to ensure that Barnet Hospital was properly served by public transport. 

Members expressed concern that there very limited direct public transport links to Barnet Hospital which should be taken into account when developing a revised Transport Strategy.  Mark Easton undertook to feed this back to the Transport Group.  

Responding to a question, Siobhan Harrington advised Members that despite being five years old, the BEH Clinical Strategy was regularly refreshed by both the Trust and commissioners. 

The Committee noted that whilst the primary function of the BEH Clinical Strategy was to deal with service changes, this would not preclude reviews of other services including those provided at Finchley Memorial and Edgware hospitals. 

In relation to the proportion of current A&E admissions that would be dealt with by the Chase Farm Urgent Care Centre (UCC), Mark Easton advised the Committee that this was estimated to be approximately 40 per cent.  Statistics relating to the number of patients presenting at Barnet and Chase Farm hospitals from local NHS trusts were tabled.  

Dr Sue Sumners reported that the Clinical Commissioning Group (CCG) would be working closely with BCF Hospitals NHS Trust to educate patients about the most appropriate care pathway.  The Committee expressed concern that some patients felt they were not being given GP appointments sufficiently quickly, resulting in a number of patients presenting at A&E unnecessarily.  Members were advised that the CCG and Trust were aware of these issues and were taking steps to address this by providing multiple access points and undertaking  ...  view the full minutes text for item 6a

Mark Easton (Chief Executive of BCF Hospitals NHS Trust) and Cathy Rodgers (Consultant Midwife at BCF Hospitals NHS Trust) provided the Committee with an update on Maternity Services. 

In response to a request for information from the Committee, a report detailing the number of maternity diverts had been circulated.  It was noted that due to the Trust providing maternity services at three sites, they had been able to deal with peaks in demand by diverting patients between sites.  Members were informed that there was a well established triage system to prevent the unnecessary use of beds which assisted in reducing the number of diverts.

In relation to caesarean sections, the Trust were aware that their statistics were comparably high.  The Committee were informed that the Trust had been working with commissioners in undertaking a range of activities to address this. 

Responding to concerns regarding the number of missed 12-week midwife appointments, Cathy Rodgers reported that this issue had been addressed and performance was currently above 90 per cent in this area.    

The Committee noted that whilst the Edgware Community Hospital Birthing Unit had a capacity of 500 per year, the actual number of births had been 300.   The Committee were informed that whilst there was an increasing trend towards using birthing centres, mothers often preferred having clinicians on-site as a reassurance.  

Resolved that:–

1.             the Committee note the Maternity Services Divert Report.

2.             the Committee requested that BCF Hospitals NHS Trust provide the number of Maternity Services Diverts for the previous three years (2009-2012).

Ceri Jacob (Acting Borough Director for NHS Barnet) presented a report on Developing Primary Care in Barnet.  She informed the Committee that £11.7million would be invested in primary care over the next three years to reduce dependence on secondary care.  It was noted that Barnet CCG were working with the London Borough of Barnet’s Social Care Services to develop integrated care networks. 

The Committee noted that the CCG had been developing peer review networks to increase skills in specialisms across Barnet and that these had been positively received by practitioners. 

Resolved that:–

The Committee note the report on Developing Primary Care in Barnet.

Dr Sue Sumners (Chairman of Barnet Clinical Commissioning Group) and Ceri Jacob (Acting Borough Director for NHS Barnet) presented a report on the implementation of Barnet CCG. 

Whilst welcoming the progress made to date, the Committee noted the challenging timescales for implementation.

Resolved that:–

The Committee note the report on Clinical Commissioning Group implementation.

Ceri Jacob (Acting Borough Director for NHS Barnet) presented a report on options for redesigning the Urgent Care Pathway in Barnet. She highlighted that despite increasing the number of access points via GP Out of Hours services and Walk In Centres, there had still been a 6% increase in A&E admissions. 

The Committee noted that this was a very complex issue which made identifying the optimum flow through the care pathway difficult. 

Members questioned what impact the financial deficit would have in the development of services.  Ceri Jacob reported that an element of savings from secondary care would be diverted to primary care. 

Resolved that:–

The Committee note the report on the development of an Urgent Care pathway in Barnet.

Dolphin Ward, Springwell Centre, Barnet Hospital

The Chairman introduced an urgent late item of business on the Older Adults Admissions Unit, the Dolphin Ward in the Springwell Centre at Barnet Hospital.  Ceri Jacob advised the Committee that Barnet, Enfield and Haringey (BEH) Mental Health Trust had closed the Dolphin Ward because of clinical concerns.  Staff and patients had been moved to the Chase Farm Hospital site and there was a possibility that the move may be made permanent.   The Committee noted that the commissioners had not agreed on the next steps and were working with the Council on the development of patient pathways. 

The Chairman reminded the Committee that when the former Napsbury Patients were transferred from Elysian House to the Springwell Centre in September 2011, she had sought assurance from the BEH Mental Health Trust that these residents would not be subject to any further transfers.  This assurance had not been forthcoming regarding either the short or long-term future of the residents, raising a concern that the Trust may ultimately dispose of the Springwell Centre.   

Resolved that:–

The Committee note update on the transfer of patients from the Dolphin Ward as set out above and request that an update be provided to the next meeting on any progress or developments.

Barnet Local Involvement Network (LINk)

At the invitation of the Chairman, Adam Goldstein (Vice-Chairman of Barnet LINk), updated the Committee on the work of Barnet LINk to date.  He advised Members that over the last four to six months six enter and view visits to care homes had taken place.  Additional activity had taken place in relation to mystery shopping with Central London Community Healthcare NHS Trust. 

The Committee noted that neither they nor the Safeguarding Overview and Scrutiny Committee (OSC) had received any enter and view reports yet.  Mr Goldstein undertook to raise this with the Barnet LINk Manager and ensure that these were forwarded to the Committee or to the Safeguarding OSC, whichever was more appropriate, as soon as possible.

Resolved that:–

The Scrutiny Office be requested to liaise with the Barnet LINk Manager on enter and view reports, and the timescale for production of the Barnet LINk Annual Report for 2011/12. 

Barnet Hospital Parking

The Chairman advised the Committee that BCF Hospital NHS Trust had submitted a planning application to the Council for the redevelopment of the Barnet Hospital site which included the provision of a an additional 202 parking spaces on site.  It was noted that the car park would only be developed after the construction work had been completed.

The Chairman advised the Committee that she had requested that the minutes of the JHOSC from the 10 July 2012 meeting be amended to more accurately reflect the discussion on the issue of parking at the Barnet Hospital site.  A revised version of the minutes, agreed by the JHOSC at their meeting earlier in the day, was tabled for the Committee to consider. 

Resolved that:–

The Committee note the amended JHOSC minutes.

Resolved that:–

1.      The Health Overview and Scrutiny forward Work Programme be approved, subject to the inclusion of item 2 below.

2.      That an update report on the Dolphin Ward at the Springwell Centre (adjacent to Barnet Hospital) be added to the Forward Work Programme for consideration at the 12 December 2012 meeting.

RESOLVED that –

The Committee note the Cabinet Forward Plan.