Decision details

At their meeting on 30 March 2015, the Committee considered a report which provided an update from NHS England and Barnet CCG on the provision of GP Services or a primary care facility at the Finchley Memorial Hospital site.

The Committee noted that the project was scheduled to develop a series of initial options for review in April 2015, which would then need appraisal and planning in order to work through the commissioning and costing consequences.  The Committee noted that the intention was to identify agreed options by the summer of 2015, with a view to commencing work on implementing the new models of service.   The Committee have requested to consider a further update report to capture the agreed options which are due for agreement in the summer of 2015.

The Chairman introduced the report from Barnet Clinical Commissioning Group (CCG) and NHS England which provided the Committee with an update on plans to improve utilisation of the Finchley Memorial Hospital site.  The Chairman invited Jill Webb, Head of Primary Care Commissioning at NHS England (NHSE), Dr. Debbie Frost, Chair of Barnet Clinical Commissioning Group (Barnet CCG) and Mr. Alan Gavurin, Barnet CCG’s Finchley Memorial Hospital Project Manager, to the table.

Mr. Alan Gavurin explained that in January the CCG had launched a project to review how the CCG could make more use of the facilities on the FMH site in order to deliver its objectives for improving healthcare for the local population.  The Committee noted that the CCG had been working with NHS England on the commissioning of GP Services, for which NHS England is responsible.

The Committee noted that the project had reviewed all of the commissioning plans and the areas of local health care need, which had then been presented to a stakeholder workshop in April 2015.  The Committee were informed that a list of possible options was agreed at this workshop and presented to a meeting of the CCG’s Clinical Cabinet in July 2015.

Mr.Gavurin informed the Committee that the CCG wanted to have a focus on the frail elderly and that the Clinical Cabinet had identified four priority schemes, which are as follows:

1.    An Older People’s Assessment Service (OPAS): The Committee was informed that the OPAS was designed to keep people well and independent at home for as long as possible, and would have the advantage of being able to work closely with the existing Falls Clinic at Finchley Memorial Hospital. 

2.    Filling the Empty Inpatient Ward: The Committee noted filling the empty ward would help local system sustainability. The Committee noted that there were 17 unused beds at Finchley Memorial Hospital and that on average there were 18 – 20 Barnet residents in community rehabilitation beds at Chase Farm Hospital following transfer from Barnet Hospital. By opening these beds, the CCG would be able to repatriate those patients back to Barnet. 

3.    Breast Screening: North London Breast Screening Service (NLBSS) are planning to move to providing services from permananent locations rather than their current mobile service. NLBSS and the CCG are agreed that this service should be accommodated at FMH and they will require two rooms  to replace the current mobile facility.

4.    General Practice services: The Committee noted that the CCG are exploring how they could  develop a specialist primary care facility focused on the frail elderly and care home patients.  There would be a meeting with NHS England on the matter the following day. 

Ms. Webb commented that she recognised that previous primary care proposals for the site had not worked out and that she hoped collectively as co-commissioners they could make this proposal work.  Mr. Gavurin informed the Committee that he hoped one day there would be a specialist practice on site that could also take general patient registrations. 

The Vice Chairman commented that if Commissioners were looking for a new cohort of patients, there are many care homes in the area where the patients could be transferred from their existing GPs.  However most of the prospective population of the groups being considered would be living in their own homes with their own GPs.  The Vice Chairman questioned the likelihood of attracting them away from their current GPs.  Dr. Frost noted that this approach would give patients a better choice of where they would like to go.

The Chairman questioned whether the Cornwall House GP surgery was still involved in a possible primary care facility at Finchley Memorial Hospital.  Dr Frost informed the Committee that this option had now been dropped because of the practice’s concerns about the cost of moving to FMH.

Mr.Gavurin informed the Committee that a Programme Board had been set up to progress plans and that the Local Authority had been invited to send  a representative of Social Services to sit on the Board.  The Committee noted that the CCG’s plans were to develop commissioning business cases for the new services and bring them to the CCG Governing Body by the end of March 2016. 

A Member commented that Barnet Hospital was constantly facing a shortage of beds and questioned if it would be possible to open more beds at Finchley Memorial Hospital immediately.  The Member feared that there would be a crisis during the coming winter and an escalation in the numbers of Delayed Transfer of Care. The Committee noted that the CCG had applied for capital funds to convert some single rooms into multi bed bay areas in order to alleviate isolation.

Mr.Gavurin noted that if they were successful in their grant application to create a series of multi bed bays, the hospital would have a more appropriate, sustainable model.  A Member requested that consideration be given to maintaining a mix of single and mixed rooms.  Responding to a question from a Member, Dr. Frost informed the Committee that the aim was to have a mix of single rooms and multi-bed bays to allow the best and most flexible models of care and nursing.

A Member commented that when the issue of primary care provision had been considered at Committee previously, there had been a suggestion of a “health village” on site.  Mr. Gavurin noted that this option had been considered but that unfortunately this was not now considered feasible. 

A Member questioned if Officers could provide any further information regarding the negotiations with Transport for London about improving accessibility to the site by public transport.  Mr. Gavurin commented that the survey requested by a local MP had been deferred until there was a higher footfall.

A Member commented that he generally welcomed the ideas proposed for Finchley Memorial Hospital, especially the proposed Older Person’s Assessment Service (OPAS) which has been working so well at the Chase Farm site since it was introduced.  The Member commented that if the site was going to have an OPAS, there would be more specialism and suggested that it would create the opportunity for a good link with the acute sector.

A Member asked for assurance on the long term sustainability of the breast screening unit, noting that early intervention and prevention should take priority.  Mr. Gavurin informed the Committee that it was hoped that the new Breast Screening Unit would be the first of a series of prevention services at FMH.

RESOLVED that the Committee notes the update from NHS England and Barnet Clinical Commissioning Group.