Agenda and draft minutes
Venue: London Borough of Hackney, Room 3, Assembly Hall, Hackney Town Hall, Mare Street, London, E8 1EA
Contact: Email: jarlath.oconnell@hackney.gov.uk tel: 020 8356 3309
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INNER NORTH EAST LONDON JOINT HEALTH OVERVIEW AND SCRUTINY COMMITTEE (INEL JHOSC)
Meeting held on 20th November 2013 in Assembly Hall 3, Hackney Town Hall, Mare St, London E8 1EA
Members Present: Councillor Winston Vaughan (Chairman), Councillor Luke Akehurst (Vice Chairman), Common Councilman Wendy Mead, Councillor Ann Munn, Councillor Terence Paul, Councillor Rachael Saunders and Councillor David Edgar
Member Apologies: Councillor Dr Emma Jones, Councillor Benzion Papier and Councillor Ted Sparrowhawk
Officers in Attendance: Luke Byron-Davies (Scrutiny Manager, LB Newham, Jarlath O'Connell (Overview and Scrutiny Officer, LB Hackney), Hafsha Ali (Head of Scrutiny, LB Newham), Neal Hounsell (City of London Corporation), Tahir Alam (Strategy Policy and Performance Officer, LB Tower Hamlets), Sarah Barr (Senior Strategy, Policy and Performance Officer, LB Tower Hamlets) and Philippa Sewell (City of London Corporation)
Also in Attendance: Peter Morris (Chief Executive, Barts Heath), Mark Graver (Head of Stakeholder Relations and Engagement, Barts Health), Mark Cubbon (Executive Director of Delivery, Barts Health), Neil Kennett-Brown (NHS England), John Hines (London Cancer), David Fish (UCL Partners), Muntzer Mughal (UCL Hospitals/London Cancer), Ben O’Brien (Barts Health/UCL Partners), Hilary Ross (UCL Partners), Dr Ash Paul (Consultant, Public Health, LB Hackney), Aidan Keightley (Healthwatch Newham), Michael Vidal (Healthwatch Hackney), Beth Earmington (NHS North and East London Commissioning Support Unit), Ruth Hardy, Stuart Maxwell (Hackney resident), Christopher Sills (Hackney Resident)
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Welcome and introductions Minutes: The Chair welcomed everyone to the meeting and stated it had been convened to jointly consider the report on financial turnaround for Barts Health NHS Trust and the consultation on the proposals for specialist cancer and cardiovascular services in North and East London and West Essex. |
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Membership of the Committee PDF 38 KB Minutes: The Committee noted the updated Membership list for Inner North East London Joint Health Overview and Scrutiny Committee. It was noted that Councillor David Edgar had replaced Councillor Lesley Pavitt from the London Borough of Tower Hamlets. |
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Apologies for absence and announcement of substitutes Minutes: Apologies for absence were received from Councillor Dr Emma Jones from the London Borough of Tower Hamlets, Councillor Benzion Papier from the London Borough of Hackney, and Councillor Ted Sparrowhawk from the London Borough of Newham. |
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Declarations of Interest Any Member of the Committee, or any other Member present in the meeting room, having any personal or prejudicial interest in any item before the meeting is reminded to make the appropriate oral declaration at the start of proceedings. At meetings where the public are allowed to be in attendance and with permission speak, any Member with a prejudicial interest may also make representations, answer questions or give evidence but must then withdraw from the meeting room before the matter is discussed and before any vote is taken.
Minutes: There were none. |
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Minutes of the previous meeting PDF 36 KB Additional documents: Minutes: The Committee gave consideration to the minutes of the meeting held on 29 May 2013.
RESOLVED
That the minutes of the meeting of the Committee held on 29 May 2013 be agreed as a correct record. |
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Actions and matters arising from the previous meeting Minutes: There was none. |
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Barts Health NHS Trust - Report on financial turnaround PDF 40 KB Additional documents:
Minutes: 7.1 The Chairman welcomed the following senior officers from Barts Health NHS Trust to the meeting:
Mr Peter Morris, Chief Executive Mark Cubbon, Executive Director of Delivery Mark Graver, Head of Stakeholder Relations and Engagement
7.2 At their previous meeting on 29th May 2013, the INEL JHOSC considered the draft Quality Accounts for Barts Health NHS Trust. Mr Morris stated that since then the Trust had begun a financial turnaround programme to improve the quality of patient care, increase speed of delivery and improve efficiency whilst delivering cost savings and productivity improvements.
7.3 As the largest NHS Trust in the country the reduction of the National tariff by 4% would result in a £50m saving to be made per year for Barts. In addition, a further local target of £28m needed to be found as transitional funding had been received previously and would fall away over a 2 year period.
7.4 Mr Morris outlined a three year plan in place to achieve a sustainable long term financial position. In 2013/14 the focus was on stabilising finances via cost reduction and increasing income through Payment by Results. In 2014/15 Mr Morris stated attention would shift to address the underlying financial deficit so that in 2015/16 a financial equilibrium could be achieved.
7.5 Mr Morris highlighted the need to change current operational practices, and advised that this would involve restructuring and unifying the workforce. A review of management, nursing and administrative posts within clinical services had followed a corporate review, and a consultation on staffing levels had been launched in August 2013 with unions, staff and stakeholders to ensure proposed structures and processes were fit for purpose.
7.6 The turnaround and change in practices would require continued support for clinical and corporate functions, along with support for smaller groups within the organisation in order to utilise opportunities for improvement and ensure best practice was shared.
7.7 With regard to income, Mr Morris advised that over the past 12 months they had moved away from block contract payments, and would operate via Payment by Results so that work undertaken would be paid for in full. He also stated that income was a significant consideration in the long term plan.
7.8 Mr Cubbon provided more detail on the process for challenging and scrutinising decisions and ensuring robust practices. Recommendations from the National Audit Office had been implemented to improve quality of care and health and safety: The organisation was split into a number of divisions and each would have assessment levels to scrutinise proposed decisions and plans.
7.9 Senior doctors would present to a panel of officers (i.e. from Finance and HR) on any new plans, giving assurance and taking questions. The scheme would then be accepted or challenged accordingly and go on to be presented to the Chief Nurse and Medical Doctor. The cost implications of each scheme would go to the Trust Board to undergo a further degree of scrutiny.
7.10 With regard to external involvement in the process, an ... view the full minutes text for item 7. |
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Additional documents:
Minutes: 8.1 The Chair welcomed the following senior officers to the meeting:
Neil Kennett-Brown, NHS England John Hines, London Cancer David Fish, UCL Partners Muntzer Mughal, UCL Hospitals/London Cancer Ben O’Brien, Barts Health/UCL Partners Hilary Ross, UCL Partners
8.2 Mr Kennett-Brown thanked the Chairman, and informed the JHOSC that early engagement to gather feedback on the proposals for improvements to specialist services showed strong support. A leaflet and public events campaign had begun on 28 October and would conclude on 4 December.
8.3 Mr Mughal, from UCL Hospitals and London Cancer, outlined the vision for a world class cancer service with an advanced computer system and the latest treatments. He informed Members that survival rates and patient experience was poor in this part of London, which was a major driver to change and strengthen services. Five centres were proposed for five rare types of cancer: brain, head and neck, urological (bladder, prostate and kidney), acute myeloid leukaemia and oesophago-gastric (upper GI). Focus would be on giving patients access to the best specialist care and to the latest treatments and clinical trials, improving patient experience and holistic care, and utilising the research opportunities.
8.4 Mr O’Brien, from Barts Health and UCL Partners, spoke about the cardiovascular proposals. Although the new building was an enabling factor, the high a number of deaths from cardiovascular illnesses was the real driver for change. Recent innovations in treatment were now being offered, but there was still a high number of cancellations due to organisational issues.
8.5 The proposal would see specialist cardiovascular services currently offered by both University College London Hospital (UCLH) NHS Foundation Trust and Barts Health NHS Trust come together in a single centre for excellence at St Bartholomew’s Hospital in late 2014. Services provided at the London Chest Hospital and The Heart Hospital would join the new site, but care would extend beyond the three centres to create an integrated system felt in the community. Academic forces would be linked to ultimately create one centre of excellence that could compete with the world’s academic power houses.
8.6 In closing, Mr Kennett-Brown returned to the feedback from the on-going engagement exercise. Support had been received from Clinical Commissioning Groups (CCGs), although the Outer North East London Joint Health and Scrutiny Overview Committee had voiced concerns regarding prostate cancer and the future of oesophago-gastric cancer moving from two to one centre. Travel and access were also important issues, with patients prepared to travel further for better outcomes and the UCLH committing to specific access arrangements (i.e. requesting additional disabled parking bays).
8.7 Wendy Mead opened the questioning by asking officers why UCLH had been selected over Barts to provide specialist treatment for head and neck cancer, despite the latter treating more patients in 2012/13?
8.8 Mr Fish, from UCL Partners, responded that the lead for head and neck cancer was an employee from Barts who supported the selection of UCLH. The hospital could offer strong infrastructural support, including the UCLA Ear, Nose and ... view the full minutes text for item 8. |
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Any other business Minutes: Councillor Akehurst proposed an amendment to the Committee Procedure Rules for INEL JOSC. This was seconded by Wendy Mead.
RESOLVED – That Rule 9.1 be amended to read:
“The lead administrative and research support will be provided by the Health Scrutiny Officer from the borough which holds the Chair with the assistance as required from the officers of the participating boroughs |