WELCOME AND INTRODUCTIONS

The Chair opened the meeting. She introduced herself and welcomed Members and guests to the meeting. She then asked all those participating to introduce themselves and state their role at the meeting.

PROCEDURAL MATTERS

The Chair informed all present that a procedural issue had arisen because due notice of the meeting had not been given across all of the participating boroughs; legal advice on this matter had therefore been sought.  Having received this advice, the Chair informed the Committee she intended that the meeting should be held because of the time sensitive nature of the issues to be discussed. Members considered the rationale presented and all supported the proposal that the meeting should proceed.

PUBLIC PARTICIPATION

Stephanie Clark of Healthwatch Tower Hamlets made a submission concerning agenda item 5, ‘Update on the North-East London Sustainability and Transformation Plan (STP), highlighting concerns around whether the requirement to consult could be met within NHS England's deadlines for the sustainability and transformation plan STP.

Dr Coral Jones representing Keep Our NHS Public, made a submission in relation to agenda item 4, ‘Overview of NHS 111 Integrated Urgent Care Procurement’, highlighting issues revealed in a study undertaken by Cambridge University in 2011 which related to the value of the 111 service in reducing emergency visits to Accident and Emergency departments.  Dr Jones, noting that the timeframe for procurement of this service in the Inner North East London NHS area remained at 1 April 2016, asked what steps would be taken by STP to avoid the issues revealed by the local study and over-reliance on A and E services as a result of 111 calls.

The Chair thanked the contributors for their submissions and advised that the matters raised would be considered as part of the discussion of the respective agenda items.

No apologies for absence were received.

No declarations of disclosable pecuniary interests were made.

To agree the minutes of the meeting held on 7^th and 17^th November 2016.

The minutes of the meetings held on 7 November 2016 and 17th of November 2016 were presented.

RESOLVED:

1.         that the unrestricted minutes of the meeting held on 7 November 2016 be approved as a correct record of proceedings.

2.         that the minutes of the meeting held on 17 November 2016 be approved subject to the following amendments:

·         that the apologies of Councillor Mustaquim be noted

·         that the question from Councillor Masters which was omitted regarding the capacity for elective surgery and how this was quantified be added to the minutes; and the NHS response to this question be pursued and appended to the minutes.

·         that the amendments be incorporated into the finalised document.

ArchnaMathur, Director of Performance and Quality NHS Tower Hamlets CCG, Selina Douglas Deputy Chief Officer Newham CCG and Henry Black Chief Finance Officer NHS Tower Hamlets CCG attended to discuss the report which provided an overview of NHS 111 Integrated Urgent Care (IUC) procurement.  Ms Mathur provided an overview of the intended procurement for NHS 111; which was to be rolled out in February 2018.  Service specification and vision for the wider IUC services were presently under consideration.

The Committee was informed that the 111 service:

·         concept was born out of work carried out in 2014 and aimed to ease pressures in the system. The PowerPoint presentation circulated in the agenda set out how the services will mirror the sustainability and transformation plan (STP).

·         was intended to address access to health care issues in the context of significant population growth, significant challenges faced by Accident and Emergency (A&E)  Departments and Ambulance services, difficulty in accessing emergency services quickly and patient confusion about when best call 999, GP or other healthcare services.

·         was intended to deliver more accessible seven-day primary care and fulfil national priorities.

·         would comprise: 111 helpline, out of hours services, extended primary care, urgent care in hospital and urgent community response. 

·         vision was to provide better access to the named services by providing a single contact number.  Patients would be able to speak to clinicians earlier than present arrangements allowed and receive appropriate triage for the services required by the caller based on early access to advice.  An additional benefit would be the economies of scale available through the single service model.

·         would be regulated through targets and performance monitoring to ensure that pressure on A&E services was better managed. 

·         call-takers’ role would be to establish the patients’ circumstances, verify them and make an appropriate onward referral.  Noting that feedback from the survey of the general experience of those using the NHS 111 service was mixed, the Inner North East London model therefore would include call-back targets of 15 minutes and this would be tested in undertaking the procurement for the services.

In summary the NHS 111 IUC Service would form the first port for telephone emergency access and involve assessment for appropriate onward referral to clinical or other services.  This Service would create a central point of delivery were clinicians, doctors and other professionals were available to give advice.

The Committee considered the report and Dr Jones’ submission and this was followed by questions and comments from Members.  Ms Mathur representing the CCG responded to Members’ questions.  These are summarised below and attributed to Members of the Committee at their request:

Questions, Comments and observations:

Publicity and Communications

Ms Mathur responded to Councillor Masters’ questions regarding:

• how the service would be publicised to hard-to-reach groups and non-English speakers. She informed the Committee that this matter had also been raised elsewhere and this question will be referred back to the project group.

• how the service would respond to speakers of other languages. She  ...  view the full minutes text for item 4.

Nicola Gardner Programme Director, North-East London Sustainability and Transformation Plan, (STP), July Low, Director of Provider Collaboration North-East London STP and Ian Tomkins, Director of Communications and Engagement North-East London STP introduced the report and presentation which provided an update on the development of an STP in the North-East London NHS area.  This set out how the NHS five-year forward view would be delivered and health and care services will transform and become sustainable and be built around the needs of local people.

Mary Burnett (a former social worker) and Terry Day (Formerly a  Non-Executive Member of Whipps Cross Hospital; Board) representing North-East London Save Our NHS made the following representations:

• STP representatives were asked to justify the approach that had been taken in delivering the STP, in the context of the statement made by Stephanie Clark regarding the requirement for formal consultation when considering a substantial variation in service provision (such as that proposed in the NELSTP) and
• asked JHOSC to consider if this this requirement can be met within the timeframe notified by NHS England (namely that the STP was to be signed by December 23rd 2016).
• Ms Day although not arguing against the integration of community care put forward that the overall financial deficit will counteract the intended benefits of the plan and,  coupled with the expected population increase, it was not credible that the STP could deliver its intended benefits.
• Ms Burnett noted:
  •  That the NHS plans are not quantified and NHS providers are being forced into the transformation program in order to gain access to funds.
  • The proposal for a whole system change in the period proposed was not achievable.
• Ms Day put forward:
  • That it was necessary to test the provision before bed-base is reduced.  This testing was not taking place and therefore creates risk in the inherent service delivery.
  • There is no plan to meet the service requirements.

The Committee noted these submissions and the Chair then invited the Programme Director, North-East London STP to make her presentation.

The Programme Director noted the challenges to delivering the STP described by Ms Burnett and Ms Day.  She made her presentation informing the Committee that:

• The STP Project Team was presently translating the ideas of the STP into the procurement.
• There would be no sign-off of the plan  on 23 December 2016 because feedback was presently awaited.
• Paragraph 6 of the report outlined the plan to deliver a single sustainability and transformation plan across the seven North-East London Clinical Commissioning Groups (CCGs).
• There were eight work-streams including services, property, workforce, and new roles to address short-term and medium-term shortages and IT/ media.
• NHS England was presently beginning to work up proposals and these would require further work over the coming months.
  • Plans were to be worked up by clinicians, local authorities and stakeholders.
  • NHS England was, eager to receive input into the proposals from local authorities and agencies.
• Mr Tomkins acknowledged that notice of the STP had not been communicated in an ideal way.  ...  view the full minutes text for item 5.