Agenda and minutes

To approve as an accurate record, and the Chairman to sign the minutes of the meeting of the Housing, Health & Adult Social Care Select Committee held on 13 November 2013.

The minutes of the meeting held on 13 November 2013 were deferred to the next meeting.

Councillor Buckmaster considered that the consultation document was disappointing in that the focus was on governance as opposed to the Trust’s vision.

Councillor Freeman referred to the improvement in the Trust’s financial position which had been brought about by cuts and the enormous f

If a Councillor has a disclosable pecuniary interest in a particular item, whether or not it is entered in the Authority’s register of interests, or any other significant interest which they consider should be declared in the public interest, they should declare the existence and, unless it is a sensitive interest as defined in the Member Code of Conduct, the nature of the interest at the commencement of the consideration of that item or as soon as it becomes apparent.

At meetings where members of the public are allowed to be in attendance and speak, any Councillor with a disclosable pecuniary interest or other significant interest may also make representations, give evidence or answer questions about the matter.  The Councillor must then withdraw immediately from the meeting before the matter is discussed and any vote taken.

Where Members of the public are not allowed to be in attendance and speak, then the Councillor with a disclosable pecuniary interest should withdraw from the meeting whilst the matter is under consideration. Councillors who have declared other significant interests should also withdraw from the meeting if they consider their continued participation in the matter would not be reasonable in the circumstances and may give rise to a perception of a conflict of interest.

Councillors are not obliged to withdraw from the meeting where a dispensation to that effect has been obtained from the Audit, Pensions and Standards Committee. 

Councillor Joe Carlebach declared a personal interest in that he is a trustee of Arthritis Research UK and Chairman of Wormwood Scrubbs Charitable Committee, which owns the Hammersmith Hospital car park.

This report informs members about the Trust’s consultation on its proposals and plans for becoming a foundation trust.

This item and item 6,  ‘Imperial College Healthcare NHS Trust (the Trust) Business Plan’ were taken together.

Professor Nick Cheshire introduced the presentation of the NHS foundation trust application, emphasising that the changes were evolutionary dating back to the 1990s and that the application was part of the ongoing work to provide 21^st century care on three sites.

Mr Bill Shields outlined key facts in respect of the Trust and the five hospitals: Charing Cross, Hammersmith, Queen Charlotte’s & Chelsea, St. Mary’s and Western Eye, and the reasons for becoming a foundation trust. The proposed governance arrangements included: membership open to all people over the age of 16, provided that they met the criteria; a Council of Governors and a Board of Directors.

Mr Shields outlined the Trust’s vision for the future and strategic objectives, which were consistent with Shaping a Healthier Future proposals and the advantages of becoming a foundation trust.

Professor Cheshire  presented the Trust’s clinical strategy , operating from three main sites: Hammersmith Hospital (Specialist); St. Mary’s Hospital (Major Acute) and Charing Cross (Local and Elective). All sites would provide local services in addition to their particular unique function.

Professor Cheshire outlined the outcomes against six core dimensions of clinical quality and specifically:

·         Standardised mortality rate of 70, compared with an England Average of 100, which is amongst the lowest in the country and particularly strong in comparison with North West London hospitals; and

·         The NHS Safety Thermometer indication that 96% of patients received ‘harm free care’.

The patient experience indicator, however, showed a mixed picture, with improvement needed and significant underperformance in cancer care.

In respect of Operational Performance, the Trust had achieved seven out of eight standards in the third quarter. The Cancer Waiting Times Standard had not been achieved. Operational Performance to December 2013 (when published) would shown that the eight standards had been achieved.

In respect of financial performance, a surplus of £15 million was predicted.

Professor Cheshire presented:

·         the Medicine Division ‘Dashboard’, which demonstrated the detailed work to analyse performance.

·         The Quality Assessment of the six dimensions of quality;

·         The Clinical Services categorised as locally provided service, specialist provided service, general emergency and specialist emergency and the percentage of the Trust’s clinical income.

The specialist emergency service was an unique area, but the locally provided services generated some 50% of the Trust’s income.

Profess Cheshire emphasised that unselected emergency care could not be provided on three sites. St. Mary’s would provide specialist emergency services: Hammersmith elective specialist services and Charing Cross local elective services. The three sites would be inter-dependent, with 24/7 access to A&E consultants. Attendance figures for A&E and the Urgent Care Centres (UCCs) showed that, when all three UCCs were open, 50% of attendances were at the UCCs.

The services on the Charing Cross site had yet to be determined, and were dependent on a number of factors including Commissioner intentions, the University estate, Hammersmith & Fulham Council desires and the future of the Central  ...  view the full minutes text for item 38.

This report will follow.  

This item was taken with item 5.

This report will follow.

Mr Steve McManus presented the Cancer Services Update, outlining sustainable improvements:

• New pathways implemented in Lower GI, lung, breast and urology;

• Head and Neck and Upper GI pathways currently being reviewed and revised;

• Pathways broken down into ‘timed sections’ to ensure no un-necessary delays at any point in the pathways;

• Work in partnership with providers across the network to ensure more timely Inter-Trust Referrals (ITR’s);

• Additional capacity in place where required;

• Prospective reporting now in place highlighting all booked activity and flagging all treatments scheduled outside target to Operational Managers.

A series of events has been scheduled every 100 days to ensure key stakeholder engagement in cancer improvements and to maintain high momentum in implementing best practice. Members were invited to attend the next event on 14 February. Further information would be provided.

Action:

Imperial College Healthcare NHS Trust

The Trust had delivered seven out of eight of the nationally defined cancer standards in the current quarter. The 62 day standard (first referral to treatment) had not been met. Performance to December would show that all standards had been delivered, and it was expected  that the Trust would continue to deliver the eight standards.

Mr McManus outlined the clinical review process, instigated after the reporting break, whereby a comprehensive clinical audit was carried out for all patients that had waited longer than 100 days for treatment  The audits undertaken to date had been completed by the Chief of Service for Cancer and in future would include external LCA representatives for additional assurance

Mr McManus stated that there was no evidence of harm to the progress of the cancer caused to any patient as a consequence of pathway delays. 

Mr McManus outlined the initiatives to improve patient experience and the improvement in multi-disciplinary team meetings.

Mr McManus responded to a member query that improvements had been made to the data system and the Trust was confident that there were no furter misplaced referrals. Assurance was provided by regular internal audit and external scrutiny.

Councillor Carlebach queried the outstanding information in respect of flu vaccinations. Dr Harrison responded that he had provided the process and would provide the data as soon as it was available.

Action: Imperial College Healthcare NHS Trust

RESOLVED THAT:

The update be noted.

The Committee is asked to note that the dates of the meetings scheduled for this municipal year are as follows:

 21 January 2014

19 February 2014

2 April 2014

21 January 2014

19 February 2014

2 April 2014