Agenda and draft minutes

The Chair invited Councillor Daniel Crawford of London Borough of Ealing to welcome attendees to Ealing Town Hall.

Apologies were received from Councillor Jaeger (LB Richmond).

Councillor Sheth stated that he was the lead governor for the Central and North West London NHS Foundation Trust (CNWL).

Consideration was given to the minutes of the previous meeting of the Committee which had taken place on 14 October 2016.

Councillor Arzymanow made reference to the request for consultancy spending on page 2 of the minutes, asking if these figures could be shared with the Committee. The Chair advised that the figures had not yet been received, but would arrange for them to be forwarded to all Committee members when available. Christian Cubitt (Director of Communications & Engagement, NHS North West London Collaboration of CCGs) stated that he would look into whether arrangements had been made to forward the information.

Resolved: That

(i) the minutes of the previous meeting of the Committee held on 14 October 2016 be agreed as a true and correct record; and

(ii) information on consultancy spending be forwarded to all Committee Members when available.

The Chair invited Clare Parker (Accountable Officer, CWHHE CCGs), Christian Cubitt (Director of Communications & Engagement, NHS North West London Collaboration of CCGs), Susan La Brooy (Medical Director, NW London Shaping a Healthier Future) and Neil Ferrelly (Chief Financial Officer, Brent, Harrow and Hillingdon CCGs) to update the Committee on the development of the Shaping a Healthier Future (SHaF) Strategic Outline Case (SOC) Part 1 released by the Clinical Commissioning Group (CCG) in December 2016.

Clare Parker provided background context, advising that the SOC was a business case detailing how £513m would be invested in the NW London primary care estate, out of hospital hubs, acute hospitals in outer NW London and the local hospital at Ealing, addressing the existing challenges faced in these locations and enabling the CCG to implement a new model of care to improve outcomes for residents.

Part 1 of the SOC was in place to secure the capital investment needed to deliver the next phase of the CCG’s ‘Shaping a Healthier Future’ (SaHF) plans. At this stage it did not further develop any of the clinical or other service changes already set out in the SaHF. It did not explicitly consider transport, communications or equalities issues as these had been addressed in the Decision Making Business Case published in 2013 and would be addressed again as services were developed and more detailed business cases were produced.

Part 2 of the SOC was being prepared separately because of the opportunity to maximise the redevelopment potential at the St Mary’s site as part of the wider Paddington regeneration. Rather than slow down other critical developments the SOC was instead split into two parts to enable both to progress at the fastest possible speed.

Due to the technicalities of the business case required by the Treasury, the SOC Part 1 had been divided into five sections, each of which was detailed separately.

Strategic Case

The strategic case stated that funding improvements to the GP practice estate would give the capacity to help patients be seen and treated quicker.

The development of out of hospital hubs would reduce unnecessary hospital appointments and use of hospital services, bringing care closer to home for people with multiple long term conditions who required highly coordinated services.

It was stated that better outcomes would be achieved for patients through the consolidation of expert care for particular acute conditions onto fewer sites.

It was explained that the capital required would be divided into three pots:

·         GP Practices (£69m) – The monies would be utilised to make it easier for patients to physically get in and out of practices, used to fund better waiting rooms and more provision for consulting rooms.

·         Out of hospital hubs (£141m) – The monies would go towards building seven new hubs as well as modernising the eleven extant community hubs.

·         Acute hospitals (£304m) – The monies would be used for supporting Ealing Hospital’s move towards becoming an ‘excellent local hospital’. The monies would  ...  view the full minutes text for item 5.

The Chair invited officers still in attendance from the previous item to make a presentation concerning the North-West London Sustainability and Transformation Plan (STP).

The focus of the first two years of the STP would be to:

·         Develop the new proactive model of care across North West London

·         Address the immediate demand and financial challenges

It was reemphasised that no changes would be made at Ealing Hospital until there was sufficient alternative capacity elsewhere, and no changes were planned to the Charing Cross A&E service currently being provided during this STP period.

The STP identified a set of nine priorities that would help in achieving its vision and fundamentally transform the system. These were:

To support people who were mainly healthy to stay mentally and physically well, enabling and empowering them to make healthy choices and look after themselves

·         Improve children’s mental health and physical health and wellbeing

·         Reduce health inequalities and disparity in outcomes for the top 3 killers: cancer, heart disease and respiratory illness

·         Reduce social isolation

·         Reducing unwarranted variation in the management of long term conditions – diabetes, cardio vascular disease and respiratory disease

·         Ensure people access the right care in the right place at the right time

·         Improve the overall quality of care for people in their last phase of life and enabling them to die in their place of choice

·         Reduce the gap in life expectancy between adults with serious and long term mental health needs and the rest of the population

·         Improve consistency in patient outcomes and experience regardless of the day of the week that services are accessed

These priorities would be delivered within five separate delivery areas:

·         Improve your health and wellbeing

·         Better care for people with long-term conditions

·         Better care for older people

·         Improving mental health services

·         Safe, high quality sustainable services

Since the October 2016 submission of the NW London STP work had focussed around the establishment of Delivery Area boards, enabler groups and project groups that were fully representative and had the skills and expertise required to successfully deliver the STP outcomes. Statutory bodies for discussion of the STP were being supported and STP governance arrangements were being strengthened across the board.

As part of the discussions ahead of the JHOSC meeting, CCG officers had been asked to address a number of questions on implementation timelines, governance, transport strategies and the inclusion of community pharmacies within the reconfiguration strategy. A series of detailed answers to these questions had been included within the Agenda, beginning at p340 (http://bit.ly/2nH6RlQ - Item 6d).

Questions

The Chair then invited Committee Members to comment and ask questions.

In relation to community pharmacies, the Chair asked about suggestions that minor-ailments services were to be withdrawn from 1 April 2017. If this was true, would it bring further pressures to bear upon GP practices?

Officers were not aware of such a plan as NHS England retained control over pharmacies, therefore a response would be provided in writing.

Councillor Sheth asked that if the NW London  ...  view the full minutes text for item 6.

Any Other Items the Chair Considers Urgent

As the meeting was not quorate at this point, the vote for the Chair and Vice-Chair of the Committee would be deferred until the next meeting.

Panel Members were advised that the date of the next meeting would be confirmed in due course.

Councillor Mel Collins

Chair.

The meeting ended at 4.20pm.