An update will be given at the meeting.
Minutes:
Stuart North, Chief Officer at NHS Bury Clinical Commissioning Group attended the meeting to report on the Healthier Together pre consultation business case that would soon be available on the Healthier Together website.
The Committees in Common had met earlier in the day with a view to agreeing to pre consultation business case and recommending that the consultation commence on 8 July for 90 days.
It was explained that the Committees in Common had received guidance from NHS England in respect of the consultation and that NHS England required the business case to meet 96 standards before consultation could begin.
Stuart explained the case for change and the need to change the way that services were provided;
• Variation in patient outcomes, quality and safety standards
• Rising demand on services
• Workforce availability
• Many patients using hospital rather than primary and community services
• More care needs to be provided within the community
The future model of care was set out;
• Deliver care locally for the majority of patients – Local Services
• Upgrade Local Services so all attain standards
• Create a smaller number of Specialist Services for the few patients with ‘once in a lifetime’ life threatening illness and injury delivered in line with GM standards
• Create Single Services – multi-disciplinary teams responsible for Specialist and Local Services for a population of GM
• Work with the Ambulance Service to direct patients to the right place at the right time
• Consultant led care delivered to best practice standards
• Effective clinical leadership and decision making
It was explained that local services would remain and provide care locally, specialist services would be provided at either 4 or 5 sites depending on the outcome of the consultation
Stuart explained that the consultation would be looking at where services should be provided. There were 8 options available with Manchester, Oldham and Salford already being identified as specialist sites and Bolton, Wigan, South Manchester and Stockport being considered as the possible other sites.
The key elements to appraise were explained:
· Capital Estate Capacity
Ø All options reviewed to understand the capital estate requirement.
Ø Every option is possible, however the cost of the options varies dependent on existing estate capacity and quality
· Workforce Capacity
Ø Analysis of the standards identifies a consultant requirement for 4 and 5 site options
Ø This is then compared to the current number of consultants to determine a deficit
· Travel and Access Standards developed:
Ø Standard 1: 20 minute emergency access to a hospital (general or specialist)
Ø Standard 2: 45 minute emergency access to a specialist site
Ø Standard 3: 75 minute public transport access to a specialist site
Ø All options are compliant with Standards 1 and 2
Ø There is a range between the options when meeting Standard 3 (Access by Public Transport)
Ø The lowest compliance of any CCG area is 97%
4. Financial Revenue Implications
Plus, understanding different ways Single Service could be developed.
Stuart explained that all existing sites are included within these options and there is no preferred option.
Options were proposed as a way forward to achieve Quality & Safety Standards, however consultation response may provide alternative suggestions.
The next steps were explained:-
• NHS England will review PCBC documentation and submitted evidence against their 96 Assurance Criteria
• Greater Manchester Joint Overview & Scrutiny Panel will review the consultation material
• No change is not an option and the challenge is immediate
• Significant improvements in Community and Primary Care before Hospital changes
• No District General Hospital will close
• No A&Es will close
• All existing sites included within options; no preferred option
• Launch of the consultation to gain people’s input and opinions of these proposals.
Members were given the opportunity to ask questions and make comments and the following points were raised:-
Ø Councillor Bury explained that he was a member of the Joint Overview and Scrutiny Panel that had been tasked with reviewing the consultation material. Councillor Bury stated that he was impressed with the document that had been produced as he felt that it was set out well and easy to understand.
Ø Councillor Bury referred to specialist services and the fact that Stroke Services were already situated at Fairfield Hospital in Bury. Councillor Bury asked whether this would continue to be the case.
Stuart North explained that not all specialist services were being considered within the consultation and as far as Bury CCG were concerned there were no plans to move the stroke services from Fairfield Hospital.
Ø Councillor Walker referred to Pennine Acute NHS Hospital Trusts indication that A & E at Fairfield Hospital would remain open. Councillor Walker stated that he always felt uncomfortable when such statements were made and asked that confirmation be given that Fairfield A & E was safe.
Stuart explained that the consultation document stated that the plan was to retain all 10 sites but to use them differently than currently. All options to be considered included 10 hospital sites.
Ø Councillor Smith referred to the specialist hospitals working jointly and asked whether this would have implications in relation to the different trusts across Greater Manchester. Councillor Smith asked whether the trusts would need to reorganise to accommodate the changes in service provision?
Stuart explained that the provider reference group would be reviewing this issue.
Ø Councillor Smith referred to Wythenshawe Hospital as being included as a possible option for a specialist site and the fact that the Metrolink network was planned to be extended. Councillor Smith asked whether any decisions on specialists services would impact on this.
Ø Councillor FitzGerald referred to transport issues and asked that all transport issues be reviewed to ensure that patients’ and visitors’ access to hospitals was straightforward.
Ø Councillor Pickstone asked the committee to recognise that North Manchester General Hospital was the ‘local’ hospital for residents in the south of the borough and as such should be considered by the Committee when looking at the possible options.
Ø Councillor Mallon referred to the 20, 45 and 75 minute access requirements and asked when the timing started, would it be when the patient called or when the ambulance left?
Stuart explained that he would seek clarification on this.
It was agreed:
1. That Stuart be thanked for his attendance at the meeting.
2. That Members would receive regular updates on the consultation process.