Agenda item

6.1   The Chair explained that as part of the new ICS an Acute Provider Collaborative had been created involving Barts Health, BHRUT and Homerton Healthcare whereby the three acute health trusts in the patch would work to agree a single approach to service development proposals.  The APC first met in July and plans for engagement and consultation would emerge over the following months. 

6.2  He welcomed for this item:

  Rt Hon Jacqui Smith (JS), Chair in Common, Barts Health/BHRUT

  Zina Etheridge (ZE), CEO, NHS North East London

6.3  JS gave a verbal presentation on the plans. In summary there would be 5 Collaboratives covering : Mental Health, Learning Disability and Autism; Community Services; Primary Care; VCS; and Acute Care.  The focus is on improving outcomes for patients and on ensuring value for money. The APC is now focusing on its work plans which are wide ranging and a key element is having an Acute Clinical Strategy.  They are also looking at taking on more responsibilities for Specialist Services and at developing the work on Clinical Trials. They’ve also added strands such as ‘Babies children and young people’; ‘workforce;’ and ‘information and informatics’. Each programme has been assigned lead from one of the Trust  and they have an Executive Group and a Shadow Board which is chaired by Sir John Gieve. They are bringing together some of the work done previously at Trust level e.g. on HVLC centres.  Support had been canvassed for creating a network of centres of clinical excellence in surgery but this had been delayed by the pandemic. They are now back at the task and reflecting on the learning from the pandemic, which had accelerated some of the work and stopped others. JS cautioned that it was early days and the APC plan hadn’t yet been seen by the boards of the individual Trusts nor the APC Board itself but it will come back and of course feed into the Forward Plan for NHS NEL in time for next March. 

6.4  The Chair asked to what extent this was an Estates issue. JS replied that an element of it was and neither was it all about High Volume Low Complexity care but how to ensure resilience of Critical Care.  The challenge was how to get more services out of hospital, what will deliver the best outcomes, what do the Clinicians say and what do we need to move around to accommodate those changes. She added that in the APC they do not have a Masterplan and they are genuinely having to go back and to work done before the pandemic to review it in light of what we learned since. 

6.5  Cllr Brewer asked how will the APC practically assist with improving outcomes for patients e.g. on eliminating 4 hr waits in A&E or the huge 62 day cancer wait backlogs. SD replied that during the pandemic every hospital had cancelled routine surgery leading to a huge backlog.  NEL had been hit harder earlier with Covid and it recovered later than other regions.  There was a constant focus now in clearing backlogs and use of HVLCs are part of that. The idea was to concentrate efforts in fewer centres as this will lead to better clinical outcomes for patients and will get better throughput. Patients were already going to specialised centres to receive care earlier. 

6.6  The Chair asked whether the High Volume Low Complexity hubs would continue. JS replied that elements of it were being done in King George V in Ilford. What was paused was the real strategic planning about what it was going to look like and they are now returning to that.  In terms of consultation on all this, it  would depend on the scale and the significance and the materiality of any proposed Change.

6.7  The Chair asked whether this was predominantly about moving round services rather than any reductions considering our growing population. JS provided reassurances that Emergency Departments could not be reduced considering the pressures already on them adding that she could not foresee any scenario where EDs would be closed. In terms of other key areas of focus for the APC one was on ensuring maternity services were properly staffed and another was on improving safety and building on Ockenden report recommendations.

6.8  The Chair thanked the senior executives for their update and for attending to answer questions and he asked that once the APC was further along, the Committee would like to be kept informed of its progress.

ACTION:

Update briefing on the Acute Provider Collaborative to be added to the future work programme.

RESOLVED:

That the report and discussion be noted.