Agenda item

5.1   The Chair explained that this item allowed us to hear updates from the key local trusts.  He welcomed for the item:

  Shane DeGaris (SD), Group Chief Executive Barts Health/BHRUT

  Louise Ashley (LA), Chief Executive of Homerton Healthcare

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

5.2  Members gave consideration to the report North East London Health updates    which comprised overview updates from Barts Health, Homerton Healthcare   and ELFT/NELFT.  SD and LA took members through the report.

5.3  The Chair asked SD how they had made insourcing financially viable. SD replied that a key focus had been bringing staff onto the ‘agenda for change’ terms and conditions and the move was important in terms of equity for lower paid staff. The increased cost could partly be offset by improvements in ways of working and having a better motivated workforce.  There was a net cost but it was the right thing to do, he added.

5.4  The Chair asked SD about sharing the learning from their insourcing journey with Homerton Healthcare. SD explained that this was happening and they also worked closely together in the Acute Provider Collaborative. LA added that she was pleased that it was happening and that they will have an opportunity to learn from it as they make similar considerations.

5.5  The Chair asked LA how the system was adapting to the new Pathology Partnership. LA explained that they had some teething problems in getting the electronic systems working and in sorting out facilities issues in the new Labs but all of these were solvable and it was bedding in. SD added that Lewisham and Greenwich NHS Trust were the third partner here so it was an in-house NHS Pathology Partnership and did not involve the independent sector.

5.6  Cllr Masters asked about keeping across developments at BHRUT and also  requested that, in future reports, more data be presented in graphical form so as to better illustrate trends. SD replied that they had similar slides on BHRUT for use at ONEL but didn’t present them here as they understood the focus was INEL, but they could present both in the future. He also undertook to provide more graphical information in future reports. JS added that more information from BHRUT is obviously focused on the ONEL committee. She recalled that she had presented on the Barts Health-BHRUT Collaborative previously and would be happy to do this at the next meeting, to provide an update on the key areas of work.

  ACTION:

'Update from NHS NEL Chair on the progress of the Provider Collaboratives' and a separate 'Update on the Barts Health-BHRUT Collaborative from their Chair in Common' to be added to the agenda for the next meeting.

5.7  Cllr Sweden asked what other medical conditions would be suitable for the virtual wards approach; about plans for further tranches of in-sourcing; about sharing best practice on IAPT; and on further integration of ELFT and NELFT. SD explained that Virtual Wards were currently used for areas like cardiology and utilise ‘remote wearables’ and kit that can be used easily at home. There definitely are applications to other illnesses and they were looking at its uses in monitoring ‘Frailty’ and in other areas.  On insourcing, by May, Barts Health would have insourced security, portering, catering, cleaning and car parking so there were only a few small areas remaining. A related issue for Royal London and St Barts however was that they had the largest PFI contract in the country and that ‘hard facility’ contract was outsourced to the PFI contractor. There were no plans to in-source that because of the scale involved so their focus instead had to be on working with the PFI partner to get best value for the taxpayer. ZE responded on ELFT and NELFT collaboration, describing the two trusts’  work on the new Mental Health, Disabilities and Autism Collaborative, the focus of which was to reduce unwarranted clinical variation across NEL as well as working on patient leadership and service user engagement. The Community Health Collaborative had begun but was at a less advanced stage, she added. She offered to provide more information on these at a future meeting. On Homerton Healthcare’s strong IAPT performance LA replied that she was very pleased with it and could also update in future if required. She added that when things do go well they should reflect more on that too as that is also important for learning.

  ACTION:

Group CE Barts Health/BHRUT to provide further detail of the type of equipment being used for the ‘cardiology at home’ Virtual Ward.

  ACTION:

CE of NHS NEL to join with ELFT and NELT officers to present a future meeting item on the work of both the Mental Health, Disabilities and Autism Collaborative and the Community Health Collaborative.

5.8  The Chair asked JS what the main focus of work currently was in the  Barts-BHRUT Collaborative. JS replied that across the Collaborative and in the wider Acute Provider Collaborative, which also includes the Homerton, they were focusing on 6 clinical areas and research and had a particular focus on ‘Workforce’ to support challenges at BHRUT. They were working to develop medical education and leadership. She added that in all her visits she would hear staff discuss how they were reaching out to the other Trust to get advice and there were numerous examples of using capacity at one to support the other. She illustrated this with the example of expanding the REACH programme by using consultants in Emergency Medicine at the Royal London to work more closely with paramedics to make sure patients were taken to more appropriate settings than ED, when appropriate.

5.9  The Chair asked whether the decrease in job vacancy rates at Homerton Healthcare was mirrored at Barts Health. SD replied that within Barts Health it was quite mixed at the macro level but there was greater variation when you dive further down to the individual hospitals. An ongoing challenge was that it was easier to recruit to inner rather than outer London hospitals

5.10  The Chair thanked the Chair and Chief Execs for their reports and attendance and their kind offers of further items which would be scheduled.

  RESOLVED:

  That the report and discussion be noted.