Agenda item

Brent CCG, in conjunction with the North West London Collaboration of CCGs, has been asked to provide an update on the plans for Central Middlesex Hospital which will now follow as a direct consequence of the Shaping a Healthier Future plans.

Rob Larkman (Chief Officer – Brent, Ealing, Harrow and Hillingdon Clinical Commissioning Groups (CCGs)) provided an update to the committee on the plans for Central Middlesex Hospital (CMH) under the Shaping a Healthier Future (SaHF) programme. He advised that colleagues from SaHF, Daniel Elkeles (North West London CCGs) and Dr Mark Spencer, were also present to address any queries from the committee.

Rob Larkman reminded the committee that Ealing Council had referred the SaHF plans to the  Secretary of State for Health and had made an application for Judicial Review (JR). The JR had been declined and in October 2013, the Secretary of State for Health had given his broad approval to the SaHF proposals including that CMH become a Local Hospital and Elective Centre.  The Secretary of State for Health had also recommended that the changes to A&E at CMH take place as soon as practicable after winter. It was emphasised that the current restricted opening hours of the A&E service at CMH were not a result of the SaHF proposals but instead were related to clinical safety issues.

Members were advised by Rob Larkman that the plans for CMH created potential for significant investment in the site. Work was currently being undertaken to build a long term sustainable model for the site. Working groups had been established which would complete evaluations of clinical and financial factors as well as exploring the impact on patients of moving existing services to CMH. An Equalities Impact Assessment would also be completed to explore how protected patient groups would be affected by any proposals. Weekly meetings were being held to oversea the progress of the work streams. Members attention was drawn to the list of options under consideration, set out in the report. In response to a query it was clarified that this list represented the core elements of the portfolio of services being considered for CMH. It was emphasised that there would be full and meaningful engagement with local residents and other stakeholders. In line with this, an engagement plan was being developed. Rob Larkman concluded by noting that a final report setting out proposals for CMH would be presented to the Partnership Board and Implementation Programme Board on 6 February 2014.  Approval would then be required to be sought through several decision making bodies including the Clinical Commissioning Groups, National Health Service England (NHSE), Trusts and the NHS Trust Development Body (NTDA). 

In the subsequent discussion, the committee raised a number of issues. A member queried the percentage of the CMH site currently in use and sought an explanation for the figure provided. In response, David Cheesman (Director of Strategy NWLHT) advised that approximately 65 per cent of CMH was currently being used and at present the A&E service was closed overnight for reasons of clinical safety. Additional elective work had been transferred to CMH from Northwick Park Hospital (NPH) but without a 24 hour A&E service this would only be temporary. Daniel Elkeles explained that the aim for CMH was to make it into a large hub for elective services; this was considered best use of the site based on its size and location. It would not be possible to install additional surgical beds for instance to meet a capacity gap as whilst there was the physical space at CMH there were not the teams that were required to support those beds.

The committee expressed concern regarding the potential transfer of mental health services from the adjacent Park Royal Hospital (PRH) site and queried the reasoning for this. Dr Mark Spencer informed the meeting that there were currently four wards at the PRH, encompassing an admissions assessment unit, two acute mental health units and a mother and baby unit for those with post natal depression. The current facilities at the PRH were not sufficient and it would be possible at CMH to provide a higher quality accommodation at ground level with access to courtyards. Daniel Elkeles advised that the mental health units were low security, unlocked wards and would have a separate entrance to the rest of CMH.

In thanking the representatives for their contributions, the committee requested that an update on the plans for CMH be provided at the next meeting in January 2014, alongside a report on the proposals for Willesden Hosptial.

RESOLVED:

    (i)        that the report be noted;

  (ii)        that an update on the plans for Central Middlesex Hospital be provided to the committee at its next meeting in January 2014;

 (iii)        that a report on the proposals for Willesden Hospital be provided to the committee at its next meeting in January 2014.