Agenda item

The Health and Wellbeing Board will be presented with a report on the progress in implementing the recommendations from Shaping a Healthier Future. The report will focus on the plans for Central Middlesex Hospital and the implications for Willesden Centre for Health and Care.

A presentation was delivered by Rob Larkman (Chief Officer, Brent CCG) updating the Board on the implementation of the Shaping a Healthier Future (SaHF) Programme in Brent, with a focus on the recent work undertaken with respect to the Central Middlesex Hospital and the implications for Willesden Centre for Health and Care. The meeting was reminded that SaHF was taking forward the reconfiguration of North West London’s hospitals to establish specialist centres of care. The programme was underpinned by an out-of-hospital strategy which aimed to reduce unnecessary hospital admissions by treating patients in primary care settings, thereby allowing hospitals to concentrate on the critically ill or those that required specialist care. In line with this, Brent CCG was implementing ambitious plans to improve primary care and patient access to services. The Board’s attention was drawn to a map detailing how each hospital had been categorised under SaHF. Business cases were currently being developed by the hospitals and these would be reviewed and subsequently submitted to the Treasury to confirm funding.

Rob Larkman outlined the recent developments regarding Central Middlesex Hospital (CMH). It was explained that CMH currently had an annual deficit of £11m and was under utilised. Considerable work had been undertaken to explore options for a long term, clinically viable and financially sustainable model for the site. This work had encompassed discussions with service providers across North West London and a range of stakeholder workshops.  Three options had been considered; allow the hospital to continue as it was; close the hospital; or, add additional services. The additional services identified for CMH were outlined to the Board and it was explained that these involved the relocation and expansion of community rehabilitation beds from Willesden Health Centre. As a consequence, a range of services had also been identified for transfer to the Willesden Centre to ensure the site continued to be fully used. The presentation detailed that the evaluation agreement, made at a North West London wide workshop held in January 2014, had selected two preferred options; full utilisation of both sites, and full utilisation of CMH with partial utilisation and partial disposal of the Willesden site. The preferred option of Brent CCG remained the full utilisation of both sites and therefore, further work would be undertaken to identify other services that could be located at Willesden.

Rob Larkman concluded his presentation by detailing the required next steps and associated timeline. He explained that an outline business case for CMH was in development, with an intended deadline of the end of 2014/15 for completion and approval. It was planned that final services would be in place for 2015 onwards.

In the subsequent discussion it was noted by Anne O’Neill that CMH had always been under utilised and assurances were sought that the current planning process was sufficiently robust and future proof, particularly when considering the potential partial disposal of the Willesden site. In response, Dr Mark Spencer (Brent CCG) advised that the design of CMH had reflected an incorrect assumption that demand for Laparoscopic surgery would increase and had not predicted the significant amount of conditions that would become treatable in community settings. Jo Ohlson (Brent CCG) advised that Willesden Health Centre would make a great community hub and though the option to partially dispose of the site was being retained, all efforts were being made to increase occupation of the site. Local general practices had been approached to consider operating from the centre and a number of outpatient services would also be located at the site.

Responding to queries regarding the disposal of the Park Royal Centre for Mental Health site following the transfer of services to CMH, Dr Mark Spencer and Rob Larkman explained that some financial assumptions had been made based on advice from architects and that any funds released would be reinvested in the programme.

Anne O’Neil further commented that it was important that a focus remained on improving community engagement. It could be difficult for people to feed their views into the process due to a lack of understanding of the different groups and sub-groups in operation. She added that supporting documents had become more accessible to members of the public, but the overuse of acronyms could cause barriers to effective engagement. Mark Spencer acknowledged that  further work to improve community engagement was needed.