Agenda item

The attached report from the Brent Clinical Commissioning Group (CCG) outlines the proposals and processes for deciding the new configuration of health services available from Central Middlesex Hospital.

Rob Larkman (Accountable Officer, Brent, Harrow and Hillingdon CCGs) introduced a report updating members on the work being undertaken to develop Central Middlesex Hospital (CMH), including consultation and engagement activities. It was explained that the plans to develop CMH were underpinned by the acknowledgement that the CMH site had been underutilised for many years. The intention was to provide a range of additional services at CMH to ensure that the site was clinically viable and financially sustainable in the long-term. 

Rob Larkman advised that CMH had been defined as a local and elective hospital under the acute services reconfiguration set out in the Shaping a Healthier Future (SaHF) programme. Amongst the services it would provide would be a 24/7 Urgent Care Centre, outpatient services, diagnostics, elective services and primary care hub. Further work to build on the services to be offered had resulted in the development of a Strategic Outline Case (SOC) in 2013, which had subsequently been agreed by the relevant Boards in 2014. The SOC encompassed a preliminary assessment of costs, benefits, risks and funding in scoping the possible range of services that could be provided at CMH and proposed services such as an Elective orthopaedics centre, Mental health inpatient facility, primary care ‘hub’ and genetics laboratory. An Outline Business Case (OBC) was now being developed which built upon the SOC to further refine and develop proposals. It was anticipated that the OBC would be completed by the end of 2014 and that it could then be taken through the approval procedures to obtain the necessary capital investment. Rob Larkman highlighted that the OBC would no longer include a mental health in-patient facility as the ward configuration and open space required could not be accommodated.

The Chair thanked Rob Larkman for his presentation. The committee requested that the proposals be provided in greater detail, including a financial breakdown of costs and the investment configuration for the proposed services. Members then raised several queries. With reference to the proposal to relocate rehabilitation beds from the Willesden Centre to CMH, a member questioned the implications for Willesden Centre. It was further queried what services were located at the Willesden Centre and a concern was raised regarding the costs to the tax payer of an underutilised site. It was subsequently proposed that the committee undertake a site visit to the Willesden Centre. The committee sought further information regarding the provision of in-patient mental health service at the Park Royal site. Queries were raised regarding the consultation activities undertaken, including the number held and how they were advertised.  Further details were sought regarding the services available in the North of the borough and the procedures in place to deal with large scale health emergencies. A view was put that consultation on changes to primary care had been poor. Councillor Daly requested that details of the number of beds to be removed across North West London under SaHF be provided to her in writing.

In response, Rob Larkman and Ethie Kong (Chair, Brent CCG) advised that the development of the Willesden Centre formed part of the Primary Care Strategy and the services to be offered were being reviewed in conjunction with the plans to develop CMH. Willesden Centre had also historically been underutilised and work was underway to explore how best to develop the important local facility and support the delivery of the out-of-hospital strategy. A range of community services were currently offered at the site, including GP services and the rehabilitation beds. The cost of the Private Finance Initiative (PFI) for the Willesden site was approximately £2m and was met by the NHS. It was acknowledged that the site did not provide sufficient revenue to cover the cost of the PFI and therefore additional services needed to be provided to address the underutilisation of the site. There had been three main consultation events held on the development of services at CMH and these had been widely advertised. The Brent Youth Parliament had been engaged but schools had not been directly approached.

Rob Larkman confirmed that in-patient mental health services would continue to be delivered at the Park Royal site and the future of the site would be considered. With regard to services available in the North of Brent, the committee was advised that a walk in centre was available in Wembley and this was supported by the Urgent Care Centre at CMH and the Primary Care Hubs. Emergency Planning for healthcare in North West London was captured by the system wide resilience strategy for North West London. There also existed a North Central London resilience strategy, as well as a London-wide strategy.

The Committee advised that Wembley did not constitute the north of the borough and Ethie Kong stated that Brent CCG would work collaboratively regarding points of service across the borough.

RESOLVED:

    (i)        That the update report be noted

  (ii)        That further information regarding the proposals for Central Middlesex Hospital be provided to the committee in writing and include a breakdown of the financial implications of the proposals.