Agenda item

NHS Brent and North West London Hospitals NHS Trust have asked to present a paper to the committee on plans for paediatric services at Central Middlesex Hospital.  An update on the service is attached.

Fiona Wise (North West London NHS Hospitals Trust) introduced this item and advised that a review by the Clinical Team at Central Middlesex Hospital had identified that there had been a significant reduction in patient numbers at the Paediatric Assessment Unit (PAU) since Care UK’s Urgent Care Unit (UCC) had opened in March 2011.  This had the effect of reducing staff morale in the PAU and there was a danger of de-skilling because of the reduced activity.  As a result, it was proposed to absorb the paediatric assessment function within the UCC and to de-commission the PAU, whilst the paediatric outpatient service and Brent Sickle Cell service would remain at the hospital.

David Cheesman (North West London NHS Hospitals Trust) added that PAU had experienced a number of staff resignations and it was difficult to maintain minimum staff levels and was also costing the hospital £6.5K per week because of the lack of patients.  By contrast, the UCC had proven to be a big success since its opening and on average was absorbing 87% of paediatric demand.  David Cheesman advised that patients requiring specialist opinion or overnight care were being transferred to Northwick Park Hospital and this arrangement had been in place since October 2010.  The committee heard that the proposals did not include major service changes and under Section 2.2, an informal consultation with relevant community groups would be required.  Members noted that it was intended to implement the proposals in October 2011.

During Members’ discussion, Councillor Cheese expressed concern about the time delay in transferring patients who had arrived at Central Middlesex Hospital to Northwick Park Hospital.  He also queried whether St Mary’s agreement to accept rare, critically unwell children was sufficient and stressed that standards could not be compromised in such situations.  Councillor Daly sought clarification as to whether the UCC was staffed by Care UK and was there a protocol in place.  Views were sought as to whether the Care UK contract could be extended to other services.  Councillor Daly also requested that a patient satisfaction survey for Care UK be undertaken.

Councillor Hunter agreed that the relevant community groups should be consulted regarding the proposals which she felt offered the benefit of reducing unnecessary overnight stays.  She also sought clarification with regard to how the proposals fitted in with the overall strategy. 

In reply, Fiona Wise advised that patients were already being transferred to Northwick Park Hospital for emergencies, specialist care and overnight stays.  Children who arrived at Central Middlesex Hospital would initially be treated by UCC who would determine whether a transfer was necessary.  Presently PAU was only treating around 30 patients a week on average. 

David Cheesman advised that there was a robust system with regard to patient arrangements which ensured that patients were receiving the most appropriate treatment at a suitable hospital.  Central Middlesex Hospital would continue to provide a 24 hour accident and emergency service.

Jo Ohlson advised that a number of other services, such as sickle cell treatment and safeguarding were also being looked at and it was possible that Care UK may have further involvement in future.  The committee noted that the UCC was also staffed by a paediatric trained nurse or GP on a 24 hour basis.  With regard to PAU, Jo Ohlson explained that it had been anticipated that it would treat much more children when it was originally established, however the creation of UCC had proven to be more successful than had been imagined.  Jo Ohlson advised that a patient satisfaction survey regarding Care UK could be undertaken as part of the customer engagement process. 

Sarah Basham confirmed that the UCC was staffed by Care UK and stressed that there was a robust system in place with regard to referring patients to other hospitals.  She advised that St Mary’s Hospital had been treating critically unwell children from across West London for a number of years and that this arrangement was robust and effective and that this offered the best treatment in the area for such situations.

The Chair thanked the presenters and requested that there be an update on this item at the next committee meeting on 20 September.