Agenda item

The report is attached.  Presentation slides have also been circulated to Members.

Andrew Davies (Performance and Policy Officer, Strategy, Partnerships and Improvement) introduced the item and confirmed that following on the meeting in November 2011, the chairs and vice chairs of Brent, Ealing and Harrow health scrutiny committees had met with representatives from Ealing Hospital Trust and North West London Hospitals NHS Trust on 24 January 2012 to discuss concerns raised in a letter sent to both trusts at the previous meeting.  Andrew Davies referred to the main issues to emerge from the second meeting as outlined in the report and advised that the Chair of this committee was seeking to send a further letter to the trusts outlining the committee’s views on the merger.

The Chair then invited Simon Crawford (SRO, Organisational Futures Project) to make some opening remarks.  Simon Crawford advised that following the presentation of the outline business case to Members in November 2011, the final business case was due to be put to both trust boards in March 2012.

Members then discussed the item.  Councillor Daly sought clarification regarding the amount that the 15% back office savings would represent and she also commented that there was real concern amongst GPs about the proposed merger.  She suggested that the relationship between the NHS and the public was deteriorating and that management should pay more heed to the concerns of both residents and front line NHS staff.  Councillor Hunter enquired how the increase in community services would be resourced and commented that the viability of service changes needed to be considered.  Councillor Colwill commented that residents wanted both hospitals in Brent to remain open after the merger and he sought assurances that this would be the case.  He also asked what views the GPs had on the proposed merger.

The Chair sought assurances that there were sufficient funds to provide the transition of service provision to the community and stressed the importance of not compromising on providing a service to those who most needed it. 

Mansukh Raichura (Chair, Brent LINk) was invited to address the committee.  He confirmed that Brent LINk had already submitted a response to the proposals and stated that there was significant opposition to health reforms in general and concern about the impact on patients.  He emphasised the need for a joined-up approach in undertaking these changes.

In reply to the issues raised, Simon Crawford advised that the outline business case submitted included plans by the commissioners to reduce acute services, with a third of its budget being re-invested in an integrated community and acute services.  Members heard that the final business case needed to demonstrate the viability of the merger and that no major service changes were planned on any of the sites.  The commissioners were to put together a plan to specify what services each site would provide and an earlier report had included four possible case scenarios which were to be consulted upon.  Simon Crawford acknowledged that the changes presented a challenge, however a collaborative approach would be taken to provide more healthcare in the community in order to reduce demand on the already strained resources in hospitals.  The strategy would include support provisions for implementing changes which would also be subject to negotiations between relevant partners.  Simon  Crawford acknowledged that there was some opposition within NHS generally to commissioning groups and changes, however the merger between the two trusts had been proposed prior to the health reforms as there was clinical and empirical evidence in support of this move.

David Cheesman (North West London NHS Hospitals Trust) added that Northwick Park Hospital was a particularly busy one, whilst Central Middlesex Hospital was a private finance initiative and liable for rent payments for the next 30 years and so would remain open for at least this period.  He felt that the merger would make both trusts stronger in light of the commissioning changes to come.

Rob Larkman (Chief Executive, NHS Brent and Harrow) confirmed that any service changes would be subject to consultation.  He explained that the overall direction included developing out of hospital services and stated that the scale of the changes both locally and nationally was a challenge for all.

Dr Mark Spencer (Medical Director) stated that the merger would ensure that funds were not lost in respect of the changes from acute to community provision and the trusts would be in a stronger shape together.  He also felt that GPs overall were in favour of the merger, although some understandably had individual concerns regarding their jobs, although it was acknowledged that it would lead to service improvements.

Ethie Kong (GP) added that every effort would be made to ensure that the changes made were in the interest of Brent residents.

The Chair requested that monthly updates to Members on the merger continue and she confirmed that this would remain a standing item on the committee’s agenda.