Agenda item
Implementing Healthcare for London - Strategic Commissioning Plan and Primary Care Strategy Update
NHS Brent has provided the Health Select Committee with an overview of progress in implementing Healthcare for London, which forms a major part of its strategic planning of health services in the borough. The report covers progress in refreshing the organisations Commissioning Strategy Plan, developed in 2008/09, as it needs to be amended to reflect the changing economic situation in the country. It also has to align with wider health priorities in North West London and to reflect the Healthcare for London's care pathways.
The Committee will be given an overview on the work to develop primary care services in the borough, following on from previous items on the Primary Care Strategy. Members will also have an opportunity to consider the developments at the Stag Lane Clinic, which NHS Brent is to close in the near future. The Committee will be able to discuss this in the wider context of the primary care commissioning plans for Brent.
Minutes:
Mark Easton introduced the presentation pack which provided the committee with an overview of the progress made in implementing ‘Healthcare for London’. Mark Easton reminded the committee that in 2008/09 NHS Brent developed its Commissioning Strategy Plan which set out a 5 year investment programme. He noted that it was held by Healthcare for London as being one of the best strategies in London. However, he explained that due to changing circumstances, NHS Brent were having to review the plan to ensure that it was aligned with others across North West London and so that it could still support progress towards delivering the goals and outcomes in the changing economic environment. He stated that because last years plan was so good, NHS Brent was committed to retaining the same goals.
Mark Easton explained that NHS Brent was redefining the Commissioning Strategy Plan to align with the 8 ‘Healthcare for London’ Pathways. The presentation pack, he explained, highlighted the case for change, the progress made to date and the plans for the next stage for each of the pathways. He stressed the importance of the polysystem vision and model as underpinned by the Primary and Community Services Strategy. He explained that the presentation pack showed the emerging polysystem sites and explained future plans. He stated that the overarching Polysystem Implementation Model together with the plan for consultation and implementation would be included in the revised Commissioning Strategy Plan. He stated that the signed-off Commissioning Strategy Plan had to be submitted on the 18th December and that in the meantime a series of engagement activities would be taking place.
Following a request by the committee, Mark Easton took the committee through the financial context in which the commissioning plans would be delivered, as shown from slide 40 onwards in the presentation pack. He brought to the committee’s attention the three possible financial scenarios that were being looked at, which were the ‘base case’, the ‘upside’ and the ‘downside’ scenario. He stated that all three scenarios had been built on a ‘do nothing’ basis from 2010/11, which he explained meant no further investment or savings programme. He commented that all three scenarios indicated that if a do nothing approach was used, there would be a budget deficit. He then set out the level of savings or disinvestment which was required to achieve a sustainable financial position under all three scenarios.
Mark Easton informed the committee of some of the ‘Healthcare for London’ initiatives which could be undertaken to achieve the savings required. He then explained how the slides in the presentation pack showed how the Healthcare for London model had been applied to Brent specifically and the savings that could be made by each initiative. He concluded by explaining that if the Healthcare for London savings were achieved, in all scenarios except the downside scenario, the budget would move back into balance. He stated that additional savings would be needed in the case of the downside scenario in order to reach a sustainable position. Mark Easton stressed that the figures could be used as a basis for conversation with the clinical community about how NHS Brent could provide just as good, if not better, services by using resources more effectively.
In the discussion which followed, it was asked by the committee as to when a suitable time for the committee to look at the Commissioning Strategy Plan would be. In response, Mark Easton suggested that the committee looked at the Commissioning Strategy Plan at the 9th of December meeting before it was submitted on the 18th December. Following an enquiry over the progress of the polysystem plans and whether residents were noticing a big difference, Mark Easton explained patients would not have noticed a big difference at the moment. He added that there was now an opportunity for patients to get involved with designing their practices. He stated that there was a need to move away from incremental change to transformational. In response to a concern regarding the fact that it seemed that the East of the borough had a lack of access to a proposed polyclinic site, Mark Easton commented that the big challenge was being able to afford new buildings. He explained that the way forward was to encourage GPs from smaller practices to come together and share costs.
The committee requested an update from NHS Brent regarding the plans to close the Stag Lane Clinic in Kingsbury following the discovery of a crack in the building. Mark Easton noted that a series of discussions had taken place with the practice about moving the practice to a temporary building. At the same time he explained that NHS Brent was working with GPs to formulate a long term plan for Kingsbury. The hope, he added, was for practices in the area to come together thus reducing the number of small practices. In response to a question as to what would happen to the Stag Lane site, Mark Easton explained that one option would be to sell the site. This, he stated, could contribute to a new building but it would only cover a small fraction of the cost required. It was also asked whether temporary portable cabins would be used. Mark Easton explained that this would be one of the options but that there would be planning consent issues to consider. He reiterated that any solution at the moment would be temporary. Dr Helen Clark (Chair of Brent Local Medical Committee) commented that practices were keen to work together but that the problem was getting the funding to do so. She stated that she was concerned as to what will happen to Stag Lane if the practices did not come together. In response, Mark Easton explained that the options needed to be examined carefully and that it was too premature, at this stage, to speculate as to what would happen.
RESOLVED:-
i) that the update from NHS Brent on the review of the Commissioning Strategy Plan and Primary Care Strategy be noted;
ii) that the update on position with Stag Lane Clinic and primary care services in Kingsbury be noted.
Supporting documents:
- Implementing Healthcare for London Covering Report, item 10. PDF 85 KB
- Implementing Healthcare for London - WCC and Primary Care Strategy, item 10. PDF 609 KB