Agenda item

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 60.

In accordance with Standing Order 60, the Chair agreed to take two urgent items regarding Sickle Cell care and the Urgent Care Centre at Central Middlesex Hospital and welcomed Pippa Nightingale to provide those updates.

Sickle Cell Care

Pippa Nightingale began by thanking the Committee for the opportunity to attend the meeting to keep members informed of the rapid changes happening within the NHS and within NWL.

In providing an update on Sickle Cell care, Pippa Nightingale advised that one of the largest Sickle Cell populations in NWL was in Brent, so it was important to get their healthcare needs right, which she felt the NHS had not always done in the past. She emphasised the need for the NHS to hold itself to account on that and recognise that it had not designed services that met the needs of the Sickle Cell population. As such, a large piece of work had been undertaken over the last year between LNWT and Imperial College London, who provided the majority of healthcare for Sickle Cell patients in London, to re-design the pathway in partnership with patients and service users. She highlighted that there was a very active Sickle Cell community in NWL who were very open to telling the NHS their health needs, and so the new pathway had been co-designed with that community. The changes included a new Sickle Cell Acute Hub, located at Hammersmith Hospital, which allowed patients direct access to a Haematology Sickle Cell Specialist instead of needing to go through an A&E department. NHSE funding had been received to set up a 24/7 triage service for that hub and the patient could be seen straight away, which was what Sickle Cell patients had been asking for over the years.

The second part of the workstream on improving the Sickle Cell care pathway was to expand the outpatient service at Central Middlesex Hospital. Patients had been clearly expressing the want for that service to be expanded to be open 7 days a week for longer hours, so the hours of that service had been extended and the NHS was now looking to expand the service to be open 7 days a week. In concluding the update, she thanked clinicians across LNWT and Imperial College London for coming together to make the changes happen.

The Chair thanked Pippa Nightingale for the information and asked how the changes would be communicated to patients and service users. Pippa Nightingale advised that there was a very active Sickle Cell Patient Engagement Group who had co-designed the pathway and helped communicate the changes. They had also attended two very large Sickle Cell engagement events at Hammersmith Hospital to communicate the changes which had been well attended. The changes had been communicated through the Haematologist Specialist Teams who had close access to patients and all Sickle Cell patients had been written to about the changes.

The Committee asked whether there was capacity to manage all patients at the same time at the new hub if they were to become ill at the same time. They heard that the majority of Sickle Cell patients should not need crisis care, and it was only those who were very unwell who would go to the acute hub where they might need intensive care or high pain relief. The hub provided complex care, and the majority of Sickle Cell patients managed their health well in partnership with their providers and could be managed in an outpatient setting. There was capacity at the hub for all Sickle Cell patients, and there were still inpatient beds at Northwick Park Hospital which would be maintained as there may be patients admitted for other reasons who also had Sickle Cell.

Urgent Care Centre at Central Middlesex Hospital

Pippa Nightingale then provided an update on changes to the Urgent Care Centre at Central Middlesex Hospital. She reminded members that LNWT ran three Urgent Care Centres, of which Central Middlesex Hospital was one, which performed well with good feedback and saw approx. 130-140 patients per day. The site was not supported by an A&E onsite and was an urgent GP and nurse-led service. Currently, the Urgent Care Centre opened between 8am – 11pm, but saw the majority of patients between 8am – 3pm. LNWT wanted to align the opening times with radiology services, available until 8pm, as the majority of patients attending the Urgent Care Centre at Central Middlesex needed an x-ray and this would stop patients needing to return the following day for an x-ray if they were attending past 8pm. LNWT proposed to bring the closing time forward to 9pm to align that with radiology and put resources in at peak times. There had been work done with the local population and two further online engagement events would take place soon to discuss how to disseminate communications regarding the change.

In considering the update, the Committee asked when the changes would take place. Pippa Nightingale advised that LNWT had two more engagement sessions to hold over the next two weeks before the changes were made, and it was envisioned that the new opening hours would be put in place at the end of October.

The Committee asked whether there would be an increase in staff due to the reduced opening hours. Pippa Nightingale confirmed that staff resource and clinician time would be reinvested on the busiest parts of the pathway to be used across all sites. Northwick Park Hospital had a much bigger Urgent Care Centre and LNWT wanted to be able to improve performance on that site as well.

The Committee asked whether there would be changes to any other Urgent Care Centres, and heard that other Urgent Care Centres would remain the same. Pippa Nightingale added that Northwick Park Hospital was the biggest site seeing approximately 500-600 patients per day just through the Urgent Care Centre, and patients typically attended Urgent Care Centres where there was an A&E on site, meaning sicker patients were seen through those other urgent pathways. The majority of cases at Central Middlesex Urgent Care Centre were minor injuries.

As no further issues were raised, the Chair thanked Pippa Nightingale for attending the meeting to provide an update to the Committee and closed the item.

Retirement of Director

The Committee heard that this would be Dr Melanie Smith’s final meeting, who would be retiring from her role as the Director of Public Health, Parks and Leisure. The paid tribute and thanked her for all the work she had done for Brent residents.