This item has been included on the agenda at the request of the Chair.
On 17 June 2015 the Clinical Commissioning Groups’ Committees in Common (CiC) announced their decision to move to a model of four ‘single services’ or networks of linked hospitals working in partnership “as the best way to deliver hospital services in Greater Manchester to improve standards of care and save more lives”. The CiC did so following a review of a range of evidence such as; the feedback from the public consultation held last year; data relating to travel and access; quality and safety; how easy it will be to achieve the change, and affordability and value for money.
CiC will meet on Wednesday, 15 July to decide the location of the single services and which hospitals will work in partnership.
Minutes:
This item had been placed on the agenda at the request of the Chair.
The Scrutiny Committee were reminded of the recent decision of the Greater Manchester Clinical Commissioning Groups’ ‘Committees in Common’ (CiC) on 17 June 2015 in relation to Healthier Together. The CiC had agreed the option for four ‘single services’ or networks of linked hospitals working in partnership. The decision followed a review of a range of evidence, including feedback from the public consultation held last year; data relating to travel and access; quality and safety; ease of achieving the change, and affordability and value for money. A further decision was due on 15 July 2015 on the location of the single services and which hospitals would work in partnership.
Dr Ranjit Gill (Chief Clinical Officer), Stockport Clinical Commissioning Group and member of the CiC attended the meeting to answer questions from the Scrutiny Committee.
Dr Gill explained that there would be a series of workshops and other activities to determine the best choice for the 4th hospital site to be designated as having specialist status. He stressed that the CiC’s decision would be based on the best interests of Greater Manchester, not just the narrow local interests of each hospital or local authority area. This would also need to consider the impact of the Devolution agenda and the work around integrating health and social care.
The Executive Councillor (Independence & Wellbeing) welcomed the development of the Single Service model and the greater emphasis given to the two other strands of Healthier Together (Primary Care and Joined-Up Care) than had been the case in the press coverage of the programme and the consultation. This would link well with the ongoing Stockport Together Programme.
Councillors asked a number of questions in relation to the decision of 17 June 2015. The issues raised included:-
· Members queried the role of the public consultation in the decision to designate four rather than five hospital sites, particularly given the public preference for five. In response it was stated that the consultation asked a number of questions about hospital services and these responses overall had shown a recognition of the need for, and preference for, a smaller number of hospitals (than currently provide) providing specialist care even if this required travelling further.
· It was commented that feedback from surgical professionals had a significant impact on the decision as this indicated that a key determinant of outcome of surgery was the delay between the onset of symptoms and surgery taking place – this was not primarily a function of travelling time but related to concentration of skills in a particular hospital.
· The decision on four sites also reflected the deliverability of change, particularly in relation to recruitment of staffing. It was queried whether or not this information was made explicit in the public consultation and whether it was appropriate to ever seek views on five sites if this was undeliverable. In response it was stated that the aim of the consultation was to seek views on the range of issues and this was part of a broader picture.
· Part of the rationale for the creation of the ‘Single Service’ model was to overcome competition between NHS Trusts that was contributing to difficulties in recruiting specialist staff and to encourage greater collaboration between Trusts and hospitals. Concentrating expertise in a smaller number of centres would make Greater Manchester hospitals more attractive to potential staff and would help develop new techniques.
· It was stressed that of decision on hospital sites related to a limited number of surgical and acute services. The aim was to ensure that 50-60 patients with particular need were able to see a consultant surgeon sooner for emergency/ acute treatment at a specialist centre, thereby improving their outcomes. Longer term care would be provided at the patient’s local hospital.
RESOLVED – (1) That the Healthier Together update be noted and that Dr Ranjit Gill be thanked for his attendance and contribution.
(2) That the Democratic Services Manager be requested to include an item on the agenda for the September meeting in relation to the implications of the Healthier Together decision due to be made on 15 July 2015 and that representatives of appropriate organisations be invited to attend.