Agenda and minutes

Apologies for absence were received from Councillor Gareth Allatt, Councillor Ian Dunn and Tim Spilsbury, and Councillor Keith Onslow, Councillor Angela Wilkins and Stephanie Wood attended as their respective substitutes. 

Apologies for absence were also received from Councillor David Jefferys and Justine Godbeer.

There were no declarations of interest.

Peter Herring, Chief Executive, Dr Shelley Dolan, Chief Operating Officer, Chief Nurse and Executive Director: Midwifery, Matthew Trainer, Managing Director: Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust and Dr Angela Bhan, Managing Director: Bromley Clinical Commissioning Group gave a verbal update on the management structure of the Princess Royal University Hospital and other Bromley sites.

The Chief Operating Officer, Chief Nurse and Executive Director: Midwifery confirmed that the current Managing Director: Princess Royal University Hospital would be leaving King’s College Hospital NHS Foundation Trust in September 2018.  Laura Badley, Deputy Director: Operations, Networked Care at King’s College Hospital NHS Foundation Trust had recently been appointed Interim Managing Director: Princess Royal University Hospital for a period of six months and was working alongside the departing Managing Director to ensure a smooth management transition.  Work was underway to recruit a permanent Managing Director: Princess Royal University Hospital and several high quality candidates had expressed interest in the opportunity. 

The Chairman led Members in thanking Peter Herring, Dr Shelley Dolan, Matthew Trainer and Dr Angela Bhan for their verbal update and congratulated Matthew Trainer on his appointment as Chief Executive: Oxleas NHS Foundation Trust.

RESOLVED that the verbal update be noted.

The Committee considered a presentation by Peter Herring, Chief Executive, Dr Shelley Dolan, Chief Operating Officer, Chief Nurse and Executive Director: Midwifery, Matthew Trainer, Managing Director: Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Dr Angela Bhan, Managing Director: Bromley Clinical Commissioning Group and Jodie Adkin, Associate Director: Discharge Commissioning, Urgent Care and Transfer of Care Bureau, Bromley Clinical Commissioning Group and London Borough of Bromley on proposals by King’s College Hospital NHS Foundation Trust to close the Elizabeth Ward at Orpington Hospital which provided frailty beds for older patients as part of a ‘Step Down’ facility.

The Elizabeth and Churchill Wards at Orpington Hospital opened in January 2017, making 38 inpatient beds available to older patients as part of a wider frailty model that aimed to bridge the gap between hospital and home care.  Opening three months earlier than planned to help meet Winter pressures, the inpatient facility had faced a number of challenges during the first 18 months of operation including difficulties with the recruitment of permanent staff and the admission of patients with higher complexity of need than expected, and had been identified as not offering good value for money, primarily due to the high number of temporary staff.  In July 2018, King’s College Hospital NHS Foundation Trust notified the Local Authority that it proposed to close Elizabeth Ward as part of wider plans to refocus Bromley’s integrated care model towards providing more home-based care.  It was planned to deliver a number of initiatives within the new model including a Bromley Community-Based Admissions Avoidance (Virtual Ward) scheme and a Frailty Ambulatory model, and the Integrated Care Network Pro-Active Care Pathway would also be updated.  The new model would be supported by robust evaluation and monitoring processes as well as the establishment of a joint integrated oversight structure that would oversee delivery of the proposed initiatives.

The Managing Director: Princess Royal University Hospital emphasised that there were no plans to close Churchill Ward, which would continue to provide 19 inpatient beds as part of the frailty model. 

The Chief Operating Officer, Chief Nurse and Executive Director: Midwifery advised Members that having reviewed best practice from national bodies including the Acute Frailty Network, it was planned to move towards a care model which supported frail older people to maintain their health within their own homes or existing nursing or care home placements, which was expected to reduce ‘decompensation’ caused by inpatient care, where the health of individuals deteriorated away from their daily routine.  The Managing Director: Bromley Clinical Commissioning Group reported that this would be supported by further development of Bromley’s integrated care model, and that the Elizabeth Ward would be repurposed as an outpatient facility offering equivalent care to the previous inpatient provision in a cost effective way.  The Associate Director: Discharge Commissioning, Urgent Care and Transfer of Care Bureau, Bromley Clinical Commissioning Group and London Borough of Bromley noted that the “Bromley at Home Service” initiative would offer intensive support to frail older people with  ...  view the full minutes text for item 16.

The Chairman to move that the Press and public be excluded during consideration of the items of business listed below as it is likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

RESOLVED that the Press and public be excluded during consideration of the items of business listed below as it was likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

Information has now been moved into Part 1 of this agenda

Discussions on this item took place in the Part 1 (Public) part of the meeting.