Agenda and draft minutes

Venue: Ground Floor Meeting Room G02B - 160 Tooley Street, London SE1 2QH

Contact: Graham Walton  020 8461 7743

Items
No. Item

1.

APOLOGIES

Minutes:

There were apologies from Councillors Ross Downing, Cherry Parker, Clare Morris, John Muldoon and Jacqui Dyer, who sent a representative, Councillor Ed Davie.

2.

NOTIFICATION OF ANY ITEMS OF BUSINESS WHICH THE CHAIR DEEMS URGENT

In special circumstances, an item of business may be added to an agenda within five working days of the meeting.

Minutes:

There were none.

3.

DISCLOSURE OF INTERESTS AND DISPENSATIONS

Members to declare any interests and dispensations in respect of any item of business to be considered at the meeting.

Minutes:

Councillor Judi Ellis declared that she was a Governor and her daughter was an employee of Oxleas NHS Foundation Trust.

 

Councillor Robert Hill declared that his wife was the Assistant General Secretary of UNISON.

 

Councillor James Hunt declared that his wife was an employee of Dartford and Gravesham NHS Trust.

 

Councillor Bill Williams declared that he was a Governor of Guy’s and St Thomas’ NHS Foundation Trust.

4.

MINUTES pdf icon PDF 160 KB

To approve as a correct record the Minutes of the open section of the meeting held on 13th December 2017.

Additional documents:

Minutes:

The Minutes of the meeting held on 13th December 2017 were agreed as a correct record.

5.

DISCUSSION OF ANY OTHER OPEN ITEMS AS NOTIFIED AT THE START OF THE MEETING

Minutes:

There were none.

6.

KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST - FINANCE BRIEFING pdf icon PDF 2 MB

Please find enclosed a presentation.

Minutes:

The chair asked NHS colleagues to introduce themselves:

 

·  Alan Goldsman – Chief Financial Officer, Kings College Hospital NHS Foundation Trust

·  Andrew Bland – STP Lead, Chief Officer for Southwark CCG & AO for Southwark, Greenwich and Bexley CCG

·  Angela Bhan – Chief Officer, Bromley CCG & STP SRO for Urgent & Emergency The chair invited NHS colleagues to run through the presentation circulated with the agenda papers. The committee was then invited to ask questions.

 

A member asked what figure the Trust is being fined for not meeting targets. The chief financial officer said it was about 4 million. A member said that they thought this was perverse, particularly when there are matters outside of the control of King’s: e.g. winter pressures and delayed discharge. He asked if there was more that local authorities could do to alleviate the pressures though social care and public health, while noting that councils obviously have their own pressures. He said that in particular he understands that in the region of 20% older people are not being discharged promptly, therefore perhaps collaborative work to improve this would be helpful.

 

CCG officer said that the fines are usually imposed in the context of a commissioner reinvestment; the CCGs do try and mitigate the impact, but they cannot speak for national NHS commissioner plans and policy. They did agree that variations and failures frequently reflect system failures. In terms of improvement discharge is important; however delayed transfers are in the region of 10 per day - not 20 %. The CCGs have a number of admission avoidance schemes to keep people well in the community, and CCGs also have work streams focused on complex patients. The member clarified that he was referring to 20% of older people facing delayed discharge. The CCG officer agreed that older people do have a range of complex needs that often need to be met and this can increase delays.

 

A member asked how the non – executive voice is engaged. The Trust has an Audit Committee. Is there any consultancy? The NHS do have PWC involved supporting the Trust with financial planning.

 

A member asked if there was enough due diligence with Princess Royal University Hospital (PRUH), given King’s is a big business. She asked if the Trust have people of the right calibre. Kings said that they are presently conducting a wide consultation on the plan to improve the Trust’s financial position, in order to encourage clinical and managerial engagement and accountability. The Chief Financial Officer said that it is important to be transparent, and discuss issues openly. They intend to continue to secure the present high level of clinical and management engagement. He said there is short term financial input and the Trust is working to strengthen the financial function going forward, this will focus on developing the Trusts own capability by training people and also through a new appointment.

 

A member asked about capital capacity in the PRUH. She said that she understands that there are shortfalls in resuscitation, which  ...  view the full minutes text for item 6.

7.

KENT AND MEDWAY STROKE SERVICE CONSULTATION pdf icon PDF 116 KB

A cover report and summary of the consultation are enclosed.

Additional documents:

Minutes:

The following NHS colleagues presented this item:

 

·  Alan Goldsman – Chief Financial Officer, Kings College Hospital NHS Foundation Trust

·  Andrew Bland – STP Lead, Chief Officer for Southwark CCG & AO for Southwark, Greenwich and Bexley CCG

·  Angela Bhan – Chief Officer, Bromley CCG & STP SRO for Urgent & Emergency

 

Background was provided to the consultation. Stroke services in London had been reorganised nearly 10 years ago in order to create a network of 8 Hyper Acute Stroke Units (HASUs) where patients suspected of having a stroke are now taken. The units have the ability to provide patients with specialist care 24 hours a day. This model has proved successful.

 

Kent are now looking to reorganise into HASUs also in order to improve outcomes. The models compiled by Kent and Medway would leave 3 HASUs across the county with various different combinations. Depending on the options chosen there may be potential impacts on stroke services in SE London.

 

·  It was noted that should Darent Valley Hospital (DVH) not be designated a HASU then more patients may access services in SE London, with the potential for additional pressures at the PRUH. However, Angela Bhan stated that it would be a manageable number.

 

·  It was likewise reported that if DVH is designated a HASU then there may be a slight reduction in the number of patients at the PRUH. It was acknowledged however, that South East London STP would support the improvement of stroke services in Kent. It was noted that Bexley CCG is a consultor and the other 5 boroughs of the SEL STP are consultees.

 

·  A member commented that her principle concern is the volume and numbers of patients and if there has been sufficient modelling to accurately assess the impact on services. The CCG ED lead responded that they are doing the modelling and consultation in tandem. King’s commented that they are looking at the impact; including follow on therapies.

 

·  The committee asked if there will be consultants 24/7 at all three units. The CCG leads confirmed there will be; in order to do this there will need to be a concentration of resources at those sites.

 

·  A member commented while it may make sense to spend 20 minutes longer travelling if there are better clinical services at the end, as has proved the case in recent changes to London HASU provision, however this present proposal covers a larger geographical spread in Kent and is looking like a much longer time traveling time; perhaps as long as 120 minutes. This needs to be accurately quantified in the modelling.

 

(From previous item)

 

·  Kings reported that they will be making a response to the Kent and Medway Stroke Services consultation as some options may have implications for the PRUH including additional patients. It was reported that the data provided is from NHS England and relates to episodes of care not numbers of patients; it was confirmed that the data in the consultation papers are accurate as they can be.

 

·  Members expressed concern regarding  ...  view the full minutes text for item 7.

8.

WORK-PLAN

Minutes:

The Committee will meet following the local elections and set a workplan.

9.

PART B - CLOSED BUSINESS

10.

DISCUSSION OF ANY CLOSED ITEMS AS NOTIFIED AT THE START OF THE MEETING AND ACCEPTED BY THE CHAIR AS URGENT

11.

EXCLUSION OF PRESS AND PUBLIC

The following motion should be moved, seconded and approved if the committee wishes to exclude the press and public to deal with reports revealing exempt information:

 

“That the public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information as defined in paragraphs 1-7, Access to information Procedure rules of the Constitution.”

 

Original Text: