Agenda item

Dr Bhan provided the Elective Care update. She informed the Board that inpatient orthopaedic centres still existed on 7 sites, and that the associated rehabilitation services were working well. An Evaluation Panel had been set up to evaluate site options for the development of the new orthopaedic centres against the criteria developed by clinical and patient groups and signed off by the CCG Committee in Common (CiC). The task of the Evaluation Panel was to assess the suitability of potential sites against financial and non-financial criteria. It was hoped that the determination of the site would be by non-financial criteria if possible. It was intended that one site be located in inner London, and one in outer London.

The scores for each option against non-financial criteria were listed in the report:

·  Guy’s and Lewisham  1.15

·  Guy’s and Orpington   2.15

·  Orpington and Lewisham  1.08

So based on non-financial criteria, the 2 favoured sites would be Guy’s and Orpington. The CiC would meet again on 8^th November, and it was anticipated that the Evaluation Panel would have completed its work by then, and this would have included a financial evaluation of the proposals.

It was noted that for the orthopaedic centre proposal to go forward it would have to demonstrate the following criteria:

·  that the proposal did not destabilise any hospital

·  that trauma services could be maintained at A&E departments

·  that the proposal was affordable and made a positive financial contribution

Cllr Ruth Bennett expressed the view that some of the objections from the public had been made on the basis of dis-information, and that this would need to be countered. Dr Bhan mentioned that some consultation had already been undertaken, but a full consultation was planned. It was anticipated that the implementation of the orthopaedic elective care centres would act as a prototype for similar centres of excellence in other disciplines. 

Mr Trainer stated that it was not the case that the NHS were looking to strip resources, but that the aim was to facilitate an efficient consolidation of resources. It was important that people understood this as demand was outstripping funding. Cllr Dunn referred to the conditions outlined in the report for an orthopaedic centre proposal to go forward. He asked how it could be demonstrated that ‘trauma services can be maintained at our A&E departments’. Dr Bhan responded that outpatients and day surgery still had to function as normal. Duty rotas would be maintained to ensure that trauma centres had the correct level of medical input.

Councillor Diane Smith asked how the financial arrangements would be handled when people had treatment in the Elective Care Centre from outside the borough. Dr Bhan assured that the correct lines of communication would be put in place between social services departments. It was the case that a model was already working in south west London. Mr Stephen John commented that under the Social Care Act, there was a statutory obligation for the responsible social services department to pick up costs. Dr Panajape explained that pre and post-operative arrangements, along with rehabilitation would remain unchanged.