Agenda item

The Committee considered an update on the Orthopaedic Clinical Network which was being developed with the aim of providing elective orthopaedic services on fewer sites across the South East London Region to support the implementation of the Getting it Right First Time recommendations.

Following an extensive assessment and consultation process, it had become clear that it would not be possible for a consensus to be reached on the best model to adopt within the South East London Region, and it was therefore proposed to move forward with creating an Orthopaedic Clinical Network across the existing three providers.  Terms of Reference had now been formulated for the Orthopaedic Clinical Leadership Group and it had been recommended to the South East London Sustainability and Transformation Partnership that the Network be established and that a Clinical Lead be appointed.  From 2018/19, orthopaedic services would be commissioned against the standards and performance metrics set out in the Getting it Right First Time report, and the Network’s progress in delivering quality and efficiency benefits would be independently assured by the London Clinical Senate.  Commissioners would review the findings of the Clinical Senate on embedding the Getting it Right First Time recommendations over the three sites after 12 to 18 months, at which time a decision would be made on whether quality and efficiency benefits had been met and could be sustained across three sites.

In response to a question from the Chairman, the Programme Director, "Our Healthier South East London" Programme confirmed that patients within the South East London region would not be compelled to use services within the Orthopaedic Clinical Network and could continue to use other orthopaedic services, such as those offered by Dartford and Gravesham NHS Trust.

Members discussed the recent announcement that Guy's and St Thomas' NHS Foundation Trust and Johnson & Johnson Managed Services would be working together to deliver an Orthopaedics Centre of Excellence at Guy’s Hospital.  This would include the construction of three new operating theatres which would increase the total number of operating theatres to eight. The Consultant Orthopaedic Surgeon and Clinical Director of Surgery, Guy's and St Thomas' NHS Foundation Trust advised Members that it had been projected that demand for Orthopaedic services would continue to increase as a result of the ageing population, and that the Centre of Excellence would deliver sufficient additional capacity to meet this increasing demand as well as supporting innovation and research in the area of orthopaedic surgery.  The partnership did not represent a privatisation of the service as Guy’s Hospital already used Johnson & Johnson Managed Services within its existing supply chain, and one of the key aims within the proposed new arrangement was to streamline processes to procure devices, surgical instruments and implants required for orthopaedic surgery to reduce costs.  To support this, work had been undertaken with individual surgeons over the past two years to identify best practice in orthopaedic surgery, supporting surgeons to work more efficiently.  In response to a question regarding the total project value, the Director, Commercial Directorate, Guy's and St Thomas' NHS Foundation Trust confirmed that the total project cost had been projected as being £300M over the planned 15 year partnership, £50M of which was linked to capital build.  The partnership with Johnson & Johnson Managed Services had been subject to a full procurement process and was evaluated on the premise of providing an ‘as is’ or better service to patients.

In discussing the Orthopaedics Centre of Excellence, Members were concerned that they had not been made aware of the plans for an Orthopaedics Centre of Excellence during the process to develop the Orthopaedic Clinical Network, which would necessitate the expansion of the three orthopaedic centres within the South East London region.  The Clinical Chairman, Bromley Clinical Commissioning Group highlighted that orthopaedic services also included community-based services, and that it was important to ensure there was a joined-up approach to the delivery of all orthopaedic services across the South East London region.

RESOLVED that the update be noted.