Minutes:
The Joint Committee received a presentation from Hazel Fisher (Programme Director, Cardiac and Paediatrics, Specialised Commissioning, NHS England, London Region) and Claire McDonald (Engagement and Communications Lead, Specialised Commissioning, NHS England London Region) on reconfiguration proposals for Congenital Heart Disease (CHD) in London.
CHD standards were consulted upon and agreed by NHS England in 2015; one of the three centres in London, Royal Brompton Hospital, Chelsea, was no longer compliant with the new standards. There were two proposals to address this, from Royal Brompton Hospital and Kings Health Partners and from Chelsea and Westminster and Imperial College Healthcare. However, commissioners needed to consider a wider range of options to meet the new national standards.
Currently, south east London residents accounted for 2.2% of patients at the Royal Brompton Hospital (both inpatients and outpatients) with most patients attending Guys and St Thomas’. Movement of services to meet national standards would add very little to travel times, and one of the proposals would see services moving to St Thomas’ Hospital in Lambeth. The key stages of the reconfiguration process were set out in the presentation, as well as proposals for consultation, which would include overview and scrutiny committees.
The Chairman commented that it was important to emphasise that the Royal Brompton Hospital would continue to provide services.
Cllr Muldoon asked for further detail about patient numbers, whether great Ormond Street Hospital (GOSH) was a feeder site for young patients at RBH, and whether quality of life for patients was a major consideration. The Committee was informed that approximately half of patients were from outside London – further detailed figures could be provided. GOSH was linked to University College Hospital and did not feed patients through to RBH. There were over 200 standards relating to CHD; many were surgical, but they also reflected broader quality of life issues for patients and their families and were informed by patient representatives.
Cllr Downing asked whether finance was part of the considerations, and when consultation would be carried out (given that this would throw up a range of issues.) Finances were indeed part of the consideration for this programme, and a three to four month formal consultation was proposed. Paediatric co-location was intended by 2022; if this could not be achieved, then there would probably be a decommissioning of services and a re-commissioning along the lines originally proposed in 2017.
Cllr Noakes asked whether it would be possible to continue with just two compliant services in London and whether there was any capital funding associated with the Kings Health Partners bid. In response, it was explained that any move had to be planned to ensure continuity of services and consolidating the expertise of the existing teams. Care would have to be commissioned – it could not just grow organically. At present, this was widely seen as a positive move to improve services. Capital funding would be part of the considerations, and the assumption was that there would be money from the sale of the Royal Brompton site (although the Trust would continue to operate from its other sites.)
The Chairman thanked Hazel Fisher and Claire McDonald for their presentation, and looked forward to further consultation on the proposals.