Agenda item

NHS LONG TERM PLAN (LTP) - SEL RESPONSE

Minutes:

Julie Lowe presented an update on the South East London ICS response to the NHS Long Term Plan (LTP). The draft reply needed to be submitted to NHS London on Friday (27th September 2019) and there would be further work, including aligning with the London Vision which would be launched at City Hall the next week, until 15th November. There had already been public engagement, and additional engagement with the voluntary sector would be carried out. Discussions had taken place with Directors of Public Health and Directors of Adult Services, and local authority Chief Executives were being briefed.  The update included reports from Kaleidoscope, who had arranged the public engagement, and Healthwatch. 

 

Members sought clarification from Ms Lowe about the engagement programme. She was clear that there was no claim to have engaged with a statistically representative sample of the population. Healthwatch had carried out a survey with over a thousand responses and a small number of focus groups with hard to reach groups. Some work had then been carried out with Kaleidoscope, who arranged six borough-focused events (two of which had already taken place at the time of the Joint Committee’s last meeting), six topic-focussed events, a number of meetings with community groups (which had about two hundred attendees) and a survey. Members had expected following their meeting in July to be advised of the remaining dates, but did not recall receiving any information. The Chairman requested that their comments be included in the final report to NHS England.

 

In response to questions, Julie Lowe explained that there were legal requirements to carry out formal consultation in certain circumstances, where there were changes to services, and certain organisations and individuals had to be given the opportunity to comment. The Long Term Plan process did not involve specific changes and formal consultation was not required, so a range of engagement activity had been arranged. This was a submission to NHS England on 15th November, rather than a public-facing reconfiguration of services in South East London, and did not require submission of a letter giving JHOSC comments. She accepted that a summary table of all the engagement events would have been helpful. Healthwatch had been commissioned by NHS England to provide engagement nationally; in South East London this was not considered to be sufficient, so Kaleidoscope had been engaged, but she accepted that the engagement was not as thorough as some Members may have wanted. In addition, she confirmed that they were offering to come to Health and Wellbeing Boards before November - a meeting with health and Wellbeing Board chairmen had been held on 2nd September, but she would write out to them again. 

 

Councillor Diment suggested that the aims of the document were broadly supported, but requested some further comment on the system financial challenge in South East London, particularly at Kings, and the effect on residents and the services they required. Julie Lowe reminded Members that this was a five year plan, but there were not yet plans in place to achieve financial balance. However, the problem was not just about Kings, and it had been identified back in 2016 that the demand for healthcare delivered via existing services was not sustainable. Instead of the internal market, tariff-based system it was necessary to bring South East London’s funding together to establish how it could be used most effectively.  NHS England had set out five tests, one of which was for individual providers to return to financial balance. Kings did not have a deficit recovery plan, but this would need to be put in place. The NHS needed to be more productive, reduce the growth in demand, reduce unjustified variation in performance and make better use of capital investment. Shutting hospitals or services was not the answer, but the way that services were provided would need to change. For example, very expensive out of area placements needed to be reduced. Further work was needed to establish whether budgets could be brought into balance within five years. Councillor Diment commented that it would be useful to see figures relating to this once they were worked out, and to be reassured that money would not be drawn away from services to solve the financial problems at Kings.

 

Councillor Liz Johnston-Franklin commented that it was very disappointing given the diversity of South East London that BAME people were not well represented in the engagement programme, and she requested that this be highlighted in the report. The Chairman added that there also appeared to be an under-representation of young people. Julie Lowe responded that this point had been acknowledged, and comments on the methodology would be fed back to NHS England. There would be an Equalities Impact Assessment of the final document. In response to a question from Councillor James Hunt, it was confirmed that the decision to hold an engagement process, rather than a full consultation, was taken by Simon Stevens and NHS England.

 

The Chairman commented that there was much in the document that would enhance services, but usually with an additional price-tag and no indication of how savings could be achieved. The proposed improvements were worthy but bland.

 

Agreed that the Committee is disappointed at the limited extent of the engagement exercise and the resulting lack of diversity of opinion. 

 

 

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