Agenda item

To receive an update on elective services recovery in North Central London.

Ali Malik, Lead for Elective Recovery, introduced the report which provided an update on elective services recovery in North Central London. It was explained that, at various points over the past two years, elective services resources had been redeployed to respond to the Covid-19 pandemic. It was also noted that infection prevention control measures had also reduced the efficiency of services by about 15%. As a result, it was explained that the elective services waiting list had grown. However, this had provided some opportunities to transform delivery and work differently.

It was noted that the team had rapidly developed a governance structure and programme around elective recovery after the start of the pandemic and had been the first Integrated Care System (ICS) in London to be given permission to re-start

elective services. A new elective centre had been opened in the Grafton Way building which was part of University College London Hospital (UCLH). It was added that seven clinical networks had been developed which covered the high volume elective specialties and, through joint working, had resulted in improvements to pathways.

It was highlighted that North Central London (NCL) had been identified as an accelerator site. It was noted that accelerator site status came with some additional funding for this year only. It was added that there were 13 accelerator sites in the country and only one in London. It was noted that 15 projects had been funded in North Central London through this programme and some progress had been made. For example, this had allowed investment in a community gynaecology service which provided a service that was more aligned with the community and which reduced pressure on acute hospital background. It was also noted that there had been investment in a data system, one system patient tracking list, which meant that all providers had access to the waiting lists and could look to redistribute patients accordingly to even out waiting times.

In response to questions, the following responses were provided:

·         It was clarified that the shared waiting lists were only for NHS use and that there were strict criteria on what information was visible.

·         In response to a question about the resilience of the elective services recovery programme, it was noted that there had been significant learning throughout the pandemic and that there were now processes and measures in place which meant that the impact of any new variants or changes should not be as significant. It was added that the programme was resilient and that there were parts of the system, such as Chase Farm, which provided ringfenced capacity for elective services.

·         It was explained that community diagnostic centres were designed to provide an initial diagnostic test and potentially reduce the amount of touchpoints, or interactions, that patients had with hospital services. It was noted that this would be more efficient and better for patients who would have fewer outpatient appointments. It was added that a comprehensive communications plan would accompany this proposal.

·         In relation to the accelerator pilot, it was noted that the £20 million funding was new funding that would only be available for this year. The funding would allow NCL to pilot new ideas, consolidate and share any learning from the pilots, and consider whether to take any of them forward. It was explained that the projects were being run by the NHS and overseen by the Clinical Commissioning Group.

·         It was explained that the health and social care capacity pilot aimed to consider how the health and social care system could support the elective recovery backlog and the pressure on hospitals generally. It was noted that the additional funding could support teams and processes which allowed patients to receive treatment in non-hospital settings where this was medically appropriate.

·         It was noted that there had been a recent reduction in performance relating to colorectal surgery. It was reported that the service had seen an increase in cancer referrals over recent months which had higher priority than normal elective pathways. It was explained that some capacity in this area had therefore been temporarily repurposed to respond to the demand for cancer services. It was anticipated that performance would improve once there was some stabilisation.

·         It was explained that staffing was a key challenge and that innovative ways of working were being explored. It was noted that, where staff were willing and able, services were provided during evenings and weekends as overtime provision.

The Chair noted that there were particular stresses around workforce and suggested that it would be useful for the Committee to consider this. It was commented that this could focus on the pilots, possibly the health and social care pilot where there was some council involvement. The Chair added that the Committee would request an update on the outcomes of the elective services recovery programme and whether waiting times had been reduced as a result.

RESOLVED

1.    To note the update.

2.    To request a future update on the outcomes of the elective services recovery programme, including consideration of workforce issues.