Agenda item

To receive a presentation from NHS Haringey on additional financial savings required in 2010-11.

The Committee received the briefing on NHS Haringey additional financial savings and the tabled document; the “Savings Pro Forma”.

The Committee asked how the deficit came about. The Interim Chief Executive – NHS Haringey, Ian Wilson, explained that a number of factors were involved including changes to how the NHS was financed, how acute services were utilised in Haringey (there had been a sharp upturn in people visiting emergency services in the last year) and the paying back of loans from previous years.

Clerk’s note: 11:35hrs the Chair, Cllr Bull, left the room.  Cllr Browne (Vice Chair) took over as Chair.

The Committee discussed some of the schemes in the Savings Pro Forma and the following was noted.

Scheme 1: Barnet, Enfield & Haringey Mental Health Trust (BEHMHT) in year contract review

There would be some consultation with a small number of people regarding changes to contracts with the Trust. The Committee asked for copies of the equalities impact assessments (EIA) when they were available.

Scheme 3 – GP Referral Management

GPs would be given comparative information in order to discourage inappropriate referrals and the wasting of resources.  The information was readily available and therefore this was not an expensive exercise.  The Committee requested that GPs be asked to consider the impact on the delay of certain treatments.

Scheme 5a,b & c – Mental Health: User Engagement and Mental Wellbeing, Turkish Kurdish Community and Day Service Escorting for Mental Health Clients

The Committee asked to see the relevant equalities impact assessments.

Clerk’s note: 11:45hrs Cllr Bull returned to the meeting and resumed as Chair.

Scheme 6a, b & c: HAVCO, Age UK, Carers Centre

Ms. Kania reported that Haringey LINk had concerns about the potential impact of the budget reductions on future of the Stroke Club and were seeking reassurance on this issue from NHS Haringey.

The equalities impact assessments concluded that the removal of funding from HAVCO would not destabilise the service.  Councillor Winskill asked for it to be noted that HAVCO had always behaved responsibly.

The Committee asked for access to the equalities impact assessment.

Scheme 7 – Effective use of surgery – reducing the caesarean section rate

The caesarean section rate would be reduced in a safe way by individual hospitals which could refer to institute guidance to support and encourage women to have natural births.

Scheme 8 – Effective use of surgery - IVF

The Committee requested to see the relevant equalities impact assessment.  Members expressed concerns that this was a fundamental treatment for couples who were unable to have children.  The Committee also noted that the changes would mean that the PCT would be working against relevant National Institute for Clinical Excellence (NICE) guidelines.  NHS Officers commented that the savings in this area amounted to more money than could be saved in any other areas of low priority treatments which had been considered.

The Committee was very unhappy with the suggested saving in the area of IVF treatment and NHS Haringey Officers agreed to reconsider scheme 8.

Scheme 9 – Additional “low priority procedures” (LPT)

The LINk Co-opted Member of the Committee expressed that LINk could not support the raising of the threshold for bariatric surgery from a BMI of 32 to 50 as this could potentially put patients at risk.    The Interim Chief Executive of NHS Haringey stated that the proposed change had been subject to clinical input.

It was noted that the list of low priority treatments was on the NHS Haringey website.

Scheme 10 – Further Public Health Savings

A Committee member asked when a decision would be made on how much public health funding NHS Haringey would receive and whether it would be reflected in the local authority’s funding allocation. Jeanelle De Gruchy (Joint Director of Public Health) would be asked to respond when more information about funding was available.

Scheme 17 – Out of Hours

The urgent care provider Harmoni would be working out of two centres, including the Whittington Hospital in Haringey.

Scheme 18 – Urgent / Unscheduled Care – Redirection Centre

This project would include arrangements for referring people to a GP if they were not already registered and would also give North Middlesex Hospital access to GP appointments so that people would not have to be treated by the Accident and Emergency department (A&E). Patients who were re-directed would be checked but not treated.

Scheme 19 – Introduction of eligibility criteria/ thresholds for community services

Officers from NHS Haringey stated that these proposals needed further work.  The changes to eligibility criteria and thresholds would be shared with the Committee and Haringey LINk in due course.

Scheme 20 – Decommissioning of Chestnut (Greentrees) Ward

A Committee member highlighted that the decommissioning of Chestnut Ward would result in an overall cost increase if beds at St Anne’s were utilised instead.

RESOLVED that NHS Haringey’s proposed additional savings and the comments made above be noted.