Agenda item

Dr Yi Mien Koh, Chief Executive, Whittington Health

Representatives:

• Dr Koh
• Dr Greg Battle
• Philip Yent
• Richard Martin

Dr Greg Battle introduced the item with the following points:

• The Estates Strategy is one of a number of plans and falls out of the integrated care strategy
• There is recognition that they did not consult properly with both Members and residents and that there is more work to do.
• The Strategic Health Authority has asked them to pause taking forward their Foundation Trust application by 4-6 months.  They are therefore in ‘listening mode’.
• The SHA has said they like their overall strategy and integrated care vision however:

·        They need to gain more clarity on financial savings;

·        Do better at communicating; and

·        Work harder around staff and community engagement.

The following discussion points were noted

• Listening mode is about listening to comments and concerns and about communicating.
• The Whittington recognises that they have not made the link between the clinical strategy and the estates strategy clear enough to people.
• The Whittington recognises that they have failed to get people on board and to get people to understand the clinical background
• The Estates Strategy could be modified during this pause.
• The Adults and Health Panel have recently visited St Ann’s hospital site and Chase Farm mental health wards.  At their visit to St Ann’s they were able to see the conditions of the buildings and the site overall and therefore gain a better understanding of the redevelopment issues and needs.  This same opportunity has not been presented by the Whittington.
• The Panel noted that a lot of elected Members have been informed of what is happening via the press as opposed to from the Whittington communicating directly with stakeholders, including the Adults and Health Scrutiny Panel.
• The Panel queried whether the Whittington had shared the strategy with Haringey Clinical Commissioning Board (CCG) and shadow Health and Wellbeing Board (sHWB).  They were informed that the CCG had given their general support to the clinical strategy in writing, which had enabled the Whittington to approach the SHA regarding Foundation Trust status.  However, it was not thought that this included the Estates Strategy.
• The Panel queried whether discussions had taken place with Adult Services on possible implications and were informed that this was ongoing.
• The Panel were informed that the Whittington Board is deeply committed to having an A&E on site and that they are fully committed to having a full set of clinical services around the A&E.
• Dr Koh informed that Panel that they hope to keep all clinical services which are there at the moment, however sometimes directives come from above as happened with stroke services.
• The Panel queried the percentage of the current land which was intended for sale and how much of the strategy is finance led.  The Panel were informed that the strategy is a direction of travel and that the Whittington reserves the right not to sell buildings and use them for something else if they wish.  With regards to the percentage, it is about 40% of the site, about 4% of which is used for clinical activity.  The rest is administrative, education and training.
• The Panel noted that the Whittington services are not confined to the Whittington Health hospital site and that there are as number of community services across Haringey in the Whittington’s capacity as an integrated care organisation.
• The Panel were informed that the figures in the Estates Strategy were evolving and that the situation may change depending on markets.
• Noted that as the care pathways change that way that inpatient wards are used will also change and therefore there could be empty wards further down the line as more patients are treated in the community.
• With regards to the ‘cap’ on maternity services the Panel were informed that this word should not have been used in the strategy.  The hospital currently has about 4,000 births a year and the maternity figures suggest that this will continue to be the case. 
• Work is needed on the maternity wards to develop and improve them.
• There is no formal cap and no one would be turned away from the maternity services.
• The Panel raised concerns about older people leaving hospital too early and asked whether the money would be channelled into community services to support people in these settings.  They were informed that the majority of the money would be going into acute services.
• There is a cultural shift needed to ensure that staff feel comfortable in settings outside of hospitals and also recognition that long stays in hospital can make you unwell.
• Whittington Health are hoping to take on 16 new sites for community services shortly.  The Panel requested a map of this.  This would show services ‘as is’ given that there is work and engagement to be done on what is planned longer term.
• Whittington Health is engaging with residents by holding a number of events, which have already started for example an event held at the Whittington a week earlier was attended by about 100 people.
• The Whittington are taking the current situation as an opportunity to engage with people, whilst acknowledging that this should have been done earlier.
• The Panel noted that all plans are signed of by medical directors in order to mitigate risk.  They are checked for safeguardijng and quality issues.  The Panel also noted that changes, for example ambulatory and maternity are all clinician led.
• The Panel also noted that there is a commissioner impact as finances available from commissioners has an impact on services.
• The Panel noted that they are happy that there is a pause in the process and an opportunity to engage with residents and Members.
• Once the Panel has visited the site and had an opportunity for further discussions they may be able to make recommendations.

Agreed

• The Adults and Health Scrutiny Panel will visit the Whittington Hospital site.  MP to speak to Philip Yent to arrange.
• Whittington would provide a map of new buildings and services as is.
• Whittington Health would attend a future Panel meeting to present on the Integrated Care strategy.