Agenda item

To consider proposals from Whittington Health for changes to estates and services within Haringey and, in particular, a proposed engagement plan for the adult and children’s services moves arising from these.

The Committee received a presentation from Whittington Health regarding proposals that they had developed for improvements to services within Haringey.  They had a locality vision and had worked with partners to develop this.  This was based around early intervention and a simple, joined up system of care with a shared approach to person centred care.  The vision involved the creation of three localities within the borough.  These would be co-ordinated with Council services, primary care and the voluntary and community sector and would have the same geographical footprint as Primary Care Networks and Council localities.   Services would be located in a specific centre within each area and kept local.   Some preliminary engagement had been undertaken and Healthwatch Haringey had indicated that its enthusiasm for the proposed changes. 

The vision was a longer term view of how services would develop.  In respect of the location of central hub, the options being considered included Wood Green mall.  Work was currently taking place with the landlord in respect of this.  Services would continue to be provided locally.   Any future changes would be subject to engagement and involvement with the community at the appropriate time.   An opportunity had arisen in the short term to re-locate some specialist children’s services to Tynemouth Road Health Centre from St. Ann’s Hospital.  A decision was required by the end of March on whether to proceed with the move in order to avoid duplication of planning and building costs. The current proposals involved re-locating the Children’s staff team bases and clinic space from the St Ann’s Hospital site and Bounds Green Health Centre to Tynemouth Road Health Centre. The move from St Ann’s would affect between 180-200 children per week. 

It was felt that Tynemouth Road Health Centre was particularly well suited to act as a hub for children’s services.  The area had a number of key characteristics:

·         Significant deprivation;

·         The local population was expected to increase with significant development and regeneration planned;

·         It had the highest proportion of people between 0-19 years in Haringey;

·         It had the lowest life expectancy of any area in Haringey; and

·         It had the most ethnically diverse population in Haringey

The Tynemouth Road site was owned by Whittington Health and was currently under-utilised.  Transport links were good and this included close proximity to bus, overground and underground.  Premises at St Ann’s Hospital were currently in a poor condition and required refurbishment.  This had been referred to in a Care Quality Commission inspection report.   In addition, they were at the rear of a psychiatric hospital.  Bounds Green Health Centre was also currently in a poor condition. 

The proposals also required the movement of some services for adults to Lordship Lane.  This would enable a hub to be developed for adult services in the east of the borough.   In particular, it would enable a one-stop-shop podiatry, diabetes and leg ulcer clinic to be developed, thus saving trips and providing better care.  The Bridge Renewal Trust had assisted with the arrangement of three engagement sessions with patient representatives in respect of this.  Consideration could also be given to bringing voluntary and community organisations into the hub in order to expand the range of services available.

Whittington Health had identified key people within the community whose views they would like to receive regarding current services and the proposed re-locations.  They were anxious to know about their concerns and respond to them.  In addition, it was hoped that feedback from the community could help shape the design of the of the re-located services.   He reported that positive feedback had been so far been received from the Council and Haringey CCG on the creation of three integrated health and well-being hubs within the borough.  Healthwatch had felt that, whilst the proposals were not of major significance, engagement with service users still needed to be thorough. 

They were proposing an engagement process with stakeholders on the proposals.  However, they were able to undertake a statutory consultation in the proposals instead if necessary. There was a legal distinction between engagement and consultation.  If consultation was deemed to be necessary, this would be undertaken by commissioners as this was required by the legislation.  However, there were concerns in respect of the timeframe that a consultation exercise would entail as a decision on the re-location was required by the end of March.  The Trust was willing to do whatever was required to meet this. 

Committee Members emphasised the need to involve all relevant stakeholders, including Headteachers, social workers and schools.  The needs of those whose first language was not English also needed to be taken into account.  It was also felt that the proposal entailed a big change in accessibility.   It was noted that most services for children would still be provided in schools and homes and Tynemouth Road had been rated highly in respect of accessibility.  However, the Committee commented that it was in the middle of a residential area.  It was likely that a significant number of patients would travel by car.  Although there was a car park, this was only for staff.   Vanessa Cooke, from Whittington Health, stated that the parking would be reviewed and changes made as it was recognised that it was important to have parking on the site.  St Ann’s had previously had a good amount of parking space but this was no longer the case are two thirds of the site had now been sold off.  Unlike St Ann’s, Whittington Health owned the Tynemouth Road site and were therefore better placed to respond to the needs to their patients.

The Committee noted that engagement had taken place with relatively small numbers of individuals so far.  This was approximately between 80 and 90 across the borough.  They expressed concern on the air quality in the Tynemouth Road area, which frequently exceeded European Union limits.  Crossing the road could also be difficult in the area.  They are also of the view that it was important that the community were able to feed in any concerns, particularly as it was possible that there were issues that the Trust had not so far considered.  It was likely that the current pandemic would impact on the response to consultation and it was therefore essential that there was digital access. 

Mr Gardner reported that they were anxious to engage with the community.  A similar engagement exercise had taken place in Islington recently and this had allowed responses to be made either electronically or on paper and a similar approach could be followed with this.  They were happy to receive feedback on how engagement might best be undertaken.  Consideration of how to make Tynemouth Road more accessible could be included within the engagement process.  It would be possible to invest in the site to improve accessibility.  They had not specifically looked at other venues but alternatives could be expensive in comparison, particularly if they needed to be completely gutted before being put into use.  Tynemouth Road had not only been chosen as it was the only option – it was considered to be a good location for services.  Ms Cooke reported that there were already a number of services based at Tynemouth Road, including health visitors and school nurses.  They would upgrade the current premises once the re-location had been finalised.

Committee Members noted that the current premises at St. Ann’s Hospital would be refurbished if children’s services remained on the site.  Mr Gardner responded that they would still be at the back of a psychiatric hospital and were not likely to be as well designed as premises within the Tynemouth Road would be following re-location. 

The Committee noted that the proposals entailed changes to the accessibility of services and impacted on the wider community.  The Trust also needed to show that there was clear evidence that the proposals were in the interests of the local community.   Whilst the concerns of the Trust regarding the timescale were noted and it appeared that the proposals would be beneficial, it was nevertheless felt that full consultation was required.   Although there had been some evidence of engagement, more was required. Mr Gardner responded that Whittington Health genuinely wanted to engage.  If consultation was felt necessary, the matter would be passed onto the CCG.  Whittington Health would nevertheless undertake the work that was necessary on this.

AGREED:

1.    That the proposals by Whittington Health for the development of their estates and services in Haringey be noted; and

2.    That the proposals be subject to a consultation process due to their impact on the accessibility of services and the wider community and the number of patients potentially affected.