Agenda item

To scrutinise the process and procedures for considering the creation of a new central Haringey health hub, based in Wood Green.

Report from Whittington Health NHS Trust to follow.

Cllr Khaled Moyeed introduced this item, noting that it concerned the proposed creation of a new health hub in Wood Green and that the aim of the meeting was for the Committee to consider the proposed consultation process including input from Scrutiny.

Jonathan Gardner, Director of Strategy and Corporate Affairs at Whittington Health, introduced a presentation about the proposed health hub which covered the following points:

• The new health and wellbeing hub in central Wood Green would include primary care and other NHS services, as well as some Council services and voluntary sector services.
• The hub would be aligned with the localities work through the Haringey Borough Partnership. This was based on organising services around three localities (west, central and east) in the borough and co-ordinating and co-locating council services, primary care and the voluntary sector with a community feel.
• The main location option being explored was inside The Mall at Wood Green Shopping City though no decision had yet been taken and any other viable options would be considered. The aim was to find a new modern facility that was fit for purpose and would enable partnership working as part of an Integrated Care System along with improved accessibility and a group space that could be used by the community to improve their health. There would be an opportunity for close working with the new Community Diagnostic Hub that would be opening in The Mall in summer 2022.
• Two adult health hubs already existed in the borough. These were at the Hornsey Central in the west of the borough and Lordship Lane in the east so Wood Green would become the third hub located in the centre of the borough. There was also a new children’s health hub at Tynemouth Road Health Centre. Primary care services were delivered at a wide range of locations across the borough and this would continue. The hubs were for services that were best delivered at fewer locations in conjunction with other services (such as clinics for podiatry, diabetes or leg ulcers).
• Adult services would be moved out of:

o   Bounds Green Health Centre;

o   Stuart Crescent Health Centre;

o   St Ann’s Hospital.

This relocation would improve accessibility with good transport links to the central Wood Green area.

• Services would be co-located with Hornsey Wood Green GP Practice.
• As part of a pre-engagement exercise, 120 residents were asked if they would attend a healthcare appointment in central Wood Green and 94% (113 out of 120) said that they would. There was also strong support for integrated health and wellbeing hubs across the borough.

Faye Oliver, Communications and Engagement Lead at Whittington Health, then provided some details to the Committee about the proposed consultation timeline:

• It was proposed that the 12-week consultation period would begin on Wed 23^rd February, ending on Wed 18^th May. 
• While the consultation would therefore run during the pre-election period, the intention was to carry out the larger engagement events before then, with smaller focus groups taking place during the election period.
• Data analysis would take place from Mon 23^rd May to Sun 5^th June.
• The Healthwatch Haringey Independent Evaluator would carry out analysis from Mon 6^th June to Sun 19^th June.
• Findings would then be shared with the OSC on the week commencing Mon 20^th June.
• Engagement methods included writing to patients/service users from the past three years, workshops, surveys and drop-in sessions with staff, email contact to Wood Green stakeholders and contact with partner provider organisations and commissioners.

Cllr Moyeed noted the proposal in the officer report that a formal response to the consultation would be developed by the Adults & Health Scrutiny Panel and it was clarified that this draft response would then be referred back to the Overview & Scrutiny Committee for approval.

Jonathan Gardner and Faye Oliver then responded to questions from Committee Members:

• Cllr White expressed concerns about possible difficulties with accessibility for some groups to the proposed new site for the hub. Jonathan Gardner said that the overall access to the Wood Green site would be much better because the catchment area for the services was for the whole of Wood Green and not just the areas to the north where services were currently located. However, issues of accessibility and transport links would be explored further during the consultation period.
• Asked by Cllr White about the current ownership of The Mall, Jonathan Gardner said that the current landlords were Capital & Regional. He confirmed that the sites of the services being moved to The Mall were currently owned by the Whittington Trust and BEH-MHT. He explained that the idea was to use the proceeds from selling the land at the old sites to be able to fund the refurbishment at the site at The Mall. Cllr White asked if the map of the sites shown on the slides could be circulated to the Committee. (ACTION) Cllr Connor expressed concerns about the shift to a private leasehold, including the potential cost and the risks and lack of control associated with leaseholder status. She asked for further details about the terms of the lease. Jonathan Gardner acknowledged that the length of the lease would be crucial but was unable to provide further details as negotiations were currently ongoing. He added that the financial modelling indicated that this proposal would be approximately cost neutral or slightly positive for the NHS. He undertook to provide more details to the Committee in writing in the coming weeks as this process progressed. (ACTION)
• Asked by Cllr Carlin what would happen to primary care services at Bounds Green, Jonathan Gardner said that there weren’t any primary care services at the Bounds Green site but that the services that were provided there would move to the hub. He confirmed that no services would be reduced or downgraded as part of this move.
• Cllr Carlin asked what steps would be taken to consult with people for whom English was not their first language, people with mental health difficulties and people with literacy problems. Cllr Moyeed requested that a clear logical basis be used for selection of languages used for any translation, including the prevalence of languages spoken in the area. Faye Oliver said that translations would be made in accordance with the information held in the patient and service user lists. The Trust would also be proactively approaching established community network groups and this engagement could take place online or face-to-face. ‘Easy read’ translations would be made available to improve accessibility. Carers’ networks would also typically be able to help reach vulnerable groups where necessary.
• Cllr Carlin asked whether mental health services being provided as long-term care through primary care services would be moved to the hub. She expressed concerns that people with serious mental health problems would not be able to access services at The Mall as it was too busy and hectic. Jonathan Gardner responded that this was an important point but noted that BEH-MHT would be co-designing their services. He said that the current thinking was that services would be split between St Ann’s and The Mall so would be available at both sites. External access for patients to the hub at The Mall was also an important requirement that would be prioritised.
• Cllr Carlin expressed concerns about the long-term future of the hub given that the demolition of The Mall/Shopping City had been mooted in the past. She suggested that other sites in the area owned by the Council/NHS could be more suitable. Jonathan Gardner said that there would be a lease that secured the space and so this was not anticipated to be a problem in the medium-term.
• Anita Jakhu commented that not all service users would be able to respond directly to the consultation, even if suitable translations were made, so it was therefore important to approach community groups. Cultural interpretation and issues of confidentiality would also be important factors. Jonathan Gardner confirmed that proactive approaches to community groups would be a part of the consultation process.
• Asked by Anita Jakhu what learning there had been in the consultations for the two existing hubs, Jonathan Gardner said that there the Hornsey and Lordship Lane hubs had been established some years ago and there may not have been any formal consultation at the time. However, there had been a consultation over the recently established children’s services hub at Tynemouth Road and a lot was learned with changes to services made as a consequence of the views heard during that process.
• Asked by Anita Jakhu what engagement rate they expected to achieve as part of the consultation, Faye Oliver said that the highest response rate achieved as part of the Tynemouth Road consultation was 28% (podiatry) but the rate had been as low as 7% in other areas (nutrition & diet). The rate achieved this time would be likely to be within that range. There would however, be more opportunity for stakeholder and community feedback as the Tynemouth Road consultation had taken place almost entirely online due to the Covid restrictions in place at the time.
• Anita Jakhu asked if details of the questions that people would be asked could be provided to the Committee, Faye Oliver said that there were two surveys that could be provided, one of which was specific for patients and service users and one was for other stakeholders. (ACTION)
• Cllr Connor asked about access to podiatry services and the role of outreach clinics given that people with foot problems often experienced difficulties with transport. Jonathan Gardner acknowledged that this was an important point to be explored as part of the consultation to understand the accessibility needs of patients.
• Cllr Connor noted that the report summarising the themes from engagement activity referred to wider support to mental health including “access to green space and other social determinants e.g. housing, employment” and asked how this would be addressed as part of this proposal. Charlotte Pomery, Assistant Director for Commissioning at Haringey Council, said that the Council was having early conversations with BEH-MHT about the community offer and noted that Canning Crescent would be opening with an integrated mental health offer in May/June. This would be an opportunity to bring together a range of services through the crisis café. Thought needed to be given to how this would link to housing locally and with the mental health offer at Wood Green to make pathways as straightforward as possible for residents.
• Cllr Connor highlighted the importance of co-production and stakeholder involvement and asked whether a wider stakeholder engagement process, bringing community groups together under terms of reference similar to the Osborne Grove co-production, could be of benefit. Charlotte Pomery said that conversations were ongoing about how to make the co-production work as there was quite a wide range of services involved. She acknowledged that having an engagement group working throughout the delivery of the project as well as development could be very helpful as had happened with the Chad Gordon Autism Campus.
• Cllr Connor asked about the GP practice being brought into the hub, including how autonomous it would be and how accessible it would be to existing patients. Owen Sloman, Assistant Director at NHS Haringey, said that it was proposed that the Hornsey Wood Green GP Practice on Turnpike Lane be moved into The Mall. This practice had two GP partners who had taken over in June 2020 and its patient list size had grown by 49% since then, so was outgrowing the building that it was in. The two GP partners were both local and one was also the lead GP at the West Green practice which was the only practice in North Central London to have an Outstanding overall rating with the Care Quality Commission (CQC). Owen Sloman said that he had confidence in the GP partners in managing the change and building a practice with a strong and diverse leadership team. When the practice moved to The Mall it would operate under a GP contract but the partners were conscious of the need to work differently as part of an integrated hub. He acknowledged that patients who live further away would have longer journeys but noted that there were good bus connections and that there was also a new GP practice on Green Lanes as an alternative. In terms of consultation, HealthWatch had been commissioned and the first meeting of the patient and participation group had taken place recently. HealthWatch would shortly be carrying out a patient survey and focus groups aimed at vulnerable groups. Cllr Connor suggested that a further conversation with Hornsey Ward Councillors could be useful to understand any concerns about the proposed move. It was agreed that any concerns could be fed into this process. (ACTION)
• Cllr Moyeed requested that local Residents’ Associations be included in the Stakeholder Survey referred to on page 25 of the supplementary agenda pack. (ACTION)

RESOLVED –

That the process for considering proposed changes to local NHS services, as outlined in the Health Scrutiny guidelines, be noted;

That the Committee concurs with the view of NHS commissioners that the proposals are substantial in nature and require formal consultation;

That the Committee comment on the proposals by NHS commissioners for consultation with the public and patients on the proposed changes; and

That development of a formal response to the proposed changes to services by Whittington Health on behalf of Overview and Scrutiny be referred to the Adults and Health Scrutiny Panel for consideration after the forthcoming local government elections.