Agenda item

To receive an update on the engagement findings report for the NCL Surgical Transformation Programme: Ophthalmology Surgical Hub.

The report for this item was introduced by Richard Dale, Executive Director of Performance and Transformation for the NCL ICB, Jon Lear, Senior Operations Manager at Royal Free London NHS Foundation Trust, Rachel Anticoni, Director of Operations at Royal Free London NHS Foundation Trust, and Dilani Siriwardena, Deputy Medical Director at Moorfields Eye Hospital and NHS London Clinical Director for Ophthalmology.

Richard Dale told the Committee that the report provided an update on the progress and engagement work that had taken place in relation to the Ophthalmology Surgical Hub proposal since the previous report to the Committee in June 2023. There were over 260,000 patients waiting for elective care in NCL, of which 30,000 were waiting for surgery. It was anticipated that the new surgical hub would enable an additional 3,000 operations per year.

Richard Dale added that the key feedback from the engagement exercises included that residents wanted well trained and supportive staff, a choice of appointment times, advice and support for vulnerable patients, the opportunity to discuss choices for surgery with a GP, support for travel where necessary and for spare capacity to be used to help reduce waiting lists in other areas.

DilaniSiriwardena explained that, while the clinical benefits were clear, some patients could be impacted by the change in location as set out on page 71 of the agenda pack. Patients who live close to Chase Farm Hospital or Whittington Hospital would have a longer journey to Edgware Community Hospital instead. However, patients would still have the option to transfer to a provider that may have a closer site.

Jon Lear explained that the benefits of the new surgical hub would also include a more efficient use of theatre capacity and a reduced number of cancellations. The number of procedures at Edgware Hospital were still at an early stage but 159 had been carried out in October 2023 and 323 carried out in November 2023. Staff and patient feedback had been largely positive. A small number of patients had chosen to have their procedure carried out elsewhere and this had been facilitated.

Richard Dale, Dilani Siriwardena, Jon Lear and Rachel Anticoni then responded to questions from the Committee:

• Asked by Cllr Revah whether patients were made aware of their option of choosing an alternative site for their procedure at an early stage, Dilani Siriwardena confirmed that this should be happening now as part of the process with their GP or optician when arranging the procedure. Richard Dale added that patients would also receive information at this stage about waiting times at each site.
• Cllr Clarke and Cllr White expressed concern about the more difficult and longer transport requirements that some residents would experience. Richard Dale responded that, under existing arrangements, patients who meet the eligibility criteria can access patient transport to and from sites. GPs could provide information to patients about their transport choices at the same time as explaining the options for their procedure site. He also noted that the majority of patients from Camden and Islington were choosing to go to Moorfields so there were not many journeys to Edgware so far from these boroughs.
• Asked by Cllr Revah about the services provided at Brent Cross, Dilani Siriwardena explained that this was a diagnostic hub so surgical procedures were not provided at Brent Cross.
• Cllr Chakraborty requested clarification on the figures about how many additional patients would be treated. Dilani Siriwardena confirmed that the new arrangements would enable an additional 3,000 procedures to be carried out per year.
• Asked by Cllr Chakraborty about the impact on services that were being displaced from the new hub site, Rachel Anticoni explained that some chronic pain services would now instead be provided from Hadley Wood Hospital in High Barnet and this would be a ‘like-for-like’ provision of services. In addition, some podiatry services were being moved to alternative sites. While there was therefore some displacement, there would be an overall increase in capacity as a result of the changes.

Cllr Clarke thanked those in attendance for presenting the report and said that the Committee would appreciate being kept informed about progress on the transport issues that had been discussed (ACTION)