Agenda item

To receive an update on the ‘Start Well’ programme following the recent public consultation on proposed changes to maternity, neonatal and children’s services.

Anna Stewart updated the Committee as to the progress of the Start Well project. The project had moved into its consultation phase and an update was given on the interim report.  A summary of the stakeholder feedback is given here.

The Committee’s formal response to the interim report was requested by August 16^th. (ACTION)

The floor was opened to the Committee for questions.

Cllr White questioned the framing of the results of the stakeholder feedback. Although the beginning of the feedback phase seemed open ended, there was a clear policy direction proposed through the case for change with the closure of one of the units. It was explained by Sarah Mansuralli that although stakeholder feedback was sought, the process was about developing the case for change, and defining the baseline of services that should be delivered. None wanted to see the units close, but stakeholders understood Level 2 Quality of Care was needed. However, this quality of care was not possible with 5 units open. Wynne Leith then added that with a smaller number of births, the numbers of deliveries would be diluted around the whole of north London. This in turn would deskill many consultants and the level of care would be at risk. Cllr White then responded that it could be made more explicit in the report that the proposals are being led by experts rather than stakeholders.

Discussion then turned to the quality of stakeholder feedback. Cllr Chakraborty required clarification as to the degree of engagement and representation and questioned whether ‘reach’ had been included as a ‘response’ in the consultation. The Committee was assured that this had not been the case. ‘Reach’ had been separated out from overall response statistics.

Cllr Connor then outlined that this was an interim report. The Committee was then advised to give feedback appropriate for a draft and not final report.

Cllr Cohen asked why the consultation had not been about closing a facility rather than the open approach that had been favoured by ICB. It was reiterated that the aim of the consultation was to look fairly at all the viable options and make sure the proposals were well informed and designed, using staff expertise and patient experience as its basis.

Cllr Clarke was pleased that 67% of stakeholders had accepted the need for change. She suggested that responses may have been skewed as feedback from the Royal Free was included. (Royal Free Maternity and Neo Natal Services closure was deemed by all as the most likely). However, Ms Stewart denied that responses were skewed or particularly negative from the staff at the Royal Free. She outlined that there were other units that were under consideration for closure, so it was unlikely to have skewed results.

Cllr Revah noted that most of the statistics were in percentages and that a clearer picture could be given if numbers were given. Also, more detailed qualitative feedback was needed with comments included. Cllr Revah also asked for a delay in the report feedback as she wanted to discuss it with Camden’s Health Overview and Scrutiny Committee (HOSC) Ms Steward stated that Camden’s viewpoint had already been considered as had a rich range of feedback and that this meeting was a way to provide comments from HOSC. More detailed feedback will be in the final report.

Cllr Atolagbe pointed out that more money would be needed for these proposals. Ms Mansuralli agreed that more money would be needed for the closures. She emphasised that the reasoning behind the closure proposals was not about efficiencies but improving the quality of care that could be offered to patients.

Cllr Jones questioned the practicalities of the proposal to ‘join up’ policies and procedures between Royal Free and Barnet hospitals. Ms Stewart affirmed that the ICB would incorporate broader feedback into an action plan about how policies and procedures can be aligned. The final report would have more details on this. (ACTION)

Cllr Sheth then asked about feedback from his areas of Edgware, Brent and Harrow, and what the next steps were in taking that forward. Anna Stewart stated that the feedback would go into the modelling of the Universal Pathway. It was divulged that travel concerns and access to services dominated the localised feedback. However, stakeholders weren’t adverse to the closure of the Birthing Centre in Edgware if it meant they could access wider services and a higher quality of care in another area. Cllr Sheth was assured that engagement with residents of his borough would continue.

Cllr Connor then noted that time had not allowed for Committee questions on the Children’s Surgical proposals. She then highlighted questions and comments from the Committee and requested written responses to the below. 

• The Committee was keen to know how the views of ‘hard to reach audiences’ and those not able to give feedback had been considered in the proposals. (ACTION)
• It was also stated that the business case should consider following up with stakeholders after the proposals have been implemented. A timescale for this should be detailed in the next report. (ACTION)
• The business case should also consider the knock-on effects with other hospitals and detail the extra support needed by other services. (ACTION)

Cllr Chakraborty asked for the date by which the final report would be published. Ms Steward stated that the report would be released in early autumn. The ICB would tell the Committee when it was published.

A formal response by the Committee on the interim report was AGREED to be given by 16th August. (ACTION)