Agenda item

To consider the report of the Head of Scrutiny and Member Development presenting additional information in respect of matters relating to the Review of Children’s Congenital Heart Services in England.

The report of the Head of Scrutiny and Member Development introduced additional information previously requested by Joint HOSC.  The following information was appended to the report:-

·  Testing Assumptions for Future Patient Flows and Manageable Clinical Networks (Price Waterhouse Coopers (PwC) final Report – October 2011).

·  Report (and associated letter) of Sir Ian Kennedy’s panel in response to questions made by the JCPCT (17 October 2011).

·  Report of Dr Patricia Hamilton CBE, Chair of the Safe and Sustainable Steering Group, on behalf of Steering Group Members (17 October 2011).

The following were in attendance for this item:-

·  Andy Buck, Chief Executive – NHS South Yorkshire and Bassetlaw and Yorkshire and Humber JCPCT representative.

·  Cathy Edwards, Director – Yorkshire and Humber Specialised Commissioning Group.

·  Matthew Day, Specialty Registrar in Public Health – Yorkshire and Humber Specialised Commissioning Group.

Testing Assumptions for Future Patient Flows and Manageable Clinical Networks (Price Waterhouse Coopers (PwC) final Report – October 2011)

Notwithstanding the outcome of the Judicial Review discussed earlier in the meeting, it was reported that the JCPCT was in a position of being able to consider the PwC report on patient flows and clinical networks. 

It was confirmed that the JCPCT had been considering the PwC report and the issues highlighted were being given serious consideration.  It was also confirmed that such meetings had been held in confidential session.

The following issues were highlighted and discussed by members of the JHOSC:-

·  The PwC report cited Leeds, Leicester, Bristol and Southampton as having well developed networks.

·  The PwC report supported the findings of the Joint HOSC and this had been information that the Committee had reserved right to pass comment on.  It was stressed that this needed to be considered by the JCPCT in conjunction with the JHOSC initial report. 

·  It was confirmed that the JCPCT was still giving full consideration to the PwC report and the other additional information as these were not part of the consultation process. 

·  In response to a question as to whether the JCPCT could consider any further response/ comment the JHOSC may wish to issue in light of the PwC report, it was reported that this would be dependant on the outcome of the appeal currently lodged.

It was reported that the JCPCT was endeavouring to arrive at a decision that was in the best interests of children and families across the country.  However, it was acknowledged that with fewer centres some would have to travel further than they did at present. 

Reference was also made to the provision of outreach arrangements and the focus on services and networks as well as the reconfiguration of centres.

Report (and associated letter) of Sir Ian Kennedy’s panel in response to questions made by the JCPCT (17 October 2011)

With regard to the report of Sir Ian Kennedy’s Panel, it was reported that the JCPCT would be giving full consideration to the observations regarding co-location of services and critical clinical inter-dependencies. The wider benefits of different forms of co-location including the experience for families would also be taken into account. 

The reassurance provided was welcomed by the JHOSC.

Report of Dr Patricia Hamilton CBE, Chair of the Safe and Sustainable Steering Group, on behalf of Steering Group Members (17 October 2011)

In considering the information presented, the following issues were highlighted and discussed by members of the JHOSC:-

·  Transport arrangements, the suggested amalgamation of services and the necessary financial support this would need. 

It was outlined that the introduction of Embrace across Yorkshire and the Humber had been regarded as a significant improvement for neo-natal transfers and retrieval.  A national stock take had been carried out on retrieval services by the 10 Specialised Commissioning Groups (SCGs). It was reported that a variety of arrangements were currently in operation across the country and many other areas did not have combined transfer and retrieval services. 

Amalgamation of services and geography were being taken into consideration and transport  was considered to be of high priority in the national programme.

·  The potential impact on Paediatric Intensive Care Units and subsequent effects on staff retention and recruitment. 

It was reported that the JCPCT was acutely aware of the potential impacts associated with implementation and full consideration would be given to these issues.

·  Fragmentation of care and the role of networks

There was an assumption that with fewer centres, there would be a need to reconfigure existing networks and establish new ones.  However, the view of the JHOSC was that Yorkshire and Humber already had an established and well developed network and that this should have been given much greater consideration before and during the consultation process. .

·  Treatment of Patent Ductus Arteriosus (PDA)

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The Chair highlighted the seemingly difference of approach/ advice provided by the Steering Group regarding the treatment of PDAs.  That is, a cardiac surgical procedure not required to be performed at a designated surgical centre – but through the despatch of a surgical team from a designated surgical centre.  Members questioned both the rationale and practicalities associated with this proposed additional standard.

RESOLVED –

(a)  That the report and discussion be noted.

(b)  That a further submission be made to the JCPCT in relation to the PwC report findings, which reinforced some of the points previously highlighted in the JHOSC’s initial report.