Agenda item

To receive a report from the Head of Scrutiny and Member Development introducing a range of inputs from key stakeholders for the Committee to consider and to help inform its formal response to the current public consultation on proposed service specifications and draft standards, arising from the new Congenital Heart Disease (CHD) review

The Head of Scrutiny and Member Development submitted a report introducing a range of inputs from key stakeholders to help inform the Joint Committee’s formal response to the current public consultation on the proposed service specifications and draft standards arising from the new Congenital Heart Disease (CHD) review.

The following representatives were in attendance to help the Committee consider the information presented:

·  Julian Hartley – Chief Executive (Leeds Teaching Hospitals NHS Trust)

·  Dr Bryan Gill – Medical Director (Leeds Teaching Hospitals NHS Trust)

·  Dr Elspeth Brown – Consultant Cardiologist (Leeds Teaching Hospitals NHS Trust)

·  Carin Van Doorn – Consultant Congenital Heart Surgeon (Leeds Teaching Hospitals NHS Trust)

·  Sharon Coyle – Director (Children’s Heart Surgery Fund)

·  Lois Brown – Parent and member of the relevant Clinical Reference Group

Prior to the Joint Committee discussing matters in detail, the Principal Scrutiny Adviser drew members’ attention to the written submission provided by Embrace.  In summary, this highlighted the following:

·  An acknowledgement of the invitation to attend the meeting.

·  Offered apologies for non-attendance due to operational issues.

·  Confirmed that Embrace currently meets the service specification and standards (as drafted).

·  Embrace continues to work with Leeds Teaching Hospitals NHS Trust and other trusts in Yorkshire and the Humber in order to ensure a focus on quality and safety in relation to patient transfers.

·  From a transport view the proposed specifications and standards do not raise any issues.

·  Should there be any changes to the current configuration and provision of services across Yorkshire and the Humber then a re-assessment against the standards will be required.

·  Currently, Embrace had not been asked to participate in any specific groups or workstreams of the new CHD review.

The Chief Executive of Leeds Teaching Hospitals NHS Trust (LTHT) addressed the Committee and outlined the Trust’s involvement and engagement with the new CHD review.  The Chief Executive noted the new CHD review had been a much more inclusive process than its Safe and Sustainable predecessor. 

The Joint Committee discussed the information presented and raised a number of specific matters, including:

·  The Trust’s overall position against the proposed standards – i.e. the percentage of draft standards currently met.

·  The financial implications of achieving the proposed standards and the Trust’s current position with regard to achieving ‘Foundation Trust’ status, including any barriers this created in terms of making necessary improvements.

·  Any specific funding gap currently at the Trust – based on achieving the proposed standards.

·  The Trust’s position against the standards, relative to other centres across England.

·  Numbers of surgeons and trainee surgeons, including the impact of the Safe and Sustainable Review on the number of trainees.

·  The Trust’s governance arrangements relative to the proposed standards.

·  Current and future approaches to commissioning CHD services for children and adults, including:

·  The Trust’s position relative to the proposed standards around Paediatric Intensive Care Unit.

·  Any potential risks associated with the changing nature of commissioning, and in particular co-commissioning.

·  Network arrangements – not just regional networks, but networks between specialist surgical centres.

·  The balance between services for children and adults.

·  Bereavement services and End-of-Life care. 

In response to some of the issues raised, representatives from Leeds Teaching Hospitals NHS Trust highlighted the following matters:

·  Cardiac surgery was a high priority for the Trust.

·  Available resources were an important issue and some of the draft standards required investment.  It was anticipated that this would necessitate discussions with commissioners.

·  Resource issues had been highlighted at the providers group and were an issue across different units.  The financial modelling was unclear.

·  The Trust was currently undertaking a mapping exercise of current provision against the draft standards.

·  The availability of specialist cardiac surgeons was a national issue and had been affected by the Safe and Sustainable Review.

·  The Trust was in a good position when comparing current arrangements against the draft standards. In terms of governance, the Trust was most likely ahead of the draft standards. Specific issues/ considerations were likely in the following areas:

Ø  Network arrangements

Ø  Staffing – specifically in terms of Liaison Nurses

Ø  Hybrid Theatre

Ø  On-going equipment replacement

·  The Trust current employed 3 surgeons and was actively looking to recruit a fourth, and had 3-years to do so.

The Director of Children’s Heart Surgery Fund addressed the Joint Committee and raised the following matters:

·  The charity welcomed the new standards and was currently seeking views of families across Yorkshire and the Humber through a series of planned events.

·  It was felt important the issue of co-location of services should not be watered down.

·  Concern around arrangements to consult with different parts of the community, in particular with BME communities – which had also been an issue during the previous Safe and Sustainable Review.

·  Concerns around funding in order for Trusts to meet the draft standards.

The Joint Committee discussed the information presented and reiterated a number of issues previously discussed.

 RESOLVED –

(1)  That the report and information presented to the meeting be noted.

(2)  That the details provided be used to inform the Joint Committee’s draft response to the proposed service specifications and draft standards arising from the new Congenital Heart Disease (CHD) review.

At the conclusion of the discussion, the Chair thanked all representatives for their attendance and contribution to the meeting.