Agenda item

To consider a report from Leeds City Council’s Head of Governance and Scrutiny Support that introduces details provided by NHS England Specialised Services Commissioners relating to proposed changes to specialist vascular services for adults in West Yorkshire.

The Joint Committee considered a report from the NHS England Specialised Services Commissioners relating to the proposed reconfiguration of specialist vascular services for adults in West Yorkshire; namely the number of arterial centres required to provide complex vascular care across West Yorkshire. The report also set out the proposed approach to future public consultation and engagement on the proposals for consideration by the Joint Committee.

The following key points were highlighted in the report:

·  The current service provision across West Yorkshire, including three arterial centres (Bradford Royal Infirmary, Leeds General Infirmary and Huddersfield Royal Infirmary) and two non-arterial centres (Pinderfields and Airedale General Hospitals).

·  The National Service Specification Requirements to ensure resilience and maintain the skills and competence of the team.

·  The options appraisal for the future of the service and the impact of the preferred option.

·  Proposals for the approach to public engagement and consultation.

The following were in attendance and contributed to the discussions:

-  Matthew Groom – Assistant Director of Specialised Commissioning (Yorkshire and Humber), NHS England

-  Sarah Halstead – Senior Service Specialist for Specialised Commissioning (Yorkshire and Humber), NHS England

-  Mr Neeraj Bhasin – West Yorkshire Vascular Service Clinical Director

-  Matt Graham – Programme Director, West Yorkshire Association of Acute Trusts

In introducing the report and associated proposals, the Assistant Director of Specialised Commissioning stated that NHS England Specialised Services Commissioners did not envisage significant growth in patient numbers / demand for the specialism to warrant retaining a third arterial centre to provide complex vascular care across West Yorkshire.

The following key points were highlighted by the Joint Committee during its discussions:

·  Acknowledgement that the proposals:

o  Aimed to provide a regional solution for the provision of urgent and non-urgent vascular care services, through a network of hospital centres offering a range of services.

o  Envisaged clinicians working across different hospital centres within the network, rather than a single centre. 

·  Concern over the potential impact on other services provided by Calderdale and Huddersfield NHS Foundation Trust (CHFT), should the hospital no longer function as an arterial centre (as proposed).

·  Concern over potential, and as yet undetermined, future consequences of centralisation of the service.

·  Assurance sought over long-term service provision and that workforce matters were not the principle driver for the proposed reconfiguration of services.

·  Assurance sought that there were sufficiently robust plans in place to train and retain and relevant clinicians required to deliver the proposed services.

The Joint Committee heard that recruitment and retention of staff was at the heart of the proposals – a single service for WYH would provide an attractive opportunity for consultants to undertake intensive work and gain extensive skills and experience, on rotation with less intensive work; and ensure the WYH service remained sustainable.

·  A request for more detailed information regarding journey times, and the associated assumptions, for patients and their families in the areas most affected by the proposals. 

·  Concern that public consultation would be limited to ‘a single option’ and that details of the other (discounted) options should be presented to the public as part of the consultation phase. 

·  A request for more detailed information on the plans for consultation, alongside the public consultation materials.

·  Confirmation around the potential impact of in/out of area patient flows and any capacity implications for the ambulance service (Yorkshire Ambulance Service NHS Trust). 

The Joint Committee considered the nature of consultation already undertaken and expressed its disappointment that, although there had been some engagement with Trusts, clinicians and patients in early 2017, the issue had only very recently been brought to the Joint Committee’s attention and only now being presented in the public domain, as a point when formal public consultation was due to commence.

RESOLVED -

a)  To note the contents of the report and the proposals put forward.

b)  That the further information and/or assurance sought at the meeting be provided to all members of the Joint Committee.

c)  That further consideration of the proposals be considered at a future meeting of the JHOSC, including any emerging themes from the public consultation.