Agenda item

The Chair welcomed Ailsa Claire, Chief Executive of NHS Barnsley and the current Yorkshire and Humber representative on the JCPCT to the meeting.

Also in attendance for this item was:

• Andy Buck, Chief Executive, South Yorkshire and Bassetlaw Primary Care Trusts.
• Cathy Edwards, Director, Yorkshire and Humber Specialised Commissioning Group
• Matthew Day, Yorkshire and Humber Specialised Commissioning Group

The Chair referred back to the relevant report on the agenda, which introduced a series of written questions (including supplementary questions) previously identified by the Joint HOSC and the associated responses provided on behalf of the JCPCT.  The questions covered a range of issues, including:

·  Co-location of services;

·  Caseloads and population density;

·  Vulnerable groups;

·  Travel and access to services;

·  Costs to the NHS

·  The impact on children, families and friends;

·  Established congenital cardiac networks;

·  Adults with congenital cardiac disease; 

·  Nationally commissioned services;

·  The Kennedy assessment scores and associated processes.

Following a brief presentation and introduction of the report, the following provides a summary of the issues, including comments and questions from members of the Joint HOSC, discussed:

• It was reported that due diligence was given to Yorkshire and Humber in the review, but the overall decision that would be taken by the JCPCT would be the best for all of the country to ensure the delivery of safe and sustainable.  All centres (with the exception of Oxford) had demonstrated strong, capable organisations able to deliver quality services. 
• The JCPCT felt a reduction in the number of centres nationwide, would enable the development of more specialist centres.
• Concerns that, despite repeated requests, details of the scoring exercise used to inform the public consultation would not be available until after the JCPCT had reached its decision.  Members highlighted the impact of this approach on overall accountability and transparency.
• Access, journey and retrieval times had all been taken into account as part of the overall assessment of viable configuration options..
• The significant impact on families with increased travel times and costs, particularly those from deprived areas – and the disproportional impact across Yorkshire and the Humber.
• Concern that information identified from the Health Impact Assessment and around the Patient Flow Analysis had not been available before the preparation  of the options.  In response, it was felt that enough information had been available to develop the options whilst still giving due diligence to the centres concerned.
• It was felt that not enough weighting had been given to the existing outreach network across Yorkshire and the Humber, which under three of the four consultation option would be dismantled due to the proposed network configurations.
• Concern that Adult Services had not been reviewed at the same time – it was reported that this view would be reported to the JCPCT and it was recommended that this should be reflected in the Committee’s consultation response and associated report.
• It was suggested that if Adult Services had been included in the review, then there would have been a case for retaining at least two more centres based on the overall number of procedures carried out.
• The option to keep all centres open was considered and the decision to reduce the centres was not a cost cutting exercise.  It was unlikely that any reconfiguration would give any cost benefits and additional expenditure was highly likely..
• It was felt that insufficient consideration had been given to the co-location of other related medical services in Leeds – with similar services not available in some other centres, including Newcastle.
• Concern that the consultation document was difficult for some people to understand.
• Concern that full weighting may not be given to the petition from Yorkshire and the Humber.and may not be adequately reflected in the JCPCT’s deliberations and decision-making process..
• Consultation responses from BME communities, with the Joint HOSC expressing disappointment that consultation documentation had not been available in other languages when first issued, particularly given the region’s large number of BME communities .

It was highlighted that the final meeting of the JCPCT, when the decision would be announced, would be held in public. However, the date of the meeting had not yet been agreed.

In conclusion, the Chair outlined the Joint HOSC’s extreme disappointment that, despite its best efforts, not all information requested had been made available – nor would it become available ahead of the consultation deadline.  It was agreed that the Joint HOSC’s report would particularly emphasise and reinforce this point.

RESOLVED –

(a)  That the report and discussion be noted.

(b)  That the issues raised be incorporated into the Joint HOSCs response  to the proposed changes to Children’s Congenital Heart Services in England and the proposed reconfiguration of designated surgical centres, and its associated report