Apologies for absence were received from Cllr Annamarie Critchard, (Wandsworth) Councillor Peter McCabe (Merton), Councillor Andy Stranack (Croydon), Cllr Munir Ravalia (Kingston).

The Scrutiny officer asked for nominations for chair of the committee, Councillor Anita Schaper, accepted the nomination. 

RESOLVED

 Councillor Anita Schaper was duly elected as Chair of the South West London and Surrey Joint Health Overview and Scrutiny Committee for the 2018/19 municipal year.

The Chair asked for nominations for vice-chair of the committee, Councillor Lewer accepted the nomination.

RESOLVED

Councillor Ian Lewer was duly elected as Vice- Chair of the South West London and Surrey Joint Health Overview and Scrutiny Committee for the 2018/19 municipal year.

Agreed by the Committee

The Joint Programme Director for Acute Sustainability gave an overview of the report and highlighted that Epsom and St Helier Trust developed a Strategic Outline Case which set out three key challenges; clinical sustainability, modernising the estate and financial sustainability. The Trust conducted an engagement exercise and made recommendations to address these challenges and identified potential solutions.

Sutton, Merton and Surrey are the three principle customers of services from Epsom and St Helier therefore the respective Clinical Commissioning Groups have formed the Improving Healthcare Together 2020-2030 programme to look at the challenges identified by Epsom and St Helier. It was recommended that the Joint Health Overview and Scrutiny Committee should mirror the NHS arrangements. 

A recent meeting of the Committees in Common agreed the initial proposals within the Improving Healthcare Together Programme and given approval for the work to move to the engagement stage. The CCG’s are keen to keen to engage with all sections of the public and local authorities.

Members noted that the report is still at a high level and asked if the figures are predicated on current provision and if so what assumptions will be made. The Managing Director for Merton and Wandsworth  said the current assumptions are broadly based on current services, this information is still being compiled.  Further information will model the demographic and non demographic growth as well as planned commissioning changes. As the population is ageing, south west London will need the range of services that are provided at the moment retaining the current acute services and any potential solution must retain acute services within the combined geography.

Members were concerned that a reconfiguration of acute services could result in a change in patient flows as residents may use acute services elsewhere rather than local community services. The Managing Director for Merton and Wandsworth said they recognise there may be a change in the local authorities who are affected by the change in acute configuration. They have commissioned some work to assess travel times as many acute services are accessed by ambulance, there is a need to understand how patient flows will change.  They will also look at the impact of deprivation and how deprived communities access care differently and if they use more acute care.

There are no results at this stage, the outcomes from the reviews will feed into engagement when the information becomes available. The Improving Healthcare Together  Programme is also working closely with other acute  providers to ensure they are  not de-stabilised  by this process. 

Members asked how the CCG’s can lead on the provision of healthcare from modern buildings when the power to raise this funding rests with the acute trusts. The Joint Programme Director for Acute Sustainability  said

Commissioners will play an important role in developing the pre- consultation business case which will demonstrate if the proposals are affordable, they are also working with regulators and the Trust. Members noted it will not be possible to go to public consultation until support in principle is secured  ...  view the full minutes text for item 5.

Members agreed to form a sub-committee to scrutinise the Improving Healthcare Together Programme and  that membership of the  sub committee will initially compromise of Sutton, Merton and Surrey.  This is subject to further information from the NHS and on the basis of the information presented may open the sub committee to full voting rights for other local authorities in the South West London area.

The Committee had concerns about the delegating power to the sub- committee but upon discussion it was agreed that decision making should rest with the authorities who are most affected. The CCGs confirmed they will have a better understanding of the impact on other boroughs when the analysis is completed.

Members asked for all the JHOSC membership authorities to be kept up to date with the latest developments within the Improving Healthcare Together Programme.

The committee made some revisions to the recommendations set out on page 27 of the agenda.

RESOLVED

The Committee agreed to the establishment of a sub-committee to carry out detailed scrutiny of the Improving Healthcare Together 2020-2030 programme.

The Committee agreed that the membership of the sub-committee include one member from the affected boroughs of Merton Surrey and Sutton, which may be subject to revision as a result of evidence arising from the on-going NHS work programme.

The committee agreed that the final decision making power is delegated to the sub-committee.

The Committee agreed to appoint Councillor Steers as the interim Chair of the sub-committee and that the formal appointment of Chair would be made at the first meeting of the sub-committee.