NHS London Board Meeting 7th October 2009

Written by Joan Davis

Wednesday, 07 October 2009 09:58

The agenda was wide - the most relevant issues for Harrow and Hillingdon were:

Challenged Trust Board

At the end of 2008 London PCTs and NHS London agreed a strategy to tackle historic debts across London. London PCTs set up a collective fund for the 10 Challenged Trusts (CTs) – 9 Acute Trusts (including North West London Hospitals NHS Trust) and 1 Primary Care Trust (NHS Hillingdon).

A two level assessment was agreed. In order to be considered for funding CTs would need to complete level 1 and the more intensive Level 2 appraisal.

Level 1 assessments ended in May 2009. The CTs were rated as either Category A (including NHS Hillingdon), ready to move to Level 2 - or Category B (four CTs including NWLHT), reported in the Board papers as:

– “the trust has not satisfied the CTB that they have the strategic vision, capability and support to deliver a viable future as the current stand-alone organisation. On a case by base basis CTs are being assisted either to prepare an alternative future to be considered at Level 1 or for a much amended proposal to be considered.”

KPMG have been appointed to undertake detailed assessments at Level 2. The goal is to eliminate historic debts by the end of March 2011.

London’s Integrated Strategic Plan - progress to date includes:

· Seven polyclinics opened in London by April 2009.

· Designation of major trauma and stroke centres and associated stroke networks for London.

· A London clinical advisory group set up and improved commissioning capabilities, including establishing six commissioning sectors.

· Projects underway addressing unscheduled care, local hospitals, diabetes, maternity, children and young people, mental health and end-of-life care.

The pace of implementing the plan is slow. The financial context has changed since 2007. Recent work suggests that the current model of healthcare in London will soon be unaffordable. Rapid implementation of the Healthcare for London plans would create a higher quality health system which would also be affordable.

The London Sectors and PCTs are developing their plans for polyclinics and polysystems – networks of health centres and GP practices. Final plans will be submitted to NHS London by 18^th December 2009.

Swine Influenza statement of readiness

London experienced a small surge of Swine Flu during the summer, which has now subsided. It is likely that there will be a second wave of the virus starting this Autumn and Winter. Guidance published on 3^rd September predicts a clinical attack rate of 30% of the population, a case hospitalisation rate of 1% and a fatality rate of 0.1%. The levels are lower than at first predicted but would still put the NHS under great pressure if realised.

A flu epidemic would be a more extreme version of the increased demand that winter usually places on NHS emergency care systems. All London NHS Trust Boards are ready to deal with swine flu, but the service most likely to come under pressure in a second surge is critical care. Total number of London critical care beds can be increased from 773 to 1,575, for a maximum of 8 weeks, by switching resources from operating theatres and reducing the levels of planned surgery.

Joan Davis

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