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008 - Picture of Health Rpt

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									 CABINET                                                                    DATE              ITEM NO
                                                                            10 June 2008      8
 TITLE                                                                      WARDS
 Response to the Consultation on ‘A Picture of                              All
 Health’
 DECISION CLASSIFICATION                                                    FORWARD PLAN ITEM
 Non-Key                                                                    No
 CHIEF OFFICER                                                              CABINET MEMBER
 Director Adults & Older People’s Services                                  Health, Adults & Older People


1.        Decision Required

          The Cabinet is requested to;

1.1       Consider and approve the proposed response to this consultation on ‘A
          Picture of Health in S.E. London’, which is essentially a review of the service
          configuration at the four acute hospitals Queen Elizabeth, Woolwich, Queen
          Mary’s, Sidcup, University Lewisham and Princess Royal Bromley.


2.        Reason for Urgency

2.1       A decision is urgently required so as to remain in line with the next stage of
          the decision-making process.

3.        Reason for Decision

3.1       This matter is submitted to Cabinet to consider as a review of key aspects of
          service delivery by partners which has an impact on residents of the borough.

4.        Background

4.1       From the consultation document and the presentation to Council on
          30 January, 2008, the following information provides a context

               i)         The Government has invested heavily in the NHS in this part of
                          London, with £500 million across the four PCTs concerned since
                          2003/


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               ii)        Across the four hospitals, there have been appointments of 125
                          additional consultants 278 additional junior doctors and 533 nurses
                          since 1997.

               iii)       This review is led by clinicians and driven by the need to raise the
                          quality of care across South East London.

               iv)        The clinicians conclusion is that maintenance of the status quo, four
                          fully admitting hospitals, each with on A&E Department, is not
                          sustainable and cannot deliver the expected standards of care.

               v)         Clinicians believe that a move towards greater specialisation, away
                          from a model where each hospital attempts to deliver every service,
                          is now clinically essential.

               vi)        Whichever of the options is pursued, there would still be four
                          hospitals on the existing sites, with different mixes of services and
                          specialisation.

               vii)       No closures are proposed. The options reflect proposed re-
                          alignments of services. Overall service levels would improve because
                          part-time or under-staffed services at some locations would be
                          replaced by fully staffed units specialising in those services.


5.        Comments of the Head of Law and Governance

5.1       This is the Council’s proposed response to a consultation paper and as such
          raises no legal issues.


6.        Financial Implications and Comments of the Director of Finance and
          Customer Services

6..1      The Director of Finance confirms that there are no financial implications for
          the Council arising from this report, which is simply a consultation response,
          at this stage.




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7.1       Options

7.1       Members approval of the consultation is required for successful submission.
          If Members refuse submission the Councils views and comments may not be
          taken into account.

8.        Conclusion

          Based on the above considerations, a proposed response to the consultation
          is attached.


Background papers

None Submitted


Report Author:                 John Nawrockyi, Director of Adults & Older People’s Services
Tel No.                        020 8921 3000
Email.                         john.nawrockyi@greenwich.gov.uk

Reporting to:                  Mary Ney, Chief Executive
Tel No.                        020 89215000
Email:                         mary.ney@greenwich.gov.uk




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                                                                                  APPENDIX

             CONSULTATION RESPONSE – GREENWICH COUNCIL

                                            ‘A PICTURE OF HEALTH’

1.        Introduction

          Greenwich Council has been fully engaged in the proposals for the review of
          S.E. London hospital services since they were first mooted, well in advance of
          the formal launch of the consultation ‘A Picture of Health’.

               • There were early and direct briefings of the relevant Councillors and
                 Chief Officers.

               • Two Cabinet Members and the Director of Adults & Older People’s
                 Services attended all meetings of the Board of Greenwich Teaching
                 Primary Care Trust (TPCT) where proposals were discussed.

               • The Healthier Communities and Older People’s Scrutiny Panel was
                 made aware of the pending consultation, and Greenwich Council then
                 joined the Joint Health Overview and Scrutiny Committee established
                 across the four Boroughs affected.

               • The Chief Executive and Acting Director of Public Health of Greenwich
                 TPCT attended a full meeting of the Council to give a presentation on
                 the clinical rationale for the consultation options. The questions and
                 concerns of Councillors were noted, and informed the Council’s
                 participation in the joint scrutiny process

          Having considered the rationale for the review and the various options put
          forward, the Council makes the following comments in response to the
          consultation on ’A Picture of Health’.

2.        Types of Hospital on the Four Sites

2.1.      The Council accepts the advice of clinicians that the maintenance of four fully
          admitting hospitals is not viable as the means to secure the required
          standards and levels of serviceprovision, but welcomes the fact that all
          options maintain hospitals on each of the four sites.



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                                                                                  APPENDIX
          There is also a need to bear in mind the capacity and availability of public
          transport routes in the event that reconfiguration leads to variations in the
          journeys required to and from the treating hospital.

2.2       The Council does not support the proposal that full Accident & Emergency
          Departments should be maintained at the present time at only two of the
          four sites. That Queen Elizabeth Hospital, Woolwich should maintain a full
          A&E Department is strongly endorsed, as is its proposed status as a fully
          medically-admitting hospital.




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