Sunday, 23 November 2014

Brent hospital proposals must come under intense scrutiny on Thursday

Days after NHS England announced an inquiry into why waiting times at Ealing Hospital and Northwick Park A&Es have the longest waiting times in the country, LINK, Brent's Scrutiny Committee on Thursday will be examining several important aspects of local health care.

Representatives of the North west London NHS Hospital Trust will be questioned about progress on the recommendations of the Care Quality Commission's (CQC) critical  report on Northwick Park Hospital.

The report LINK sets out the issues to be examined clearly:
CQC made specific recommendations for improvement at Northwick Park Hospital concerning A&E and related services. These are set out below:-

• Ensure that there are appropriate numbers of staff to meet the needs of patients in the A&E department, surgical areas and critical care.
• Ensure that there are systems in place to assess and monitor the quality of services provided in A&E, critical care, surgery and maternity to ensure that services are safe and benchmarked against national standards.
•Review the coping strategies within A&E during periods of excessive demand for services.
•Empower senior staff to make changes to ensure that patients are safe in A&E in maternity.
•Review discharge arrangements in A&E and critical care to avoid re-admission to these areas.

Given the significant number of areas requiring improvement in the current A&E provision at Northwick Park Hospital reassurance is sought from the senior management concerning implementation of actions and the safety of the A&E services available to Brent residents.
Another area to be examined is the proposals from Shaping a Healthier Future and Brent NHS to close maternity and other associated services at Ealing Hospital. 

The committee is recommended to question representatives of the Brent Clinical Commissioning Group on:-

•the robustness of their modelling assumptions and assurance plan;

•the timescale for their implementation; and
•what contingency plans are in place in case any of the proposals turn out not to be possible or feasible
A puzzling aspect of the report LINK is the timing. This meeting is on November 26th and it looks as if key decisions on this issue are actually to be made by the CCGs on the same day:
The next stage of reconfiguration is the changes to maternity services and the inter dependent services at Ealing Hospital. Brent Clinical Commissioning Group is due to make a decision on delegating the decision on timing to Ealing Clinical Commissioning Group, along with the other CCGs across North West London, on 26thNovember 2014. Ealing Clinical Commissioning Group is due to make a decision on the timings of changes to maternity services, and the interdependent services at Ealing Hospital on 26th November 2014.
One can only wonder if what the Scrutiny Committee thinks will have any impact given this timetable.

The report's authors reach a soothing conclusion:
The impact on Brent residents and NHS services of changes to maternity and inter-dependent services at Ealing Hospital is not expected to be significant. Local services have the capacity to receive additional activity from Ealing without causing a negative impact on accessibility for Brent residents
The final health report to be considered is on the future use of the Central Middlesex Hospital site LINK. Current proposals are:
An elective orthopaedic centre.
Mental Health inpatient facility relocated from the site at Park Royal.
A GP and primary care ‘hub’.
A Genetics laboratory relocated from Northwick Park Hospital.
Relocation of rehabilitation beds currently at Willesden.
This is a crowded agenda with lots of 'suits' from Brent NHS Health, the Clinical Commissioning Group abd Shaping a Healthier Future attending.  At previous meetings the chair has seemed irritated by the searching questions posed by Cllr Mary Daly and tried to hurry through proceedings with so many of the scrutinised wanting to speak.

In fact Daly's interventions seemed based on the fact that, unusually, she is a councillor who has done her homework as well as being someone passionately committed to the health of local residents.

I hope that at this meeting, however inconvenient, she gets a fair hearing. I also hope, for the sake of the public, microphones are installed to get over the acoustic problem in the committee rooms as well as the suits' mumbling.

If all that Health material is not another there is a major and very interesting report  LINK by a Task Group on the Agenda.The Task Group, chaired by Cllr Neil Nerva, looked at promoting electoral engagement following the introduction of Individual Electoral Registration and is packed with information and ideas. The most innovative of which is the involvement of the campaign group Hope Not Hate.

Once again such a crowded and complex agenda raises the issue of the wisdom of reducing Brent Council's scrutiny committee to just one. This was a hasty decision made at the beginning of the administration with no prior consultation which took many Labour councillors by surprise.

These are decisions about vital issues, at the extreme perhaps a matter of life or death, and must have proper scrutiny.

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