Agenda item

The Committee received a report from the Corporate Director of Programmes and the Commissioning and Development Manager, North Durham Clinical Commissioning Group that outlined proposed communications and engagement plan for services currently delivered from Shotley Bridge Hospital (for copy see file of Minutes).

The Commissioning and Development Manager assured members that no decisions had been made and that this report was to inform about the decision making process.  She confirmed that North Durham CCG were committed to providing a facility either on the existing or on a new site.  She went on to explain that funding had been secured for the development and she highlighted the process of engagement.  The eight to ten week period of engagement would be flexible and could be extended due to inclement weather, as the CCG wanted as many people as possible to contribute.  The engagement process would allow open discussions on all potential options and would inform what to take forward in terms of the consultation exercise.  There were nine events planned across the area and social media would be utilised to allow further feedback.

The Commissioning and Development Manager informed the Committee about the options for the following:-

·         Urgent Care Centre

·         Bed Provision

·         Chemotherapy Unit

·         Theatre Provision

·         Diagnostics

·         Endoscopy

·         Outpatients

In terms of the site, the Commissioning and Development Manager said that there was not a lot of detail in the proposals as they were prioritising transport and access to the locality.  These discussions would then allow the CCG to form a shortlist in terms of the potential sites.  She went on to advise of the timelines and said that committee would be appraised of the findings from the engagement process at their meeting on 1 April 2019.

Ms Burton, member of the public, stated that she was glad nothing had been decided but said that the main driver appeared to be funding driven.  She went on to ask if the financial information would be given before the engagement exercise to allow people to make an informed decision, as the current situation was an option and she felt that people would vote for this.  However, she was concerned that the CCG did not have the finances to go forward and continue with the current situation.

The Corporate Director of Programmes explained that it was the CCGs intention to share all information to ensure that the right engagement was carried out with an understanding of financial and workforce constraints.  With regards to the condition of the building, he advised that it would need significant investment to modernise it so that modern health care services could be delivered.  With regards to the financial aspect he advised that discussions would need to be had with NHS England but he confirmed that capital funding had been secured which in turn had allowed this engagement process to take place.  The CCG would be looking at current activity and demand and at where people go for their health care needs.  He confirmed that everything would be shared.  The Commissioning and Development Manager added that the engagement exercise was very different to the consultation process as there would be more open conversations and therefore the CCG would not be at the stage where cost options could be shared.  At the consultation stage those options would be put forward and the CCG would provide as much information as they could.

The Chairman invited members of the Shotley Bridge Hospital Reference Group to ask questions.

Councillor Clarke commented that this was a decision that followed decades of uncertainty for the future of Shotley Bridge Hospital and he was concerned that if the public were given all options at the engagement stage, the majority would want as much retained as possible.  He asked that serious consideration was given to potential sites in the area.

Referring to page 71 of the report, Councillor Jewell said that the point about construction in 2019/2020 suggested that the decision had already been made.

Councillor Tinsley, referring to increased housing in the Consett area, and asked how the needs of people not living there yet could be assessed.  He asked what other issues had been considered as part of the options appraisal engagement process and why option two was included in the bed provision section as it had already been informed that an eight bed option was not sustainable.

The Corporate Director of Programmes advised that the options and how they would be presented were based on the discussions gathered to date and now it was the opportunity to engage with the wider community, presenting all relevant information showing flexibility for the future.  He added that the new sites would not just focus on a transport model but the needs of local people.  In terms of the new site he advised that a survey would be carried out following the engagement exercise.  With regards to the comment about construction he agreed that conversations had been ongoing for a number of years but confirmed that no decisions had been made.  Any plans for construction would need approval from the CCG board.  He confirmed that the CCG had recognised local housing needs and 10% growth had been factored in.  He confirmed that a range of issues had been considered for the engagement process including travel, access, decision making criteria and this would be presented through to the consultation period.  With regards to the point made concerning options that may not be viable, he advised that by including all options in the engagement process would allow the CCG to have open discussions regarding bed provision.

Councillor Shield commented that he would not want to see a repeat of what had occurred at other hospitals with closures.  With regards to paragraph 34 of the report he was concerned that the hospital had already seen the withdrawal of services recently and that it was not always given as a health care option for service provision.  He went on to comment on page 26 of the report and felt that a huge demographic had been missed as vulnerable people should also include the young population.  He looked forward to the meeting of the Reference Group on 17 December where the options could be carefully scrutinised.

Councillor Watson was pleased to learn that the CCG had made no decisions as yet and he asked that all options included in the engagement process were deliverable.  The Commissioning and Development Manager confirmed that all options were absolutely viable and the CCG very much welcomed an open debate.  She added that carrying out a good job with the engagement process would make the consultation process easier.  Richard Morris, Director of Operations confirmed that the choice for patients attending Shotley Bridge Hospital was there however he did acknowledge that clinics took place at limited times.

Councillor Patterson expressed her disappointment that the options requested by this committee had not been brought back regarding all service delivery options that were available at Shotley Bridge Hospital.  She believed the options were a nonsense with a foregone conclusion. She asked that the CCG re-think the options before the engagement process started.  She added that the impact would not only be on residents in the area but on other urgent care services, such as the University Hospital North Durham, where they were already stretched.  She asked if these options had been presented to the reference group.

Councillor Temple echoed the comments made by Councillor Patterson as he too recalled the minute from this committee asking that a further report be presented including analysis of need and post code.  As this was missing he failed to see how the CCG could go out to engage when facts had not been presented.  He said how important it was to have the trust of the people that you are engaging with and to be able to give a clear message.  He again added his disappointment and asked for an apology from the CCG for the lack of information presented as he believed that this undermined the whole process.

The Corporate Director of Programmes gave a guarantee that the CCG were taking this seriously and were not ignoring the committee or any other feedback received.  He advised that the work on demand was available and would be shared during the engagement process.  He pointed out that nothing was off the table and that information shared would enable meaningful conversations.  He added that information had been shared with the reference group and would be shared through the engagement process.

In response to a question from Councillor Temple, The Corporate Director of Programmes confirmed that £16 million of capital was available for any new facility.

Mr Taylor Gooby felt that this was an honest attempt by the CCG to have a debate with the public and said that people were aware of the pressures faced by the NHS.

Councillor Jopling asked if any consultation had been carried out with other providers to ascertain if they had the capacity to cope with providing further services.

Referring to Councillor Temple’s point about the need for demand data, Councillor Bell asked why this had not been shared with this committee if it had been shared with the reference group.

Councillor Patterson added that the committee had asked for options to consider services across the area and she could not endorse them as presented today.  She asked that the CCG go back to the reference group to discuss and then report back to this committee on what had been requested.  Councillor Temple seconded this request.

The Corporate Director of Programmes confirmed that the CCG were not looking at shipping out services and that there was no option to disperse services from Shotley Bridge Hospital.  He explained that they were looking at what could be delivered and what the demands were for services and that the engagement process would allow all options to be considered through open discussions.  He advised that the public would be listened to.  Options such as Teams around the Patients and community services would also be explored.  The Corporate Director of Programmes agreed that the demand data could be shared with this committee and re-iterated the point that no decisions had yet been made.

The Commissioning and Development Manager said that the engagement process was about having discussions by guiding people and sharing information and that this would help shape the consultation exercise.  She stated how important it was to start this process and start having those important conversations.

Councillor Shield confirmed that the reference group had asked for an extension on considering the options.

Councillor Patterson asked that the CCG refine the options including service delivery through the reference group as she felt that as they stood the public would be led to choosing the least worst option.  The Corporate Director of Programmes pointed out that this would be done via the engagement process.

Resolved that:-

(i)            The previously requested health care needs analysis data and information on a postcode basis and based upon healthcare demands on the local population be shared with the Adults Wellbeing and Health Overview and Scrutiny Committee as a matter of urgency and;

(ii)          Further work on the development of a full range of future service model options be undertaken prior to the commencement of any pre-consultation engagement to ensure that the engagement process is not prejudiced by an inadequate range of options put to key stakeholders and the population of the county.