Agenda and minutes

Councillor Farzanna Mahmood – work commitments

Councillor Sarita-Marie Rehman-Wall – personal reasons

Sarah Collis (Healthwatch Nottingham and Nottinghamshire)

In the interests of transparency, Councillor Saj Ahmad stated that she is an employee of NHS England and the Department of Health and Social Care.

Minutes of the meeting held on 16 November 2023, for confirmation

The Committee confirmed the minutes of the meeting held on 16 November 2023 as a correct record and they were signed by the Chair.

Report of the Statutory Scrutiny Officer

Alex Ball and Mark Wightman, Director of Communications and Engagement and Director of Strategy and Reconfiguration at the NHS Nottingham and Nottinghamshire Integrated Care Board (ICB), and Phil Britt and Dr Mark Simmonds, Programme Director and Deputy Medical Director at the Nottingham University Hospitals NHS Trust (NUH), presented a report on the work being carried out on the development of the Tomorrow’s NUH project for the purposes of starting a formal public consultation on the proposals. The following points were raised:

a)  The report and its appendices outline the Tomorrow’s NUH proposals, Pre-Consultation Business Case and Consultation Plan. The scheme has four main elements:

·  consolidating care services for women and children at the Queen’s Medical Centre (QMC);

·  consolidating emergency care services at the QMC;

·  consolidating elective care services at the City Hospital; and creating a two-site ‘centre of excellence’ for cancer treatment.

b)  The original timeline aimed for the completion of the Tomorrow’s NUH project by 2030. However, NHS England has since needed to prioritise works to other hospitals where deteriorating Reinforced Autoclaved Aerated Concrete has been identified. This means that the NUH scheme will be started later than originally anticipated. The ICB Board will meet on 11 January 2024 to discuss the project and when a full public consultation would best be carried out.

c)  The approach to the public consultation on the proposals has been designed to reach as wide a demographic of the population as possible, and will be monitored proactively throughout so that action can be taken if it becomes apparent that the views of certain key groups or communities are not being represented. All consultation materials will be produced in the top 5 most-spoken languages in Nottingham and Nottinghamshire, as well as in easy-to-read formats. There will be a series of consultation events (including online, face-to-face and telephone consultation) and public meetings – and NUH and the ICB will be working to reach people outside Nottinghamshire who might also be users of the QMC and City Hospital.

d)  A significant focus of the consultation will be actively going to places where people are and engaging with them where they are comfortable, such as at social groups, community activities and similar settings. There will also be sessions to explore specific focuses such as mental health, green issues, travel plans and maternity services.

e)  Information on the Tomorrow’s NUH project was presented previously at the Committee meeting on 12 October 2023 and members raised a number of points. In response, the ICB and NUH have undertaken:

·  extensive stakeholder mapping to ensure that people living near the QMC and City hospitals are engaged with closely;

·  enhanced communication with NUH staff, including Union briefings, walk-arounds and drop-in sessions;

·  the production of easy-read documents to ensure that the consultation is fully accessible to people with lower levels of literacy, with materials in multiple languages; and

·  the development of integrated impact assessments, with a Travel Advisory Group established to support accessibility and ‘green’ themes.

The Committee raised the following points in discussion:

f)  The Committee asked how it will be demonstrated to those taking part in the consultation that their voices will be considered and have an impact on the Tomorrow’s NUH proposals. It was explained that, in all of the consultation material distributed, NUH and the ICB will highlight the original plans and how these have been altered and adjusted following initial feedback form patients, partners and stakeholders. There are clear examples of how plans have been changed that will be highlighted to help show that the feedback from the consultation is valuable in shaping the proposals.

g)  The Committee asked what work had been done around transport to the two main hospital sites and, in particular, whether local public transport providers had been approached to consider updating routes to ensure that the train, tram and bus lines could more easily inter-change. It was reported that a Transport working group had been established to look at travel issues for staff and patients to the hospital sites. Work is underway to review car parking, transport routes and other travel issues, and will continue throughout the process. The working group is made up of people with lived experience of accessing the hospital sites by a range of different transportation methods, as well as transport industry partners and stakeholders.

h)  The Committee queried the timelines around completing the project development stages and then achieving practical Planning Permission, and whether sufficient time had been planned into the programme to allow for those processes. It was confirmed that the Planning process has been factored in and initial discussions with Planning colleagues within the Council had taken place to give an informed opinion for the draft timeline for works.

i)  The Committee asked whether there was a definitive start time for the consultations, when public meetings and other engagement would be scheduled and how many events there would be. Dates for the start of the consultation have not yet been finalised, but the ICB Board is meeting to consider the start of the consultation at its meeting in early January. The duration for public consultation is yet to be confirmed and will depend on the start date, but will be flexible to ensure that any active changes can be made to allow feedback for under-represented groups to be captured. The Committee will be kept informed of the activities taking place as part of the consultation as it progresses.

j)  The Committee noted that elections were taking place in May 2024 for the Mayor of the new East Midlands Combined County Authority and for the Nottinghamshire Police and Crime Commissioner, and asked whether this would have an impact on the planning of the consultation period. The NHS’ general guidance is that consultations that are underway should be completed within any pre-election period, while any new consultation should not be started within a pre-election period. Members commented that a consultation start date should be set as soon as possible, given that a General Election could also be announced during 2024.

k)  The Committee asked whether there was any more information about the future of the University of Nottingham’s medical school on the QMC campus, and how this was being factored into the Tomorrow’s NUH programme. It was reported that although there had been initial conversations with the university, no decision was due to be taken on the medical school in the near future. The building would be costly to convert for clinical use, so initial suggestions for usage could be for non-clinical services. However, there are no preliminary or early plans in place as there are currently too many variables. Until the university make a final decision on the future of the medical school, the Tomorrow’s NUH plans will remain agile and adaptable to make the most of what ever opportunities arise.

l)  The Committee asked for summary of the projected programme timetable. The consultation would start following the ICB Board’s approval, which would be during January at the earliest. The consultation would then run, with changes made to the proposals following the end of the consultation. The ICB would create a Decision-Making Business Case within around six months of the consultation closing, with NUH then producing a Capital Business Case to detail construction and building costs. NUH would then undertake detailed planning through business cases and clinical modelling, working with staff, stakeholders and technical experts to design the facilities. The development work following the consultation would likely take three to five years, with the intention of Planning Permission being in place by 2028 at the earliest. The construction phase would then be likely to take around three years.

m)  The Committee raised concerns that there could be a number of people in local proximity to the City Hospital campus who would not be in favour of the planned changes as they would need to go to QMC for certain services, instead. It was confirmed that the changes would mean increased travel for some patients. However, in overall terms, the number of people in favour of the changes in the early engagement process was high. Although the Tomorrow’s NUH programme focuses on the hospital sites, there is also work underway to increase the treatment options in more localities, such as the delivery of some maternity services from the Mary Potter Centre. The Transport group has a particular focus on those people who will be affected by additional travel time and what mitigation can be put in place to minimise the impact.

n)  The Committee highlighted that hearing from women about maternity and children’s issues was vital, and also requested that a specific focus be included to hear them about other particular women’s health issues. It was confirmed that this specific measure could be added to the consultation process. Members recommended that other groups should also be engaged with as part of the consultation, including people with care experience, young people and working-age adults who were not regular service users.

The Chair thanked the representatives of the ICB and NUH for attending the meeting to present the report and answer the Committee’s questions.

Resolved:

1)  To request that, following the ICB Board meeting on 11 January 2024, the Committee is informed when it is planned for the public consultation to start and, on the basis of this, what the anticipated timetable for the commencement and delivery of the Tomorrow’s NUH project will be.

2)  To request, in relation to the consultation, that:

a)  further information is shared on the stakeholder mapping process that has formed part of delivery planning;

b)  the Committee is updated on the proposed volume of consultation activity once this has been planned fully;

c)  the Committee is updated on how engagement with hard-to-reach communities is progressing, once the consultation is underway; and

d)  care is taken to ensure that women are a properly targeted group in the consultation in relation to their specific health needs, along with users of mental health services, young people (particularly children in care and care leavers) and working-age adults.

3)  To request that further information is provided on the Equality Impact Assessment (EIA) work carried out to date, and that the Committee is kept informed as to the development of the final EIA documents.

4)  To recommend that:

a)  a clear travel plan is developed to show how people will be able to access the hospital sites easily (particularly for communities that live locally to one hospital, but would now need to travel to another to access certain services);

b)  people who are primarily public transport users, with limited or no access to a car, are represented on the Travel Group; and

c)  active engagement is carried out with Nottingham City Transport and the Council’s Portfolio Holder for Transport as part of planning an integrated transport system for the hospital sites.

5)  To recommend that it is vital that there is a clear ‘green’ theme to the Tomorrow’s NUH project, with opportunities to work towards achieving carbon neutrality taken wherever possible.

6)  To recommend that proactive engagement with the University of Nottingham is carried out where appropriate regarding its potential proposals to relocate its Medical School from the Queen’s Medical Centre Campus, at this could have an impact on the final Tomorrow’s NUH proposals.

7)  To recommend that proactive engagement should be carried out to ensure that NUH staff and their unions are kept fully informed in relation to the development of the Tomorrow’s NUH project.

Report of the Statutory Scrutiny Officer

The Chair presented the Committee’s current Work Programme. The following points were discussed:

a)  It is intended that the Committee’s next meeting on 18 January 2024 will take a close focus on the potential service impacts of the upcoming 2024/25 Council Budget on Adult Social Care services.

The Committee noted the work programme.