Agenda and minutes

Councillor Sam Gardiner (personal)

Councillor Kirsty Jones (unwell)

None

To confirm the minutes of the meeting held on 17 February 2022

The minutes of the meeting held on the 17 Feburary 2022 were agreed as an accurate record and signed by the Chair.

Lucy Dadge, Chief Commissioning Officer, Nottingham and Nottinghamshire Clinical Commissioning Group (CCG) and Alex Ball, Director of Communications and Engagement, Nottingham and Nottinghamshire CCG updated the Committee on the ‘Tomorrow's NUH’ programme. The following information was highlighted:

a)  The NHS in Nottingham and Nottinghamshire has an ambition to transform health and care services and currently, the configuration of services and buildings are a constraint in achieving this ambition.

b)  The population of Nottinghamshire continues to live longer and with the development of new treatments there is a need to improve and provide additional facilities.

c)  Since last talking to the public in late 2020, proposals have evolved and developed taking into account input from citizens, expert advice and the lessons learned in response to the outbreak of the Covid virus. Evidence has been gathered from best practice to ensure that services can be effectively delivered.

d)  In summary, the current proposal is that the Queens Medical Centre site (QMC) will be the main admission site for Accident and Emergency cases and the Major Trauma centre.  This will reduce the need to transfer patients who are acutely ill. It will also become the primary facility for cancer patients, ensuring that those who are very ill with cancer will have access to urgent care and to provide ground- breaking research, in conjunction with the University of Nottingham, in cancer treatments.

e)  The QMC site will also host paediatric care, maternity, genetics and fertility services, currently provided at both the QMC and the City hospital. The drive behind this is to provide the best quality, safest, high quality services to families, which would be a new facility designed by patients and staff. Pre and post-natal care will be provided at both hospitals to allow for ease of access.

f)  The proposal includes the ambition for the City Hospital to be transformed into a centre of excellence for elective surgery with an emphasis being placed on offering more elective care in the community. Where there is no benefit to face to face meetings, remote consultations could be carried out; although it will be necessary to be mindful of digital exclusion.

g)  The relocation of services provided at both hospitals will provide new opportunities for construction and medical developments, with social and economic gain to the areas in close proximity. Consideration has also been given to the impact of travel and improvements to parking with detailed impact assessments being undertaken.

h)  The latest proposals will be going live for feedback between 7 March and 1 April 2022, and feedback is welcomed. Three public meetings will be held in addition to targeted events with specific communities and groups. A survey has been designed to capture feedback and wider briefings with elected members and stakeholders are being held to help inform further development of the proposals and also the formal public consultation.

In response to questions raised by the Committee, the following information was provided:

i)  The Tomorrow’s NUH programme is part of the Government’s New Hospital Programme (NHP) – a capital funding programme to improve existing acute hospital estate and to build new acute hospitals. There is no similar major capital programme for mental health facilities, but it is recognised that people don’t just attend an acute facility with physical illness and there will be an integrated approach to both physical and mental health with appropriate facilitates for those with mental health and sensory needs.

j)  Assurance was given that consideration has been given to the reduction of inequality and there was a commitment to delivering core services closer to people’s homes, reducing the need and cost of travel when treatment in a clinical setting is not a necessity.

k)  Committee members commented that while many people will be willing to travel slightly further for better, safer care there must be community infrastructure to support this.  CCG representatives assured the Committee that commissioners are committed to having appropriate investment to delivery on the pledge of care closer to home.

l)  There has been engagement with numerous community groups, including Healthwatch and as a CCG and Local Authority Partner sound links had been established. Councillors were requested to encourage people to complete the survey and notify the CCG of any people who are hard to reach and efforts would be made to encourage their engagement.

m)  The information provided for public consultation will be comprehensive and is still under development. The most relevant points will be highlighted to reflect the major changes with a focus on patient stories and experiences. An extensive media campaign is planned to encourage public participation including radio, TV and social media.

n)  While welcoming plans to engage with existing groups in the community who represent/ are involved with sections of the population who have been identified as those likely to be most significantly affected by the proposals, Committee members highlighted there are large sections of the population who are not affiliated to existing groups and will need to be reached differently. 

o)  Sarah Collis, Healthwatch Nottingham and Nottinghamshire, reported that Healthwatch is chairing a stakeholder reference group about the programme and has good links with many existing groups for example people with an interest in maternity services.

Resolved to

1)  recommend that Nottingham and Nottinghamshire Clinical Commissioning Group:

a)  ensure that engagement activity reaches those in typically harder to reach groups, including by:

  i.  making information available in alternative languages

  ii.  considering how information can be communicated to, and responses received from those with lower literacy skills

b)  ensures that proposals for a women and children’s hospital take into account the needs of trans and non-binary individuals so that they are able to access services;

c)  gives consideration to how the needs of those who attend the Emergency Department in mental health crisis can best be met.

2)  review how the findings of the second phase of pre-consultation engagement are informing development of the final proposals, and plans for public consultation in July/ September 2022 prior to commencement of the formal public consultation.

The Chair briefly summarised the Committee’s current conclusions in relation to its recent scrutiny of action taken by Nottingham University Hospitals Trust to improve its maternity services and the way that the organisation is led, insofar as that impacts on service delivery.  She reminded the Committee that, at its last meeting in February, the Committee remained concerned about the lack of evidence that the necessary improvement is taking place to provide the Committee and, most importantly, the citizens of Nottingham with assurance on the safety and quality of services provided.  Therefore, on behalf of the Committee, she has written to the Secretary of State for Health and Social Care and the Care Quality Commission to escalate the Committee’s concerns. 

The Committee noted its work programme for the remainder of the municipal year.