Agenda item

THE ALTRINCHAM HUB DEVELOPMENT

Minutes:

The Committee gave consideration to a report of the Accountable Officer for NHS Trafford and Clinical Commissioning Group (CCG) which informed of the the background of the Altrincham Hub development and the CCG’s response to the outcome of the independent review of the Hub, commissioned by the Greater Manchester Health and Social Care Partnership.

 

The author of the report, accompanied by the Associate Director of Primary Care Trafford CCG, attended the meeting to present the information and to address the enquiries of the Committee.

 

In May 2015, a full business case had been approved by the CCG Governing Body to locate a health care hub on the site of the former Altrincham Hospital which was owned by a local developer. However, due to historic governance processes and lack of appropriate challenge of the business case, the project led to expending of funds and resources that could have been saved.

 

The Accountable Officer explained that the independent report commissioned by the Greater Manchester Health and Social Care Partnership on the Hub had been published on 6th March 2019. The CCG had accepted the nine recommendations listed in the report which urged the organisation to put in place measures to ensure the efficient accomplishment of future projects of similar size and strategic importance. 

 

The Accountable Officer went on to explain that, in addition to addressing those nine recommendations, the CCG also wanted to focus on the wider issues in the review, such as ensuring that appropriate governance arrangements were in place during the key decision making process, building a high performing Governing Body able to appropriately challenge future schemes and identify risks and the ability of management to deliver agreed actions. As a result, the responses to the recommendations and the plans and processes put in place to address the wider organisational issues were reviewed, internally, by the CCG’s Governing Body and the Audit Committee and, subsequently, approved by the Greater Manchester Health and Social Care Partnership.

 

The Accountable Officer also informed the Committee of the future use of the Altrincham Hub and confirmed that the CCG had entered a legal agreement with two GP Practices which would move in the near future from their existing buildings into the hub, providing primary care services for over 24,000 residents. This would be pivotal in securing the opening of a community pharmacy in the building. The Accountable Officer also reported that conversations with the Council were ongoing about the possibility of an integrated health and social care team located in the Hub. The NHS Property Services was in conversation with commercial organisations about the use of the third floor.

 

The Committee sought reassurance from the CCG’s representatives that the lesson learnt from these circumstances would lead to a more robust procurement process and a clear audit trail of decision making within the organisation. Members were informed that, as a consequence of the independent review and the acceptance of its findings, the CCG had developed a three phase response which had consisted in the review of CCG’s Governing Body’s constitution signed off by NHS England, the assurance of effective scrutiny of decision making through the revised Terms of Reference of committees and sub-committee within the organisation and the review of all policies and procedures. The outcome of the internal review also ensured that effective record keeping of decision making was in place to comply with good governance standards as well as with openness and transparency through publication of records. 

 

Ward Members, who attended this evening’s meeting, highlighted the frustration of residents about this matter, considering the current national and local context, characterised by financial constraints and reduction in public spend. Ward Members queried the function of the Council’s Health Scrutiny Committee with regard to this issue and whether there was a lesson to be learnt by NHS England on this matter. It was explained that the amount of information available to the Health Scrutiny Committee had been limited. However, CCG’s processes had changed and Members of the Council’s Executive were being invited to attend CCG’s meetings where discussions took place on the quality of services, their performance and finance.  

 

The Committee also queried the CCG agreement with NHS Property Services to retain the financial risk of void space through an indemnity deed and the role of NHS Property Services in this decision. It was explained that, currently, the yearly cost to the CCG of not having tenants in the building was over £2 M. However, the CCG was determined to work with partners to make the best of the building. 

 

With regard to the future use of the building, Members asked what would be the cost of converting the third floor into a commercial space. It was explained that the third floor was already organised as an office space. However, the conversion cost would be around £1.3M, should a different destination be decided. 

 

The Committee raised questions regarding the lack of competitive procurement for selecting a developer for the hub. It was explained that the CCG had now secured the expertise of STAR Procurement; the management of large scale projects in future would follow national standards of procurement.

 

Members requested to clarify the relationship between CCG and NHS England. It was explained that, within the Devolution Agreement, Greater Manchester Health and Social Care Partnership had to report to NHS England. CCG had quarterly meeting with the Greater Manchester Health and Social Care Partnership regarding the lesson learnt on the Hub development.

 

Members requested an update on progress against the CCG’s action plan at the meeting of the Committee in November 2019. Members also asked to visit the site with a member of the CCG to fully understand the potential use of spaces. 

In addition, Members requested to have access to agendas and minutes of the CCG Governing Body’s meetings. It was explained that these were available on line, on the Trafford CCG’s web-site.

 

RESOLVED:

1.    That an update on the CCG Action Plan on the Altrincham Hub be presented at the meeting of the Health Scrutiny Committee on 8th November 2019;

2.    That members visit the Altrincham Hub building with a representative of the CCG to fully understand the potential use of spaces;

3.    Further information be provided by the CCG to the Committee with regard to NHS England and NHS Property Services and their role in the lesson learnt process and risk management.

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