To receive update reports on the New Health Deal for Trafford from representatives of Trafford CCG, UHSM and CMFT (to follow).

Members received a presentation from Trafford Clinical Commissioning Group (CCG) on the New Health Deal for Trafford.  Dr Nigel Guest thanked the members of the Joint Health Scrutiny Committee for their swift response to the need to accelerate progress in changes to the Urgent Care Centre (UCC) at Trafford due to issues identified at North Manchester General Hospital (NMGH).  Gina Lawrence explained they had been approached by the Health and Social Care Partnership in September to consider providing support to the Pennine Acute Trust by accelerating their model in order to release consultants. She explained the considerations which informed the decision and that clinical teams from all partner organisations were involved and all pathways had been worked through.  She added that a number of case studies had been considered consisting of various scenarios.  Gina Lawrence explained that the numbers attending in the evening over recent months had dropped considerably.  Clinicians agreed that the majority of patients attending in the evening could wait until the following day and Mastercall was available to pick up those patients that were more urgent.  Healthwatch had also carried out an independent audit which focussed on the patient voice and were satisfied that the requirements of their audit were met.  She added that had they not provided support to NMGH the fallout would have had a detrimental affect on all partners and letters of support had been provided from them which she could provide to the Joint Health Scrutiny Committee if required.

Dr Mark Jarvis, Trafford CCG gave an overview of developments since the new service went live on Monday 3 October 2016.  He explained that by Tuesday 4 October 2016 the new arrangements for the Walk in Centre were also fully operational. He commented that the staff were working well together and treating on average 180 patients per day.  He said that at the start of the week they were receiving approximately 5 people per evening after 8pm which dropped to three people per evening by Thursday.  Of the evening visitors they were either dealt with on the ward or re-directed elsewhere.      

In respect of the Single Hospital Service Stephen Gardener explained that the Programme Board were currently developing a Communications and Engagement Strategy and had identified key stakeholders including the Trafford Health Scrutiny Committee and the Manchester Health Scrutiny Committee.  He explained there were no specific implications for the New Health Deal for Trafford. 

A member welcomed the detail contained within the presentation.  Members discussed whether the name of the centre should change and enquired who held overall responsibility.  A member asked whether the public were confused about the service currently offered and whether this would impact on the numbers attending. A member sought assurance that the opening hours would remain stable.  Stephen Gardener responded that the centre was in principle under shared ownership.  Officers confirmed there were no plans to change the opening hours again at the present time.  Gina Lawrence advised that initial communications regarding the changes to opening hours had been made via the local press and radio.  She explained that they didn’t want to confuse people or make them think the centre had moved.  She explained that the NHS had clear definitions for how centres were named and advised consideration would be given to the name going forward. 

A member asked how savings would be produced.  A member enquired about the impact to other parts of the NHS with these patients being redirected and whether any funding would be provided to offset this.  Officers confirmed that Trafford CCG had agreed £4million for investments in community services which CMFT had been subsidising until Trafford CCG found other input.  Officers confirmed that Trafford CCG put £0.5 million of Transformation Funding into the Urgent Care Centre to maintain it.  Stephen Gardener explained that Trafford Health Care Trust had historical financial pressures which CMFT had helped to alleviate, however there was still a £1 million funding gap.  He described that savings from other services were used to cross subsidise and the sheer scale of savings that providers were required to make year on year.   He explained that the move to a nurse led model only yielded enough savings to help them break even.  

In response to a members query regarding whether the unit was now fully staffed Mary Burney responded that recruitment was still ongoing but she was confident this would be completed shortly.  She described the urgent care model adding there was lots of interest in the unit by nurses.  Mark Jarvis advised the system had been designed so there was no impact elsewhere so there was no requirement to offset.  Gina Lawrence described the differences between planned and unplanned care, explaining that community services took time to develop and embed adding that the unit had a 95% occupancy rate at the current time. Dr Nigel Guest advised the next stage was to increase the capacity of General Practitioners (GP’s) to help alleviate the impact on A&E Departments. 

Decisions:

1.    To endorse the decision made by the Joint Health Scrutiny Committee members on 16 September 2016 to support the NHS in bringing forward the implementation of their plans for the Urgent Care Centre in order to move consultants to the A&E Department at North Manchester General Hospital.

2.    To note the reports.

3.    To agree on the continued need to monitor the implementation of the New Health Deal for Trafford, in particular the performance of the Urgent Care Centre at Trafford General Hospital

4.    To call a further meeting of the Joint Health Scrutiny Committee in January 2017.

5.    To request that statistical data be provided to the Committee’s next meeting including the numbers and status of attendees to the Trafford Urgent Care Centre in addition to those standing items on the agenda.

6.    To re-iterate that the Committee does not at this point support the downgrading of the Trafford Urgent Care Centre to a Minor Injuries Unit.

7.    To request that should the NHS wish to make any further changes to the service provision at the Trafford Urgent Care Centre appropriate consultation is carried out with both the Joint Health Scrutiny Committee and Trafford Health Scrutiny Committee.

8.    To note that the NHS have confirmed that individual health scrutiny committees including Manchester Health Scrutiny Committee and Trafford Health Scrutiny Committee will receive regular updates on the Single Hospital Service.

9.    To request that, should any emerging implications for the New Health Deal for Trafford arise from the development of the Single Hospital Service, they be reported to the Joint Health Scrutiny Committee.