Agenda item

This report and appendices deal with a proposal for reconfiguration of children’s specialised cancer services treatment centre. The Committee is asked to consider whether this constitutes a substantial variation or development of a health service.

Discussion:

The Director of Transformation and Programmes, London Region. NHS England introduced the report which sought a decision from the Committee on whether the reconfiguration of the treatment centre constituted a substantial variation of a health service. This was a period of pre consultation on the service change. The combining of the principal centre and that of a paediatric centre on one site was deemed the best option for children receiving treatment.

Members raised several questions and comments which included:

It was commented that the main question was whether Medway felt the need to participate in a joint overview and scrutiny committee over the proposals.

Practicalities of Joint Health Overview Scrutiny Committee (JHOSC) - it was asked what value a JHOSC would add and what the potential delays could be to the proposal timeline. Additionally what decisions had been made by the other Authorities that had been consulted with. The Director of Transformation and Programmes said that children from all the Authorities consulted attended the Royal Marsden and St Georges Hospitals for treatment. Kent County Council had made the decision that they did not view the proposals as a substantial variation but wanted to be engaged with during the consultation process. East Sussex County Council also made the decision that this was not a substantial variation but wanted to be able to submit a letter if needed to a JHOSC if one was formed. South East London Authorities indicated they were likely to come to a decision of no substantial variation. South West London Boroughs and Surrey County Council had not come to a final conclusion but were likely to decide that this was a substantial variation as the hospitals involved were within their authority area.

The proposals were regarded by NHS England as a substantial variation and as a result they would run a public consultation to get a view from stakeholders before a final decision would be made on the appropriate site.

Impact on Medway Children- it was asked that if either of the identified options for the site was to progress, what the impact and potential outcomes would be for Medway children. The Director of Transformation and Programmes, NHS England, stated that Professor Mike Richards who was commissioned for an independent view, had concluded that having a principal treatment centre on the same site and a paediatric intensive care unit was a good decision. The clinicians on the clinical commissioning reference group also held the same view that it would benefit children to receive holistic treatment on one site. The premise of the proposals was to improve patient experience as well enhance better outcomes for children.

Travel - the proposed sites would mean further travel for some families, with improved public transport access for all families by over 90% but a decrease in ease of driving access of 50% for families to St Georges Hospital and 70% to the Evelina Centre. Good travel transport systems would continue to be made available for very vulnerable children and travel options for all would form an extensive part of the equality, diversity and impact assessment.

It was commented that it was important that NHS England engage comprehensively with Medway residents as part of their consultation process to which the officer agreed that they would welcome input from Medway Engagement Officers as part of the process.

Decision:

The Committee noted the report and agreed that:

a)    The proposal from NHS England on changes to the children’s cancer specialist treatment centres does not constitutes a substantial variation or development in the provision of health services.

b)    NHS representatives be invited to attend this Committee and present an update at an appropriate time.

c)    Medway officers participate in the engagement and consultation process and the Committee be sighted on development of this process.