Southwark Clinical Commissioning Group (SCCG) Twelfth Meeting of the Dulwich Project Board Thursday 29 th November 2012 Room 132, Tooley Street Present: Robert Park (Chair) Non Executive Director RP Rebecca Scott Programme Director - Dulwich SCCG Dr. Femi Osonuga GP Clinical Lead - SCCG FO Dr. Roger Durston GP Clinical Lead - SCCG RD Rosemary Watts Head of Membership and Engagement SCCG RW Colin Beesting Communications and Engagement Manager CB Gaby Charing Lay Member Development GC Pat Roberts Primary Care Contracting- NHS SE London PR John King EPEG representative JK Millie Hutchinson LINk MHu Martin Saunders LINk MS Leighann Li Head of Customer Service and Facilities Management, GSTT Community Services LL Vicky Bradding Corporate Secretary SCCG VB Apologies: Andrew Bland Chief Officer SCCG AB Malcolm Hines Chief Financial Officer SCCG Jill Solly Head of Primary/Secondary JS Care Interface, King s College Hospital Sec-Chan Hoong LINk SH David Sturgeon Director of Primary Care, NHS SE London DS Rylla Baker AD of Primary Care, NHS SE London RB Gwen Kennedy Director of Client Group Commissioning - SCCG GK Julian Alexander Senior Estates Manager, NHS SE London JA Pam Cooper EPEG representative PC Tamsin Hooton Director of Service Redesign SCCG TH Sarah McClinton Head of Adult Services LB Southwark SMcC Angela Dawe Director of Operations AD GSTT Community Services 1 Introductions and welcomes RP welcomed members to the meeting, especially Gaby Charing, who is part of the Lay Members Development Programme, and who will be attending the Dulwich Project Board in the future. Board members introduced themselves. Action 1
2. The minutes of the meeting held on 25 th October 2012 were agreed to be a correct record. The final minutes from 27 th September 2012 meeting were also noted. stated that more detail in the minutes had been requested. She has tried to incorporate this into the minutes presented and has also produced a one page summary of the minutes to facilitate feedback. She requested comments. All RP welcomed these developments and emphasised the need for the minutes to be as clear as possible to avoid any misinterpretation. In answer to a question from MHu, RP confirmed that Dulwich Project Board is not a meeting in public. It is a working group with two patient and LINk representatives and it reports and makes recommendations to the Clinical Commissioning Committee. The combination of the patient involvement in the process and the decisions being made in public provide an open and transparent process. The minutes represent a summary of the discussions and are available, with the final versions of reports to the SCCC, on the Developing Health Services in Dulwich web page. 3. Matters Arising Matters Arising [24 th July] Feedback from the Public Meeting Q&A Sheet to resend updated sheet to RD for checking. JK circulated notes of his visit with Pam Cooper to Betty Alexander Unit. /RD Programme Director s report Meetings with Clinicians reported that she has met with AD to discuss the proposed workshop on bringing ideas together. She has been invited to participate in some of the Integrated Care Programme [ICP] strategy discussions and this will provide a useful forum to see how the work of the DPB and the ICP Board interrelate. She saw the Dulwich Project as being an enabler for the future development of the ICP. Consultation Process - CB reported that he has met with LINk, Community Action Southwark and local advocacy organisations. Feed back received so far is that everyone is happy to work alongside and support the consultation process. Service Model/Development of Service Options Work on-going CB TSA on agenda Programme Director s report Education Funding Agency reported that she has met with the Education Funding Agency who has agreed to liaise with the local authority to determine plans for primary school education in the Dulwich area. 2
Site search and survey work Last year a local site search was undertaken to confirm there are no alternative sites available in the Dulwich area. As a year has passed this search is being repeated. A survey of the existing building has been requested to get an assessment of the costs of work necessary to allow the building to continue to be used in the future. Feedback from discussions with clinicians presented a paper which set out a summary of the discussions she has had with clinicians at King s, and invited comments. RD stated that the summary of discussions is extremely useful. The common themes of transport and space pressure have continued to emerge and he stated that the recommendations of the Trust Special Administrator [TSA] may put more pressure on King s. He stated that it is essential that we to look to ensuring the provision of high quality services cost-effectively. He also commented that within the financial constraints any developments as a result of this project should have the capacity for future expansion. FO agreed and highlighted that any improvements must be co-ordinated with acute developments. stated that she has discussed the paper with JS. The report presented is very much a clinical perspective and it will be important to engage the wider management at King s. By transferring activity to Dulwich, space is released at KCH who would be able to attract more money by undertaking tertiary or specialist work. The incentives are there for shifting activity out of their main site and use the current estate for more tertiary work. FO pointed out that this would also encourage hospital consultants to work in the community. MHu highlighted the need to ensure that Kings is kept as the local hospital for Southwark, and the Project Board agreed. RD said that we need King s to be as efficient as possible so that we can balance the wider health economy. agreed that she would discuss how best to progress these discussions with Jill Solly and Prof Moxham, and asked for clinical lead support in these discussions. JK enquired whether considered that clinicians comments are a wish list rather than being realistically achievable. stated that it is clear in some areas what can be achieved but there are some other grey areas remaining eg extent of cost effectiveness if diagnostics are provided in a hub. The detail needs to be worked through to develop a service model which makes clinical sense as well as being deliverable. RD stated that in discussion with clinicians it is clear that some prefer their service to operate from one site as there are advantages in this. There are sometimes tensions between patient and clinical preferences which will need addressing. RP thanked for her report which has opened up the routes for conversations between KCH and the CCG. An update will be provided for the next meeting Timetables & process for approval of consultation plan, pre- 3
consultation business case and consultation document presented a draft paper with the key dates and pointed out that these are consistent with the TSA timetable although there will be pressure to meet all deadlines at the end of the process. MHu enquired whether the timetable fits with the future ownership of the site. stated that the site will be formally transferred during the consultation, and noted that the process will commence as a PCT but will finish as CCG consultation. will circulate the newssheet from NHS Property Services. She will also discuss with MH how best to obtain more formal confirmation of the future working arrangements through possibly writing to the London Director now they are in post to confirm the support arrangements. RP noted that it still stood that the first call for use of the Dulwich site is for health services followed by the second call for public use and all work will need to be carried out within these limitations. stated that some members of the public have very strong principles about the use of public land. This policy is however national, and the CCG will be expected to abide by it. However, the CCG can seek to demonstrate that as much as possible of the site is being used for services for the public. RW pointed out that there is no SCCC on the 17 th January so the process for sign off of the pre consultation business case and consultation document needs to be discussed. CB also highlighted that the TSA report may require the timetable to be revised. noted that she is seeking legal advice, and would confirm the process of making the actual consultation document public. As part of the development process in the run-up to the consultation noted that she has also presented the draft service model to the South Southwark Locality PPG where it was positively received. Consultation Plan CB stated that this is the means by which responses are sought. He outlined the plan and requested members views or comments on whether there is anything else or other groups that need to be targeted. He highlighted that while South Southwark is the key area for targeting there are also stakeholders from other areas who use existing services in Dulwich whose views need to be sought. CB requested DPB members views on different styles of presenting information at public meetings. Briefings also need to be provided for DPB members. MHu enquired about the use of social media for consultation responses and CB explained that this is a point he is clarifying so that there is no misunderstanding. GC suggested that social media could be used only to promote consultation, with a link to the consultation webpage stating clearly that comments using social media would not be considered formal responses to the consultation. 4
CB summarised the process for evaluation of responses. He will circulate a link to an example good evaluation report so that members can see the kind of information to expect.. Pre-consultation Business Case detailed responses to the engagement process outlined the process and requested members comments on the document. Members were asked for comments by the 14 th December. will complete the rest of the work required and the report will form part of the public documentation and be put onto the webpage. Appointment of Technical support master planning phase 1 stated that she has always been clear that the CCG will consult on both the service model and the use of the wider site. LIFTCo have been asked to oversee the work to develop very high level outline masterplan scenarios. stated that she is keen to have DPB members involvement, particularly PPI involvement, in the choice of masterplanners and stated that it would be necessary to meet early next week to review the bids received and then meet with the preferred bidder so that feedback can be provided to the January DPB meeting. RP expressed concerns about the timing of this and the restrictions that may result, but emphasised that this stage is only about the high level master plan options and not designing the buildings. CB also pointed out that this work will provide some ideas of what the site could look like and will provide tangible visual representation for the consultation document. A range of possibilities can be included. It was agreed that work commences on producing the master plan for the site. RP/JK/ and JA [if possible] meet early next week to confirm the choice of architects and meet with the preferred bidders. RP/JK//JA Governance Risk Log The Project Board had a discussion about the Dulwich Project in relation to the TSA process. The following issues were identified as potentially impacting on Southwark CCG and the Dulwich Project, and it agreed that a risk would be added to the register covering these points: Future role of KCH in the wider sector Development of high quality community services[being addressed by CCG] Maternity services Closure of Lewisham A&E highlighted that her colleagues in the Service redesign team were trying to get details of the activity assumptions underpinning the recommendations. Without that information it is difficult to assess the extent of the additional activity which could come to King s and 5
potentially impact on the future size of any additional facilities in the Dulwich area. It was noted that if Lewisham A&E is closed following the TSA recommendations there will be a significant impact on Kings, and JK pointed out the need for discussion between the TSA and TfL MS also pointed out that (for instance) trauma/fracture clinics will be affected, and suggested that follow-up appointments could be undertaken more locally. Schedule of meetings The revised meeting dates for the first quarter 2013 and dates for the rest of the year were noted. The first meeting will be held on the 3 rd January 2013. Any Other Business reported that a submission re Dulwich has been received from Ken Hoole. A response has been drafted and both the submission and the response will be presented to the CCG on 6 th December. A submission from the chair of Melbourne Grove Residents Committee has also been received. Copies of both submissions and responses will be circulated to the DPB. Date of Next meeting 3 rd January 2013 9.30 11.30 Room 132 Tooley Street 6