Agenda item

To consider NHS England’s proposals for the future provision of Congenital Heart Disease Services with particular reference to University Hospitals of Leicester NHS Trust.

NHS England launched a national consultation on its proposals for the future commissioning of Congenital Heart Disease services on 9 February 2017. 

This consultation will run until Monday 5 June, closing at 23.59. Extra time has been added to the usual 12 week consultation period to allow those involved in local government elections to have a full opportunity to contribute to the consultation.

The “Proposals to Implement Standards for Congenital Heart Disease Services for Children and Adults in England - Consultation Document” is attached at Appendix B1 – Page 1.

This Joint Committee is the appropriate body to be consulted by NHS England on the proposals in accordance with Regulation 30 of the Local Authority (Public Health and Wellbeing Boards and Health Scrutiny) Regulations 2013.  The regulation provides that where the appropriate person (NHS England) has any proposals for a substantial development or variation of a health service in an area they must consult the local authority.  Where the consultation affects more than one local authority in an area, the local authorities are required to appoint a Joint Committee to comment upon the proposal and to require a member or employee of the responsible person to attend its meeting and respond to questions in connection with the consultation.

The Regulation does not prevent constituent Councils of the Joint Committee considering the issues separately; but it is the responsibility of the Joint Committee to formally respond to the consultation process.

The Regulations also provide that a Council may refer a proposal to the Secretary of State where:-

·                   it not satisfied that the consultation has been adequate in relation to content or time;

·                it is not satisfied with the reasons given for the change in services; or

·                it is not satisfied that that the proposal would be in the interests of the health service in its area.

This referral must be made by the full Council unless the Council has delegated the function to a Committee of the Council.  Currently, only the City Council had delegated the powers to refer the NHS proposals to the Secretary of State. Leicestershire County Council and Rutland County Council would need to approve any referral at their respective Council meetings.

Supporting Information

The following supporting information is supplied to assist the Joint Committee to comment upon the proposals in the Consultation Document.

a)         Minutes of the Meeting of the Joint Committee held on 29 September 2016 when the Joint Committee considered the proposals in the pre-consultation engagement stage. Appendix B2 (Page 75)

b)         Letter from Will Huxter responding to issues raised by the Joint Committee on 29 September 2017.  Appendix B3 (Page 87)

c)         Proposals to implement standards for Congenital Heart Disease Services for Children and Adults in England - Consultation Summary. Appendix B4 (Page 91)

d)         Congenital Heart Disease Equality and Health Inequalities Analysis – Draft for consultation.  Appendix B5 (Page 109)

d)         Congenital Heart Disease Provider Impact Assessment: National Panel Report.  Appendix B6 (Page 157)

e)         NHS England Congenital Heart Disease Provider Impact Assessment.  Appendix B7 (Page 247)

g)         Congenital Heart Disease Consultation – Events List.  Appendix B8 (Page 283)

NHS England will be represented at the meeting by Will Huxter, Regional Director of Specialised Commissioning, London Senior Responsible Officer CHD Commissioning & Implementation Programme, NHS England and Dr Geraldine Linehan, Regional Clinical Director (Midlands & East) Specialised Commissioning, NHS England.

The Joint Committee received NHS England’s proposals for the future provision of Congenital Heart Disease Services with particular reference to University Hospitals of Leicester NHS Trust.

NHS England had launched a national consultation on its proposals for the future commissioning of Congenital Heart Disease services on 9 February 2017.  This consultation would run until Monday 5 June, closing at 23.59. Extra time has been added to the usual 12 week consultation period to allow those involved in local government elections to have a full opportunity to contribute to the consultation.

It was noted that the Joint Committee was the appropriate body to be consulted by NHS England on the proposals in accordance with Regulation 30 of the Local Authority (Public Health and Wellbeing Boards and Health Scrutiny) Regulations 2013.  The regulation provided that where the appropriate person (NHS England) had any proposals for a substantial development or variation of a health service in an area they must consult the local authority.  Where the consultation affects more than one local authority in an area, the local authorities were required to appoint a Joint Committee to comment upon the proposal and to require a member or employee of the responsible person to attend its meeting and respond to questions in connection with the consultation.

The Regulation did not prevent constituent Councils of the Joint Committee considering the issues separately; but it was the responsibility of the Joint Committee to formally respond to the consultation process.

The Regulations also provided that a Council may refer a proposal to the Secretary of State where:-

•           it not satisfied that the consultation has been adequate in relation to content or time;

•           it is not satisfied with the reasons given for the change in services; or

•           it is not satisfied that that the proposal would be in the interests of the health service in its area.

This referral must be made by the full Council, unless the Council has delegated the function to a Committee of the Council.  Currently, only the City Council had delegated the powers to refer the NHS proposals to the Secretary of State. Leicestershire County Council and Rutland County Council would need to approve any referral at their respective Council meetings.

The following information was supplied to the Joint Committee prior to the meeting to assist it comment upon the proposals in the Consultation Document.

a)         The “Proposals to Implement Standards for Congenital Heart Disease Services for Children and Adults in England - Consultation Document”.

b)         Minutes of the Meeting of the Joint Committee held on 29 September 2016 when the Joint Committee considered the proposals in the pre-consultation engagement stage.

c)         Letter from Will Huxter responding to issues raised by the Joint Committee on 29 September 2017. 

d)         Proposals to implement standards for Congenital Heart Disease Services for Children and Adults in England - Consultation Summary.

e)         Congenital Heart Disease Equality and Health Inequalities Analysis – Draft for consultation. 

f)          Congenital Heart Disease Provider Impact Assessment: National Panel Report. 

g)         NHS England Congenital Heart Disease Provider Impact Assessment. 

h)        Congenital Heart Disease Consultation – Events List. 

Mr Huxter was invited to make an introductory statement and he welcomed the opportunity to discuss the proposals and the consultation process as set out in the documents that had been circulated to the Joint Committee members prior to the meeting.

During his introduction Mr Huxter emphasised that:-

a)         No decision had been made in relation to any of the providers in the proposals in the national consultation document.

b)         This was a national consultation process and there were no predetermined views on how many providers of service there should be or on any proposed closure of services in the consultation document but it was important to make sure that the national standards for service were implemented.

c)         The ambition and the role for NHS England was to ensure that all patients across the country had consistent access to high quality services and he felt progress had been made since the original proposals were put forward.

d)         In relation to UHL NHS Trust, NHS England had held discussions on arrangements for co-location of services and the substantive recruitment to surgical posts which had now been resolved.  The only outstanding issue related to the number of surgical operations carried by each surgeon to get to the figures of 375 operations per year.

e)         NHS England were not responsible for choosing where patients came from or to mandate where patients came from to have surgery at a particular specialist centre.  It was for the parents/patients to decide where they wished to receive treatment.