Agenda and minutes

Leicestershire, Leicester and Rutland Joint Health Scrutiny Committee
Tuesday, 4 September 2012 2:00 pm

Venue: THE COUNCIL CHAMBER - FIRST FLOOR, TOWN HALL, TOWN HALL SQUARE, LEICESTER

Contact: Graham Carey 0116 2298813 

Items
No. Item

1.

APOLOGIES FOR ABSENCE

Minutes:

Apologies for absence were received from Mr G Jones CC and Mr P A Roffey CC (Leicestershire County Council) and Councillor Parsons (Rutland County Council).

2.

DECLARATIONS OF INTEREST

Members are asked to declare any interests they may have in the business on the agenda, and/or indicate that Section 106 of the Local Government Finance Act 1992 applies to them.

Minutes:

Councillor Alfonso declared an interest in the general business of the meeting, in so far as she had been involved in raising signatures for the petition against the Secretary of State’s decision.

 

Councillor Cooke declared an interest in the general business of the meeting, in so far as his wife was a patient at the Glenfield Hospital.

 

Councillor Naylor declared an interest in the general business of the meeting, in so far as he had signed the petition and had helped collect signatures for the petition against the Secretary of State’s decision and he was a Shadow Governor of the Leicester Partnership NHS.

 

Councillor Westley declared an interest in the general business of the meeting, in so far as his sister worked in the cardiology unit at Glenfield Hospital and he had been involved in raising signatures for the petition against the Secretary of State’s decision.

 

In accordance with Leicester City Council’s new Code of Conduct the interests declared by its Members were not Disclosable Pecuniary Interests but were Other Disclosable Interests and for the Scrutiny Committee Members these were not considered so significant that they were likely to prejudice Members judgement of the public interest.  Members were, therefore, not required to withdraw from the meeting as a consequence.

3.

DRAFT PURPOSE AND SCOPE OF THE REVIEW pdf icon PDF 54 KB

To approve the attached Draft Purpose and Scope of the Committee’s review of the Joint Committee for Primary Care Trusts decision on 4 July 2012 to move health services from Leicester to Birmingham.

Minutes:

A Draft Purpose and Scope of the Committee’s review of the Joint Committee for Primary Care Trusts decision on 4 July 2012 to move health services from Leicester to Birmingham was submitted for approval.

 

RESOLVED:-

That the draft Purpose and Scope of the Committee’s review  of the Joint Committee for Primary Care Trusts decision on 4 July 2012 be approved.

 

4.

LETTER TO THE SECRETARY OF STATE pdf icon PDF 507 KB

Members to note the attached letter that has been sent to the Secretary of State indicating that the Joint Health Scrutiny Committee is considering referring the decision of the Joint Committee of Primary Care Trusts (JCPCT) back to Secretary of State once it has heard further evidence and completed the current review.

Minutes:

A copy of the letter sent to the Secretary of State indicating that the Joint Health Scrutiny Committee was considering referring the decision of the Joint Committee of Primary Care Trusts (JCPCT) back to Secretary of State once it has heard further evidence and completed the current review was submitted for Members information.

 

RESOLVED:

                        that the letter to the Secretary of State be noted.

 

5.

PAEDIATRIC CONGENITAL CORONARY CARE AND ECMO UNITS GLENFIELD HOSPITAL pdf icon PDF 92 KB

To scrutinise the Joint Committee for Primary Care Trust’s decision of 4 July 2012 to move the Paediatric Congenital Coronary Care Unit and the ECMO Unit to Birmingham Children’s Hospital.

 

The Decision Making Business Case, Safe and Sustainable, Review of Children’s Congenital Heart Services in England: July 2012 can be found at: http://www.specialisedservices.nhs.uk/document/safe-sustainable-review-children-s-congenital-cardiac-surgery-decision-making-business-case.  This link also provides access to a number of ancillary documents.

 

A copy of the Decision Making Business Case will be sent under separate cover to the members of the Committee.

 

A)   To receive as evidence as part of the scrutiny process, the Minutes of the Meeting of Leicester City Council’s Health and Community Involvement Scrutiny Commission held on 26 July 2012, together with the supporting reports and background papers that were submitted at that meeting.  (Appendix C)

 

The supporting reports and background papers were:-

 

1)    Appendix D of the Overview and Scrutiny of Health Guidance issued by the Department of Health.  (Appendix C1)

 

2)    The decision of the Leicester City Council Meeting held on 28 June 2012.  (Appendix C2)

 

3)    The decision of the Leicestershire County Council’s Cabinet Meeting held on 23 July 2012.  (Appendix C3)

 

4)    A report from the University Hospitals of Leicester NHS Trust to the Public Trust Board on 26 July 2012  giving an update on the Trust’s review of the Secretary of State’s decision in relation to securing legal advice and a clinical review of the decisions.  (Appendix C4)

 

5)    A copy of an e-mail from Leicester LINks to all East Midlands MPs together with a briefing note on the outcome of the Safe and Sustainable Review.  (Appendix C5)

 

6)    A paper submitted by Dr Nichani, Consultant Paediatric Intensivist University Hospitals of Leicester (UHL) outlining grounds for challenging the decision made on 4 July 2012 by the Joint Committee for Primary Care Trusts (JCPCT).  (Appendix C6)

 

Members are asked to receive the evidence and supporting documents and background papers.

 

 

B)   UNIVERSITY HOSPITALS OF LEICESTER (UHL)

 

To receive evidence from Mr Jim Birrell, Interim Chief Executive and Mr Aidan Bolger, Head of Service for Cardiology, on the outcome of the UHL review of the JCPCT’s decision in relation to securing legal advice and a clinical review of the recommendations.  A report to be submitted to the UHL Trust Board Meeting on 30 August is not currently available but this will be circulated to Members as soon as it is in the public domain.  This report will be Appendix C7.

 

Following the submission of evidence Members will have an opportunity to ask questions.

 

C)   UNIVERSITY OF LEICESTER

 

To receive evidence from Sir Bob Burges, Vice Chancellor, University of Leicester supported by Jo Wood, Assistant Registrar, University of Leicester to highlight and publicise the excellence of Leicester University and the research/training benefits and links with the Glenfield Heart Unit facilities.

 

Following the submission of evidence Members will have an opportunity to ask questions.

 

Additional documents:

Minutes:

Members were asked to scrutinise the Joint Committee for Primary Care Trust’s decision of 4 July 2012 to move the Paediatric Congenital Coronary Care Unit and the ECMO Unit to Birmingham Children’s Hospital.

 

It was noted that the Decision Making Business Case, Safe and Sustainable, Review of Children’s Congenital Heart Services in England: July 2012 could be found at: http://www.specialisedservices.nhs.uk/document/safe-sustainable-review-children-s-congenital-cardiac-surgery-decision-making-business-case.  This link also provided access to a number of ancillary documents.

 

A copy of the Decision Making Business Case had previously been sent to all the Members of the Committee.

 

It was noted that the City Council’s Health and Community Involvement Scrutiny Commission had already heard evidence from the Leicester LINks and the University Hospitals of Leicester at its meeting on 26 July 2012.

 

RESOLVED: 

 

that the Minutes of the Meeting of Leicester City Council’s Health and Community Involvement Scrutiny Commission held on 26 July 2012, together with the supporting reports and background papers that were submitted at that meeting, be  received as evidence as part of the scrutiny process.

 

The supporting reports and background papers were:-

 

1)    Appendix D of the Overview and Scrutiny of Health Guidance issued by the Department of Health. 

 

2)    The decision of the Leicester City Council Meeting held on 28 June 2012. 

 

3)    The decision of the Leicestershire County Council’s Cabinet Meeting held on 23 July 2012. 

 

4)    A report from the University Hospitals of Leicester NHS Trust to the Public Trust Board on 26 July 2012  giving an update on the Trust’s review of the Secretary of State’s decision in relation to securing legal advice and a clinical review of the decisions. 

 

5)    A copy of an e-mail from Leicester LINks to all East Midlands MPs together with a briefing note on the outcome of the Safe and Sustainable Review. 

 

6)    A paper submitted by Dr Nichani, Consultant Paediatric Intensivist University Hospitals of Leicester (UHL) outlining grounds for challenging the decision made on 4 July 2012 by the Joint Committee for Primary Care Trusts (JCPCT). 

 

 

 

 

 

6.

UNIVERSITY HOSPITALS OF LEICESTER (UHL)

Minutes:

Mr Jim Birrell, Interim Chief Executive and Mr Aidan Bolger, Head of Service for Cardiology, attended the meeting to present evidence on the outcome of the UHL review of the JCPCT’s decision in relation to securing legal advice and a clinical review of the recommendations.  A report that was submitted to the UHL Trust Board Meeting on 30 August had previously been circulated to Members.

 

Mr Birrell in presenting his evidence to the Committee made the following comments:-

 

Ø  That, having considered Counsel’s advice, the Board had concluded that challenging the decision of the JCPCT on legal issues was not likely to achieve a beneficial outcome and this route would not be pursued.

Ø  The Board had considered that it had a convincing case to question the JCPCT’s decision on clinical grounds based around quality, capacity and risk issues.

Ø  Representatives of UHL had met with Sir Neil Makay last week and had presented their case to him.  He had taken the case away to assess it and had subsequently written to the Secretary of State to suggest that the evidence now submitted should be looked at in detail.

Ø  The Board believed that the only route to question the JCPCT’s decision was through a formal referral by the Committee.

Ø  The UHL supported the Safe and Sustainable process and felt it was a good model to secure the safest and best quality services and recognised the philosophy of concentrating the best skills in a smaller number of units to achieve this.

Ø  The UHL had also put forward a further option to create a  modified midlands unit based on two sites at Birmingham and Glenfield to be subject to single audit, reporting and research processes.  

   

Mr Bolger stated that :-

 

Ø  The capacity for the proposed midlands’ network did not take account of the fact that demands for the services exceeded the capacity at the Birmingham Children’s Hospital.  The risks of the JCPCT’s proposal had been underestimated and there were local, regional and national implications of closing the Paediatric Intensive Care Unit.

Ø  The Safe and Sustainable Committee had commissioned work to predict demand up to 2025 for Paediatric Cardiac Surgery.  The only data available to them was surgical data for 2006/07.  At that time there were 4,750 operations and a flat growth of operations were predicted.   Data now available up to 2010 indicated a rapid increase in the number of operations to 5,452, an increase of 700 operations per year.  This data was not available to the JCPCT at the time it made its decision but UHL felt that it would be negligent to ignore this now. Reference was made to the data on pages 8 and 9 of the UHL report (Appendix C7).

Ø  If the data in the graph on page 9 of Appendix C7 was extrapolated, it showed a marked increase in the predicted number of operations nationally in the future.

Ø  This had implications for the proposed midlands network as the predicted  ...  view the full minutes text for item 6.

7.

UNIVERSITY OF LEICESTER

Minutes:

 

Sir Bob Burgess, Vice Chancellor, University of Leicester supported by Jo Wood, Assistant Registrar, University of Leicester attended the meeting to highlight and publicise the excellence of Leicester University and the research/training benefits and links with the Glenfield Heart Unit facilities.

 

The Vice Chancellor thanked the Committee for the opportunity to submit evidence and made the following comments:-

 

Ø  The University had built up considerable achievements and expertise in research since 1974.  This had led to a reputation and ethos which attracted high calibre people who wanted to work in a successful research environment.

Ø  The work of the Cardiovascular Research Centre provided benefits to both the local and national provision of cardiovascular services.

Ø  This had been further recognised when the Secretary for State had visited the Cardiovascular Biomedical Research Unit and had stated that the ‘centre cemented Glenfield’s reputation as a leading international heart hospital.’

Ø  The University was judged as ‘internationally excellent’ in the rigorous 2008 Research Assessment Exercise.  95% of the submissions were judged to be of international standing and 55% of the submissions had been placed in the top two grades compared to 40% for Birmingham University.

Ø  Considerable funds had been raised from external sources based upon the success of the research and the close working arrangements with Glenfield Unit.  £13m had been raised in the last two years for the construction of the Cardiovascular Research Centre with approximately £6m being donated by local philanthropists.

Ø  The University had recently secured £7m of investment through the van Geest Foundation and staff involved in the Cardiovascular Research Centre had independently secured £20m of funds in the last three years.  The ability of the University to secure future investment and funding could be jeopardised if cardiovascular and ECMO services were lost at Glenfield as this would impact negatively on the current comprehensive cardiovascular service that had been built up over a long period of time.  The ability to raise funds was dependent upon having a comprehensive range of services available and often local philanthropists donated generously because they or a family member had been treated at the Glenfield Hospital.  This local connection would be lost if services transferred.

Ø  The current paediatric surgery and ECMO made a substantial contribution to published work on trials and other work by staff in the Lancet and the New England Journal of Medicine.     

Ø  Professor N Samani, Director Leicester NIHR Biomedical Research Unit in Cardiovascular Disease had originally trained at the University and had an international reputation.  He had a support staff of 30 academics, 150 researchers as well as clerical, technical and manual staff.  Any diminution of the services and opportunities currently available could have detrimental impacts upon these staff as well.

Ø  Currently there are a number of Professors who were undertaking research of international recognition in the following fields:-

§  Genetic factors in heart disease;

§  Advances in controlling blood pressure;

§  Stents for coronary heart disease;

§  Strokes;

§  Diabetes prevention; and

§  Valve replacement  ...  view the full minutes text for item 7.

8.

RESPONSES FROM EAST MIDLANDS HEALTH AND OVERVIEW SCRUTINY COMMITTEES pdf icon PDF 208 KB

To receive and comment upon the responses received from other East Midlands health Overview and Scrutiny Committees.

Minutes:

The responses received from other East Midlands Health Overview and Scrutiny Committees were submitted to the Committee for information.

 

RESOLVED:

that the responses from other East Midlands Health Overview and Scrutiny Committees be noted.

 

9.

EAST MIDLAND LINkS

Minutes:

A copy of a press release issued by the East Midlands Local Involvement Networks supporting the University Hospitals of Leicester’s clinical case for review of the closure of the Glenfield Paediatric Cardiac Care Centre was circulated at the meeting.

 

RESOLVED:

                        that the press release be noted.

10.

BUSINESS FOR THE NEXT MEETING

Members are asked to note that arrangements are being made to hold a further meeting of the Joint Health Scrutiny Committee to hear evidence from Sir Neil McKay and his Team from the Joint Committee for Primary Care Trusts (JCPCT) and Catherine Griffiths, Chief Executive of the Leicester, Leicestershire and Rutland Primary Care Trust Cluster in her capacity as the person who attended the JCPCT meeting on 4 July 2012 on behalf of the Leicester Leicestershire and Rutland PCT Cluster. 

 

It had originally been planned to hear this evidence at this meeting but the JCPCT Team were unable to attend and they wish to send as strong a Team as possible to give evidence and explain their decision.

 

Minutes:

The Chair stated that a number of attempts had been made to arrange for the Committee to hear evidence from Sir Neil McKay and his Team from the Joint Committee for Primary Care Trusts (JCPCT).  The original approach had been made on 27 July and on 1 August an invitation had been made for the team to present evidence at this meeting but the JCPCT Team had indicated they were unable to attend and they wished to send as strong a Team as possible to give evidence and explain their decision.  A further offer was then made to arrange a meeting in October on dates suitable to them.  An e-mail had been received earlier in the day stating that the only date they could attend a meeting was 29 October 2012, although the date was still provisional.   

 

The Chair stated that he wished for the Scrutiny process to be as thorough as possible but felt that delaying the process until the end of October could compromise the Committee’s position in making a referral to the Secretary of State.

 

The Chair further commented that it had been brought to his attention the previous day that Lincolnshire County Council’s Health Scrutiny Committee had already referred the JCPCT’s decision to the Secretary of State on 27 July 2012.  The Secretary of State had responded to their referral letter on 8th August 2012 stating that he had referred the matter to the Independent Reconfiguration Panel (IRP) and had asked them to report back to him by 21 September.  In view of this it was felt that it would be inappropriate to wait any longer before following up the letter sent to the Secretary of State on behalf of the Committee on 23 August (Appendix B).

 

The Chair therefore submitted a number of proposals which were circulated to the Committee.  Following discussion of these proposals it was unanimously:

   

RESOLVED:

1)    that the Committee considers that the evidence submitted at the meeting at Minute 5 above, together with the evidence from the UHL and the University of Leicester,  is sufficiently strong enough upon which to make a decision to make a referral to the Secretary of State;

 

2)    that in view of the response of the Secretary of State to the referral made by Lincolnshire County Council indicating that the Independent Reconfiguration Panel (IRP) was undertaking an initial review with a view to reporting back by 21 September, the Committee needs to ensure that the additional evidence in its referral is taken into account by the IRP before it submits its views to the Secretary of State on 21 September;

 

3)    that in view of the urgency, the Committee should respond to the Secretary of State by the end of the week and that the Chair and Vice Chair be given delegated authority to approve the response which will then be circulated to all members;

 

 

4)    that given the attempts to invite the JCPCT to give evidence to this Committee today and their unavailability to  ...  view the full minutes text for item 10.

11.

ANY OTHER URGENT BUSINESS

Minutes:

There were no items of Any Other Urgent Business.

12.

CLOSE OF MEETING

Minutes:

The Chair declared the meeting closed at 3.56pm.