Agenda item

(15 mins presentation; 25 mins Member Questions)

John Pullin (JP), Deputy Director, Strategy and Planning, NHS Berkshire East, outlined a report and presentation on the Externalisation of Community Provider Services. 

JP advised that “High Quality Care for All” (DH2008) had set a clear vision for patient safety, patient experience and the effectiveness of care.  The transformation of Community Services would require PCTs and GPs as commissioners to focus on developing more services in a community setting.  It was recognised that there was tension in the programme of transformation and the PCT was required to review the best options for the most appropriate and separate organisational form for a future community service that best suited local needs and circumstances.  It was noted that the Coalition Government had confirmed that this separation must be achieved by April 2011.

JP discussed the externalisation options, which included integration with an NHS Acute or Mental Health provider or continued direct PCT provision. The Panel was advised that NHS Berkshire East and West had undertaken a similar process and both had concluded that the Berkshire Health Care Foundation Trust (BHFT) should be invited to provide community health services for Berkshire.  The two PCTs had then agreed to work together to produce a joint business case to support the application to transfer their community services to the BHFT.

The Panel noted that the outcome of provider separation would crucially support the delivery of key objectives, quality, innovation, productivity and prevention.  It was also a key vehicle to deliver the care for the future programme.  The benefits of having a new merged organisation would include the provision of a model of care that enabled people to access good information on health issues, and a system of care that made provision for the majority of the individuals to have treatment at home or as close to home as possible.  It would also provide integrated care that brought together all of the professionals a person would need in one pathway to ensure that organisational boundaries did not impair health outcomes.  Further benefits would include the reduction of costs, greater efficiencies and the sharing of clinical and managerial infrastructures.

The Panel was advised that the joint business case would be reviewed by the SHA as part of the assurance process and the case would also be forwarded to the Competition and Co-operation Panel for their assessment.  Staff engagement events were scheduled over the next few months and regular progress reports would be provided to each PCT board and the joint strategic commissioning board. 

The Panel thanked Mr Pullin for his report.

In the ensuing debate Members raised a number of questions/comments including the following (responses shown in italics):-

• A concern was expressed regarding the movement of mental health beds from East Berkshire to West Berkshire.

An ongoing consultation was being carried out regarding this issue. 

• Were any objections lodged during the negotiation for the merger?

There were no objections but some concerns were submitted from a variety of sources regarding further imposed management changes. It  was highlighted that the NHS was familiar with change.  There were some issues surrounding how a set fixed management structure could be merged with others but both PCTs had reflected on this and assessed the best way forward. 

• What did the future hold for Upton Hospital in terms of mental health bed provision and the new building?

The development of the Upton site was part of the PCT’s plans and there was a single stream of work on this.  The Upton site was still crucial to the strategy of the PCT. 

• What impact would externalisation have on staff cuts and resources?

There would be some synergy in this area; for example it was unlikely that  there would be a requirement for three Heads of Human Resources or three Chief Executives.  There would also be back office savings. 

• Had there been a consultation carried out with staff?

Yes – a consultation was ongoing and staff had been fully engaged in the process.  It was highlighted that the terms and conditions of staff would fall under the transfer of undertakings. 

• Would the enactment of market interventions result in having monolithic providers?

The management of market interventions fell within JP’s brief.  He was looking to commission high quality services and he assured the Panel that there would not be a monopoly situation.

Resolved- That the report be noted and that the Panel be updated and appraised of progress on a regular basis.