Agenda item

a      FULL TEXT OF NEW PROPOSAL

b      ASSESSMENT OF IMPACT OF THE DECISION

The Committee considered an update on the Orthopaedic Clinical Network which

was being developed with the aim of providing elective orthopaedic services on

fewer sites across the South East London Region to support the implementation of

the Getting it Right First Time recommendations.

Following an extensive assessment and consultation process, it had become clear

that it would not be possible for a consensus to be reached on the best model to

adopt within the South East London Region, and it was therefore proposed to

move forward with creating an Orthopaedic Clinical Network across the existing

three providers. Terms of Reference had now been formulated for the

Orthopaedic Clinical Leadership Group and it had been recommended to the

South East London Sustainability and Transformation Partnership that the Network

be established and that a Clinical Lead be appointed. From 2018/19, orthopaedic

services would be commissioned against the standards and performance metrics

set out in the Getting it Right First Time report, and the Network’s progress in

delivering quality and efficiency benefits would be independently assured by the

London Clinical Senate. Commissioners would review the findings of the Clinical

Senate on embedding the Getting it Right First Time recommendations over the

three sites after 12 to 18 months, at which time a decision would be made on

whether quality and efficiency benefits had been met and could be sustained

across three sites.

In response to a question from the Chairman, the Programme Director, "Our

Healthier South East London" Programme confirmed that patients within the South

East London region would not be compelled to use services within the

Orthopaedic Clinical Network and could continue to use other orthopaedic

services, such as those offered by Dartford and Gravesham NHS Trust.

Members discussed the recent announcement that Guy's and St Thomas' NHS

Foundation Trust and Johnson & Johnson Managed Services would be working

together to deliver an Orthopaedics Centre of Excellence at Guy’s Hospital. This

would include the construction of three new operating theatres which would

increase the total number of operating theatres to eight. The Consultant

Orthopaedic Surgeon and Clinical Director of Surgery, Guy's and St Thomas' NHS

Foundation Trust advised Members that it had been projected that demand for

Orthopaedic services would continue to increase as a result of the ageing

population, and that the Centre of Excellence would deliver sufficient additional

capacity to meet this increasing demand as well as supporting innovation and

research in the area of orthopaedic surgery. The partnership did not represent a

privatisation of the service as Guy’s Hospital already used Johnson & Johnson

Managed Services within its existing supply chain, and one of the key aims within

the proposed new arrangement was to streamline processes to procure devices,

surgical instruments and implants required for orthopaedic surgery to reduce

costs. To support this, work had been undertaken with individual surgeons over

the past two years to identify best practice in orthopaedic surgery, supporting

surgeons to work more efficiently. In response to a question regarding the total

project value, the Director, Commercial Directorate, Guy's and St Thomas' NHS

Foundation Trust confirmed that the total project cost had been projected as being

£300M over the planned 15 year partnership, £50M of which was linked to capital

build. The partnership with Johnson & Johnson Managed Services had been

subject to a full procurement process and was evaluated on the premise of

providing an ‘as is’ or better service to patients.

In discussing the Orthopaedics Centre of Excellence, Members were concerned

that they had not been made aware of the plans for an Orthopaedics Centre of

Excellence during the process to develop the Orthopaedic Clinical Network, which

would necessitate the expansion of the three orthopaedic centres within the South

East London region. The Clinical Chairman, Bromley Clinical Commissioning

Group highlighted that orthopaedic services also included community-based

services, and that it was important to ensure there was a joined-up approach to

the delivery of all orthopaedic services across the South East London region.

RESOLVED that the update be noted.