Agenda item

The management boards of Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS foundation trusts are exploring plans for an organisational merger and a strengthened partnership with King’s College London. The Strategic Outline Case is attached.

Professor John Moxham; Director of Clinical Strategy and Jill Lockett; Director of Performance and Deliverywill be attending to present and take questions.

6.1  The chair invited Professor John Moxton, KHP Director of Clinical Strategy, and Jill Lockett, KHP Director of Performance and Delivery, to introduce the discussion on the proposed merger of King’s Health Partners (KHP). The Director of Clinical Strategy started by explaining that KHP is already an Academic Health Science Centre and the central motivation for this proposed merger is to improve the outcomes for our patients, many of whom have ordinary conditions.

6.2  The chair asked the Director of Clinical Strategy how confident he was in the proposals of the TSA and he responded that constructive reservations had been expressed. He noted that no patient is going to leave local providers to receive less good care elective. A member wondered if the Secretary of State had the power to dictate this and the Director of Performance and Delivery comment that she did not think the plan was that all elective care would go to Lewisham Hospital. She commented that we know the elective care at Guy’s and St Thomas’ is good.

6.3  A member asked the Director of Clinical Strategy if KHP are still proceeding with the merger and he explained that they are moving forward, as KHP are keen to maintain momentum, but more slowly. He reported that they are waiting to hear the Secretary of State’s announcement on the TSA report before they start the stakeholder consultations.

6.4  A member asked if there was equal enthusiasm across all four organisations, and commented that he had heard that SLaM were not so keen. The Director of Clinical Strategy commented that at the beginning the proposed merger was led by the two acute trusts ( Guy’s & St Thomas’ and KCH) however, as the acute trusts have become more aware of the importance of mental health, and likewise clinicians working in mental health have become more aware of the physical health needs of their patients, all the trusts now see the great benefits of coming closer together.

6.5  It was noted by a member that the reports outlining the virtues of a KHP merger often emphasize the world-class nature of the clinical care that can be better delivered, rather than improvement to local people’s health. The Director of Clinical Strategy commented that this is about driving up the value of health care. He commented that there are people in the health economy who are just talking about cost, others just about outcomes. He stated in his view both are useless and we need to talk about a value of an intervention.

6.6  A member commented that he would like to see more under-represented groups working in medicine, more black and working class people. He noted that the predeterminants of health are paramount and quality employment is one of these. The Director of Clinical Strategy agreed that jobs are of great importance and that a successful, expanding organisation driven by excellence will improve these prospects. He noted that there is a move to treat patents in the community, rather than hospital institutions, and better meet the needs of tertiary patents. However, at the same time he envisaged that hospital services such as bone marrow transplants would expand as people travelled to King’s for treatment.

6.7  KHP staff were asked about improving quality and how the proposed merger would affect this. The Director of Clinical Strategy commented that they are measuring things constantly, such as outcomes and satisfaction, in different locations and settings. He reported that this enables patterns and variation to be identified and so drive up quality.

6.8  The chair ended by commenting that he is glad to hear the plans for merger will be slowing, because of the TSA report, albeit not stopping.