Agenda item

8.1  The chair invited Professor John Moxham, Director of Clinical Strategy, King’s Health Partners (KHP) and William McKee, Director of Transition and Transformation, King’s Health Partners to update the committee. Professor Moxham reported that KHP are developing options for closer working, however progress has been slowed because of the impact of the TSA and the proposed acquisition of Princess Royal University Hospital (PRUH). He commented that there are two judicial reviews in the pipeline concerning the TSA and Lewisham Hospital.

8.2  William McKee introduced himself and explained he is a career trust chief executive and oversaw the merge of six previous Trusts in Northern Ireland. These are now fully integrated .He will be leading on closer integration of KHP and developing the business care.

8.3  He reported that KHP felt the respective organisations could do better if they came together more tightly. There is intense activity going through to June and if the partners think that there will be benefits then they will go to a full business case this autumn, which will then go to stakeholders. Options that are being explored include full merger or formal cooperation. A contract with consultants Mckinsey & Company has been agreed. A full merger would be considered by the Office of Fair Trading and Monitor,  which takes time and KHP would not expect to hear back until 2014

8.4  A member asked about risks and William McKee said he will be commissioning a piece of work from a range of sources looking at the potential risks

8.5  KHP representatives were asked how a closer working relationship between partners would benefit local people. Professor Moxham said that KHP will see global quality services in people’s backyard and the partnership would also be offering better services for people with co-morbidity. He assured members that KHP do not have to do this and that if the partners find the benefits in terms of better care are not there, they will not pursue the merger option. A member commented there are problems related to the democratic deficit; people do tend to be concerned about their services in their patch and local people will be concerned about the vastness of KHP and people's ability to exert influence. Professor Moxham commented that if a local resident had a stroke they would go to King’s, but an aneurysm would be treated at Guys and St Thomas, whereas a bone transplant would take place at King’s too - working at scale allows this level of specialism. A member remarked that he understands the rational for the acute services but is less convinced that this will improve services to the local communities.

8.6   A member commented that the KHP population now include the patients served by Princess Royal University Hospital (PRUH).  Professor Moxham commented that the TSA process been challenging. King’s is a medically successful organisation but it is rammed full. The upside of King’s acquiring PRUH is that can it can drive positive change and efficiency in the PRUH. However, he cautioned, the acquisition of PRUH is still not a done deal and no final decision has been made yet .King’s will not take PRUH on unless there is sufficient transitional funding to invest in PRUH. There would also need to be enough money to provide more maternity and emergency capacity, as King’s is already full.

8.7  Members asked about the relationship with SCCG and Professor Moxham said they are extremely cordial and that KHP will have to demonstrate a convincing case to our commissioners and patients. Andrew Bland, SCCG Managing Director commented that the SCCG have produced a statement on what would be good for KHP. He continued that the TSA have said that the solution to King’s being too full is to bring to life Community Care. Professor Moxham commented that  integrated care is the future is we all want to make best use of money

8.8  A member commented that adding PRUH to KHP means the addition of the Bromley population. Whereas before there was more of a focus on the local population of Southwark and Lambeth, with existing close community and geographical ties,  this additional population is an additional layer of complexity,  and there is the additional a risk that the acquisition of PRUH  will not be completed. William McKee said that when KHP write the higher order business case KHP will write in an assumption that PRUH is acquired.

8.9  A member voiced concerns that the merger could be perceived as a done deal and asked to what extent people will be able to see the evidence of each option. KHP representatives responded that the board is arranging an away weekend for a deep dive to identify risks. The chair asked if this information will be published and KHP representatives responded that this would be encouraged but they are unable to say for sure. There was a discussion on if a merger of KHP would amount to a substantial variation. KHP representatives said that they thought that the Secretary of State would be neutral and that a merger would not need his or her approval.

RESOLVED

The committee asked to be kept up to date about progress with negotiations between King’s and the Department of Health and to have first sight of early documents produced in June in connection with the business case for PRUH and the options for KHP.