Agenda item

King’s College Hospital NHS Trust (KCH)  will present the following proposals:

a)Transfer of elective adult inpatient orthopaedics from Denmark Hill & Princess Royal University Hospital (PRUH) to Orpington Hospital

b)Transfer of elective inpatient gynaecology from Denmark Hill to PRUH

c) Transfer of non-complex cataract surgery from Denmark Hill and PRUH

to Queen Mary’s Hospital (QMH)

Detailed proposals are attached.

KCH representatives Sue Field, Head of Capacity Planning & Service Development and consultant, Dr Polly Edmonds will present. Andrew Bland, CCG, will be in attendance.

6.1  King’s College Hospital Foundation Trust (KCH) representatives Peter Fry, Director of Operations, and consultant Dr Polly Edmonds referred to the papers circulated with agenda and briefly presented the case for moving more surgery from the King’s site at Denmark Hill to Orpington Hospital and the Princess Royal University Hospital (PRUH). They were supported by Andrew Bland, Chief Officer, Southwark CCG, as the lead commissioner. The Director of Operations emphasised the increase in presentations at A&E at Denmark Hill and most importantly the significant increase in acuity. He explained that this has a knock on affect on elective planned care. KCH are therefore looking to decompress Demark Hill Hospital and move more services to Orpington Hospital.

6.2  The committee  conducted a question and answer session with the KCH representatives covering the following queries and concerns: 

• Will Southwark patients want to have their operations at Orpington or the PRUH? Patients are presently opting to go and feedback has, on the whole, been positive. KCH expect 80% – 90% of patients to choose this option, but people can choose to stay at Denmark Hill, although there will be a longer wait.

• Can local people choose to have their operations performed at Guy’s Hospital? Yes, and some people on the waiting list are already offered Guy’s Hospital, however many still choose to go to Orpington Hospital. Andrew Bland added that the CCG do not think that these proposals would adversely affect Guy’s & St Thomas Foundation Trust (GST) and the sustainability of the South East London (SEL) health system.

• There is concern about carers visiting family members at Orpington Hospital and PRUH and the cost of travel and that this could have adverse impact on patient recovery and well-being.  We have not noticed adverse impacts from the Friends & Family feedback mechanism but this is not something that we have examined in detail, and that I agree it would be good to look specifically at the impact on families. Andrew Bland added that the length of stay is quite short and patients and family are most concerned by delays. He also cautioned that the ‘Friends and Families’ feedback is quite a blunt instrument.

• Are you able to give any reassurance that, longer term, the offer would not change to ‘no choice’ and people would therefore have to go to Orpington Hospital or PRUH? KCH representatives said that some patients will always need to be treated at Denmark Hill as they have complex needs and need the high dependence facilities availably at Denmark Hill. Longer term KCH wouldn't exclude more of a more of a move towards more elective procedures being carried out at Orpington Hospital. KCH are looking at increasing volume at Orpington generally so we have more capacity to deal with increasing emergency admissions; however the use of Orpington Hospital is time limited. Andrew Bland added that the agreement between KCH and South East London (SEL) commissioners lasts until 2016. In future there will be a cross borough discussion on elective care which it will be at the SEL system level.

6.3  The chair then invited comments and questions from a member of the public. She raised a concern with the hospital transport performance and gave the example of a 90 year old that had to wait 9 hours and to be picked up. She queried the capacity and adequacy of transport and asked what would be the offer, and if this would be a taxi or the present hospital patient transport service. KCH said that patient transport has been re-tendered and KCH are confident that elective care, which is planned, will not experience those kinds of problems.

6.4  The chair commented that, while she appreciated that the local elections had impacted on the committee time, in future the committee would like to review proposals at an earlier stage. 

RESOLVED

KCH will report in 6 months time on:

-  Choice and uptake including the number of patients who have chosen to use Orpington Hospital, Princess Royal University Hospital(PRUH) and Queen Mary’s Hospital (QMH), alongside and the number who have chosen to use Denmark Hill.

-  A report on the performance of the transport used to take patients from home to PRUH, QMH and Orpington Hospital.

-  ‘Friends and Family’ feedback and scores.