Report of the Director, Single Hospital Service

This report provides an update on the City of Manchester Single Hospital Service Programme. It sets out the work that has taken place since the creation of Manchester University NHS Foundation Trust (MFT) on 1st October 2017 and describes the approach used within MFT to track the anticipated benefits of the merger. It also outlines the part MFT is playing in the work being led by Greater Manchester Health and Social Care Partnership to transfer North Manchester General Hospital (NMGH) into MFT.

The Committee considered a report of the Director, Single Hospital Service that provided an update on the City of Manchester Single Hospital Service Programme. It set out the work that had taken place since the creation of Manchester University NHS Foundation Trust (MFT) on 1 October 2017 and described the approach used within MFT to track the anticipated benefits of the merger. It also outlined the part MFT was playing in the work being led by Greater Manchester Health and Social Care Partnership to transfer North Manchester General Hospital (NMGH) into MFT.

The Director, Single Hospital Service referred to the main points of the report which were: -

·                Providing a background and rationale for the SHS;

·                Describing the work of the Integration Steering Group (ISG), chaired by the Director for the Single Hospital Service, that continued to oversee delivery of all integration work streams, providing resource and support to help work stream leads deliver their objectives;

·                An update on the Integration Programme, noting the published Year One Post-Merger Report;

·                A description of the benefits realised for both staff and patients in relation to a range of services; and

·                An update on the proposed acquisition of North Manchester General Hospital.

The Committee were also shown two videos that demonstrated the improvements that had been achieved to date and how staff had been engaged throughout this process.

A Member sought clarification on the role of the Council of Governors and enquired if they would vote on the final decision to incorporate NMGH into the City of Manchester Single Hospital Service Programme. The Director Single Hospital Service reported that the Council of Governors had been established to review the probity and governance of the transition process and ensure that due diligence had been observed, however they would not have a vote on the final decision to transfer NMGH into MFT.

Members expressed their frustration at the length of time taken to incorporate NMGH into the City of Manchester Single Hospital Service Programme and asked what could be done to speed this process up. Members enquired if the recent senior management change at Salford Royal had any impact on this process. The Executive Lead for Finance and Investment, Greater Manchester Health and Social Care Partnership acknowledged the frustrations expressed by the Committee. He commented that the process was complex and was dictated by national guidance and process, however the commitment was given at a Greater Manchester level to move NMGH into the SHS, stating that the strategic case would be completed by March 2019 and this would be followed by a national agreement to proceed to implementation phase. He said that all partners, both local and national, including NHS Improvement recognised the case to move NMGH into the SHS and were positively involved with delivering this programme. He further commented that risks associated with this programme were closely monitored and reviewed to support this transaction.

Members sought an assurance on how any financial deficit Pennine Acute Hospital Trust had would be apportioned to NMGH. The Executive Lead for Finance and Investment, Greater Manchester Health and Social Care Partnership explained that this was being carefully considered. He further responded to a question regarding the suggestion that services would be disrupted or withdrawn at the NMGH site prior to the move to the SHS by giving an assurance to the Committee that the expectation was to maintain the current service at the site and any change would have to be considered by the Transaction Board.

The Executive Member for Adults, Health and Wellbeing sought an assurance that had previously been given to the Committee that Members would be informed of any proposed changes to service prior to them being implemented would continue to be honoured.  The Director Single Hospital Service said that he remained committed to this request.

A Member commented that rumours frequently circulated amongst residents in North Manchester regarding the removal of services at NMGH and recommended that the senior leadership team at NMGH provided the Executive Member for Adults, Health and Wellbeing and the Chair of the Health Scrutiny Committee with regular updates regarding the progress on the move of NMGH into the City of Manchester Single Hospital Service Programme.   

The Director Single Hospital Service acknowledged the comment regarding rumours and stated that they sought to address this by holding monthly team meetings to address any concerns and answer any questions staff had. He said that these sessions were very well attended and had proved useful. He further commented that the staff were the Trusts strongest asset and the delivery of the SHS provided an opportunity to look at the terms and conditions of staff and pay grades to harmonise this across the estate. He said this was being undertaken with the full involvement from staff side.  

In response to a question from a Member regarding the number of patients currently attending NMGH who would be diverted to other sites with Pennine Acute Trust the Clinical Director at North Manchester General Hospital said that this had been modelled and figures would be circulated following the meeting. He said that this activity needed to be considered in the context of other wider programmes, such as Healthier Together, noting that in addition to providing a service for local residents NMGH delivered specialised services, such as the Infectious Diseases Department. The Committee noted that the identity of each hospital would be retained as this was understood by the local population. He further commented that the recent change at Salford Royal would not have any impact to this programme of work.

In response to a question regarding patient and public engagement the Director of Corporate Affairs, Manchester Health and Care Commissioning said that a number of events had been delivered in North Manchester and the programme of delivering Health Checks in the area provided an opportunity for staff to engage with residents and make them aware of the proposals and obtain their views. In addition, regular meetings were held with Healthwatch and strong relationships had been established with local faith groups.

In response to a concern expressed by a Member regarding patient choice the Executive Director of Planning and Operations, Manchester Health and Care Commissioning said that the delivery of the SHS would not impact on the provision of patient pathways and patient choice would be maintained.

The Executive Member for Adults, Health and Wellbeing said that she welcomed the discussion at the meeting and stressed the importance of bringing NMGH into the City of Manchester Single Hospital Service Programme as quickly and as safely as possible. She further welcomed the stated commitment given that any proposed changes to the services delivered at NMGH would be reported to the Committee.

Decision

The Committee;

1. Express their disappointment at the length of time taken to incorporate North Manchester General Hospital into the City of Manchester Single Hospital Service Programme;

2. Welcomes the commitment given that the Committee would be informed of and consulted with on any proposed changes to services at North Manchester General Hospital prior to them being implemented; and

3. Requests that a progress report be submitted for consideration at an appropriate time.