Agenda item

The Chair stated that the Committee had requested an update on this matter at the last meeting and a report had been circulated.

Mark Maguire, Service Director, Sexual Health and HIV and Sarah Marriott, Divisional Medical Director of CNWL and Jonathan O’Sullivan Public Health were present for discussion of this item.

During discussion the following main points were made –

·         Members were informed that no final decision had been made on the future of the buildings, however CNWL’s sexual health services collectively have a significant funding gap this year and next. The trust’s funding gap is expected to be about £5.8m in total over this period

·         CNWL is looking at ways to maintain its services whilst addressing the current and expected funding pressure. Buildings are under review since re-provision of services onto fewer sites would significantly reduce the estate costs and be a good way of closing the funding gap

·         The Trust has not reached a final recommendation but is looking at options to move from the current 3 major sexual health service sites across Camden and Islington. The Margaret Pyke Centre is the smallest and most expensive building per patient seen and the Trust’s assessment is that the building would not be able be in a position to absorb either of the other sexual health services. Another option considered is to retain all three sites, but transfer some of the services to other locations

·         Commissioners have been and will continue to work with the Trust to develop and understand options for savings and their impact

·         In response to a statement that the Trust will consider an options appraisal on estates at its Board meeting in January 2016 and once a recommendation is made, it will need engagement with stakeholders, the Committee expressed the view that there should be expanded stakeholder engagement and this should be reported back to the Committee at its January meeting

·         It was stated that the budget reductions could result in approximately 60 staff losing their posts out of 240/250 posts

·         All the services operating from all 3 sites were rated outstanding and the CNWL priority is to retain services with fewer staff and patient satisfaction at all of the sites is high

·         Options to reduce costs were being looked at including remote screening and the introduction of new technology and there is an extensive consultation process that will take place with GP’s, Commissioners and Councils to buy into this process

·         The integrated sexual health tariff had initially been developed, but not implemented, by the NHS in London, but progress had been halted at the point when sexual health services would be transferred to Councils.

·         The London Association of Directors of Public Health re-activated the integrated tariff programme in 2014 and the analysis has indicated that overall there is potential for significant savings across London commissioners, assuming activity levels remained unchanged following introduction of a new tariff. This would result in SRH services generally seeing an increase in commissioner income and a reduction in commissioner income for GUM on existing levels of activity

·         Together the integrated tariff and transformation programmes are intended to be important in achieving a clinically and financially sustainable model for open access sexual health services and it is expected a move to the integrated tariff could save Islington as a commissioner about £1.5m a year, across all sexual health services, and combined with the transformation programme could increase to a £2m saving. It is expected that a decision on whether to proceed with implementing the tariff will be made in the near future

·         Reference was made to the fact that costly refurbishment had taken place at the Margaret Pyke Centre and there needed to be public scrutiny of any decision taken on relocation of services

·         There is a need for services to be located near to transport routes

·         It was stated that before the Board met to discuss options CNWL would meet with Executive Members for Health and Wellbeing at Camden and Islington and their communications team would be carrying out a pre-consultation exercise and the Board would consider the options

·         It was stated that the economies of running the service needed to be considered in the context of losing 40/50 staff

·         The view was expressed that there was a synergy between the staff working at Margaret Pyke and in terms of the buildings options there was underutilised space at Margaret Pyke and that this should be looked at

·         A Member stated that 60% of the users of the service were not local residents and that the Archway premises lease was up for renewal in 2 years time and enquired whether this had been taken into consideration as to whether a service could be provided if the Archway lease was not renewed. It was stated that discussions had been held with the landlord as to renewal of the lease as 60% of service users were local residents and there needed to be a presence maintained in this area, There will also be local provision at Crowndale and Finsbury to serve the needs of the local population

·         Members were informed that a small group had been established to look at options and a representative of Margaret Pyke is on the group. Staff were also invited to feed in their views and there would be close working with commissioners on how to engage the Public and CNWL were looking for support on this

RESOLVED:

That the report be noted and a further report on discussions around expanded stakeholder engagement be submitted to the January meeting of the Committee