11.05
A verbal update for the committee on the developments with PET CT scanning services for Oxfordshire.
Minutes:
Prior to consideration of this item, the Committee was addressed by the following member of the public:
Bill MacKeith of Oxfordshire Keep Our NHS Public stated that his group was concerned that the provision of mobile scanners in the other areas of the Thames Valley region could have knock-on effects for Oxfordshire. He understood that many clinicians believed that the mobile scanners were inferior and that scans would have to be redone at the Churchill Hospital in Oxford.
He asked the Committee to contact other local authorities in the region to coordinate support for public provision of services and to require a six-month report from NHS England to measure performance of the services in the different centres.
Janet Meek, Director of Commissioning South East, NHSE, described the collaborative approach that has been agreed. The OUH service based at Churchill Hospital will be retained on a separate contract directly with NHSE. New services in Milton Keynes, Reading and Swindon will be run by InHealth. The agreement increases access and will reduce waiting lists.
Dr Bruno Holthof, Chief Executive OUH, stated that the new contract met their requirements and would allow them to invest in new scanners. They were keen that pathways be maintained especially those involving multi-disciplinary teams. Any changes will be clinically-led.
Nicola McCulloch, Head of the Cancer Programme of Care, Specialised Commissioning NHSE, confirmed that this was NHSE’s view. Clinical consensus would include cancer groups.
Louise Patten, Chief Executive OCCG, added that there was a lot to be learned from the process in terms of how to engage locally in national procurement. This will set a precedent for others. There will be a local specialist commissioning board for the Oxfordshire services moving forward.
Councillor Laura Price asked what NHSE had learned from this. The feeling was that they presented a blank wall to those expressing concerns. She also asked if there was a danger of duplication if mobile scanners produced inferior quality scans, that then had to be redone at Oxford. She was also concerned that waiting times might be used to nudge Oxfordshire residents towards the services outside the county.
Janet Meek and Nicola McCulloch confirmed that there would be much earlier and greater engagement. All parties recognise their responsibilities. Changes suggested by clinicians were taken on board. They would have to make sure that they heard directly from HOSC.
Dr Bruno Holthof stated that the feedback on their original bid was that it focussed mostly on clinical quality whereas access was a key issue too, which the trust had not prioritised in its bid. Increased capacity in Thames Valley will help cope with expected increases in demand. If scans need to be redone this will be registered as a serious incident as it increases the patient’s exposure to radiation.
Janet Meek confirmed that the contract is for seven years with an option for three more. The Long Term Plan envisages earlier diagnosis and the increase in capacity will help deal with this.
City Councillor Nadine Bely-Summers asked if there would be more investment in the Churchill Hospital or if this was really about privatisation.
Janet Meek responded that only the new services were being supplied by InHealth. Investment in OUH will continue. All providers go through a rigorous process and must work closely with the NHS and clinicians. Nicola McCullough added that there had been a procurement process for the extra services and InHealth was the only bid offering services on the wider geography.
Dr Alan Cohen asked if the situation had not been inflamed by threats of legal action by NHSE. The Chairman stated that he understood there were threats made from lawyers to lawyers regarding staff speaking out. He asked for assurances that this would not happen again.
Janet Meek stated that she would not support that, never instructed it and would not ever do so.
Councillor Jane Hanna asked if the procurement arrangements took account of research networks and if there was any difference in terms of accountability and grievance processes between public and private contracts.
Janet Meek responded that all contracts are managed and evaluated the same way with the same grievance procedures including the Ombudsman. Research is outside of core NHSE services. A question about this is included in the bidding process. In this case, both providers are able to do research.
The Chairman thanked Members of the Committee for their robust scrutiny and welcomed the outcome as being in the best interests of the residents of Oxfordshire. He asked for confirmation that no consultation was needed since there was no change of service. He also asked when would be the best time to receive a follow-up report – including pathways, number of patients and patient flows – and if the contracts had actually been signed at this stage.
Nicola McCulloch said that the contracts were still being finalised and confirmed that no consultation would be required. She AGREED to provide a follow-up report as requested. It would need to be a joint report and will include notifications of any serious incidents. She suggested early in the new year.