The Health and Social Care Select Committee met on 26 January 2023 to discuss several key health and social care initiatives within Hillingdon. The committee received updates on the North West London Orthopaedic Inpatient Surgery Review, the Mount Vernon Cancer Centre Strategic Review, and the Hillingdon Hospital Redevelopment. Significant discussion also took place regarding the Council's budget proposals for 2023/2024, a public health update, and the scoping report for a review of the Child and Adolescent Mental Health Service (CAMHS) referral pathway.

North West London Orthopaedic Inpatient Surgery Review Update

The committee was updated on the proposal to consolidate routine inpatient orthopaedic surgery, primarily hip and knee replacements, into a dedicated Elective Orthopaedic Centre at Central Middlesex Hospital. This initiative aims to reduce waiting times, improve the quality and efficiency of care, and enhance patient experience by separating planned surgery from emergency services. While the concept of a specialist centre was supported, the committee raised significant concerns regarding increased travel times for Hillingdon residents and the need for a comprehensive transport strategy to mitigate these challenges. The committee stated it would withhold full support until these transport issues are satisfactorily addressed.

Mount Vernon Cancer Centre Strategic Review Update

Jessamy Kinghorn from NHS England provided an update on the strategic review of Mount Vernon Cancer Centre (MVCC). The preferred option remains the relocation of services to a site adjacent to Watford General Hospital, offering access to acute services and potentially improving journey times for many patients. However, securing capital funding for this relocation is a key challenge, with ongoing discussions about alternative funding routes and the possibility of inclusion in the New Hospitals Programme. In the interim, £7.5 million has been invested in the current MVCC site to maintain and improve facilities. Innovative approaches, such as a Chemotherapy at Home pilot, are being developed to enhance patient choice and reduce the need for hospital visits, with a particular focus on supporting patients in areas of high deprivation. The committee requested an update on the timescales for the Chemotherapy at Home initiative.

Hillingdon Hospital Redevelopment Update

Rachel Benton and Jason Seez from The Hillingdon Hospitals NHS Foundation Trust presented an update on the Hillingdon Hospital redevelopment. Significant progress has been made, with the Outline Business Case approved by the Trust Board and the planning application receiving a resolution to approve from the Hillingdon Planning Committee. The preferred option is a full new-build hospital on the existing site, delivered in a single phase, which will maintain current services while providing state-of-the-art facilities. The design incorporates enhanced patient and staff wellbeing, pandemic resilience, and digital integration. The project is progressing through the New Hospitals Programme, with confirmation of next steps anticipated in March 2023. Professor Abbas Khakoo highlighted the clinical benefits, including improved emergency department flow, increased diagnostic capacity, and enhanced infection control through increased single room provision. Keith Spencer, Managing Director of Hillingdon Health and Care Partners, confirmed that the redevelopment would support the integration of health and social care, building on existing work to reduce hospital admissions.

Cabinet's Budget Proposals for 2023/2024

Andy Goodwin and Gemma McNamara presented the Council's draft budget proposals for 2023/2024, highlighting the impact of exceptional inflationary pressures and legacy COVID-19 impacts. The Health and Social Care portfolio faces significant inflationary pressures, particularly in social care placements and staffing pay awards. Savings proposals totalling £2.4 million are required from this portfolio. The committee expressed concerns about the proposed 30% increase in fees and charges, noting its potential impact on residents already facing financial hardship. However, officers explained that this increase aims to move towards cost recovery and that Hillingdon's charges remain lower than many neighbouring authorities. The committee also discussed the move to a commissioning model for voluntary sector grants, with assurances sought that smaller local organisations would not be disadvantaged. The committee agreed to provide comments on the budget proposals, focusing on recognising the financial environment, the importance of health and social care, thanking officers and staff, and emphasising the need for robust performance monitoring, proactive engagement with the voluntary sector, and assurances on service continuity.

Public Health Update

Kelly O'Neill, Interim Director of Public Health, provided an update on public health integrated service contracts. The committee was informed about the process of reviewing and re-procuring these contracts, which are funded by the Public Health Grant and aligned local NHS commissioners. The review aims to maximise available resources, improve integration, and achieve better outcomes. Members noted the significant disparity in funding allocated to different services, such as the low spend on childhood obesity programmes compared to substance misuse services. Ms O'Neill acknowledged these concerns and outlined plans for a whole-system approach to obesity and a review of budget allocation. The committee also discussed the importance of embedding public health considerations into all council policies and decisions, with a proposal to include a health impact assessment line in all policy papers.

Scoping Report for a Review of the Child and Adolescent Mental Health Service (CAMHS) Referral Pathway

The committee agreed to initiate a review of the CAMHS referral pathway in Hillingdon. The review aims to understand the referral process, scrutinise its effectiveness, assess alternative support availability, and explore inter-agency communication. The committee will seek to identify areas for improvement to ensure children, young people, and their families can access help sooner. Healthwatch Hillingdon will be involved in the review, and the committee aims to establish tangible benchmarks to measure progress.

Cabinet Forward Plan Monthly Monitoring

The committee reviewed the Cabinet Forward Plan and noted upcoming items relevant to its remit, including Carer Support Services, the Carers Strategy Update, and the Annual Report of Adult and Child Safeguarding Arrangements. The committee expressed interest in these items and will consider them further as they progress.

Work Programme

The committee reviewed its work programme, noting upcoming witness sessions for the CAMHS referral pathway review and a rescheduled update on the Mount Vernon Cancer Centre's Chemotherapy at Home initiative. The committee also agreed to move its Q&A with the Cabinet Member for Health and Social Care to an earlier meeting.