The South East London Joint Health Overview and Scrutiny Committee met to discuss the reconfiguration of children's cancer treatment centres, an update on management cost reductions within the South East London Integrated Care Board, and urgent and emergency care performance. The committee also reviewed and planned its future work programme.

Reconfiguration of Children's Cancer Principal Treatment Centre

A significant portion of the meeting was dedicated to the proposed reconfiguration of the Children's Cancer Principal Treatment Centre (PTC). NHS England is considering relocating the PTC from its current dual-site operation at The Royal Marsden NHS Foundation Trust and St George's University Hospitals NHS Foundation Trust. The report pack outlined two potential new locations: Evelina London Children's Hospital and St George's Hospital.

The rationale for the reconfiguration centres on the requirement for PTCs to be located on the same site as a Level 3 children's intensive care unit, children's surgery, and other specialist services. This is intended to reduce the risks and stress associated with transferring critically ill children for intensive care. The report pack detailed the consultation process undertaken by NHS England, including feedback received and the key themes emerging from this engagement.

Discussions were scheduled to cover the feedback from the public consultation, with the committee being asked to consider and agree key points and recommendations for its formal response to NHS England. Key themes identified for discussion included travel and parking arrangements, workforce concerns, local support offers, and the delivery timeline for the proposed changes.

Management Cost Reduction (MCR) Update

The committee received an update on the implementation of management cost reductions required of all Integrated Care Boards (ICBs) nationally. The South East London Integrated Care Board (SEL ICB) is required to deliver a 30% reduction in real terms by 2025/26. The report outlined the process undertaken by the SEL ICB, which included a review of non-pay running costs, a vacancy freeze, and restructuring to secure core functions within the reduced allowance. The update detailed the steps of the MCR process, including staff consultation and implementation phases, and reported on the achievement of savings targets, with an overall saving of £15.2 million secured and a net reduction of 217.12 Whole Time Equivalent (WTE) posts.

Urgent & Emergency Care and Discharge Performance

The committee was presented with information regarding performance across the South East London Integrated Care System (ICS) concerning urgent and emergency care (UEC) and hospital discharge. The report highlighted that UEC pathways remain pressured, with a deterioration in the 4-hour performance target evident over recent months. Key recovery actions were outlined, including work with the London Ambulance Service (LAS) to improve handover times, the implementation of a discharge improvement plan, and efforts to optimise community alternatives and same-day emergency care. The report also noted ongoing pressures within mental health services.

Performance data on discharge was presented, indicating that in quarter 3 of 2023/24, 53.6% of patients identified as not meeting the 'criteria to reside' were discharged. The report detailed the SEL Discharge Improvement Plan, which focuses on four overarching objectives: working to a common framework for transfer of care standards, securing safe and personalised pathways, meeting complex patient needs, and avoiding unnecessary admissions. Key actions included investment in discharge funds, review of transfer of care hubs, and targeted work on complex discharge challenges.

SEL JHOSC Work Programme

The committee discussed and agreed upon items for its future work programme. Members suggested several topics for consideration, including hospital capacity planning, NHS workforce recruitment and retention, vaccine uptake, medicine shortages, follow-up on ICB structures, A&E pressures, and managing the 8am rush at GPs. The committee also noted that winter arrangements could form an agenda item, and that Public Health officers could contribute to discussions on vaccine uptake. The Chair suggested inviting SLaM (South London and Maudsley NHS Foundation Trust) to present on mental health services. The committee resolved to note these suggestions and hold an informal discussion to prioritise and formulate the work programme.