The Whipps Cross Joint Health Overview Scrutiny Committee was scheduled to discuss the ongoing redevelopment of Whipps Cross Hospital and receive an update on the End of Life Care programme. The committee was also set to review its forward plan and action tracker.

Whipps Cross Hospital Redevelopment Update

The committee was scheduled to receive an update on the Whipps Cross Hospital redevelopment programme. Since the previous meeting on 19 March 2024, construction had begun on the first of two new multi-storey car parks, a necessary step before the main hospital construction can commence. The Trust has been working with the national New Hospital Programme (NHP) team to review and refresh proposals for the new hospital, with the aim of submitting an outline business case.

The report indicated that the national Programme Business Case had been finalised before the general election was called, but the subsequent approval by Treasury ministers and the agreement of a timeline for the Whipps Cross outline business case, along with an updated funding allocation and construction timeline, were still pending. The current projected timeline for the new Whipps Cross Hospital is for construction to start on-site in 2026 and be completed in 2030.

Work was also underway to assess the alignment of the original 2021 redevelopment plans with the emerging Hospital 2.0 principles and standards, which aims to create standardised hospital designs for improved efficiency and patient care through digital solutions and optimised layouts. This work, along with the refresh of clinical and functional briefs, will inform a revised outline business case.

Progress was also reported on the mobilisation of the Academic Centre for Healthy Ageing (ACHA), a new research, education, and training centre based at Whipps Cross Hospital, a collaboration between Barts Health and Queen Mary University of London. Three internationally-renowned academics were appointed to professorial chair roles, set to begin in October 2024. Applications were also open for ACHA's first PhD programme, designed to address local needs in healthy ageing. The formal launch of ACHA is planned for autumn 2024.

The committee was also expected to be informed that the new hospital's car park would accommodate 500 spaces, maintaining the overall parking capacity of the hospital. No significant risks regarding the funding of the Phase 2 enabling works were identified.

Whipps Cross Catchment Area End of Life Care Programme

The committee was scheduled to consider the Whipps Cross Catchment Area End of Life (EOL) Programme. A Clinical Reference Group (CRG), comprising senior clinicians from Waltham Forest, Redbridge, and Whipps Cross Hospital, had been meeting to analyse and discuss EOL services and workshop improvements. A high-level, integrated model of service delivery had been agreed by the CRG, informed by national palliative care ambitions and extensive community engagement.

Members of the Community Working Group shared personal experiences highlighting inconsistencies in EOL care provision, difficulties in acquiring medication and equipment, and a lack of support in navigating services. Concerns were raised about the environment in which care is delivered for terminal patients and their families, with a desire for a supportive and welcoming atmosphere similar to that of Saint Francis Hospice.

The report indicated that direct access to EOL care, including symptom and pain management, was limited in Waltham Forest, leading to too many terminal patients presenting at A&E. Improving community services was seen as a way to create alternative pathways to specialist EOL care and support.

The committee was expected to discuss the future of the Margaret Centre, a dedicated palliative care unit. While acknowledging the centre as a good facility, it was noted that it was not currently fit for purpose. The redevelopment team had been working with the nursing team to ensure the availability of side rooms better equipped for end-of-life care. The option to re-provide an acute palliative care unit on the new hospital site was to remain under consideration. The committee was expected to seek assurances about the future of the Margaret Centre and request that significant changes to its services be put on hold until the full business case for the overall development was approved.

Concerns were also raised about the need for improved hospice services within the Whipps Cross catchment area, with committee members deeming it unacceptable for families of terminally ill patients to travel to hospices in other boroughs. The placement of the lymphedema clinic within the hospice setting at St Joseph's Hospice was also questioned, though it was explained that hospices are expected to provide symptom management for terminal patients, making the placement appropriate from a pharmaceutical perspective.

The committee was also scheduled to explore why it had taken a significant amount of time for local end-of-life care issues to be highlighted and addressed, with the Director of Place, Impact and Delivery for Waltham Forest advising that the current level of community engagement was unprecedented and had led to a greater awareness of the fragmentation of local services. The committee was also to question why services in Waltham Forest were perceived as poorer than those in Redbridge, with historical service development cited as a potential reason.

Scrutiny Report and Forward Plan

The committee was scheduled to review its Forward Plan for the ongoing municipal year and make recommendations. The Forward Plan outlines the committee's work programme, including statutory reports, major decisions, and themed reviews. Members were invited to suggest items for the 2024-25 cycle.

Additionally, the committee was to review the Action Tracker, which details actions required of officers from previous meetings and provides updates on their progress. The Recommendation Tracker, which captures the committee's conclusions on how services should change or improve, was also to be reviewed, along with the written responses from officers to previous recommendations.

Members were to be invited to add items to the work programme during the meeting or by contacting the Chair or the Scrutiny team. Prospective items would be scoped by the Chair to ensure their suitability for scrutiny.

The committee was also to consider bringing an item on the Centre for Healthy Ageing to a future meeting. The Chair was to submit an enquiry to the Department of Health and Social Care (DHSC) regarding the financial details of the Whipps Cross scheme, specifically the methodology used to calculate its capital allocation.