The Health and Care Overview and Scrutiny Committee of Staffordshire Council met to discuss the Integrated Care Board's (ICB) plan to make £306 million in efficiency savings, and a proposal to consolidate cardiac catheter services at the University Hospitals of Derby and Burton. Councillors expressed concerns about the lack of detail in the ICB's report, the potential impact of cuts on frontline services, and the effect on residents in rural areas. The committee noted a report on district and borough health scrutiny activity and discussed the committee's work programme.

ICB Financial Recovery Plan

The main focus of the meeting was the ICB's plan to deliver £306 million of efficiency savings. Councillor Colin Greatorex criticised the ICB's report as lacking the detail needed to assess whether the savings were deliverable and realistic, echoing concerns raised at a previous meeting. He said:

We're here as the local authority that are the scrutiny body for the interface between the ICB and the council. So, we're in the position of having to see whether the savings that you're looking to make are deliverable, if they're realistic. And I can't see that we've got enough detail to make that judgment.

Claire Finn, Interim Finance Director at the ICB, explained that the savings were needed to address a £95 million deficit, despite a 4% allocation uplift. She said that £169 million of the savings would be delivered by the ICB, with £23 million relating to nationally defined planning items¹. Elizabeth Disney, Interim Deputy Chief Executive Officer and the Chief Transformation Officer, outlined plans to reduce out-of-area placements for mental health patients, improve the timeliness of Section 117 ² aftercare reviews, and provide in-system solutions for adult ADHD assessments. Heather Johnston, Chief Nurse and Therapies Officer, said that work was being done to strengthen clinical leadership in continuing healthcare, aiming to reduce over-prescribing of care and promote independence for patients.

Rachel Bellio, Interim Chief Medical Officer, described a programme around value-based healthcare, focusing on resource stewardship and stopping things of low value. This included reducing the prescribing of nutritional supplements and addressing medicine waste.

Several councillors voiced concerns about the potential impact of the savings plan on frontline services. Councillor Jill Hood expressed concern about cuts to Section 117 mental health services, saying that the community was no longer equipped to manage the needs of patients being discharged. Councillor Jeremy Pert raised concerns about the risk of cost shunting from health into adult social care, and the lack of system metrics to assess the impact of the savings on operational performance.

In response, ICB officers said that the plans were compliant with the national mental health investment standard, and that they were working closely with the local authority to ensure that cost shunting did not occur. They also said that they would share project initiation documents and quality impact assessments with the committee, and offered to hold a workshop to discuss the plans in more detail.

Councillor Matthew Wallens asked about the potential for disproportionate cuts in rural areas, and whether services would get worse for residents already travelling far to get care. ICB officers responded that the plan did not represent a cut to services anywhere, and that impact assessments were looking at the impact of the changes.

Councillor Catherine Brown asked for clarification on the difference between a cut to funding and an efficiency saving. ICB officers explained that a cut to service would mean that a service that is currently available would no longer be available at all in the future, whereas an efficiency saving involves reducing costs in inefficient areas and making sure that patients are seen in the right care settings.

Cardiac Catheter Services

The committee then discussed a proposal from the University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) to consolidate cardiac catheter services at the Royal Derby Hospital from the end of September 2025.

Dr Noomin Ahmed, consultant cardiologist and associate clinical director of cardiology at UHDB, explained that the cardiac catheter lab at Queen's Hospital Burton had reached the end of its serviceable life, and that it was a diagnostic-only lab that was unable to secure British Cardiac Intervention Society accreditation. He said that consolidating services at Derby would improve the quality and safety of care, and reduce the risk of complications for patients.

James Scott, Head of Strategic Programs for Service Configuration at University Hospitals, Derby and Burton, said that Burton would remain a fully functioning district general hospital with an accident and emergency department, but that there were clinical advantages in concentrating services at Derby.

Mark Adams, deputy general manager at UHDB with responsibility for cardiology and rheumatology, said that UHDB has a dedicated cardiology team at Queen's Hospital Burton of five consultants, and that they provide a consultant of the week model, which means they have a consultant dedicated to the 20-bedded cardiology ward and 10-bedded CCU every day.

Several councillors raised concerns about the proposal. Councillor Brown said that Queen Elizabeth Hospital Burton was becoming a postcode healthcare system, and that there had been a degrading cardiac service since 2018. She asked whether cardiac radiographers would be available 24/7, and how many cardiologists were employed by UHDB and attended Queen's Hospital Burton.

Councillor Jones said that if the proposal went through, there would be no cardiology presence at Burton, and that the increased demand at Derby would increase waiting lists. He asked whether an impact assessment had been done for Stoke.

Councillor Wallens asked how travel time would be mitigated for elderly and vulnerable patients, and whether patient transport would cover all additional travel.

In response, UHDB officers said that the cardiology service at Burton would remain, with outpatient clinics, CMD, echoes, stress echoes, and exercise tests all still being provided at the Burton site. They said that patients who presented at the Burton site with changes in their ECG would go to Derby, as they do now. They also said that they would provide the committee with the quality impact assessment for the proposal.

Councillor Greatorex said that the decision had already been taken, and that the committee was not being consulted about something that might happen, but about something that will happen. He said that it would be better if it was more upfront that this was an opportunity to go into one site with one set of staff supporting one set of patients.

At the end of the discussion, the committee agreed to note the report, rather than voting to support the proposal.

District and Borough Health Scrutiny Activity

The committee noted a report on district and borough health scrutiny activity. Councillor Jones added that the withdrawal of £70,000 funding from the Morelands Home Link service in Cheadle was causing real problems. Councillor Rupert Adcock said that Newcastle Under Lyme councillors had unanimously supported calling on the government to commit to a full inquiry into the failures of regulation of the Wally's Quarry site and to the potential health impacts on local residents. Councillor Wallens asked to see feedback from residents in relation to the closure of the Samuel Johnson Maternity, the Burfin Unit.

Work Programme

The committee discussed the work programme and agreed to add a meeting to discuss the ICB's operational plan. Councillor Norman suggested that there needs to be a report on what the council are doing with regard to efficiency savings and health and social care. Councillor Pert suggested inviting the Cabinet Member for Health and Care when the ICB come back, to give confirmation that they are not anticipating any cost shunting.