Agenda item

Members gave consideration to a report of the Director of Commissioning and Operations which outlined the response to the significant service resilience issues and unwarranted variation in Urology services within Greater Manchester (GM). The GM Improving Specialist Care (ISC) programme had developed a GM-wide Model of Care (GM MoC), which had been endorsed by the GM Joint Commissioning Board (JCB).

The Committee was informed that the proposed pan-locality delivery model was fully aligned to the approved GM MOC and would support the delivery of a single urology service across Bury, Rochdale, Oldham and Salford.

This delivery model, which was designed to deliver high quality and accessible services for patients, was essentially the establishment of a hub-and spoke model – connecting Salford Royal and Royal Oldham hospitals to locality-based spokes, with most care delivered through locality based Urology Investigation Units (UIs).

The report sought endorsement of the proposed delivery model.

Members were reminded that, as a result of the Pennine Acute Trust (PAT) transaction, in April 2021 responsibility for the provision of local urology services in Bury, Rochdale and Oldham passed to Salford Royal and would, on completion of the Transaction, formally transfer to the Northern Care Alliance (NCA).

The Committee was informed that the key features of the pan-locality model were:

·         A single comprehensive Benign Urology Service delivered across Bury, Rochdale, Oldham and Salford.

·         Hub-and-spoke delivery model –

o   ROH and SRH as inpatient hubs and Rochdale Infirmary and Fairfield General Hospital as spokes.

o   Virtual corridors running from Bury to Salford and Rochdale to Oldham.

·         Single workforce within two integrated functional teams – NCA West & NCA East.

·         Bury, Rochdale and Oldham IP activity being aligned with the hub-and-spoke model whilst recognising that patients (and their GPs) would be free to choose their service provider.

·         Expansion and enhancement of clinic and diagnostic capacity at each site in the form of UIUs - increasing local access to urology services.

·         A full range of sub-speciality services (e.g. stone services, andrology etc.) would be offered, in line with the GM MOC.

The proposed delivery model was fully aligned to the approved GM MoC for benign urology and addressed the following drivers for change:

·         Risks to service sustainability, ability to meet performance requirements (exacerbated by COVID), and inequalities in access. Implementation of the first phases of the pan-locality delivery model would begin to address these issues.

·         Recommendations made in the national Getting It Right First Time (GIRFT) report for Benign Urology, largely relating to the reduction of unwarranted variation in both access and outcomes, and the future development of the urological workforce. The pan-locality delivery model addressed those issues.

·         If a new delivery model was not implemented, there would be increased movements of patients between providers, impacting upon continuity of care.

·         MFT’s long term model saw no IP surgical activity being delivered at NMGH, reinforcing the need to establish a new model that delivered more care as close to home as possible.

Members were informed that the pan-locality model would deliver high quality care for urology patients, address longstanding health inequalities, make the best possible use of available capacity, utilise new ways of working and increase the amount of care that was delivered locally.

RESOLVED that the key design features of the pan-locality delivery model, which were fully consistent with the GM MoC, and a phased approach to

Mobilisation, overseen by the Programme Board, be endorsed.