Agenda item

To receive and discuss the attached report regarding Complex Services Pennine Acute Disaggregation.

The Board received a report from the Northern Care Alliance (NCA) regarding the Complex Services Pennine Disaggregation. The report was presented by Tamara Zooman (NCA) and Alistair Craig (NCA).

Members were informed that in 2021, Manchester Foundation Trust  acquired the North Manchester General Hospital  site, and Salford Royal Foundation Trust  acquired the remaining sites of , creating the Northern Care Alliance FT. Since then, due to the way in which digital systems and clinical rotas operate, there are some services that operate across the two providers that have not yet been ‘disaggregated’. This means that the services still need to be split between the two organisations using an agreed set of principles: including splitting of the workforce, budget and waiting lists. In September 2022 the first phase of complex services were disaggregated (Fetal Medicine, Clinical Haematology and Sleep Services), these were considered by Scrutiny Committees in July 2022. A second phase (Cardiology, Gastronterology, Rheumatology and Urology (6 low volume pathways)) will be disaggregated in September 2023. Scrutiny Committees considered these proposals in January 2023.. The final phase of dissagregation is due to take place between January 2024 and March 2024 and includes Dexa (bone density) scanning, Ear, Nose & Throat, Trauma & Orthopaedics and Urology. This paper concerns this final phase, and in particular scrutiny’s approval of the substantial variation assessments that have been developed to assess the scale of impact of these changes.

Members were reminded that previous updates on the disaggregation had been given to Scrutiny and this is the final update on the remain The report provides an update regarding the dissolution of the former Pennine Acute Hospitals Trust (PAHT) and re-provision of services by both Manchester University NHS Foundation Trust and the remainder of the PAHT sites into the Northern Care Alliance (NCA). In particular, planned service changes in the context of previously agreed decisions taken in Greater Manchester to disaggregate services from the legacy PAHT and integrate North Manchester General Hospital (NMGH) into Manchester Foundation Trust and the remainder of the PAHT sites into the NCA.

The paper provides the following:

• A reminder about the background to the acquisition of the Pennine Acute Hospitals Trust
• An overview of the disaggregation approach and context of complex services
• An overview of the engagement undertaken with patients to gain feedback and insights to inform these plans
• The likely impact on Oldham patients
• A summary of the substantial variation assessment for each specialty

In response to a question, Tamora Zoaman informed the Board that transfer of staff via TUPE was in place but was still work in progress.

A question was raised regarding additional services at Oldham Hospital and problems of car parking for staff and patients which is already limited. Alistair Craig informed the Board that car parking is an issue at all Greater Manchester hospitals. Staff unfortunately have to pay for parking but this a national decision.

The Board was informed that the process was all about pathways to services. Moving services to Oldham hospital will not impact on current service levels at Oldham hospital.

In response to a question, Alistair Craig informed the Board that there are building programmes in place to facilitate moves to the Oldham hospital, this includes staffing. Staff will be moving to other sites and account is taken where some staff may not want to move with vacancies occurring.  These issues are being addressed. Any new Equipment is covered in the capital costs.

It was emphasised to the Board that disaggregation process is about pathways for patients and not the care levels.

Members attention was drawn to the Service Change Framework for Greater Manachester, Appendix 1 refers, which has been followed in the process.

In answer to a question, Tamora Zoaman informed the Board that in other areas outside Oldham none of the complex changes in disaggregation have been of a substantial nature because they are not significantly changing services which are already in place. She emphasised that some services will not be moved because certain Trusts specialise in certain services for the whole of Greater Manchester.

Alistair Craig advised that there is always a necessity for patients to be provided with core medical services close to home as core offering and specialised services in other Trust areas of Greater Manchester.

In response to a question, Alistair Craig informed the Board that currently there is no quality or benchmark process in place because the service is still rolling out. Within the next 18 months quality there will be a quality and performance process put in place.

The Chairman suggested that an update on the disaggregation process be included in the work programme for the March 2024 meeting.

Resolved: that

(i) the Board notes the update on the progress to disaggregate services as referred to in the report and supports the assessment made that none of the changes identified in phase 3 constitute a substantial variation for Dexa, Ear,nose and throat pathways, impatient Urology, and Trauma and orthopedic surgical pathways; and

(ii) an update on the disaggregation process from the NCA be included in the work programme for the March 2024 Board meeting.