Agenda and minutes

Scrutiny Committee
Wednesday, 20th January, 2016 7.00 pm

Venue: Civic Offices, St Nicholas Way, Sutton SM1 1EA

Contact: Aimee Wittams-Smith, Senior Business Support Officer (Democratic Services)  Tel: 020 8770 4171 Email:

No. Item


Apologies for absence and notifications of substitutes


Apologies were received from Councillor Nick Emmerson.



Declarations of interest


There were no declarations of interest.



Minutes of the last meeting pdf icon PDF 124 KB

To agree the Minutes of the meeting held on 14 October 2015.



The minutes of the meeting held on 14 October 2015 were signed and agreed as a correct record.




Indicative time: 20 minutes


Royal Marsden Trust

A verbal update from Councillor Nick Emmerson.


This item was deferred in the absence of Councillor Nick Emmerson.



SW London Joint Health Scrutiny Committee

A verbal update from Councillor Alan Salter.


Councillor Alan Salter provided a verbal update on progress made at the South West London Joint Health Scrutiny Committee. He informed the committee that they had worked on one issue so far, a mental health review, for which a paper would be published in the future. The Joint Health Scrutiny Committee had recognised that it would be helpful to meet again in the late spring which Councillor Salter confirmed that he would report back on.



St George's University Hospitals NHS Foundation Trust - Urogynaecology public consultation pdf icon PDF 304 KB

Representatives from the St George's University Hospitals NHS Foundation Trust and representatives of the clinicians and patients to address the Committee to discuss their plans and the impact this will have on the residents of Sutton.


Indicative time: 40 minutes

Additional documents:


At the invitation of the Chair, Michelle Fynes, Consultant Urogynaecologist at St George’s University Hospitals NHS Foundation Trust (SGUH) addressed the committee regarding the consultation that the trust has been carrying out following suspension of this service in June 2015. The principal concerns raised by Ms Fynes were:-


·         It was not clear where children and adolescent patients were being treated.


·         SGUH provides the only paediatric and adolescent Urogynaecology service in South West London.

·         There was evidence to suggest that between 30-35 referrals had been turned away without any action taken to address them.

·         She believed that children, including victims of sexual abuse, had been treated in a service designed for adults using equipment for adult gynaecology, rather than by specialist paediatric gynaecologists.

·         Staff in the gynaecology unit were not involved in the consultation, she stated that only five medics had been informed of the process.

·         She felt that the trust had been trying to shut the service down without proper consultation, and pointed out that Wandsworth Oversight and Scrutiny Committee had not been contacted until she contacted them in October 2015.

·         She criticised the engagement the trust outlined in their report, stating that they had merely contacted the named groups to inform them of the closure of the service.

·         Patients had contacted her to suggest that correspondence had been backdated


Miles Scott, Chief Executive at SGUH addressed the committee in response. The principal issues raised by Mr Scott were:

·         The trust had temporarily employed a Senior Consultant Urogynaecologist on secondment from Croydon University Hospital NHS Trust (CUH). After the departure of this employee, SGUH were concerned about the safety of patients as they lost faith in the capability of the service to provide adequate care for them. As such, they suspended the service in June 2015.

·         Whilst the service was suspended they reviewed options to move forward, and did not accept any new referrals. They decided that it was in the patients’ best interests to not to re-open the service as other suitable alternatives were available.

·         Patients were given the option to attend Croydon University Hospital instead and SGUH provided information about other alternative care providers.

·         Revised proposals would be taken to the SGUH Board in February or March for decision.


Councillors asked questions regarding the timeline of events throughout the consultation, particularly questioning why this item had been raised with the Chair in December to come to this committee meeting, after the consultation was complete. Miles Scott responded that it is common practice to move patients’ services to other NHS providers without informing scrutiny committees and confirmed that they had checked with their lawyers to ensure they had not breached policy.


Councillor Mary Burstow commented on past experiences she has encountered of NHS services being correctly suspended but then never re-opened. Dr Andrew Rhodes, Chair of the Children, Women’s, Diagnostics, Therapies and Critical Care Division at SGUH, responded to say that they are not ‘shutting down’ children’s gynaecology but that there will be changes to the service pathways and  ...  view the full minutes text for item 19.


Epsom and St Helier NHS Trust pdf icon PDF 359 KB

Daniel Elkeles invited to provide an update on CQC inspection and financial and clinical performance, and the estates strategy.


Report document to follow.


Indicative time: 30 minutes


Daniel Elkeles, Chief Executive, and Tim Hamilton, Director of Communications at Epsom and St Helier NHS Trust provided an update on the progress of the trust, including:

·         Their recruitment drive was very successful, they had recruited over 300 nurses this financial year, reducing the amount of nurses employed through agencies.

·         Both customer and staff satisfaction has increased.

·         Many key access targets were achieved, as outlined in the report, including treating patients in the Accident and Emergency unit within 4 hours, and meeting target waiting times for cancer treatment.

·         Patients had been discharged more quickly and at a higher standard.

·         The trust was £28.5m in deficit, a lot of work would need to be done over the next year to address this.

·         There was no formal feedback from the Care Quality Commission (CQC) inspection yet, however informal feedback had been received and was generally very positive. There was concern about critical care services but the trust took action very quickly and the CQC are satisfied with the action taken.


Councillors asked questions regarding re-admission figures and the five year plan. Daniel Elkeles confirmed that discharges needed to be reviewed and that they would be working with the CCG on the review. He also confirmed that there was no reason to deviate from the five year plan’s commitments to keep all services open and that the trust was passionately committed to it, with plans for major improvements at St Helier hospital including a capital bid for £5m to work on the outside of the building.


Councillor Doug Hunt asked for clarification on the definition of Junior Doctor and Daniel Elkeles explained that the recent strike was about doctors on the training programme.



Sutton CCG updates pdf icon PDF 463 KB

To update on:


·         Proposed changes to the provision of primary care (Wandle Valley Health Centre)


·         CQC inspections on local GP surgeries


·         Joint responsibility for sufficient GP capacity across the local area.


Indicative time: 20 minutes


Dr Brendan Hudson and Dr Chris Elliott presented a report to update the committee on the recent progress of the Sutton Clinical Commissioning Group. The report covered:

·         The closure of Wandle Valley Health Centre from 31 December 2015 after consultation with patients, and the decision to disperse the patient list as the centre had only managed to capture 2000 patients.

·         The closure of Beddington Medical Centre on 1 April 2016, in order to merge with Shotfield Medical practice.

·         The outcomes of the first CQC inspections that were carried out in practices in Sutton, 7 had been inspected and 2 were deemed inadequate. The practices where problems were found had endeavoured to improve and were due to be re-inspected by the end of the financial year 2016/2017.

·         NHS England’s support for CCGs to have delegation for primary care. Sutton CCG had put in a recommendation to go forward for delegation and were hoping for approval from practices.


Councillor Alan Salter expressed his concern for the two practices that were deemed inadequate as they were in his ward, and asked when the next tranche of inspections would begin and whether they prioritise practices that where there are areas of concern. Dr Brendan Hudson confirmed that the second tranche of inspections had already started, and Dr Chris Elliot confirmed that the CQC had developed a sifting tool to give them a list to work with but that it was not still being used. He informed the committee that NHS England have allocated funding across the country to help “vulnerable practices” and that approximately 67 had been identified as “failing” in London, one of which was in Sutton. Councillor Alan Salter asked when the results will be available, and Dr Chris Elliott confirmed that any causes for concern would be flagged up immediately.


Councillor Pathumal Ali raised concerns about the closure of Beddington Medical Practice as it indicated the loss of smaller practices and it was the only practice in her ward meaning patients would have to travel to other wards or to Croydon. Dr Brendan Hudson responded that there was a movement to form a federation of practices to work together in order to offer the services required at scale as a hub. Dr Chris Elliott went on to comment that the CCG was not part of the assessment of any practice, nor the process of these changes but that there was hope that sharing knowledge would be a positive step for smaller practices.



Flood Risk Management Review

A verbal update from Councillor Alan Salter.


Indicative time: 10 minutes


Councillor Alan Salter provided a verbal update on Flood Risk Management, including that there had been a number of blocked gullies but no serious flooding or flooding into houses.



Governance Review - Proposals for Scrutiny

A verbal update from the Chair and Commissioning and Business Insight Manager.


Indicative time: 10 minutes


Councillor Alan Salter provided a verbal update on the proposals for Scrutiny committee under the Governance Review, particularly that there was more scope to select items, the committee would consider items for a workplan for the coming year.


David Olney, Commissioning and Business Insight Manager, commented that the remit of the Scrutiny committee had been extended beyond the three topics that it was initially allowed to scrutinise and emphasised the importance of a discussion that needed to be held to draft a long list of ideas for topics for the coming year as Scrutiny Committee would be required to submit an annual report to Full Council.



Draft Workplan

Indicative time: 10 minutes


Members discussed on-going and potential future investigations for the committee. Councillor Pathumal Ali updated the committee on the support for Victims of Crime item. She had met with representatives from the local children’s safeguarding board and SSPS and they had decided that they must define an age group to focus on as part of mapping the boundaries of the project to move it forward. She commented that there used to be services available locally and that work needed to be done to decide where direct victims of crime to seek support. Councillor Alan Salter informed the committee that the service had merged with Merton several years ago and is now part of a more general South West London service. Councillor Pathumal Ali said that she hoped to have more feedback and raise more questions on this for the next meeting in April 2016.


Councillor Alan Salter informed the committee that the Leader had proposed inclusion of an investigation into the Probation service on a future agenda for the Scrutiny committee.



Any urgent business, brought forward at the discretion of the Chair


There were no urgent items.