Agenda item

The Panel are asked to consider the presentation on the Royal National Hospital for Rheumatic Diseases in Bath.

(Note: Councillor Anthony Clarke withdrew from the meeting for this item having declared a disposable pecuniary interest)

Kirsty Matthews – Chief Executive RNHRD, made a presentation to the Panel covering the following (a full copy of the slide presentation is available on the minute book):

·  Our position as a foundation trust

·  Money not services

·  Finding a solution?

·  The decision – we expect to join with the RUH

·  How will this happen?

·  Transition process – progress to date

·  Risks and opportunities

·  Shape of the services 2013

·  Successes at the Min

·  Communication and information

·  Coming together – Vision for the future

The Panel noted that they had been sent a statement on the concerns of the RNHRD Governors’ for the future of the Neuro-Rehabilitation patients.

Panel members raised the following points and asked the following questions:

Councillor Pritchard asked about the nature of ‘acquisition’ as opposed to ‘merger’. He stated that if it is an acquisition, the RUH might want to lose elements of the Min (RNHRD) because of the business considerations of the hospital. Councillor Pritchard noted that he had never heard a criticism of the Min and that people go out of their way to praise its valuable service. Councillor Pritchard stated that, regarding public perception, the fact that the Neuro-Rehab unit could close so early in the process of acquisition, it may similarly lead to concerns of the possible loss of other services. Kirsty Matthews – RNHRD Chief Executive explained that, due to the size of the Min compared to the RUH, it was not the classic definition of a merger and the legal term ‘acquisition’ was more appropriate. She explained that the working relationship with the RUH was good.

Councillor Pritchard asked about the public perception of the acquisition, he asked if there would be two sites or would the buildings be merged. He stated that he felt that the Min should retain its individual identity. Councillor Hall stated that she felt it was the continuation of the service that was most important, rather than the badge. James Scott – Chief Executive RUH explained that the Min and RUH are currently separate legal entities. He explained that the question regarding the future identity of the hospitals was many steps ahead of the process at the present time and for the acquisition to go ahead, the RUH had to become a Foundation Trust and this would not happen until early summer.

Councillor Brett asked what the business case for the RUH was in going forwards with the acquisition. James Scott explained that the RUH do not have a rheumatology section and that in terms of research and development, it was not a university hospital although it was research active. He stated that the acquisition would address these points. He further explained that the acquisition was in the final phase and the outcome should be clear in 6-8 weeks.

Councillor Nicol asked why the current budget situation was not foreseen. Kirsty Matthews – RNHRD Chief Executive explained that there had been strong indications about the change in commissioning intentions. She explained that there had been work done to reduce overheads but it had not had a significant enough effect. Councillor Nicol stated that he would like to look at the speed with which the acquisition will go through.

Councillor Jackson stated that the Min is in a Grade 1 listed building and it would be much cheaper to work from a more modern building

Discussion on the Neuro-Rehab Unit

Councillor Organ stated his concerns about the closure of the Neuro-Rehab unit. Councillor Hall stated that this Panel should have been included in the consultation. She stated that the figures were not good and asked how sustainable the hospital is over the next 6 months. The Chief Executive of the RNHRD stated that the majority of work is outpatient based and the changes regarding Neuro-Rehab would change the shape of the hospital. Councillor Hall asked about special commissioning regarding the Neuro-Rehab unit. The Chief Executive explained that there had been some dialogue with the specialist commissioning team and that the new position should be clear in early February 2013. She stated that she was working with LINK; had engaged with staff and was considering meeting with families. She noted the tight timescale. Councillor Hall asked what would happen if specialist commissioning was not in place by 1^st April 2013. Tracey Cox (PCT) explained that there are alternative potential providers; some may not be close to this area. Councillor Hall commented that a typical six week stay is a long time to be in a distant location.

Following a question from Councillor Simmons regarding the number of outpatients treated at the Neuro-Rehab unit, the Chief Executive explained that there were two types, the former inpatient and the non-inpatient. She stated that by the end of March 2012 there had been 240 attendances in total, 90 of which were linked to an inpatient stay.

Councillor Pritchard stated that the intention was to close the Neuro-Rehab unit on 31^st March 2013 and other area providers may not be able to accommodate extra patients. He explained that staff at the unit have had notice of intent, the consultation period had been over the Christmas period and that LINK did not feel they had appropriate opportunity to comment.

On a proposal from Councillor Pritchard, seconded by Councillor Organ, it was:

RESOLVED that there would be an extra ordinary meeting of the Panel to consider the intentions and possible outcomes of the closure of the Neuro-Rehabilitation Unit at the RNHRD.

Councillor Pritchard thanked everyone for coming and for the information shared.