Barnet, Enfield and Haringey Clinical Strategy

Published on Monday, 12 September 2011 13:39
Posted by Scott Buckler

Health Secretary Andrew Lansley has accepted an assessment carried out by the Independent Reconfiguration Panel (IRP) of the best future for Barnet and Chase Farm Hospitals in north London

In 2010, the Secretary of State asked that plans, accepted by the previous Government, for the reconfiguration of local services at Barnet and Chase Farm Hospitals be assessed against four key tests which should be applied to all NHS reconfigurations, namely that:
• There should be clarity about the clinical evidence base underpinning the proposals;
• They must have the support of the commissioning GPs involved;
• They must genuinely promote choice for their patients; and
• The process must have genuinely engaged the public, patients, and local authorities.

The IRP is a panel of independent NHS clinicians, managers and lay members. Its assessment has concluded that “the status quo has real downside risk in terms of the current safety and sustainability of local services”, and that when measured against these four tests, “the process appears to have been robust and the consideration of the evidence compiled thorough and well-balanced.”

Enfield Council was also offered an opportunity to develop alternative proposals for the future shape of local health services. However, the IRP assessment concludes that the Council’s report “does not…provide any credible alternative to the current proposals or address the increasing and real concerns about the safety and sustainability of current services that underpin the clinical case for change.”

Finally, the IRP assessment also notes that “serious concerns have been raised about the implications of not completing the implementation of the strategy for services at the North Middlesex Hospital following its refurbishment under a PFI scheme.” In 2007, the North Middlesex Hospital received £144 million to refurbish its facilities on the basis that those facilities would see a greater proportion of patients from the Enfield area – but those patients have continued to be seen at Chase Farm Hospital.

As a consequence of accepting the IRP’s advice, existing proposals for clinical changes at Barnet and Chase Farm- to centralise A&E; and maternity at Barnet and North Middlesex Hospitals and for a new Urgent Care Centre at Chase Farm - will be implemented. Services at Chase Farm will change, but the hospital will remain open. The existing proposals for change were agreed under the previous administration in November 2008.
The Health Secretary will also now ask NHS London to work with Barnet and Chase Farm NHS Trust and the North Middlesex University Hospital NHS Trust, to assess the feasibility of Chase Farm Hospital and the North Middlesex University Hospital NHS Trust becoming part of the same management organisation, with a view to ensuring this happens if the assessment of the merits of doing so supports this. The new organisation would be able to provide services specifically geared to the needs of the local population of Enfield and the surrounding area.

Health Secretary Andrew Lansley said:

“I know how strongly many local people and their representatives feel about this, and about the future of Chase Farm in particular. However, the safety and sustainability of local NHS services have to be the priority for all involved, and, as the IRP advice makes plain, both are at significant risk unless decisions are taken.
“This is not about money. We are not making cuts to local services. In fact, tens of millions of pounds have been spent on local hospitals to support these changes. We must be prepared to take a hard decision in the interests of putting patients, safety and local services first.
“We were right to ask that proposals for change should be assessed against four important tests – just as all local plans for change in the NHS should be – and I am satisfied with the IRP’s conclusions that the process appears to have been robust.

“However, the IRP’s report does not prevent the local NHS and GPs via the Clinical Commissioning Group from determining how they want to commission urgent and emergency care services for their local community in future.
“I would like to thank the IRP for its work on this important and very complex issue. The NHS needs to learn from what has happened in Barnet, Enfield and Haringey, and to ensure that, as far as possible, plans for change are evidence-based, supported by local GPs, have involved engagement with the local community, and promote real choice for patients.”

Source: DH


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