The Director of Commissioning, Strategy and Delivery and the Director of Planning, Performance and Business Strategy at South Tees Clinical Commissioning Group (STCCG) were in attendance to provide an update to the panel.
The Director of Commissioning, Strategy and Delivery advised that the breast diagnostic (symptomatic) services sat within the wider programme of the Integrated Care Partnership (ICP). The aim of the ICP was to develop a clinical strategy with the aim of achieving and sustaining high-quality health care provided across the Darlington, Durham, Dales, Easington, Sedgefield, Tees and Hambleton, Richmondshire and Whitby areas.
Currently the facilities in scope for the ICP (Breast Symptomatic) review included Darlington Hospital, Hartlepool Hospital, James Cook Hospital, North Tees Hospital and University Hospital of North Durham.
The facilities and services out of scope of the ICP review included the national screening programme (commissioned by NHS England) and the screening services at the Friarage Hospital (provided by York Teaching Hospital NHS Foundation Trust).
The ICP's focus was to stabilise and sustain vulnerable services. It was emphasised that the commissioners and providers would be working collaboratively to maintain local access to services as far as possible, deliver out of hospital care and ensure the sustainability of safe clinical services that met the needs of the population.
In terms of the process for change, it was explained that there would be engagement with stakeholders, preparation and undertaking of public consultation, evaluation of consultation and mobilisation. It was stated that the engagement exercise would commence in September and would involve gathering the views of interested parties including patients, the public and scrutiny.
In terms of the work being undertaken by the task and finish group (the group included clinicians from NT NHS FT, ST NHS FT and STCCG), an evaluation was being undertaken to understand the current workforce needs, capacity and demand requirements to help develop possible service options.
Some of the data used in the recent review was now out-of-date and needed to be revisited. The aim of the current work was to define the optimal service configuration of breast symptomatic services to outline potential options for safe care delivery. There was also a need to refine workforce planning opportunities to minimise the difficulties in recruiting to posts e.g. Radiologists.
The panel was provided with the opportunity to ask questions of the representatives in attendance.
During discussion the following points were raised :-
In addition to groups outside of the statutory framework it was advised that the CCG would pull together a stakeholder map. The map would include local community groups including breast support groups. It was emphasised that there was no definitive list and that would evolve as the process progressed.
In terms of workforce and the difficulty in recruiting Radiologists, it was emphasised that every conceivable option was being explored. There was also a recognised need to make the area of work more attractive. Currently, from a Radiologists perspective, other areas of work were more attractive than breast radiology given the more interventional, technical nature of the work involved.
In response to a query, it was advised that financial incentives to attract Radiologists were ineffective and served only to push up the market rate.
In terms of the current work being undertaken, it was emphasised that the key difference was that a number of different Trusts were now involved. That effectively increased the viable options available as there were more Radiologists employed across the wider patch.
The panel expressed the view that it was very disappointed that the CCG and the Trusts had not already reached a point where a formal consultation could be undertaken, given the length of time the issue had been on scrutiny's agenda.
The Director of Commissioning, Strategy and Delivery acknowledged the panel's concerns and apologised that the engagement and preparation for consultation work had not already been undertaken.
AGREED that the CCG, ST NHS FT and NT NHS FT be invited to attend the panel's next meeting to provide further information on the work undertaken.