Agenda item

To consider the comments regarding the Full Business Case for the merger of the Trusts running Hinchingbrooke, Peterborough and Stamford Hospitals from the Overview and Scrutiny Panel and confirm the response to the Trusts’ proposal.

i.  That the Chairman of Overview and Scrutiny Panel (Communities and Environment), Executive Councillor for Leisure and Health, Executive Leader and Managing Director meet as a matter of urgency; and

ii.  that the matter be deferred to the Overview and Scrutiny Panel (Communities and Environment) to enable the Panel to convene a Task and Finish Group to undertake a critical analysis of the Full Business Case, to formulate a proposal to the Cabinet as to whether the Council should support the Merger and its suggested response.

Having been invited to address the Cabinet, the Chairman of the Overview and Scrutiny Panel (Communities and Environment) presented a report (a copy of which is appended in the Minute Book) with a summary of the Full Business Case for the merger of Hinchingbrooke Health Care NHS Trust with Peterborough and Stamford Hospitals Foundation Trust.

The comments of the Overview and Scrutiny Panel (Communities and Environment) were circulated to the Cabinet prior to the meeting, the agenda for the Cabinet meeting having been published prior to the Overview and Scrutiny Panel meeting.

The Chairman of the Overview and Scrutiny Panel (Communities and Environment) expressed appreciation to those Members and Officers involved in the matter and explained that the Panel had wished to offer constructive comments.  However, it appeared that the Trusts had formulated their conclusion prior to having commenced the engagement process.

The Panel were concerned that there had been no consideration for a ‘Plan B’, nor of any other options, or of the possible failure of the merger.  When the Panel had challenged the Trust the response had been that the merger would not fail and that if the merger did not proceed the Trust would experience a loss of Consultants.  However, the Panel were aware that a significant proportion of mergers elsewhere had been unsuccessful.

Another significant concern of the Panel had been the ‘democratic deficit’ on the Board of Governors of the merged Trust meaning Hinchingbrooke was currently underrepresented and therefore decisions could favour Peterborough and Stamford hospitals.

The Cabinet were informed by the Executive Councillor for Leisure and Health that what was not apparent from the Full Business Case was the intention of the merger being to put the patient first.  It was noted that the Care Quality Commission inspection area rating had improved and Hinchingbrooke hospital had now been rated ‘Good’.  The size of the accident and emergency department was small which meant that retaining staff was difficult and the proposal looked to address clinical resilience.

In discussing the matter the Cabinet stated that the merger would affect all residents of the District and in order for the merger to succeed, and to have focus, it was not advantageous to have a ‘Plan B’.  The issues that the merger looked to address would not disappear and there was inevitability amongst the Cabinet that the merger would happen.  However, to proceed with a democratic deficit within the governance structure was unacceptable, as the Board of Governors had to be democratically balanced, to enable the public to hold the Trust to account.

There was some concern expressed within the Cabinet that as the merger followed the early withdrawal of Circle, the private company operating Hinchingbrooke Health Care NHS Trust, in the future the Cabinet would be responding to the potential closure of the hospital.  It was further suggested that the merger was unlikely to give Huntingdonshire or its residents any consideration.

It was not apparent from the Overview and Scrutiny Panel recommendation as to the virtue of the merger and whether the Council should respond in a supportive manner.  Given that the Panel had received presentations from representatives of Hinchingbrooke Health Care NHS Trust and Cambridgeshire and Peterborough Clinical Commissioning Group the Cabinet considered that the Panel were in the best position to formulate this opinion.

Any response from the Council needed to be positive and indicate how the community highly valued Hinchingbrooke Hospital.  The Trust had delivered its promise of financial sustainability and clinical resilience and it was important that any response included the expectation that the Trust maintained this promise.  The response could also include the Council’s concerns and if the response opposed the merger an alternative solution should be offered as the response needed to be more than a list of concerns.

The Cabinet was informed that clinical resilience would not be maintained without the merger and that there were no reduction planned in the services delivered at Hinchingbrooke Hospital, long-term the services offered would increase. As the Council was not a statutory consultee it was accepted that the Council’s response was unlikely to have a great influence.  However, it should be clear that there was support for Hinchingbrooke Hospital.

Having considered the comments and recommendation of the Overview and Scrutiny Panel (Communities and Environment) the Cabinet,

RESOLVED

i.  that the Chairman of Overview and Scrutiny Panel (Communities and Environment), Executive Councillor for Leisure and Health, Executive Leader and Managing Director meet as a matter of urgency; and

ii.  that the matter be deferred to the Overview and Scrutiny Panel (Communities and Environment) to enable the Panel to convene a Task and Finish Group to undertake a critical analysis of the Full Business Case, to formulate a proposal to the Cabinet as to whether the Council should support the Merger and its suggested response.