Update on clinical changes in Barnet, Enfield and Haringey

Last updated 11-Jan-12 16:40

NHS organisations in Barnet, Enfield and Haringey have been working together to take forward major changes to local NHS services. 

In September 2011 the Secretary of State for Health, Andrew Lansley, published his response to a review of the Barnet, Enfield and Haringey Clinical Strategy by the NHS Independent Reconfiguration Panel, giving the final go-ahead for implementation of the strategy. 

The strategy has been developed by clinicians and aims to improve the health of local people, tackle health inequalities across and within the three boroughs and improve services to patients. The changes will be across the whole local health system and see significant investment and improvements in primary and community care as well as in hospitals. 

In primary and community care, some major improvements have already taken place – such as the new Edgware Community Hospital – or are in progress or planned. They include the redevelopment of Finchley Memorial Hospital in Barnet, which is due to open in late 2012 and improvements to health centres and GP practices in each of the three boroughs.  

In Enfield, new community based services have been established for ophthalmology, oral surgery and gynaecology, five GP practices have been consolidated into the Evergreen Surgery and ultrasound and other diagnostic tests can now be carried out in local surgeries rather than in hospital. In Haringey, speciality based integrated care teams have been established and a range of services previously only undertaken at acute hospitals are now being delivered in the community such as those for anti-coagulation, heart failure and minor eye conditions. 

Commissioners are developing a new primary care strategy for consideration by the joint boards of the local primary care trusts on 26 January 2012. The primary care strategy will provide a framework for the whole area. Specific plans are being developed for each borough including timelines and investment plans for each. 

At the same time as taking forward improvements in primary care, local NHS commissioners have been working with the Barnet and Chase Farm Hospital NHS Trust and North Middlesex University Hospitals NHS Trusts to plan the changes to hospital services.  

They include centralising accident and emergency, inpatient paediatrics, obstetrics, maternity and neonatal services at Barnet Hospital and at North Middlesex University Hospitals. At Chase Farm Hospital there will be a senior clinician-led urgent care centre incorporating a paediatric assessment unit and an elderly care assessment unit, expansion to take planned operations transferred from Barnet hospital, day surgery, rehabilitation beds, and outpatient and diagnostic services.

At Chase Farm Hospital investment is planned to create modern facilities for the new urgent care centre and assessment services, as well refurbishing wards and buildings. At both Barnet Hospital and North Middlesex University Hospital investment is planned to increase the space and facilities for women’s, children’s and maternity services and for patients who will now attend these hospitals for major emergency services. 

These changes will require investment at all three hospital sites to create the physical capacity required and to refurbish buildings to create modern facilities. This will require significant investment in the hospitals at Chase Farm, Barnet and North Middlesex. The two trusts are now preparing business cases for this which will need approval from NHS London, the Department of Health and, in the case of North Middlesex University Hospital, the Treasury. 

In preparing these business cases, the lessons from South London around the clinical difficulty of moving emergency and maternity services at different times are being taken into account are further clinical advice is being sought. However the developing thinking is that the emergency and maternity service moves may need to be aligned with a potential common timetable, for these service changes to be completed in autumn 2013. By that time, a range of further developments will be in place within primary care.and all the clinical changes will be fully implemented. 

Caroline Taylor, Chief Executive of NHS North Central London which is leading implementation of the clinical strategy, said: “This will be a very significant set of changes to improve the local NHS and we will deliver them with a range of partners including GPs, local authorities and Local Involvement Networks (LINKs) to take this work forward.” 

Dr Douglas Russell, Medical Director (Primary Care) for NHS North Central London, said:  “A draft primary care strategy will be considered for approval by the joint boards of the local primary care trusts in January 2012 and is an integral part of the overall BEH clinical changes. 

“I believe passionately in the need to support the development primary and community care services which are universally excellent across all our boroughs and are properly integrated with specialist care. We need to break down the barriers between different parts of the local NHS so that patients can be confident they will get whatever high quality services they need, when they need them, moving seamlessly between the different parts of the system.” 

Ian Mitchell, Medical Director at Barnet and Chase Farm Hospitals NHS Trust, and Stanley Okolo, Medical Director at North Middlesex University Hospital NHS Trust, said: “We are pleased that, after many years of delay, we are now at a point where we can start taking forward the clinical changes with pace and vigour. We aim to create a health system for our patients which delivers high quality emergency and maternity care in the most appropriate places with the most specialist services concentrated in hospitals where staff with the very best expertise and experience are available for such patients."