Transfer of A&E services to Vocare
- Meeting of Health and Adult Social Care Policy and Scrutiny Committee, Tuesday, 13 April 2021 5.30 pm (Item 16.)
To update Members on the transfer of A&E services to Vocare.
Members considered a report that updated them on York’s Teaching Hospital NHS Foundation Trust (YTHFT) Urgent Treatment Centre (UTC) and the suggestion that there was possibility of privatisation of York hospital’s A&E minor injuries unit to Vocare.
The Accountable Officer, NHS Vale of York Clinical Commissioning Group (CCG) and the Director for Primary Care, NHS Vale of York Clinical Commissioning Group (CCG) were in attendance to provide an update and answer any questions.
The Director for Primary Care made reference to the comments raised by the public participants and she stated that the CCG had been working with a number of providers through a Clinical Reference Group to consider ways in which services could be improved and she confirmed that Vocare would be included in that range of provider services. She highlighted the background to Vocare being commissioned by the CCG to provide services, noting that they already worked alongside the Trust’s emergency department team and that they provided General Practitioner (GP) out of hours service in York Hospital alongside the emergency department.
Members were informed that the minor injuries part of the service was currently provided by the Trust’s emergency department and that York’s UTC was not compliant as minor injuries and minor illness should, in line with the national specification, be delivered as a single service for direct booking by NHS111. YTHFT and Vocare had been working together to review and redesign the existing Emergency Department Front Door service model to optimise delivery and refine the service model to meet national UTC criteria. Members noted that Emergency services were exclusively provided by YHFT, the urgent care element was streamed at the front door to avoid patients waiting in the Emergency department, if they did not need that level of care.
Members raised numerous concerns regarding private company involvement in the provision of public health care and the effect this could have on the workforce and patients. Following detailed discussions, officers answered questions relating to the interim arrangements, providers, clinicians, GPs and resident engagement. Some key points arising included:
· The CCG had extended York Trust and Vocare’s existing UTC contracts until 2021/22 to allow stability in provision so that providers could work together, to address compliance in the short term, but also allow time for the emerging Provider Collaborative to engage in service design that would achieve the objectives of public/patient and local clinicians’ feedback. The CCG very much hoped that the York Primary Care urgent care offer, as proposed by the Clinical Reference Group, would play a strong part in future provision.
· Vocare had been commissioned to deliver a service at York Hospital since 2015 and there was no intention to transfer staff or employment of staff into Vocare and YHFT had written to the CCG in response to the MP query to confirm this position.
· The provider to provider arrangement between the Trust and Vocare was viewed by the CCG as an interim solution to bring direct booking at the UTC up to national minimum standards by April 2021, whilst the CCG continued to engage with primary and urgent care providers to support a collaborative approach to delivering urgent care in a different way.
· The Clinical Reference Group was established to oversee the changes, address compliance and services over the long-term.
· The CCG would endorse and encourage the clinicians and GPs, who were part of Nimbuscare (a Primary Care services provider in York), to be involved in conversations about a future model, which would also respond to the requests and wishes of patients.
The Chair thanked the Accountable Officer and the Director for Primary Care for attending the meeting and providing a detailed update.
Resolved: That the update be noted.
Reason: To keep Members updated on York’s Teaching Hospital’s NHS Foundation Trust Urgent Treatment Centre.