Agenda item

To consider a report submitted by East Cheshire NHS Trust and NHS England as the respective provider and commissioner of specialist orthodontic and oral surgery services in Macclesfield, outlining the proposed changes to the provision of said services.

Consideration was given to a report submitted by NHS England North (Cheshire and Merseyside) regarding the decision taken by East Cheshire NHS Trust to cease providing specialist oral surgery and orthodontic services from Macclesfield General Hospital.

The Trust had served notice on the two contracts in September and October, respectively, with intent to stop providing them in March and April 2019.

The committee was united in expressing its disappointment that:

(a)  both the Health and Adult Social Care and Communities Overview and Scrutiny Protocol – setting out the mutually agreed local procedure for how NHS bodies should consult and engage with this committee regarding proposed service changes and developments – and the statutory duties placed on the Trust and NHS England North (Cheshire and Merseyside) under various pieces of legislation, had been ignored throughout the process, and

(b)  that representations had not been made by East Cheshire NHS Trust to formally address this committee to explain its rationale for closing the two services.

Members put questions and comments in relation to;

·         why the offer from staff and consultants to hold extra clinics in order to help to retain the local service had not been considered or taken up;

·         concern regarding the decision making and communication of East Cheshire NHS Trust, if they had not made the service commissioner aware that the staff and consultant had been willing to hold extra clinics to support the service;

·         why more concerted efforts had not been made to retain the two services within Macclesfield;

·         why NHS England North (Cheshire and Merseyside) would be undertaking a full needs assessment, if they, as the commissioning body, had confirmed that they had no prior concerns or issues with the services being provided before the contract notices had been served;

·         the concern for both patients – the majority of whom were children or adolescents – and their parents and carers that may have greater difficulty in travelling further for appointments, and be required to take time away from school and work respectively;

·         the impact that the service closures would have on patients presenting with early stage cancer and the disadvantage that it may have on rates of successful, early cancer screenings; and

·         whether it could be guaranteed that any future public consultation on the provision of the two dental services would include an option for the services to remain in the Macclesfield area.

In response to questions from members regarding the next steps in this process, the committee was advised that no specific timescales had yet been confirmed for the undertaking of the needs assessment or future procurement exercises, but that the committee would be kept informed throughout each stage of the process.

RESOLVED –

1          That, owing to the lack of, and therefore inadequate, consultation and engagement with this committee, the wider public and other stakeholders, the committee considers that the proposed service changes are not in the interest of service users and takes the steps necessary to the refer the matter to the Secretary of State for Health and Social Care.

2          That in light of the committee’s decision to explore the use of its power to make a referral to the Secretary of State for Health and Social Care, East Cheshire NHS Trust and NHS England be asked to halt the cessation of specialist orthodontic and oral surgery services provided from Macclesfield General Hospital to allow time for an agreed local resolution to be achieved, or for sufficient consultation to be undertaken on the proposed changes and closures to the services.