Agenda item


To receive a presentation on the consultation process relating to the Paediatric Assessment Unit (PAU) at Chase Farm Hospital, from Graham McDougall and Dr Mo Abedi


Dr Mo Abedi, Chair of Enfield CCG presented an item on Paediatric Assessment Unit (PAU) at Chase Farm Hospital, the main points of which were as follows:

·         The BEH Clinical Strategy 2013 aimed to improve the health of local people, tackle health inequality and deliver safe, high quality services for local people.


·         Since 2013, the Older People’s Assessment Unit and the Urgent Care Centre have been well utilized with good numbers of attendance.


·         The PAU has consistently low figures and the numbers of attendances are dropping. The unit provides a service for children to be seen and treated by consultants, who are unable to be managed within the Urgent Care Centre. However, on average, the unit receives 2-3 patients a day and as a result, specialist staff are not being utilized efficiently.


·         The Enfield CCG invests £409,000 a year in the PAU.


·         A review of the Unit has took place between the Enfield CCG and the Royal Free Hospital to assess the effectiveness of the current model as  a provision for children


·         Following the review, instead of the PAU, an urgent access outpatient appointment system would be available; this would ensure children and young people would be seen in a primary care setting within 2 weeks. Children who would need to see a paediatrician on the same day would be transferred to another unit such as Barnet or North Middlesex Hospital.


·         The review was considered by the Enfield CCG’s Clinical Reference Group to ensure the new service would be safe, allow specialist staff to maximise their time efficiently and provide better care for children.


Dr Mo Abedi summarised that the service re-design would be beneficial for the clinical safety and effectiveness and value for money. With the redevelopment of Chase Farm Hospital taking place, this is the best opportunity to develop new and more integrated services for children. It is planned that the new service will open on 1st April 2016.


Councillor Abdullahi voiced concerns that the residents of Enfield had already lost their A&E and Maternity Services at Chase Farm and would oppose this as they have already suffered a significant loss to their health care.


The following questions were taken from the Councillors on the panel

Q) Why do you believe that the unit at Chase Farm is currently not working to capacity as there are large waiting times at both North Middlesex and Barnet Hospital?

A) 2-3 people are visiting the unit per day, whilst 70% of GP appointments are for children. For specialist assessments children would be transferred to North Middlesex and Barnet. Paediatric Care would continue to be available at Chase Farm Hospital.


Q) Once a child is referred for an acute appointment it can still take up to 2 weeks for that child to be seen, this is a considerable amount of time for a child to wait.

A) In an emergency, children will still be sent to North Middlesex or Barnet for treatment. The re-designed service will see an increase in the number of children able to access paediatric care.


Q) Could you explain what the PAU currently does and how is this being replicated in the proposed plans?

A) Children attend the PAU with conditions not serious enough to be admitted to hospital. Currently, GP’s are able to refer patients to the unit to receive treatment or further advice.


Q) Transferring patients to Barnet and North Middlesex are inconvenient for Enfield residents. Why aren’t more GP’s in the borough making use of the service available at Chase Farm as the reconfigured services have already put pressure on Barnet and North Mid?

A) Many GP’s are able to manage patients within their own surgeries and if not the patients are transferred to acute appointments. The services available at Chase Farm are working well and GP services will be available at all sites. The CCG are constantly looking at ways to improve the services provided.


Q) How many consultants are at the PAU?

A) 1


Q) What services will be available at the redeveloped Chase Farm and could the redesigning of the hospital enhance the GP service currently there.

A) The services available will be paediatric outpatients, direct assessment, 9-5 GP services and the urgent care centre. The GP service will be better for patients and children


Q) A claim was made that this review was discussed with the Director of Children Services and the Cabinet Member for Education, Children’s Services and Protection who agreed the changes. Were the Labour Members of the Panel aware of this?

A) The Labour Members of the Health Scrutiny Panel were not aware of any such meeting. Councillor Cazimoglu stated that as the Cabinet Member for Health in Enfield, she was disappointed to not have been consulted on this.


AGREED: That the Scrutiny Panel write a letter to the CCG to express their views. ACTION: Cllr Abdullahi/Andy Ellis


Graham McDougall, Director of Strategy and Partnerships, provided a brief verbal update on the review of Urgent Care Services presently being carried out. Enfield CCG commissions a range of urgent care services allowing patients to access care for non-life threatening illnesses and injuries 24 hours a day, 7 days a week.

The review has already started and some of the data is being analysed. An online survey on the Urgent Care Centres in the borough will be available until 3rd April and has been taken to the Over 50’s Forum and a Patient Participation Event. The review wants to see how urgent care centre services are being provided. This is part of a wider North Central London engagement exercise, and leaflets and questionnaires have been sent to stakeholders and to patients.


The following questions were asked:

Q) Were members of the general public sent the consultation and questionnaire?

A)Hardcopies of the questionnaire were made available at request. These were also sent to a variety of community groups in the borough for distribution. 


It was suggested that copies of these be made available at libraries, surgeries and as they review the hospitals they should be made available within them. The Health Scrutiny Panel and the Cabinet Member for Health reiterated that they were disappointed not to have advised at an early stage, that the review was taking place. Cllr Abdullahi was notified on the 24 February that the review had commenced on 19 February.


A member of the public asked whether it was possible for people attending health facilities in the borough to state whether they are registered in the borough.

A) Work already takes place on finding out whether patients are registered to the borough where they receive their health care. When patients first attend a service they are advised on where they can register with a GP.


Councillor Abdullahi thanked the CCG for attending.



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