To receive a briefing paper from Alan McGlennan, Medical Director, Chase Farm Hospital and Sally Dootson, Director of Operations, Barnet Hospital.
Alan McGlennan highlighted the following from the report:
1) The Older People’s Assessment Unit (OPAU) is a GP referral service which cares for patients aged 65 and over. The OPAU was part of the service provision at Chase Farm Hospital but as a result of the Covid-19 pandemic, the unit was temporarily re-located to Barnet Hospital in June 2020.
2) The change was made in line with NHS England pan-London infection prevention and control guidance.
3) During the initial stages of the pandemic, the OPAU remained operational but all elective surgery at Chase Farm was cancelled. As elective surgery was re-introduced on the site, a decision was taken that it was not possible to continue with the OPAU provision at Chase Farm, with elderly patients being required to move across various departments. Unlike the majority of other patients who attended for planned care, it was not possible to screen them for Covid-19 in advance, due to the nature of their need to be seen quickly.
4) Service provision for the OPAU has remained the same following the re-location to Barnet. Referrals are accepted from North Central London and Hertfordshire.
5) Before the temporary move was undertaken, staff, GPs and commissioners were notified but The Royal Free Trust were not required to consult local overview and scrutiny committees prior to taking the decision.
6) The current arrangements for the OPAU location are being reviewed in line with recent changes in infection and prevention guidance. The Scrutiny Panel will be updated with any further developments.
The Chair opened the discussion for comments and questions;
7) In response to a question as to why Barnet Hospital was considered a safer location than Chase Farm Hospital, it was noted that it was a service related decision to minimise the possibility of transmission of the virus in healthcare. Chase Farm Hospital carries out elective surgery and outpatient clinics and can remain a ‘clean’ or covid protected site. At Barnet, admissions are via the A&E Department, directly on to wards and has the necessary infection control measures in place. With OPAU patients potentially having Covid-19 symptoms, Barnet is the site best suited to accept them.
8) Following a comment relating to the difficulties for residents from eastern Enfield travelling to Barnet, it was confirmed that the temporary re-location of the OPAU would be reviewed by the North Central London Clinical Commissioning Group.
9) Barnet Hospital has a full service for admission avoidance, including for the elderly.
10) It was re-iterated that even for patients in the west of Enfield, access to Barnet Hospital via public transport is problematic and time consuming.
11)In noting the times of service provision, it was confirmed that the OPAU was not a 24 hour service. However, elderly patients would be admitted for care, irrespective of opening hours, just like any other out-patient service.
12)With more testing becoming available, tests would be prioritised for patients with a priority need, including the elderly.
In summary, The Chair confirmed that The OPAU should be repatriated to the Chase Farm site as soon as the pandemic allows. Members of the Scrutiny Panel would be concerned if the unit was to remain in Barnet, following the end of the pandemic.
Alan McGlennan and Sally Dootson were thanked for their presentation.