1. The dovetailing of the Hertfordshire decision with North London PCTs decision regarding Barnet & Chase Farm Hospitals Hertfordshire PCTs

2. Decisions by Hertfordshire PCTs Lister Hospital to be main Acute Hospital in East & North Hertfordshire 2 Local General Hospitals at Welwyn Garden City & Hemel Hempstead Urgent Care Centres to be established with pilot of both Cheshunt & Hertford Planned Care in West Herts at St Albans Paediatric Surgery & Emergencies in West Herts at Watford

3. Decisions by London PCTs Major accident & emergency to move to Barnet – Chase Farm will have a local A&E Planned surgery will remain at Chase Farm Midwife led birthing unit, paediatric assessment unit, older peoples assessment unit

4. Approved with the following steps Appropriate implementation arrangements Independent clinically led review of types and volumes of inpatient elective surgery for Chase Farm site Transfer of Womens & childrens services away from CF will not take place until PCT are satisfied there is adequate capacity Changes to A&E will take place when PCTs satified that there is capacity at Barnet & North Middlesex Transport working Group to be established

5. Hertfordshire Activity

6. Joint work Activity projections and patient flow models were shared. Both Ambulance services worked together on impact of London changes for Hertfordshire Travel analysis took account of both changes

7. Hertfordshire Primary Care Hertsmere Clinical Services in place e.g. –Musculoskeletal –Neurology Broxbourne services –ENT secondary to primary care shift of service –Skin Health Service at Cheshunt Community Hospital –Gynaecological outpatient service at Cheshunt Community Hospital

8. Hertfordshire Elective Care Patients have choice for elective care –Primary Care for minor surgery –Chase Farm –Princess Alexandra Harlow –Lister Surgicentre –St Albans Surgicentre –London Hospitals

9. Hertfordshire outpatients Chase Farm & Barnet Hospitals – now and in the future Cheshunt Potters Bar QEII now and as a Local General Hospital Primary Care Facilities

10. Hertfordshire Urgent Care Within Hertfordshire –8 Urgent Care Centres with Out of Hours Chase Farm Urgent Care Centre at least 12 hours Princess Alexandra

11. Emergency Access East of England ambulance service has worked with London service regarding proposed changes Additional resources have been factored and costed into service to meet proposed changes – additional high dependency unit required estimate - £214,000 per annum

12. Hertfordshire Transport Proposals Strategic planning Revive the Hertfordshire Integrated Transport Project: - Senior director lead with accountability for access to health issues - Project officer to be recruited Link access to health into Local Area Agreement targets Emergency transport Additional £2m funding for ambulance service Non-emergency transport: ongoing support for community transport scheme £0.75m investment prioritising local initiatives e.g. shuttle scheme

13. Patient & Public Engagement –Provide opportunities for patients, carers & public representatives to influence the development of new services –Work closely with local authority partners and voluntary sector to raise awareness and understanding of new services among residents