Agenda and minutes

To approve as an accurate record, and the Chairman to sign the minutes of the meeting of the Housing, Health & Adult Social Care Select Committee held on 17 April 2012. 

RESOLVED THAT:

The minutes of the meeting held on 17 April 2012 be approved and signed as an accurate record of the proceedings.

Apologies for absence were received from Councillors Iain Coleman and Oliver Craig.

If a Councillor has a disclosable pecuniary interest in a particular item, whether or not it is entered in the Authority’s register of interests, or any other significant interest which they consider should be declared in the public interest, they should declare the existence and, unless it is a sensitive interest as defined in the Member Code of Conduct, the nature of the interest at the commencement of the consideration of that item or as soon as it becomes apparent.

At meetings where members of the public are allowed to be in attendance and speak, any Councillor with a disclosable pecuniary interest or other significant interest may also make representations, give evidence or answer questions about the matter.  The Councillor must then withdraw immediately from the meeting before the matter is discussed and any vote taken.

Where Members of the public are not allowed to be in attendance and speak, then the Councillor with a disclosable pecuniary interest should withdraw from the meeting whilst the matter is under consideration. Councillors who have declared other significant interests should also withdraw from the meeting if they consider their continued participation in the matter would not be reasonable in the circumstances and may give rise to a perception of a conflict of interest.

Councillors are not obliged to withdraw from the meeting where a dispensation to that effect has been obtained from the Audit, Pensions and Standards Committee. 

This report sets out the new membership of the Committee and the terms of reference of the Council’s Overview & Scrutiny Board and the three select committees as agreed at the Annual Council meeting held on 30 May 2012.

RESOLVED THAT:

The committee’s membership and terms of reference as agreed at the Annual Meeting of the Council on 30 May 2012 be noted.

The Committee is asked to agree the re-appointment of Maria Brenton, HAFAD as a non-voting co-opted member for the 2012/2013 municipal year.

RESOLVED THAT:

Maria Brenton, Chair of HAFAD, be appointed as a co-opted member for the 2012/2013 municipal year.

The Committee is asked to elect a Vice-chairman from amongst its members for the 2012/2013 municipal year.

RESOLVED THAT:

Councillor Rory Vaughan be appointed as Vice-chairman of the committee.

The committee is asked  to respond to Central London Community Healthcare NHS Trust consultation on its Foundation Trust plans.

Mr James Reilly and Ms Anne Barnard presented the application by Central London Community Healthcare NHS Trust (CLCH) to achieve NHS Foundation Trust status in September 2013.

NHS trusts either had to achieve Foundation Trust status by April 2014 or merge with another trust which had already achieved Foundation Trust status. CLCH considered that it was of benefit to the local community to remain focused as a community organisation working in partnership with other organisations to provide integrated social and health care, rather than becoming part of a larger organisation.

Foundations trusts have a membership, comprising local people, patients and employees which elects a Council of Governors. This means that foundation trusts are more accountable to the people who use its services, its staff and local communities. They are able to be more innovative in developing their services and responding to the changing healthcare needs of their local communities. They have greater autonomy and freedoms, and specifically greater financial flexibility to invest any surpluses in existing services or to develop new services, rather than returning surpluses to the NHS.

Foundation trusts are regulated by Monitor, the independent regulator, and are responsible to the Secretary of State. There is a rigorous authorisation process, which takes over a year, in which trusts have to demonstrate governance and financial capabilities as well as the capability to deliver clinical effectiveness.

In response to members’ questions Mr Reilly confirmed that CLCH was on schedule with its application, with only a five/six week delay in respect of the consultation because of the mayoral elections. The trust had considered the alternative of merging with another trust, but  this would mean merging with an organisation providing hospital or mental health services, and losing the ability to focus purely on community healthcare. There had also been the option of forming a social enterprise structure. However, staff had indicated a clear preference for remaining within the NHS.

CLCH’s application had been discussed with the North West London cluster and a formal agreement reached with the Strategic Health Authority and the Department of Health, which had to be satisfied that the programme was realistic and to sign off key milestones.

In  addition to the statutory consultation with overview and scrutiny committees, there had been a  series of public events, but these had not been well attended. Six people had attended the Hammersmith & Fulham event and attendances were similar for other events. There had been a number of outreach events, where patients had been interviewed at centres, where they were using the services. There had been a substantial mail out of the consultation document and 130 responses had been received to date. The benchmark figure for consultations of a similar size was 150.

In response to questions in respect of finance, Mr Reilly stated that CLCH had a £190million turnover, compared with an NHS average of £300 million. Some £36 million was in respect of provision of services to Hammersmith & Fulham residents. CLCH was required to achieve savings  ...  view the full minutes text for item 7.

The consultation document sets out proposals to re-configure NHS services in North West London.

The proposed options include the closure of Charing Cross, Hammersmith or Chelsea and Westminster Hospital.

NHS North West London briefly updated the committee on the hospital reconfiguration and the consultation which would end on 8 October 2012.  The summary consultation document had been circulated in local newspapers and a flyer delivered to local households. A series of consultation roadshow events would be held, with events being held in Hammersmith & Fulham on 28 July and 19 September.

The Joint Health Overview & Scrutiny Committee, comprising seven of the North West London boroughs (Hillingdon was not participating) and the London Boroughs of Camden, Richmond and Wandsworth, which considered that the reconfiguration proposals would substantially impact on their residents, had met formally on 12 July and had agreed dates for four further meetings.

Members queried the underlying assumptions in the pre-consultation business case in respect of population predictions. Mr Elkeles responded that population figures were taken from the 2001 Census and the ONS predictions and the GLA growth rate for each borough. The predictions would be reviewed in line with the 2011 Census figures, which had just been released.

Members queried travel times and whether a risk analysis had been undertaken in respect of traffic jams. Dr Spencer responded that the travel times were based on a  LAS review of travel times to stroke units.  Data had been provided for both peak and off-peak times and for each of the service reconfiguration options. The data had been reviewed once and the results of a second review by a specialist travel firm would be available by the end of the consultation.

Councillor Cowan queried whether risk analysis had been undertaken in respect of a patient dying in an ambulance. Mr Elkeles responded that the maximum journey time was not materially different under the re-configuration options.

Councillor Ivimy suggested that a patient might be saved by a 20 minute ambulance journey, but die on route with a 40 minute journey. Dr Spencer responded that patients were stabilised within the ambulance, and there were only a small number of deaths. Dr LaBrooy added that a number of people who died in hospital could have been saved if moved quicker to another hospital. There was evidence that time spent in an ambulance was less important than being taken to the right place.

Action:

Information to be provided in respect of:

(a)   deaths during ambulance journeys; and

(b)   the types of Accident & Emergency cases where travel times are critical.

Action: NHS NWL

Members suggested that the proposals were based on the requirement to make savings to fund increased demand. NHS NWL responded by referring to the workforce challenges particularly in paediatrics and obstetrics, and the shortage of consultants to maintain rosters and quality in existing services. A Clinical Review working group had been established in November 2011 to make recommendations on how to maintain quality in line with the financial and workforce problems.

Councillor Graham referred to the Secretary of State’s four tests and queried whether the proposals, which would leave Hammersmith without an Accident & Emergency Department, had the full backing of GPs.  ...  view the full minutes text for item 8.

The Chairman will provide an oral update on the recommendations made at the meeting of the City of Westminster Adult Services & Health Policy & Scrutiny Committee, which was attended by representatives from the London Borough of Hammersmith & Fulham and the Royal Borough of Kensington & Chelsea.

This item was taken before item eight.

The Chairman updated the committee on the joint scrutiny meeting with Kensington & Chelsea and Westminster health scrutiny committees, which she had attended with three members and the Cabinet Member. The Chief Executive and senior officers from Imperial College Healthcare NHS Trust (ICHT) updated members and answered questions in respect of performance failures and mis-management of waiting lists, including a reporting break.

Members were concerned about: the standard of communication and the delay in reporting the problem and informing GPs; the independence of the External Governance Review: and the lessons learned. Members remained concerned that clinical implications had not been resolved and patients might have suffered.

NHS North West London was asked to comment on the above discussion in respect of ICHT and specifically whether ICHT had the competence to take on such large complex changes. NHS NWL responded that there had been a clinical review of the medical records of all affected patients. 25 sets of records for cancer waiting list patients had not currently been verified.  Those patients who had been identified, had not suffered harm, but their medical records or GP had not been identified.  ICHT was still working to track the notes and GP and was scheduled to complete within the next two weeks.

The external governance review, which had first identified the cancer waiting list problems, had stated that ICHT had put in place systems and process to manage  waiting lists. Whilst there was concern that it had been possible for these waiting list problems to arise, it was believed that a safer system was now in place. There was no evidence of overall management problems.

NHSNWL stated that the hospital reconfiguration would not impact on patient outcomes and that there would be greater clinical risk without the changes. The changes, which would be implemented by the Clinical Commissioning Groups, were supported by ICHT. They  would result in a single organisation, as opposed to the complexity of managing three sites.

Councillor Ivimy queried whether it was ICHT’s opinion that managing three sites was too difficult and whether this was one of the critical pieces of information, which had led to the proposals. NHS NWL responded that one major acute centre would provide better patient outcomes. ICHT’s problems were related to different information systems across the three sites; there were now new informatics across the sites. The management of a multi-site was not an issue, but just part of the reason why ICHT supported the proposals.

RESOLVED THAT:

ICHT would be asked to attend the September meeting of the Hammersmith & Fulham health scrutiny committee.

Action: Committee Co-ordinator

The seven year Housing Strategy sets out how the Council will meet the housing challenges facing the borough and how it will provide opportunity in terms of the housing and housing services provided currently and into the future.

This item was replaced by the supplementary agenda ‘Housing Strategy Consultation’, shown as item 11.

THIS SUPPLEMENT REPLACES ITEM 10 ON THE AGENDA

The attached draft housing strategy documents, approved at Cabinet on 21^st May 2012, are presented to the Committee for consultation. They replace the old version of the Housing Strategy which was inadvertently circulated at item 10 on the agenda.

The following documents are attached;

Page 1 – Building a Housing Ladder of Opportunity – Report to Cabinet 21May 2012

Page 25 – Draft Housing Strategy

Page 45 – Draft Tenancy Strategy

Page 70 – Draft Housing Allocation Scheme

Page 115 – Draft Homelessness Strategy

Page 138 – Case Studies

Page 143 – Initial Screening Equality Impact Analysis

Councillor Carlebach declared a personal interest in that he had been a member of the Cabinet at the time the draft strategy had been approved, and remained at the meeting but did not vote.

Mike England presented the report which incorporated four documents providing a statement of the Council’s intent in driving forward the housing agenda and ‘Building a Housing Ladder of Opportunity’. The documents were consultation drafts of the Housing Strategy, Tenancy Strategy, Scheme of Allocation and Homelessness Strategy, which had been approved by Cabinet.

The draft Tenancy Strategy proposed fixed-term tenancies for new social housing letting, typically five years, but two years in cases such as special schemes for working households. This did not automatically mean that tenants at the end of their fixed tern tenancies would not be able to have their tenancies renewed. In addition, there were a number of exceptions where secure/assured tenancies would still be granted. The implementation of the Tenancy Strategy would not affect existing tenants housed by all registered providers, i.e. the Council in its landlord role and housing associations.

The new Scheme of Allocation would give  greater priority to those who were working, those in training leading to employment and those making a significant  contribution to the community. It proposed changes to the Housing Register to clarify who qualified for Housing and restricted access to the Register to those who had a reasonable chance of being re-housed. It was proposed to replace the Choice-Based Lettings system with a system of ‘Assisted Choice’. More detailed information in respect of people’s requirements would be collected, and applicants would be offered a number of options.

The draft Homelessness Strategy set out how the Council would meet its statutory obligations in providing services to vulnerable people, but also proposed the fundamental change of breaking the automatic link between a homelessness application and a social housing tenancy through using its prospective powers to discharge its duty in the private housing sector. 

Mr England stated that the consultation period had been extended by one week to 25 July 2012. There had been consultation with key agencies responsible for approving and/or delivering the Housing strategy and also with homeless groups. The consultation document was available on both the Council and the locata websites..

In response to a question, Mr England stated that it was intended to make available a  summary of the consultation submissions, and agreed to make available the submissions to the committee.

Action:

Consultation responses to be made available to the committee.

Action: Mike England

In response to a question, Mr England confirmed that the Accessible Register would be maintained.

Councillor Cowan commented on the ‘Ladder of Opportunity’ that even with the Governments’ discounts for eligible households,  home ownership remained of high value.

Mr England referred to the Government’s consultation 'High Income Social Tenants: Pay to Stay', which set out the proposals to give councils and housing associations new powers to charge social tenants a higher rent where the income of a  sole occupier, or the  ...  view the full minutes text for item 11.

The Committee is asked to recommend to the Overview & Scrutiny Board the establishment of a Task Group: Repairs & Maintenance, with the attached terms of reference and membership.

The Committee received the proposed terms of reference and membership for a Task Group: Repairs & Maintenance.

RESOLVED THAT:

The Committee recommended to the Overview & Scrutiny Board the establishment of a Task Group: Repairs & Maintenance, with the attached terms of reference and membership.

The Committee’s work programme for the current municipal year is set out as Appendix A to this report. The list of items has been drawn up in consultation with the Chairman, having regard to relevant items within the Forward Plan and actions and suggestions arising from previous meetings of the Committee.

The Committee is requested to consider the items within the proposed work programme and suggest any amendments or additional topics to be included in the future. Members might also like to consider whether it would be appropriate to invite residents, service users, partners or other relevant stakeholders to give evidence to the Committee in respect of any of the proposed reports.

Attached as Appendix B to this report is a copy of the Forward Plan items showing the decisions to be taken by the Executive at the Cabinet, including Key Decisions within the portfolio areas of the Cabinet Member for Housing and the Cabinet Member for Community Care, which will be open to scrutiny by this Committee. 

RESOLVED THAT:

1.                  The work programme for 2012/2013 be noted.

2.                  A date would be set for a report on Transition from Children’s to Adult Social Care.

The Committee is asked to note that the dates of the meetings scheduled for this municipal year are as follows:

11 September 2012

14 November 2012

22 January 2013

19 February 2013

09 April 2013

24 September 2012

14 November 2012

22 January 2013

19 February 2013

09 April 2013