Agenda and minutes

(a)  To approve as an accurate record and the Chair to sign the minutes of the meeting of the Health, Adult Social Care and Social Inclusion PAC held on 3 June 2015.

(b)  To note the outstanding actions.

The minutes of the meeting held on 3 June 2015 were approved as an accurate record and signed by the Chair.

Matters Arising

Preparing for Adulthood: A Report About Young People Aged 14-25 Years with Disabilities

(i)    It was noted that information in respect of the stage of the consultation (Alison Farmer) and the information requested, as detailed in the minutes of the meeting held on 3 June 2015 (Ian Heggs) was outstanding.

(ii)   Mrs Bruce clarified, on behalf of Mr Christie, comments allegedly made by him. Mr Christie did not recall making such an unequivocal statement. Whilst children had to move on from children’s services to an adult environment, they would be supported through the process and the changes being put in place would help improve the transition for children and their families.

There was an issue in that some services were funded only for children aged 18 and below, and it was therefore necessary to negotiate the continued provision. There was a need for flexibility and continuity to support a good transition.

Apologies for absence were received from Councillor Perez Shepherd, Debbie Domb and Patrick McVeigh.

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.

The following declarations of interest were made:

Councillor Vivienne Lukey is a trustee of H&F Mind.

Councillor Joe Carlebach is an ambassador for Mencap.

This report outlines progress on addressing food poverty in Hammersmith & Fulham, including measures to provide support, Food Bank services and further research being undertaken.

Councillor Vaughan stated that Daphine Aikens, Manager of the Hammersmith & Fulham Foodbank (HFFB) was unable to attend the meeting, but had read the report and had no comments, ‘other than to say that my Trustees and I are very grateful for all that the Council are doing to help us in our effort to launch a third Distribution Centre at 75 Bloemfontein Road’.

Ms Spiller introduced the progress report on addressing food poverty in Hammersmith & Fulham, which included measures to provide support, Food Bank services and further research being undertaken.

A food collection point had been installed at Hammersmith Town Hall, was proving to be a success.

The Council had agreed a Citizen’s Advice Bureau (CAB) funding proposal to enable  the service to work in partnership with HFFB to train their volunteers to become CAB Information and Budgeting Assistants and provide assisted information on money, benefits, budgeting, employment matters and housing matters and carry out an assessment of any further advice and support required and signpost/refer accordingly.

75 Bloemfontein Road had been identified as a suitable location for an additional H&F Food Bank in the north of the borough. The space was in need of renovations and refurbishing and Amey, the Council’s contractor for property repairs and maintenance had agreed to undertake the works under its Corporate Social Responsibility programme. In addition, Amey had agreed to collect the food from Hammersmith Town Hall and take to HFFB.

HFFB would need to secure additional funding for the Bloemfontein  Road site. It was proposed that the Council provided a grant from the 3^rd Sector Investment Fund to support the HFFB service, and to provide support to identify and apply for alternative funding sources as the service developed.

The Trussell Trust was interested in working with the Council and HFFB in the alleviation of food poverty at an early stage.

Councillor Fennimore stated that she was delighted with the joined up approach, and it was planned to put in place other areas of support to reduce the number of people using the foodbank. The Trussell Trust had commended the Council’s innovative way of working.

Mr Naylor queried whether there was a distribution method to help older people who found it difficult to travel. Ms Spiller agreed to discuss this with HFFB and noted that  the Winter Pressures work included food packs being left with community organisations for distribution.

Councillor Vaughan queried the age profile of those using HFFB. Ms Spiller responded that there was a fairly broad age range. It was difficult to get data from the Trussell Trust, which had concerns about confidentiality and use of the data. Food poverty tended to be a short term issue, with people using the foodbank maybe three/four times over a six month period.

Ms Spiller responded to Councillor Carlebach that the highest number of referrals tended to be from the Job Centre in Hammersmith and the CAB. The food vouchers were distributed by some 250 partners across the borough, but people  ...  view the full minutes text for item 15.

Councillor Vaughan welcomed the representatives of Chelsea and Westminster Hospital NHS Foundation Trust.

Ms McManus outlined the process, which had commenced in October 2012, with West Middlesex Hospital seeking initial expressions of interest to find a suitable partner to achieve NHS foundation trust status. Following a rigorous process, Chelsea and Westminster Hospital had been selected in April 2013.

Ms McManus stated that the decision represented the best option for securing the future of both organisations as major acute hospitals. The two trusts were similar culturally and both were relatively small. Acquisition would create a combined entity serving a population of around 1.1 million. A single organisation would provide greater opportunity to develop clinical services and more security for smaller services. There would be significant financial pressures for both, should they not become one organisation.

There was a regulatory process, but formal consultation was not required as there was not a service change: Chelsea & Westminster Trust Board would acquire West Middlesex Hospital. There was considerable discussion with the Council of Governors. The acquisition had been cleared by the Competition and Markets Authority.

The process was reviewed by the external regulators, the Trust Development Agency and Monitor, which would issue a risk rating. This would be considered by the Chelsea and Westminster Trust Board, which would make the formal decision to proceed. An application would be made to the Secretary of State for the transaction to take place on 1 September 2015.

The business case would remain confidential until the transition had been agreed by all parties. However, it would be available at the hospital for members of the PAC to view.

There were difficulties in terms of recruitment and retention. Three members of the Chelsea and Westminster Hospital management team had been seconded to West Middlesex Hospital.

Members raised concerns in respect of the lack of financial information, which should have been shared in order to facilitate proper scrutiny. Councillor Carlebach suggested that the merger was a financial transaction because the  West Middlesex PFI had become too expensive to manage.

Ms McManus responded that the merger was clinically driven, putting patient safety first. As one organisation, there would be a large enough population to continue to provide services and to ensure long term sustainability. It was not possible to share the financial detail as a confidentiality agreement had been signed.

Mr Conlin added that clinical sustainability was the catalyst of the deal. However, there were risks to the trust if the acquisition was not approved. The West Middlesex PFI was one of the smallest in London, some £2 million per annum. This would continue to be a drain until the estate was improved as an asset.  There was a short term plan to make the estate work harder.

There were over 100,000 attendances by Hammersmith & Fulham residents at Chelsea and Westminster Hospital annually and there would be no significant change. Those services currently provided would still be available on the Chelsea and Westminster site.

Councillor Holder queried patient involvement which had  ...  view the full minutes text for item 16.

This report provides information about the Hammersmith & Fulham GP Networks, GP Network Plan 2015/16, extended hours and Out of Hospital services. 

The PAC received a report on the Hammersmith & Fulham GP Networks, GP Network Plan 2015/2016, extended hours and Out of Hospital services.

Councillor Carlebach requested an update on the flu vaccination programme and integration with GPs in Kensington & Chelsea.

Ms Parker stated that a bundle of services were being implemented across the five GP Networks, and that patients would be able to access these and move from one practice to another. Patients’ records could be shared, subject to consent and network information sharing agreement. The model would be rolled out across the borough in March 2016.

Action:

A timetable for rolling out the model across boroughs to be provided.

Hammersmith & Fulham CCG

Ms Cree responded to queries in respect of educating patients that there would be a publicity campaign for extended hours, similar to Central London and Westminster, which saw a significant increase in GP attendances and reduction in Accident & Emergency Department attendances.

Information in respect of the 24 hour pharmacy at Earls Court was provided through NHS Choices/111. In addition, there were many pharmacies with extended hours across the borough.

Councillor Lukey queried whether there was coverage for the resident population or registered population; whether mental health assessments were currently only available after first going to a GP; and if there was capacity to meet increased demand with the Out of Hospital model.

Dr Spicer was not aware of any requirement to visit a GP before receiving a mental health assessment, and would provide a written response.

Action: Hammersmith & Fulham CCG

Dr Spicer stated that services were predominantly for the registered population. Unregistered patients tended to go to the Urgent Care Centre, where they would be advised to register with a GP.

Dr Spicer stated that the CCG was committed to the OHH model and would ensure that there was capacity

Councillor Barlow queried recruitment and the SystemOne interface between primary and secondary care. Dr Spicer responded that workforce was the biggest challenge at all levels and grades across West London. Trainees were attracted to London, but retention was difficult. The networks were working with Bucks New University in respect of placements. The CCG was one of the national pilot sites for physician associates. It was also looking at how to retain staff and change the skill mix.

Councillor Vaughan proposed and it was agreed by the Committee that the guillotine be extended to 10.15pm.

Mr Naylor gave an example of a GP practice  which closed half day on Thursdays and Saturday, and noted that the CCG could not insist that an independent businesses could extend its hours.

Councillor Holder noted that the Council could assist with publicity of the new model and queried the frequency of evaluation. Ms Cree responded  that there would be six monthly reviews to test that the theory and specification were right.

Mrs Bruce noted that Adult Social Care was also facing a skills shortage and that there needed to be a shared strategy for some key roles and joint work to retain staff.  ...  view the full minutes text for item 17.

The Committee is asked to consider its work programme for the remainder of the municipal year.

RESOLVED THAT:

1.    The work programme be noted.

2.    That an update on the Immunisation Programme be taken at the September meeting.

14 September 2015

4 November 2015

2 December 2015

2 February 2106

14 March 2016

18 April 2016

14 September 2015

4 November 2015

2 December 2015

2 February 2106

14 March 2016

18 April 2016