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 7 July 2015.

(b)  To note the outstanding actions.

The minutes of the meeting held on 7 July 2015 were approved as an accurate record and signed by the Chair.

Apologies were received from Councillors Andrew Brown, Joe Carlebach and Sharon Holder.

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.

Councillor Vivienne Lukey declared an interest in that she is a trustee of Hammersmith & Fulham Mind.

Debbie Domb declared an interest in that she is a user of Home Care Services.

This report updates on developments at the West London Mental Health Trust.

The Committee received a report on developments at West London Mental Health Trust (WLMHT), which focused on the following areas:

·         Changes to the management structure within the Trust

·         Progress with Foundation Trust Development

·         Update on the West London Transformation Board

There were two key transformation areas: Urgent Assessment and Care Development and Delivery and Planned Care/Shifting Settings of Care Development and Delivery.

Mr McVeigh queried how WLMHT compared with other parts of London/the country in respect of bed capacity and whether foundation trust status would improve or worsen the situation. Ms Rushton responded that all mental health trusts were seriously struggling, with the exception of East London NHS Foundation Trust.

Ms Rushton did not consider foundation trust status as so important in improving quality of services as the Care Quality Commission (CQC) inspections and Quality Improvement Plans which were very important in embedding good quality at service delivery levels.

Ms Rushton stated that it was her personal view that the freedoms from foundation trust status were not so different, although it would be easier to convert revenue into capital.

Councillor Perez Shepherd queried the different clinical pathways and ways of referral. Ms Rushton responded by giving psychosis as an example. People cared for by the recovery team were often not clear about the interventions being received and what help could be provided at a centre of care. WLMHT was working to develop generic responses and to upskill the workforce in potential interventions. Clearer goals and outcomes would put people more in control of interventions and facilitated measurement of outcomes.

In respect of referrals, people could self refer, although more complex cases tended to be through GPs or sometimes social care.

Councillor Lukey commented that the report did not address a number of issues which would have been of particular interest to the Committee such as what was happening in Hammersmith & Fulham; WLMHT’s relationship with the CCG and Adult Social Care, and specifically the recovery houses; and what worked well and the challenges.

Ms Rushton responded that WLMHT had a good long standing relationship with Adult Social Care in Hammersmith & Fulham and that the relationship with the CCGs had significantly improved over recent months and CCGs were now much more focused on mental health.

A business case was being developed to close in-patient beds and replace with three recovery centres, one in each borough. Currently this did not work financially and there were no suitable buildings. WLMHT was working with the CCGs to resolve the issues.

Ms Mangan referred to Urgent Assessment and Care and the work being overseen by Beverly MacDonald, H&F CCG Clinical Lead for Mental Health. New investment had been agreed and was being taken forward for Hammersmith & Fulham. It was expected that there would be a notable difference in the response to Accident & Emergency patients, which was a particular problem. WLMHT would work in different ways to engage GPs and align primary care services to networks.

Ms Rushton noted key challenges in  ...  view the full minutes text for item 23.

This report provides an update on immunisation programmes in Hammersmith & Fulham and action plans to improve the uptake rate of the flu vaccine.

Councillor Vaughan stated that the Committee had requested an update on flu immunisations, which had been considered in depth the previous year. Members were keen to ensure that an action plan was in place for the current year and specifically for the age 2-4 and 65+ priority groups.

The Committee received a presentation on the Flu Action Plan, Winter 2015/2016 jointly from NHS England (NHS(E)), NHS Hammersmith & Fulham CCG and Three Boroughs Shared Services Public Health Department. The presentation set out roles and responsibilities; the individual action plans and joint working to monitor actions.

The NHS(E) action plan focused on three work streams: at risk cohort and children; over 65 cohort; and frontline healthcare workers.

The CCG Action Plan included: encouraging clinical leadership to maximise flu immunisation amongst front line staff, leading by example; training for all practice nurses; maximising GP extended hours hub to deliver immunisation clinics at evenings and weekends; and using the local authority communication channels.

Councillor Barlow noted that immunisation rates in Hammersmith & Fulham were below average and queried which borough had the highest rates. Dr Anya responded that Tower Hamlets had achieved high immunisation rates through investment in additional capacity to support GPs and to target hard to reach children.

Mr Van Wijgerden suggested that Tower Hamlets might currently have a declining uptake rate, because of a number of challenges in London, including different information systems. GP surgeries needed to be pro-active in calling and re-calling patients. Immunisation had become more complex because of the number of  vaccinations and needed to be embedded in good quality care from pregnancy. Uptake rates in Hammersmith & Fulham had begun to improve.

Councillor Barlow queried engagement with schools. Dr Anya responded that a pack  produced nationally for schools had been sent out with a letter from the Directors of Children’s Services and Public Health and would be followed with posters and leaflets.

Ms Domb queried whether there would be an easy to read version and the provision of the vaccination for people unable to go out. Dr Anya responded that the national information had been produced in various formats and there would be an easy to read version.  Mr Van Wijgerden responded that provision of the vaccination would be included in the service level agreement with community and district nurses.

Councillor Lukey referred to the shingles vaccination and the poor performance in Hammersmith & Fulham. Mrs Andreae responded that GP practices would write and offer the vaccination to  the eligible consort. They would also be offered the vaccination when attending for the flu vaccination.

Councillor Vaughan queried whether the vaccination for years one and two would be delivered in schools or by GPs and whether the vaccination for 2-4 year olds would be offered in children’s centres and nurseries.

Mr Van Wijgerden responded that the vaccination would be offered at schools to all children including those in private schools, with parental consent. The vaccination would be offered out of school to children who were absent on the day. At least  ...  view the full minutes text for item 24.

This report sets out the proposal for contract awards for new Home Care Services for people who meet Adult Social Care eligibility criteria in the London Borough of Hammersmith and Fulham.

The Committee received a report on the contract awards for new Home Care Services for people who met Adult Social Care eligibility criteria in Hammersmith & Fulham.

The Cabinet, at its meeting, on 7^th September had accepted the recommendation that three Home Care Service Contracts should be awarded. Letters would be sent to the new providers on the following day, so it was not possible to disclose their names.

Mrs Douglas highlighted the key significant changes in the model of care:

·         a requirement to pay the London Living Wage;

·         working towards the provision of low level health tasks through the integration of care over the duration of the contract;

·         investment in the workforce; and

·         electronic monitoring to record care delivery, safeguard customers and enable accurate billing.

The new contracts would provide a comprehensive service to meet the increasingly complex needs of customers. They would be based on improved outcomes for customers and there would be a new way of monitoring complaints. People were reluctant to complain and therefore a system was being piloted whereby people who had not wished to make a formal complaint were contacted to find out if the problem had been resolved.

Ms Murphy noted Healthwatch’s involvement in the project group and in collecting evidence, and that the Home Care Services contracts were an example of good partnership work. Ms Connelly stated that the contracts reflected the requirements of service users such as choice of tasks, flexibility and reliability and continuity of carer.

Ms Murphy stated that the next steps would be to move into the implementation phase, to manage the change and ensure clear communications. The project group would meet with providers in November. There would be some independent monitoring of contracts, including home visits, with follow up by the Safeguarding Board if necessary.

Mr Naylor stated that home care services were concentrated on people who were already in touch with the Council, and there was a need to explain access to those who were new to the system. Mrs Douglas responded that an information and advice strategy would develop a system wide approach of self-service to determine eligibility for services.  A joint strategy with Housing was being developed around sheltered accommodation. There would be a further piece of work with private landlords.

Mr McVeigh referred to the procurement changes set out in paragraph 4.18, and queried how input would be measured. Mrs Douglas responded that a multi-disciplinary team had assessed the tenders and the requirements were twofold: to ensure home care plans were appropriate and to assure quality of services. In line with feedback from service users, services would move away from the time and task model and be more flexible.

Ms Domb considered that there had not been much communication since 2012, and that there had been a closed group which did not involve service users. Ms Murphy responded that engagement would begin again that month and Healthwatch would hold a public meeting.  There had been a small group involved in the procurement, including  ...  view the full minutes text for item 25.

This report provides a description of current mechanisms to understand customer satisfaction and experience in adult social care; a summary of some current findings from the annual service user survey and carers survey; and how the mechanisms for obtaining customer experience and satisfaction are being developed.

The Committee received a report on the current mechanisms to understand customer  satisfaction and experience in Adult Social Care; a summary of some current findings from the annual service user survey and carers survey; and how the mechanisms for obtaining customer experience and satisfaction were being developed.

Ms Domb noted that Hammersmith & Fulham was second lowest in respect of quality of life and queried how this was being addressed. Mrs Douglas responded that the different indicators which had been included in this composite indicator would be analysed. Some indicators would be the responsibility of other departments, for example, feeling safe. A number of actions identified through the Peer Review were being addressed.

Mr McVeigh suggested that as people were reluctant to complain, there should be a more independent investigation including follow up questions, and queried whether there would be a separate metric for home care in the customer satisfaction survey going forward. Mrs Douglas responded that home care would include information such as dealing with complaints in an appropriate way and qualitative information going forward. Some additional information would be included in the next report.

Mrs Douglas agreed to provide a written response to Councillor Barlow in respect of the number of complaints upheld and the improvements made.

Action: Selina Douglas

Councillor Vaughan stated that it would be useful for future reports to show the types of complaints, the lessons learnt and the actions taken to improve.

RESOLVED THAT:

The Committee noted the report and that performance in respect of the quality of life metric was not as good as other inner London boroughs. The Committee accepted that the bands were fairly narrow, but would still like to understand the reasons and the action being taken to improve.

The Committee recommended that a metric be included in respect of requests for another carer.

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

RESOLVED THAT:

The work programme be noted.

4 November 2015

2 December 2015

2 February 2106

14 March 2016

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4 November 2015

2 December 2015

2 February 2106

14 March 2016

18 April 2016