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

(b)  To note the outstanding actions.

The minutes of the meeting held on 14 March 2016 were approved as an accurate record and signed by the Chair Councillor Rory Vaughan.

Apologies for absence were received from Councillor Vivienne Lukey and Debbie Domb.

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 Joe Carlebach declared an other significant interest in all items on the agenda as the Vice Chair of the Royal National Orthopaedic Hospital Trust, Stanmore.

In view of parties present at the meeting the Chair proposed that the agenda be re-ordered, with which the Committee agreed, and the minutes reflect the order of the meeting.

The report produced by SOBUS on behalf of stakeholders provides information on the development of co-production in commissioning and outlines the next steps in the development of a Co-production Charter.

Ian Lawry CEO from Sobus provided an overview of Co-Production in Hammersmith and Fulham.  He talked about their vision to transform the process via which services were designed and delivered locally.  He also described the way in which residents would be involved in decision making and provided the local context. The key points were:

• Parity of Contribution
• Altering the delivery model of public services
• Offering people a range of incentives
• Engaging peer and personal networks alongside professionals to transfer knowledge
• Removing the distinction between professionals and recipients and between producers and consumers
• Enabling public service agencies to become catalysts and facilitators rather than being the main providers

He also spoke about the two areas which had been chosen for the co-production pilots which were the “Carers Service” and the “Supported Employment Service” and the positive feedback they had received during and since the pilots.  He went on to say that Sobus had also been appointed to use a co-production approach with the “Children’s and Families’ Universal Service”.

Ian Lawry in response to questions from Patrick McVeigh stated that embedding change was a learning process and not a finished product.  He added he was disappointed with the feedback that things were not working well but found it useful. He also confirmed in response to Bryan Naylor’s question that the charter covered the ground rules for co-commissioning in procurement and was not just about the commissioning process.  He also talked about mentoring and buddying for those involved and confirmed that they wanted to and were looking at the best ways to ensure a wide range of participation.  He summarised that with co-production design from start to finish anyone can be involved.

Ian Lawry in response to questions from the Chair, Councillor Vaughan confirmed that they were learning as they went and that once best practice was agreed a list of recommendations would be provided in terms of training.  He also stated that there would be measures around levels of engagement and residents feedback and that each service would have specific outcome measurement which would be developed by partners not commissioners.  He concluded by stating that they were unpicking and testing at present and that not everything needed to be co-produced. 

In response to a question from Councillor Carlebach, it was confirmed by Ian Lawry that there were 500 organisations on their database which included the Police and groups for young people and that they also provided online surveys and focus groups.  He also stated in response to Councillor Perez that they had started the pilots off with a light remit which they were looking to expand moving forward.  He added that it was about continuous  learning and improvement and that the goal in the first year was to get feedback and not to implement change as that would take more time.

In response to questions from Councillor Barlow, Ian Lawry stated that it was a template charter and would provide details of specific services.  He gave the example of funding sources for  ...  view the full minutes text for item 65.

This report highlights the issue of Social Inclusion and loneliness in the borough.

Sue Spiller introduced and summarised the report.  She outlined the key challenge which was identifying those most at risk and shared information about successful creative projects such as “Men in Sheds”.

Sue Spiller also talked about the causes of loneliness which were not always consistent or obvious to work out.  She also talked about the measures that were in place and the other initiatives that the council was working on, including responding to the duties set out in the Care Act 2014.

In conclusion she discussed the next steps for officers which included a workshop on addressing Loneliness and Isolation being held in April, and a proposal from Bryan Naylor to host a broader conference on the subject later in the year.  A range of initiatives are contributing to this area of work, including the 4^th annual Silver Sunday campaign in October.  Further work will be done by officers to look at how improved joining up of services will support a more coordinated prevention strategy across the council, health and voluntary sector.

Bryan Naylor commented that the biggest issues was identifying people and talked about the freedom pass data being a start point.  In response Sue Spiller confirmed that freedom pass information was subject to data protection and the council’s ability to use it for broader communication purposes was extremely limited.  Sue Spiller also noted that the 2014 Silver Sunday campaign had included distributing a printed Silver Sunday guide to all over 60s through the Older People’s Freedom Pass database.  However, the Silver Sunday campaign was expensive to produce (£14,000 for the event programme printing and distribution and £5,000 for small grants for local Silver Sunday events), but the net result was that only 30 new individuals are known to have taken up activities or joined groups as a result of the scheme

Bryan Naylor also noted that the ‘Time of Your Life’ event, was successful in reaching large numbers of local older people, but is an expensive event to run.

Councillor Carlebach gave the example of an elderly person who was locked out of her home and the difficulty in getting her access despite both housing and health partners being aware of her situation. 

Councillor Brown stated he felt the issue was not just identifying people but convincing them to join in and making the offer universally interesting enough to appeal to a wide range of audiences.  He also suggested that asking people to help was a subtle way to address the issue of loneliness.

Sue Spiller responded that a range of organisations have different approaches which can be successful.  She spoke about the Co-op and how they had impacted the local community through noticing isolated customers in their stores and enabling staff to provide broader support and assistance.

Councillor Perez commented that advice centres and agencies as well as third sector organisations were the first places people went for support. Sue Spiller responded that whilst many local organisations are in touch with local residents who enjoy the  ...  view the full minutes text for item 66.

This report provides an update on the following areas:

·         Patient experience of booking a GP appointment

·         GP access arrangements – Extended Hours

·         Services commissioned from GP Practices

·         Practice locations and detail in relation to GP workforce numbers in Hammersmith and Fulham.

It also provides information on other areas that can impact the availability of GP services to patients, in order to provide Committee members with a full overview of GP access arrangements in Hammersmith and Fulham.

Julie Sands and Vanessa Andrea introduced and summarised the report.  They talked about the patient experience in booking an appointment and the national patient survey results. The other areas covered were GP access arrangements and extended out of hours services, patient engagement and the range of commissioned services. They also talked about practice locations, the GP workforce and promotion and awareness of out of hospital services.

Julie Sands in response to questions from Councillor Carlebach stated that data was available for each borough. She agreed to provide this data to the Committee.  She also confirmed that when a GP practice closes that vulnerable patients are contacted and given additional support to re-register.  Vanessa Andrea also confirmed that residents were able to use walk in services regardless of which part of the borough they lived in and that there was a local pilot to register homeless people which GPs were aware of.

Action: JS

Councillor Brown commented that it was good news to be above the ‘London Average’ and that the extended hours scheme was a fantastic service.  In response to a question on extended hours, Vanessa Andrea confirmed that 80% of availability had been booked and 26 practices were using weekend plus.  She added it was an upward trend and that they were currently re-negotiating for the future. 

In response to questions from Councillor Barlow, it was confirmed by Vanessa Andrea that workforce planning was an issue.  There was no guidance on the number of GP’s in a Borough.  She added that they were aware of the need to work with partners on this issue and that extended hours were worked by existing GP’s.  It was also confirmed that the names of services in the report were not customer facing names and the aim was to keep it simple for service users.

Vanessa Andrea in response to questions from Patrick McVeigh stated that it was possible to train receptionists to ask questions to help patients establish how urgent their condition was but that it was essentially up to individual GP practices how they managed themselves. She added that people should not underestimate the nursing resource that was available and that there were  also lots of helpful local initiatives. 

Julie Sands confirmed in response to questions from the Chair Councillor Vaughan that the GP contract set out what had to be delivered to patients but not how it should be delivered but that they monitored adherence to contracts.  .  She also confirmed that the patient survey covered the registered patient population.  It is difficult to measure the unregistered population but information on how to register with a doctor is given out at local hospitals.

Julie Sands stated in response to questions from Councillor Holder that in order to improve satisfaction levels with same day access  constant monitoring of demand and supply for appointments by practices was necessary which could be very challenging. She added that they had captured good practice models for use by practices and sharing.  Vanessa Andrea confirmed that  ...  view the full minutes text for item 67.

This report aims to describe the flu immunisation performance in Hammersmith and Fulham and highlights some successes and key actions and learning points for next season.

Vanessa Andrea introduced and summarised the report.  She stated the key areas of success which were with children and pregnant women and that the CLCH had won the most improved award in the national Flu fighters category. 

Councillor Brown commented well done for the improvements but expressed concerns on some very poor figures especially with reference to the Imperial and he stated that more improvement was necessary. Vanessa Andrea agreed it was disappointing in other areas and stated she would liaise with the Imperial. She added that the press backlash was unhelpful and the fact there was no outbreak was a factor in the figures. She also asked the PAC to write a letter to NHS England to ask them to allow pharmacists to be permitted to administer the children’s flu vaccine.  This was agreed by the Committee. 

Action  Health PAC

In response to a question from Councillor Carlebach it was confirmed by Vanessa Andrea that there was no contract in hospitals and again asked the PAC write a letter to NHS England. It was agreed. 

Action Health PAC

Vanessa Andrea expressed her thanks to Dr Sarah Wallace for her great work and also introduced Lucy Rumbellow who would be picking up the reins. 

The Chair Councillor Vaughan expressed gratitude for the improvements but also was keen to see further improvements. He added it that it was good to see that in comparison to the London figures that Hammersmith and Fulham were bucking the trend in some areas. He also stated it was an excellent paper very clear and pro-active. He confirmed that the Committee were happy to write to NHS England to ask them to allow pharmacists to be permitted to administer the children’s flu vaccine and that a letter to the Imperial was also necessary. 

RESOLVED

That the report be noted.

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

The Chair Councillor Vaughan confirmed that the work programme was not complete yet and still in draft format. He also confirmed that reports on vaccinations and the like minded strategy would be on the agenda for the next meeting.

The dates of the future meetings are 14 June 2016, 12 July 2016 and 12 Sept 2016.

The date of the next meeting was confirmed as 14 June 2016. 

Councillor Carlebach expressed his concern on behalf of the Committee for Sue Perrin who usually clerked this meeting and was currently very unwell. He wished her a complete recovery and a return to good health.