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 4 November 2015.

(b)  To note the outstanding actions.

(i)            The minutes of the meeting held on 4 November 2015 were approved as an accurate record and signed by the Chair.

(ii)           The outstanding actions were noted.

(iii)          The Committee asked that their best wishes be passed to Sue Perrin who had taken ill.

Apologies were received from 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 interest in item 4 (Independent Healthcare Commission for North West London) as Vice Chair of the Royal National Orthopaedic Hospital Trust, Stanmore.

The Healthcare Commission report is attached. Copies are also available from Main Reception, Hammersmith Town Hall.

Peter Smith summarised the background, process, key findings and recommendations of the Commission. The Shaping a Healthier Future (SaHF) programme was consulted on in 2012. Part of the business case was to reduce the number of major hospitals in North West London to 5 from 9. The Commission was launched in 2014 by 5 West London authorities in reaction to the closure of 2 accident and emergency departments.  The Commission was chaired by Michael Mansfield QC with 2 other independent members.  It operated like a Parliamentary Select Committee inquiry with an open call for written evidence followed by 4 public hearing sessions.  The report was produced in December 2015, setting out the Commission’s key findings and recommendations.

The key findings and recommendations were as follows:-

·         Current and future healthcare needs

The data used by NHS for the public consultation in 2012  is now out of date. It did not take into account the significant increase in actual population and future projections across the region resulting from regeneration plans and economic development proposals for the area.

Recommendation – That the current business case should be made available immediately for proper public scrutiny.

·         Finance and Economics

The projected cost of the programme has escalated from £112 million to over £1 billion. The return on this investment would be insufficient, based on the strength of the existing evidence.  Evidence points to financial factors rather than patients’ needs as playing a significant role in the SaHF programme’s selection of major and local hospital designations.

Recommendation – That the National Audit Office should undertake a review of the value for money of the SaHF programme.

·         Public Consultation

No additional engagement with the local public had been carried out since the public consultation exercise was conducted in 2012.

Recommendation – A fresh consultation on the latest version of the business case should be undertaken.

·         A&E closures and other reconfiguration plans

The closure of Ealing Maternity department and the A&E services at Central Middlesex and Hammersmith Hospitals have had a huge impact on the provision of health services at Northwick Park Hospital leading to a deterioration of performance, particularly in relation to A&E waiting times.

Recommendation – The closures at Ealing and Central Middlesex should be reversed and no urgent care centre should be put in place without co-location of A&E provision.

·         Out of  hospital provision

Out of hospital provision is being developed in a piecemeal fashion and at a slow pace largely due to the lack of detailed plans.

Recommendation – That a substantial investment in GPs and out of hospital services is required within a sub-regional out of hospital strategy.

·         Governance and Scrutiny

There is a lack of transparency in the governance arrangements for the SaHF programme resulting in unclear accountability for decision making across the programme.

Recommendation – That elected local authority representatives should be invited to attend SaHF programme Board meetings for greater accountability and transparency.

The Committee noted that ongoing follow up work was being undertaken.  A letter  ...  view the full minutes text for item 41.

The Annual Report describes how the Board’s agencies, both jointly and independently, work to ensure the safety of those people within the boroughs who are deemed to be most at risk of harm through the actions of other people.

Mike Howard, Independent Chair, presented that Safeguarding Adults Executive Board Annual Report 2014/15 to the Committee.  He noted that the Board works to ensure the safety of those people within the borough who are deemed to be most at risk of harm through the actions of other people.  The Care Act 2014 was passed in April 2015 requiring:-

·         Local authorities to establish an Safeguarding Adults Board

·         The Safeguarding Adults Board to present an annual report

·         Requiring Safeguarding Adults Board  to commission Safeguarding Adults Review

·         Developing a strategy in consultation with the local community and residents, and with Healthwatch.

He drew the Committee’s attention to a display board which showed some of its work  in involving local people in safeguarding adults.  The display board highlighted  comments from a consultation event in November 2015. 

Some of the Board’s achievements included:-

·         Undertaking Safeguarding Adult case reviews

·         Producing a Safer Recruitment guide for organisations

·         Safeguarding Adult guidelines for staff

Thresholds for responding to safeguarding concerns

Members inquired about the Board’s work around:-

·         Terrorism and grooming of vulnerable adults. 

·         Homelessness and vulnerability

·         The impact of benefit changes and new service provision

·         People with learning disabilities

·         Issues of isolation and neglect abuse

Mr Howard stated that the Board had raised issues with the Department of Health on behalf of providers about the rigidity of the Prevent training.  They have been able to relax the delivery of the training.  The Board had built good links with NHS England with a representative of the organisation its board.

The Board is not a lobbying organisation.  Its Safeguarding Adults Case Review Sub Committee shares the lessons learnt from case reviews and   tracks changes and improvement to member agency systems and practice’.  The Board will soon be looking at the impact of financial abuse and vulnerability.

It was noted that the Board works with the Adult Social Care business intelligence to look at what patterns of referral tell us.  The care of people with Learning disabilities was being scrutinised through safeguarding. It was agreed that there was an increasing number of older people living alone who were not in contact with the statutory services facing the issues of isolation and neglect.  The Board had not yet considered this topic but is planning to theme a future meeting on self-neglect and hoarding

Councillor Lukey noted that the Safeguarding Board was putting many safeguards in place to reduce harm.  Financial abuse which is an issue many people have faced but are reluctant to report- due to the stigma attached, is on its work programme.

Councillor Perez asked how does the third sector get involved in this work particularly victims or people who have survived abuse and are more likely to approach community based services.  Also does the referral system work.  Mr Howard stated that there are 30 members on the Board with representatives from MIND and Peabody.  The Board has a community engagement sub group which was better placed to discuss issues with residents.  Councillor Fennimore noted that the Board is working closely  ...  view the full minutes text for item 42.

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

Councillor Vaughan stated that the response to the Mansfield report should be taken at the March meeting.  Officers should invite Imperial Hospital NHS Trust and the CCG to the meeting to respond to the report.

Councillor Fennimore suggested that the Digital Inclusion Strategy should be considered soon. While Councillor Barlow requested that the impact of devolution on local health services should be placed on the work programme.

Tuesday 2 February 2106

Monday 14 March 2016

Monday 18 April 2016