Agenda and minutes

“The Chair, Councillor Rory Vaughan, informed Members of the Committee that following a short period of illness, Sue Perrin, Committee Coordinator for this Committee had sadly passed away yesterday evening.  Councillor Vaughan said that Sue had supported the work of this Committee for many years, her loyalty, dilegence and effeciency was invaluable, as was her support to him in his role as Chair. Councillors Joe Carlebach, Natalia Perez, Hannah Barlow, and Andrew Brown fully endorsed the comments of the Chair, noting this was not an easy committee to clerk and that Sue had handled this with great strength.  Sue had been held in high regard for her commitment in serving this Council and the Committee sent their condolences to family, friends and colleagues.   There followed a minutes silence for the passing of Sue Perrin”.

(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 18 April 2016.

The minutes of the meeting held on 18 April 2016 were approved as an accurate record and signed by the Chair Councillor Rory Vaughan. 

Apologies for absence were received from Cooptee Bryan Naylor.

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 6, as a Trustee of Hammersmith & Fulham Citizens Advice Bureau, Item 7, as a Trustee Arthritus Research UK, which owns a property on the for Charing Cross site.

To note the Committee’s terms of reference and membership and to appoint a Vice-chair for the 2016/2017 municipal year.

The Chair, Councillor Rory Vaughan informed members that he understood the previous concerns of members regarding the appointment of vice-chairs and invited nominations.  Councillor Hannah Barlow was nominated by the Chair, seconded by Councillor Natalia Perez:

RESOLVED THAT

Councillor Hannah Barlow be appointed Vice-Chair of the Committee for the municipal year 2016/17

The Committee is asked to agree the re-appointment of the following coopted members:

Debbie Domb, Disabilities Campaigner

Patrick McVeigh, Action on Disability

Bryan Naylor, Age UK

RESOLVED THAT:

The following co-opted members be re-appointed for the municipal year 2016/17:

Debbie Domb, Disabilities Campaigner

Patrick McVeigh, Action on disability

Bryan Naylor, Age UK

This report outlines progress on addressing food poverty in Hammersmith & Fulham.

The Chair welcomed Sue Spiller, Head of Community Investment and Daphine Aikens, Chief Executive Officer of Hammersmith & Fulham FoodBank (HFFB).  The Committee had looked at food poverty in the borough on two previous occasions and welcomed the opportunity to receive a update following the opening of the new site at Bloemfontein Road.  Sue Spiller reported that whilst it was sadly, a much needed resource the site, named The Hub@75, was operational. Daphine Aikens explained that it was working fantastically well and heartfelt, positive feedback had been received.  There were plans to provide additional funding to extend the service and operate a summer club throughout the long school holiday, making provision for children on free school meals. 

Daphine Aiken informed members that the increased funding (from LBHF and The Trussell Trust, until March 2018) to the Hammersmith and Fulham Citizens Advice Bureau (CAB) provided for a second full time advice worker.  Work undertaken by them was invaluable, supporting 165 individuals in the past 9 months and securing additional benefits income for them. In addition, three advice sessions provided by Hammersmith & Fulham Law Centre had been held at The Hub@75 and these would hopefully continue once a new housing advice lawyer was in post.

Commenting on the Rose Vouchers scheme, it was explained that HFFB would like to develop this further.  The scheme additionally benefits the local market and ensures that eligible families are able to use the vouchers as cash in exchange for fruit and vegetables with the aim of ensuring a healthy start for young families.  Daphine Aikens expressed her disappointment that few of the larger supermarkets were proactive about food disposal and recognised that there was considerable work to be done.  FareShare initiated a Tesco pilot scheme which would be reported back on, unused food was collected and disposed of by local charities using FoodCloud.

Councillor Joe Carlebach commented that Wholefoods Market, Kensington be contacted as he was aware that they donate.  Daphine Aikens continued, commenting that in June 2010 the aim of HFFB was to alleviate poverty in Hammersmith & Fulham, providing emergency supplies for people in the area. The three sites were fully funded, operating 6 days per week.  All referrals were given food of nutritional value, hygiene products, clothing, pots, pans and kitchen utensils.  Bulk items, such as beans and pasta were shared out and redistributed with other charities. 

With reference to the HFFB annual report, there had been a 22% increase in the past year in the number of people being fed in the past two years. Qualifying some of the data, Daphine Aikens indicated that where low income was the reason for the referral, figures were slightly skewed as it was submitted directly by HFFB branches.  The referral arose because the individual had insufficient benefits to survive.  The list of Major Voucher Partners was where they saw most of the vouchers being issued and they are vital for identifying need as frontline care providers.  In response to a question from Councillor Andrew Brown, Daphine Aikens  ...  view the full minutes text for item 78.

The Committee is invited to submit any formal comments on the draft CLCH’s quality account for 2015-16 to the Trust.

The Chair welcomed Katie Wilkins, Assistant Head of Quality (Interim), Central London Community Healthcare NHS Trust (CLCH).  It was noted that whilst the deadline to respond to the consultation had passed, urgent comments could still be incorporated.  Members expressed concern that the version of the document included in the agenda had been further amended.

In response to a question from Patrick McVeigh, Katie Wilkins confirmed that the reviews were conducted by a third party organisation that asked questions about the patients experience, CLCH was not involved in this process and tried to ensure that patients were aware that their comments will not affect the quality of the treatment they receive.  Responding to a query from Councillor Andrew Brown, Katie Wilkins acknowledged that figures under Preventing Harm did not present a good picture and assured members that this was taken very seriously. Commenting on the figure for pressure ulcers (212 to 416), target to achieve 50% reduction, was a significant contributor to the overall increase.  This had been addressed with a specific pressure ulcer app in order to train staff and improve awareness.  Continuing the discussion around the reduction in medication incidents (from 73 to 36 year-end), it was understood that better training awareness was a problem area that had been addressed for example by improving labelling and packing of medicines. Katie Wilkins affirmed that publication of the figures clearly identified areas requiring improvement.

Councillor Hannah Barlow referred to the staff survey results and a quarter of staff (24%) experienced bullying.  Katie Wilkins acknowledged that this was a large, national issue and that the Human Resources Team had conducted more in-depth analysis.  Each recorded incident was reviewed and protocols established to ensure enhanced supervision and training for not just for an individual, but for that entire team.  It was noted that Peter Coles had been recently been appointed Chief Executive (previously interim).  Councillor Joe Carlebach commented on the lack of detail for children’s health services and expressed concern as to the lack of reference to paediatrics.

ACTION: CLCH

Councillor Vivienne Lukey (Cabinet Member for Health and Adult Social Care) commented on learning from serious incidents and best practice derived from shared learning.  Councillor Lukey noted that there was no mention of safeguarding incidents and asked the extent to which the organisation was outward facing and Kate Wilkins confirmed that it was.  Sue Spiller clarified that protocols had developed around sharing good practice with health colleagues.  In response to a comment from Councillor Sharon Holder, with reference to the absence of Appendix 1, Complaints Annual Report, from the draft document, Katie Wilkins confirmed that the report would be attached in the final publication.

ACTION: CLCH

Councillor Natalia Perez identified that there were particular challenges inherent in obtaining accurate feedback and enquired how CLCH captured data from individuals with learning disabilities.  Katie Wilkins confirmed that the organisation responsible for this was independent of CLCH and applied appropriate methods and tools to capture the data qualitatively.  It was noted that many patients were reluctant  ...  view the full minutes text for item 79.

This report sets out the case for change and the proposals developed by Trust clinicians for improving the current acute medicine and chest pain patient pathways.  The Trust wishes to engage as widely as possible on the proposals during a planned engagement period.

The Chair welcomed Mick Fisher, Head of Public Affairs and Dr William Oldfield, Deputy Medical Director, from Imperial College Healthcare NHS Trust. Dr Oldfield outlined plans to adjust acute medical and chest pain patient pathways.  Currently, patients would be admitted and could wait several days before seeing a specialist doctor.  With specialisms becoming increasingly hi-tech, the aim was to ensure that delays were reduced and that the patient accesses appropriate treatment more efficiently.  To illustrate, following initial assessment a renal patient will be seen by a renal specialist, without the buffering through an acute medical assessment stage, maintaining the same level of intervention but without any delay.  Dr Oldfield stressed that the number of beds will remain static.  In Hammersmith Hospital, in the cardiology station there would be an additional 15 beds and 8 beds for renal and haematology patients, he confirmed there would no bed closures. Dr Oldfield commented that the hub and spoke model was already operational in terms of cardiology at Hammersmith Hospital.  Councillor Joe Carlebach commented that it would be helpful to receive detailed information on bed numbers and allocation indicating the previous position and how this changed. 

ACTION: ICH

Debbie Domb, Disabilities Campaigner, enquired whether the length of time for treatment would be longer if she were to be admitted on a Saturday.  Dr Oldfield confirmed that this was a 7 day a week, 24 hours a day service and would not impinge on the availability of the service.  He reiterated that no beds would be lost.  In response to a point raised by Councillor Hannah Barlow, Dr Oldfield replied that staff rotas would become more robust as a result of the changes, removing any delay to specialist treatment will also mean greater long term resilience for service delivery and patient care.  Councillor Brown, enquired about stroke services and Dr Oldfield confirmed that this was already operating under this model, the difference being that London Ambulance Service (LAS) would transport an acute stroke patient directly to the nearest hyper acute stroke unit.  This will continue to be the case for suspected heart attack patients conveyed by LAS to the heart assessment centre at Hammersmith Hospital whilst the new chest pain pathway establishes itself.  Eventually, it was hoped LAS will also  transport other cardiac-origin chest pain patients directly to the nearest specialist unit. 

Responding to a query from Councillor Andrew Brown, Dr Oldfield confirmed that the 10% of patients were referred by GPs (outpatients), and approximately 10-15% were seen by emergency services.  Developing this point further, Councillor Holder asked what would happen to a patient that presented themselves (without chest pain) to a hospital and Dr Oldfield explained that they would be transferred to the appropriate site. Councillor Holder requested an assurance that the consultation process would actively engage the public and how this would be managed.

Councillor Vaughan sought additional assurance that the consultation would be of sufficient length as well as fully engaging a range of patients that might be affected by the proposed  ...  view the full minutes text for item 80.

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

The Committee noted the Work Programme for the remainder of the municipal year.

Tuesday 12 July 2016

Monday 12 September 2016

Wednesday 2 November 2016

Monday 12 December 2016

Tuesday 31 January 2107

Wednesday 8 March 2017

Monday 10 April 2017

The Chair, Councillor Rory Vaughan informed Members that a suitable replacement date was being sought to replace the meeting currently scheduled for July and that Members would be advised  as soon as possible.