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 14 June 2016.

(b)  To note the outstanding actions.

The minutes of the meeting held on 14^th June 2016 were agreed as a correct record.

Apologies were received from Councillor 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 Andrew Brown declared an interest as Managing Director of Santevis Limited, in Agenda Items 5 and 6.

It was noted that Members had previously been informed by email that Hammersmith & Fulham Council had not supported the draft STP as the plan endorsed the principle of downgrading Charing Cross hospital and A&E to which the Council is passionately opposed.  This item was subsequently withdrawn. 

Councillor Rory Vaughan welcomed joint presenters, Vanessa Andreae, Vice Chair of the H&F CCG and Lucy Rumbellow, Commisioning Lead – Immunisations, NHS England.  Vanessa Andreae explained that the membership of Immunisation Network Group was drawn from a number of local organisations and agencies including the local authority and H&F CCG, amongst others.  Councillors Lukey and Holder had attended events organised by the Group and updates on the service provided were available.

Lucy Rumbellow outlined briefly the programme which during 2015/16 offered flu immunisation for children of two and three years age, and also, school years 1 and 2.  A review of flu rates amongst primary school children had resulted in targeted practices in two or more cohorts, based on the view that a target of 40% would help ensure prevention, providing immunity for older members of the family by limiting transmission and thereby reducing rates in older people, concurrently.  Practices would make up to three attempts to contact parents and ensure that appointments are kept.  Practices were encouraged to develop action plans following national guidance. 

Vanessa Andreae explained that approval for a pharmacy pilot project was due to be signed off, with the aim of administering vaccines to a 1000 children, aged 3-5 years, in Hammersmith & Fulham.  Feedback from a children’s centres pilot project conducted in 2015 indicated ad hoc take up of vaccines from local pharmacies.  The CCG were exploring service led agreements with pharmacies and identifying training needs, although the timing of when this could be delivered needed further consideration.  They had initially identified pharmacies in convenient localities such as shopping centres and high streets. 

Councillor Vaughan touched on the fact that pharmacies had not previously been permitted to administer the vaccine to children and Vanessa Anderae clarified that this was more an issue relating to the porcine gelatine content of the vaccine as opposed to actual administration.  They were also consulting and working closely with community champions and faith leaders to address this.

Looking at the data from the Child Informatics Service (CHIS) reported to NHS England, Vanessa Andreae explained they were building in procedures to ensure that they could extract data indicating where a carer has been contacted three times, as this was also useful in developing a targeted approach. 

Janet Cree, Managing Director, H&F CCG expanded further and, parents residing on the bounderies of two boroughs, have had the benefit of living in one and obtaining services in another.  In terms of skewing data, Lucy Rumbellow confirmed that they looked at the resident population in the borough and that this was an issue that they were aware of, particularly in London.  This was one of the reasons why GPs were asked to record data on babies registered with the practice and updates records accordingly. 

Councillor Joe Carlebach highlighted the problem of capturing data, particularly from those obtaining treatment from private practice or “ghost patients”.  Vanessa Andreae acknowledged this was a complicated issue and that it was not possible to identify that particular  ...  view the full minutes text for item 87.

Janet Cree, Managing Director, NW London CCG and Jane Wheeler, Deputy Director, Mental Health Strategy and Transformation Team, NW London CCG, presented the case for change, which used an evidence-based model for care.  This had been produced following investigated planned change and the business case scheduled for later this autumn and it was envisaged that this would also include feedback from forums such as this one.  Jane Wheeler continued that there was good practice evidenced across the boroughs. Bringing this to the PAC meeting for the first time, Jane Wheeler explained that there was a whole system strategy, which set out issues and challenges but they aimed to make change happen locally. 

The single point of access, 24 hours a day, seven days a week, was central to having this service, with referrals from LBHF, local agencies and the Police, although she advocated early interventions that would pre-empt the need for Police involvement.  There existed good services on which to build upon and the Mental Health Team Strategy (MHTS) local targets reflected national targets for 2020.  With regard to the graphic on page 89 of the report, it was noted that the single box provided a useful framework highlighting priorities.  Focusing on eating disorders (work stream for April 2016), this was just one of several work streams which had been previously endorsed. 

The overall aim of achieving a holistic support system in place was to ensure continued improvement in the quality of care for those with Serious and Long Term Mental Health Needs (SLTMHN).  It was explained that people were reviewed in different parts of our system.  They should be identifiable on discharge and picked up by other parts of the service, as appropriate.   Achieving integrated transformation across social care was necessary to achieve an integrated approach.  The impact on service users and carers in LBHF would be to simplify care journeys, making it easier to access services that emanate from a single point of contact.

In responding to a query about beds not being available and the alternative service options in that scenario, how this would really work in terms of service change and whether this was the right configuration to rapidly access services, Janet Cree outlined that the CCGs were pleased to engage closely with local services provided by organisations such as MIND and Mencap, which they viewed as critical friends.  Councillor Brown congratulated them on the report, which he felt did much to challenge the stigma surrounding mental health and to ensure that these were addressed with equal assurance as physical issues. 

Patrick McVeigh briefly outlined the case of an acute patient who was a manic depressive and had committed suicide.  Enquiring about monitoring methods, in the borough, this had not been picked up until the Coroner’s Enquiry.  Jane Wheeler explained that sharing data was possible but there were inherent difficulties in suicide prevention that made it very difficult to share data.  In this case, there would have been a time lapse in receiving the data from  ...  view the full minutes text for item 88.

Councillor Vaughan briefly highlighted several items that were planned for the following two meetings taking place in October and November.   These included an item on the Public Health report, adult safeguarding and the CAMHs report (received by CEPAC in June).

RESOLVED

That the work programme for the remainder of the municipal year 2016/17, be noted.

It was noted that the next meeting of the Health, Adult and Social Care and Social Inclusion Policy and Accountablity Committee would be held on Thursday, 20^th October 2017.

The Committee noted that the date of the next meeting will be Thursday, 20^th October 2016.