Agenda and minutes

Apologies for absence were received from Councillor Andrew Brown, and, co-optees Debbie Domb, Patrick McVeigh and Jim Grealy.

(a)  To approve as an accurate record and the Chair to sign the minute of the meeting of the health, Adult Social care and Social Inclusion PAC held on 8^th March 2017;

(b)  Informal Notes of Discussion (Inquorate Meeting), 26^th April 2017; and

(c)   To note the outstanding actions.

The minutes of the previous meeting were agreed as an accurate record.

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 as the Vice-Chair of the Board of Trustees for the Royal National Orthopaedic NHS Hospital Trust, and, a link to Newcastle University, in respect of Agenda Item 7.

To note the Committee’s Terms of Reference and membership and to appoint a Vice-chair for the 2017/18 municipal year. 

The Chair, Councillor Rory Vaughan invited nominations for the appointment of Vice-Chair.  Councillor Mercy Umeh was nominated by the Chair, seconded by Councillor Daryl Brown:

RESOLVED:

Councillor Mercy Umeh be appointed Vice-Chair of the Committee for the municipal year 2017/18.

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

Debbie Domb, Disabilities Campaigner

Patrick McVeigh, Action On Disability

Bryan Naylor, Age UK

The following co-opted members be re-appointed for the municipal year 2017/18:

Debbie Domb, Disabilities Campaigner

Patrick McVeigh, Action on Disability

Bryan Naylor, Age UK

A new co-option, Jim Grealy, Save Our Hospitals, was also agreed.

The Chair welcomed Helen Mann, Programme Manager for Healthwatch, who presented an update detailing recent activities and current areas of work.  A welcome was also extended to Olivia Clymer, recently appointed Chief Executive Officer for Healthwatch.  Summarising the key points, Helen Mann reported that the organisation had reset priorities, was continuing to collate background information and evidence. 

Healthwatch was actively pressing the CCG with regards to a newly launched consultation “Choosing Wisely”, and indicated that they would be challenging the short timeframe of the consultation, due to end on 30^th June.  A key concern was that the consultation allowed for sufficiently broad and robust consultation and engagement.  Changes to prescription charges were being sought to help reduce costs through avoiding the need for a prescription for medication that was easily available over the counter. 

Obtaining feedback about mental health issues was another priority area of work for Healthwatch.  They had been working to further develop relationships with voluntary organisations commissioners, providers and users.  In response to a query from Bryan Naylor, it was noted that a carers event had recently been held in White City.  It was explained that this was a priority area, particularly in terms of addressing the needs of young carers.  Councillor Carlebach indicated his support for this, and acknowledged that while the remit of the Committee did not cover children’s services, paediatric health services did.  Councillor Coleman commented that there were approximately 6 million carers in the UK and emphasised the importance ensuring that they were properly supported. He confirmed that he would be meeting with Healthwatch to explore this issue further.  Craig Williams reported that the Health and Wellbeing Board had identified a gap in support for carers and that the development of a carers strategy was planned.

Following a comment from a member of the public regarding the issue of homecare service continuity when provision was sub-contracted, Helen Mann confirmed that they were undertaking work on this.  Ben Gladstone confirmed that user feedback was helpful, as a way of monitoring existing provision and for shaping future commissioning intentions.  There followed a brief discussion which acknowledged the invaluable commitment and support offered by unpaid cares, balanced against the provision of homecare services.  Craig Williams recognised that a significant portion of carers did not contact the Council, which had important implications for the way in which the Council Communicated with carers and how support for Carers could be managed. 

Action: Report to be prepared on Homecare

RESOLVED

That the report be noted.

The Chair welcomed NHS colleagues from Imperial College, presenting the Quality Account 2016/17.  Professor Julian Redhead, Medical Director explained that the Trust’s Quality Strategy 2015/18 was the vehicle by which they hoped to achieve quality goals, supported by annual targets and a number of improvement programmes.  They had incorporated an extended timeframe in order to ensure that there were opportunities for the document to be publicly reviewed and consulted upon, with the first draft circulated on 4^th April 2017. The report was shorter and easier to read and presented an overall picture of what was one of the safest hospitals.  While there was a high rate of reported incidents, there was by comparison a low harm rate. 

With reference to the Referral To Treatment (RTT) rates, Councillor Carlebach understood the pressure that the Trust was operating under but observed that while some rates were good, 62.62% for Dementia was poor.  ‘Access to Cancer Services, 62 day wait for first treatment from urgent GP referral’, was in Q4, 74.7%, having progressively decreased from earlier quartile performances.  Professor Redhead accepted that the Trust had struggled to meet standards for specific reasons including late referrals from tertiary providers, despite their intent to be patient-centric. They had put in place measures that would improve patient pathways, however, the key was to have in place effective preventative measures and earlier diagnosis to ensure that patients received the best treatment. 

With reference to End of Life care, Councillor Carlebach enquired about what steps had been undertaken to address this particular need.  Professor Redhead acknowledged that there was a need to bring together all sectors from primary to acute trusts, wanting to ensure that patients where not unduly distressed.  Councillor Carlebach expressed his thanks to health colleagues for the commitment and performance of staff at Imperial. 

In response to a query from Bryan Naylor, it was explained that the Trust was in the same position as many organisations, responding to the uncertainties and difficulties of Brexit, and they were doing their best to reassure staff about this.  In terms of recruitment, the Trust was also trying to ensure minimum standards for staff to communicate clearly and effectively with patients.  The hospital was a multicultural environment, with multi-lingual staff which was helpful in terms of understanding cultural differences and having effective communication. 

The discussion continued, focusing on the education and training provided to health staff, to ensure that they were able to access career pathways, upgrade their skills and develop relevant expertise in areas that offer them job satisfaction.  It was noted that this was a long term programme of on-going development, which could take up to three years for the benefits to materialise. 

Bryan Naylor highlighted concerns reported by Age UK members about discharge protocols for patients, their carers’ and families and allegations of “bed blocking”.  Prof. Tim Orchard responded that this was an important issue for the Trust.  Patients were admitted from a range of different areas, for example, Adult Social Care, district  ...  view the full minutes text for item 140.

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

Following a brief discussion, it was agreed that the following topics be added to the long work programme:

• Community Independence Service
• Patient discharges
• Workforce staff satisfaction – health / Imperial
• Homecare update

RESOLVED

That the Work Programme be noted.

The dates of meetings for the remainder of the new municipal year are as listed:

Tuesday, 4th July 2017

Tuesday, 12th September 2017

Tuesday, 14th November 2017

Tuesday, 12th December 2017

Tuesday, 30th January 2018

Tuesday, 13th March 2018

Tuesday, 24th April 2018

The date of the next meeting will be Tuesday, 12^th September 2017.