Agenda and minutes

Councillor Bora Kwon proposed herself as Vice-Chair, Councillor Mercy Umeh seconded the nomination:

RESOLVED

That Councillor Bora Kwon be elected as Vice-Chair for 2019-20.

The following co-optees have been nominated for the municipal year 2019/20:

Victoria Brignell (Action On Disability)

Jim Grealy (Save Our Hospitals)

Keith Mallinson (Healthwatch)

Jen Nightingale

That the following co-optees be appointed for 2019-20:

Victoria Brignell (Action On Disability)

Jim Grealy (Save Our Hospitals)

Jen Nightingale

Keith Mallinson (Healthwatch)

Apologies for absence were received from Keith Mallinson.

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.

None.

(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 24 April 2019.

(b)  To note the outstanding actions.

RESOLVED

That the open minutes of the meeting held on 24 April 2019 were agreed.

Verbal update from the Strategic Director of Social Care, Lisa Redfern.

The Strategic Director for Social Care provided a verbal update.

Scene setting, Vision, Achievements and Challenges

ASC provided services for 3,100 people with 234 staff, and Lisa Redfern outlined how the H&F vision was to support residents who were vulnerable to be enabled to live independently.  Co-production of services offered real choice and control over residents’ own lives.

Quality

The Care Quality Commission (CQC) rated two H&F provided services as “outstanding”: The Community Independence Service, (CIS), and the Riverside short breaks service. Lisa Redfern explained that they were very proud of these achievements as this meant that they were offering high quality services to H&F’s residents.  Ofsted and CQC had rated H&F SEND services as very good. 

ASC was committed to improving quality of care, working more with primary care to prevent hospital admissions.  The special disabilities service (Transitions) with the transfer to adult services commencing from 14 years and upwards was rated as “good”. 

Home Care

ASC continued to work very closely with all three main agencies and robustly manage and monitor provision. Quality was variable.

Performance

ASC performance on delayed discharges both for acute and non-acute service is very good. We address any quality issues through our quality assurance work and forums, including the Safeguarding Adults Board.

Budget

ASC achieved a balanced budget again for 2018/19, however, the social care budget continued to face significant challenges.

Sovereign Borough Progress

All social care services have been fully disaggregated We have two services, the hospital discharge and emergency duty services which continue to be shared.

The Borough’s Safeguarding Adults Board was launched in September 2018 and was well attended by all relevant agencies and appeared to be working very well.

A weekly Footcare service/clinic was established. The cost for toenail cutting was heavily subsidised at £16.00, rather than £60.00. The option of a home visit was also being considered with a possible charge of £32.

The new direct payments service had been co-produced, and the new service was about to be launched.

Councillor Richardson thanked the Strategic Director for her overview and its emphasis on community provision and asked why the NHS did not engage more in similar provision.  Councillor Coleman briefly provided context to the establishment of the footcare clinic, how following consultation the CCG had limited the provision of podiatry services to only those who had acute or severe medical conditions.  Feetfirst had contacted the Council and this had been supported by the Strategic Director and the Mayor.  Councillor Coleman felt that this was something that the CCG should have been able to pursue in partnership with the Council. 

Footcare was important as it helped to prevent serious trips and falls and helped those who were too embarrassed about being unable to cut their own toenails.  Councillor Kwon suggested that the availability of the service be highlighted to local diabetes charities and community groups as good footcare could help prevent amputations.  Good footcare was essential, not just about grooming or appearance, but was much  ...  view the full minutes text for item 14.

This report provides an update on Healthwatch activities.

RESOLVED

That the Committee noted the report from Healthwatch.

Councillor Richardson provided a brief update on the work of the JHOSC.  The member boroughs included Brent, Harrow, Hounslow, RBKC, Westminster and H&F, with Richmond as observers.  There had been collective and unanimous agreement that the JHOSC should continue and a work programme was agreed.  There was expected to be an additional meeting in July to discuss proposals to unify local CCGs in alignment with Integrated Care Partnerships and this was being currently explored. H&F would be hosting the September meeting, the key themes for which would be scrutiny of CCG financial long-term planning and the impact of GP at Hand and the cost of digital services.

RESOLVED

That the Committee noted the update from NWL London JHOSC.

Verbal update from representatives of Save Our Hospitals.

Jim Grealy confirmed that Save Our Hospitals had recently been renamed “H&F Save our NHS”.  He outlined priorities for the coming year, the first being the proposed health budget cuts and the impact on the residents of H&F. A second priority was to look at GP at Hand. There was a need to recoup the cost of the service as the NHS continued to move increasingly towards digital services.  It was important to address the natural injustice of this situation or the deficit would continue to accrue.  The movement towards the merger of the eight North West London CCGs continued.  This would affect eight boroughs, conducting approximately 40 CCG meetings per year. The merge would mean one CCG covering the needs of over two million people, with mixed income and diversity.  It appeared illogical that one body could determine health needs and engage services for a wide geographical area. It was explained that HFSON would concentrate on working with residents and advocate the need for local democracy.  Additional concerns included the low rate of immunisations in H&F. 

Councillor Kwon referred to GP at Hand and observed that the digitisation of the NHS would become increasingly prominent as an issue, continuing privatisation by stealth.  Historically, the NHS had a poor track record for this.  It was important to recognise that Council lacked the necessary expertise in understanding the issue, particularly given current the rate of progress, which could not be allowed to continue without proper scrutiny.  It was noted that one of the key criticisms of GP at Hand was that while they had the technical knowledge, they lacked a critical understanding of local need and diversity.

Jen Nightingale observed that the variation in information technology (IT) varied in different trusts and that it would be helpful if this could be unified, with an overarching technical policy or strategy that could be universally adopted.  This would also be more financially efficient, given the large number IT companies that a varied range of services to different trusts. Jim Grealy concurred, that it would be helpful to consolidate buying power to strengthen purchasing power. 

Jim Grealy commented on the recent CCG consultation which he felt had not considered the different was in which people now lived their lives and advocated the need for long term integrated care service planning.

Councillor Coleman commented that one of the biggest injustices had been that funding for GP at Hand had come from H&F CCG but this project had benefited those that live outside the Borough.  Councillor Kwon agreed and felt that this was the tip of the iceberg, referring to the Aviva Application initiative.  She queried whether the App was any good or if it offered value for money, noting that a Tech company had been paid for this development work by the NHS.  Merrill Hammer (H&FSON) added that this was an issue that could not be resolved locally, and that NHS England would need to be challenged.  One important concern  ...  view the full minutes text for item 17.

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

The Committee noted the draft Work Programme and in addition discussed potential items on measles and immunisations, and cervical cancer.  A planned item for July on primary care network had been moved to September. Councillor Caleb-Landy suggested an item on supported employment and to identify opportunities for the co-creation of services, with a view to forming a small working group. Councillor Kwon suggested as link to GP at Hand, an exploration of digitisation of services and patient experience, with the potential inclusion of Imperial College.

11 September 2019

11 November 2019

27 January 2020

24 March 2020

The date of the next meeting was noted as 11 September 2019.

The Committee is invited to resolve, under Section 100A (4) of the Local Government Act 1972, that the public and press be excluded from the meeting during the consideration of the following items of business, on the grounds that they contain the likely disclosure of exempt information, as defined in paragraph 3 of Schedule 12A of the said Act, and that the public interest in maintaining the exemption currently outweighs the public interest in disclosing the information.

RESOLVED

That members of the press and public are excluded.

To agree the exempt minutes of the meeting held on 24 April 2019.

RESOLVED

The closed minutes of the meeting held on 24 April were agreed.