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 27 January 2020; and

(b)   To note the outstanding actions.

Item 1a - Minutes

The minutes of the previous meeting dated 27 January 2020 were agreed as an accurate record.

Item 1b – Update on health actions and Covid 19

Dr Nicola Lang provided a brief overview of the national picture and the Council’s response to Covid 19 working with local health partners.  Almost 17,000 tests had been carried out, with 85 confirmed cases, an increase from 34 previously confirmed.  Most of these were individuals who had travelled from recognised countries or at-risk category countries.  Dr Lang reported that Dr Paul Cosford (Director for Health Protection and Medical Director for Public Health England) had predicted that transmission of the virus was highly likely to increase, and the Chief Medical Officer had also reported similarly. There was currently no vaccination or treatment to prevent infection. When cases were identified swab samples would be taken from the nose and throat and tested by Public Health England PHE).  Patients with Covid 19 were then isolated and provided with supportive treatment in special isolation units, in hospital.  Extensive contact tracing would then follow, undertaken by PHE. Dr Lang reported that this was the “containment phase”, where cases were identified, contained, and to identify the individuals who that person has been in contact with.  The next phase was known as the “delay phase” where mitigating measures were applied to slow the spread of the virus.

The Committee were referred to the recently published government plan to address the increase in the number of confirmed cases.  Linda Jackson outlined some of the ways in which the Council had worked closely with PHE and local NHS colleagues.  Briefing meetings with health colleagues chaired by Councillor Ben Coleman (Cabinet Member for Health and Social Care) had received a good response and colleagues were working well together.  Health and social care colleagues were well prepared and had well-established plans in place to respond.  Work was also underway to establish the Borough’s resilience forum which, in addition to representatives from health and social care, also included representatives from the police, fire brigade, and local colleges. 

Council internal messaging had reinforced health and preventative measures already in place.  A training event for over a hundred frontline staff had been well received and this would be extended to schools. The Council had contacted large, local businesses and employers such as Westfield and contingency planning had begun to address a potential 20% reduction in workforce.  Much of this was already in place but the key message was to ensure a measured, calm response to the possible pandemic. The Council was reinforcing the NHS message to contact 111 (by telephone or online, and links to NHS websites were on the Council website) for further advice and information, and to not visit GP surgeries or A&E.  All staff emails now had the message “catch it, bin it, kill it”.

Parsons Green (outstanding action)

The CCG to provide a written update, together with a timetable for actions Councillor Coleman reported that he had recently written  ...  view the full minutes text for item 43.

Apologies for absence were received from Councillors Bora Kwon and Jonathan Caleb-Landy (attended remotely by telephone); and Co-optee Victoria Brignell.

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.

The Committee will scrutinise the suspension of residential palliative

care services at The Pembridge Hospice and in addition consider the

engagement work undertaken by the CCGs to date on the provision of

local palliative care services.

The Chair welcomed Janet Cree, James Benson and colleagues to the meeting. Councillor Richardson briefly explained the background and that the issue had been considered by members at previous meetings.  The Committee had provided the CCG with questions in advance of the meeting with aim of achieving critical insight and Councillor Richardson thanked CCG colleagues for written responses submitted prior to the meeting (questions and answers attached as Appendix 1).

Janet Cree explained that CCGs commissioners had agreed to undertake further engagement work. Consideration of the Involvement Document by the Committee was regarded by the CCG as part of that process. The engagement period was expected to last six weeks until 13 March 2020 and subsequent to this the CCG governing body was expected to receive a report on the outcome of the engagement indicating next steps. It was confirmed that any recommended substantive service changes would generate the appropriate level of engagement and / or consultation. Any proposed timeframes for consultation was to be shared with the Committee for comment.

Mark Jarvis outlined the engagement process undertaken to date which had utilised existing networks.  Approximately 160 local people and groups had participated in workshops and further events were planned before the end of the consultation period outlining the scenarios set out in the Involvement Document. The intention had been to undertake focused engagement with smaller, local groups and to engage hard to reach groups with protected characteristics.  Details of the engagement work had been circulated across the affected boroughs, members of parliament and councillors utilising multiple media channels.

The questions were divided into four key areas of discussion (attached as Appendix 1). Each section was reviewed, and the following points were raised in response by the Committee:

1.  Operational / management

Q1a - James Benson confirmed that the current staffing arrangements for the community service was in line with the Trust’s safer staffing requirements with a level of consultant leadership provided as appropriate.

Q1c - Keith Mallinson sought clarification about the NHS intention to purchase ‘bed days’ from providers and how did the CCG ensure that a palliative care consultant was able to supervise staff in other locations. Janet Cree responded that services had always been commissioned from several hospices in addition to Pembridge (Trinity and St Johns) predominantly used for Hammersmith & Fulham residents and so this already formed part of the routine contract arrangement.  Palliative care consultants were in post at these sites. James Benson added that at the point the inpatient unit was suspended other providers were allocated junior doctors for further support to maintain a level of stability across the area.

Q1b – Councillor Richardson commented that the response to Q1b implied that the facilities at the Pembridge inpatient unit were under-utilised.  Janet Cree responded that this was not the case and that point she had made was that the increasing number of units means that a full complement of staff was required per unit.  Given that there was capacity across the service being commissioned from  ...  view the full minutes text for item 46.

To inform the Committee about progress to date on the area of

improving the inclusive employment offer.

Councillor Richardson welcomed Jo Baty, Helen Green and Kamal Motilib.  Kamal Motilib provided a brief introduction which highlighted some of the key socio-economic issues facing residents such as the high number of low paid jobs and correspondingly fewer opportunities for work that attracted higher salaries. There was also an increased use of foodbanks and debt advice agencies.  More robust analysis was needed but there were high numbers of people within the borough that were suffering from poor outcomes.

Helen Green expanded on the local offer details of which were provided on the Council’s website and outlined the collaborative work undertaken with Parents Active regarding training and development for the workforce.   Events such as the Youth takeover day, co-production and plans to recruit new posts within the service to look at post 16+ employment opportunities, pre-employment support and the journey to improve pathways and better integrate support services was all work in progress that would take careful and robust planning.  Key to this was to develop a person-centred approach that facilitated better engagement with young people and young adults with disabilities.  The lack of a more integrated approach in a challenging economy was a concern. 

Jo Baty explained that the opportunity to work with colleagues in The Economy Department was welcomed particularly in terms of developing the currently weak employment brokerage function with employers.  The challenge was to identify barriers and to understand what would benefit businesses. The Council had been facilitated supported internships for approximately 6 years focusing on the 16-25 age group partnering with local businesses such as Loreal, offering experience within the workplace with continued education on day release as appropriate.  While there were gaps within industries such as construction there were placements within the NHS and there was an intention to broaden this.  Through the West London Alliance and highlighting initiatives such as H&F Brilliant Business Awards, Jo Baty explained that they had worked across boroughs to improve access to work placements but a key part of this was ensuring sustainable employment.  

Focusing on the Council’s past activities, Kamal Motilib observed that there had little departure from what was a generic local offer on retail opportunities.  Groups that required more support had not been targeted and most opportunities had been accessed by those who lived outside the Borough.  A more nuanced approach was required if the Council was to meet the needs of an increasingly diverse Borough.  Kamal Motilib commended the growing work undertaken at Charing Cross Hospital as an inclusive employer. A Cabinet report was planned which outlined the Council’s industrial strategy to ensure a more inclusive strategic approach.

A member of Parents Active observed that it was very difficult to navigate and engage with the Council and commented that this could be addressed.  In addition to accessing opportunities it was also important to maintain support for vulnerable young people in a way that was sustainable.  Helen Green concurred and responded that it was important to streamline the process, for example, undertaking disclosure and  ...  view the full minutes text for item 47.

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

RESOLVED

That the Panel noted the report.

24 March 2020

The next meeting of the Committee was noted as 12 May 2020.