Agenda and minutes

Apologies for absence were received from Councillor Jonathan Caleb-Landy.  Councillor Bora Kwon gave apologies for her early departure from the meeting.

Councillor Richardson welcomed back Jen Nightingale who had stepped down from the Committee at the end of the summer due to work and family commitments.  Councillor Richardson thanked her for generously contributing her time and expertise in supporting work of the Committee and wished her well in her future plans.

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.

Keith Mallinson declared an interest in Agenda Item 8, Healthwatch Your Voice (H&F), as he was a trustee of Central and North West Healthwatch, the previous provider of Healthwatch services in H&F.

This meeting is being held remotely via Microsoft Teams. If you would like to ask a question about any of the items on the agenda, either via Teams or in writing, please contact: bathsheba.mall@lbhf.gov.uk

You can watch the meeting live on YouTube: https://youtu.be/iXxY7OJWQIo

The Committee noted that ParentsActive had submitted questions and continued to provide ongoing input which has helped inform the ongoing work on inclusive employment.

(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 10 September 2020; and

(b)   To note the outstanding actions.

Councillor Richardson reported that it had been expected that the lack of  a proper test & trace app and protocols was expected to be discussed at JHOSC in October, but this meeting was subsequently cancelled.  It was noted that Dr Lang would provide further insight on this under Agenda Item 5 and her Covid-19 update.  Janet Cree confirmed that the CCG would support and contribute to an item on immunisation take up to the next meeting of the Committee. Actions and outcomes on inclusive employment would be addressed under Agenda Item 6.

RESOLVED

That the minutes of the previous meeting held on 10 September 2020 be agreed as an accurate record.

This item provides a verbal update from the Director of Public Health on Covid-19 and the Council’s response in supporting residents throughout the pandemic.

Councillor Richardson welcomed Dr Nicola Lang and Linda Jackson to the meeting to provide a verbal update.  Dr Lang reported that there had been 211 new cases of Covid-19 identified through extensive testing undertaken in the borough although the overall rates was in decline.  The rates were calculated on a rolling seven-day average, testing 579 of every 100,00 people (compared to the London average of 300 per 100,00).  The borough had the highest rate of infections in London at this time, but the figures changed daily. It was also noted that the borough had administered the highest number of tests.

Dr Lang also reported that Doc Tap, a private GP in the borough had found to attributed 130 Covid-19 positive cases to the borough’s public health numbers.  Janet Cree confirmed that Doc Tap was a private contractor and that there was no contractual relationship, so they did not come under the jurisdiction of the CCG.  Any action would need to be taken through the CQC (Care Quality Commission). 

On the eve of a four-week lockdown Dr Lang confirmed that the borough planned to undertake targeted local testing. Dr Lang thanked Charing Cross hospital for their support, particularly Dr Paul Randell.

Linda Jackson explained that they had prepared action plans in response to the second wave of the infection which also incorporated a flu action plan and formed a critical part of the winter response in terms of managing the wider pressures collectively within the NHS. Targeted, mobile testing was underway with all the logistics being finalised. There was no indication that the government intended to reintroduce shielding but the council planned to continue to support clinically vulnerable people. The successful work around contact tracing was highlighted in the media and commended. 536 people had been contacted by the contact tracing team since 16 September 2020 representing a success rate of 95%, a significantly higher rate than had previously been managed by the central Government.  

Janet Cree outlined preparations being undertaken in delivering primary care services to ensure that people were able to have face to face contact throughout a second lockdown.  It was essential that access to healthcare services such as immunisation continued.  Escalated primary care clinics for those with Covid-19 symptoms have continued to operate and preparations were being made to deal with a potential increase in patient volume.  Action plans would be implemented once the threshold for implementation was reached.

Dr Bob Klaber highlighted the theme of collective and joint working which he felt was key across the wider health system.  The difficulty was to ensure the continued delivery of essential health services balanced with the competing priorities of responding to Covid-19. There were also combined issues of maintaining segregated space and limited resources to support collaboration across north west London.  Elective care numbers were almost on par with the same period in 2019 and that since Covid-19 in March there was a significant backlog that they were working hard to address. 

Dr Klaber explained that there  ...  view the full minutes text for item 5.

This verbal update to the Committee sets out the work currently on going to support young people with disabilities to find suitable employment in a supported setting.

The Committee received a verbal update from the Jo Baty following up on outcomes arising from the previous meeting on inclusive employment, support residents on pathways to employment.  A key issue was to ensure a holistic, whole council approach, which had been championed by the Chair of the Committee, Councillor Richardson.  The Economy Department was a key partner within this process to ensure a direct interface with businesses and employers, equipped with suitable knowledge of the language, data and infrastructure to make this successful. Jo Baty described some of the structures already in place which included the programme of internships within the council.  The intention was to work with the CCG and other stakeholders to take the work forward through collaboratively with a more joined up approach. 

Kamal Motalib reported that they had recently secured and agreed a programme of work as part of the Kick Start programme for which H&F would act as an intermediary.  62 places had been secured and officers planned to submit a second application to secure the next wave of placements.  It was confirmed that Action On Disability were involved in this work and that officers were keen to strategically engage with community providers such as Parents Active to also help develop the work.

RESOLVED

That the verbal update be noted.

This report provides background and context to the potential transfer of congenital heart disease surgical and interventional cardiology services away from Royal Brompton Hospital to appropriate alternative providers (subject to consultation).

Councillor Richardson welcomed guests and speakers for this item which was to receive an update regarding the Royal Brompton.  Dr Richard Grocott-Mason echoed earlier comments about the benefits and power of collaborative work which strengthened and supported the healthcare system.  The work of NHS staff in treating Covid-19 patients at the Brompton was commended with high survival rates for patients on ECMO (extracorporeal membrane oxygenation).  The Brompton was one of only two hospitals which had continued to provide cardiac treatment throughout the pandemic. 

Dr Grocott-Mason outlined why the Trust supported the proposal to relocate services to Guys and St Thomas hospital.  The time taken to invest in, build and develop specialist services such as paediatric congenital heart disease was considerable and invaluable.  It was confirmed that Brompton and Harefield hospitals would not be closed and that the intention was to ensure the continuation of clinical outcomes.  Consultation about Evalina London Children’s Hospital as the new site for services was planned for June 2021 but a new facility was unlikely to be available until 2025 or 2026.  In terms of collaboration the consolidation of services would not affect academic ties with Imperial, but this was an exciting opportunity for two hospitals to come together for the benefit of patients. 

Dr Bob Klaber outlined the views of Imperial College Healthcare NHS Trust.  The clinical needs of the population and access to high quality health services were key factors.  Dr Klaber welcomed the increased collaboration around care pathways and the assurance around academics working together.

Roy Margolis enquired about the benefits of the proposal.  Dr Grocott-Mason reiterated that this would be the unification of services based at Guys and St Thomas’s.  Myocardial infraction services at Brompton would remain and there were currently no plans to downsize the provision. 

Councillor Quigley outlined her personal association with the Brompton and expressed her concern about the potential long-term and adverse impact of residents in north west London travelling to Guys and St Thomas.  The age of the estate was also an issue, despite the many excellent services offered.   Councillor Quigley referred to page 4 of the report and enquired about how consultation and engagement would be undertaken.  Dr Grocott-Mason clarified that where two hospitals trusts joined services this was not required.  There was no plan to move adult services and if this was the case there would be a consultation and equalities impact assessment.  It was confirmed that services would be continued to be provided from Brompton for the next ten years. 

Jim Grealy asked about the value of the real estate and sought clarification about what services would remain at Brompton.  In terms of the estate, Dr Grocott-Mason confirmed that the current pandemic had highlighted the difficulties designing segregated space and managing infection control areas.  Robert Craig explained that the first service that would transfer would be children’s, subject to consultation.  NHS England had already decided that paediatric services should only be provided by a specialist children’s hospital and that  ...  view the full minutes text for item 7.

This report introduces the work of Healthwatch, Young Voices H&F supporting residents of Hammersmith and Fulham in accessing local primary and acute health services in the borough.

Councillor Richardson welcomed Maisie McKenzie to the meeting.  Maisie McKenzie outlined work priorities for Healthwatch Your Voice H&F which had been awarded the provider contract which had commenced on 1 April 2021.  A key area of work that organisation was focused on was patient access to digital services.  A survey had been prepared with input from the Executive Committee of Healthwatch your Voices H&F, Parents Active, the Carers Network and HAFSON to help draft questions, produce an easi-read, large print and braille text formats, available online and in print.  Five focus groups were planned to help glean experiences about accessing digital services. There were emerging themes around education, technology, motivation and cost.  It was becoming clear that online access needed to be complemented by face to face provision.

Councillor Richardson enquired about the social responsibility to engage locally. Maisie McKenzie explained that they would strategically link with and inform the north west London Collaborative digital strategy and that there was strategic interest in the outcomes of the survey and how digital services might meet the needs of residents on a local level. The work had been commissioned by the H&F Health and Wellbeing Board (HWB) and highlighted the collaborative and strategic approach being undertaken.  Councillor Coleman confirmed that HWB had tasked Healthwatch Your Voice H&F to draft a set of service standards that could be used as a framework of reference for the delivery of accessible digital services and which would be disseminated to GP practices.  Roy Margolis expressed his support for the survey work and offered to assist with the development of service standards.

Keith Mallinson queried the progress to date on formally establishing a shadow executive committee for Healthwatch Your Voice H&F.  Maisie McKenzie confirmed that work on interviewing and recruiting to the shadow committee was currently in progress and would be made up of local volunteers.

RESOLVED

That the verbal update be noted.

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

The Committee noted elements of the work programme for the next meeting which could include the following areas:

• Update on the NWL CCG Collaborative merger
• Immunisation take up
• Black and minority ethnic groups and immunisation take up
• Covid-19 – plans to roll out COVID vaccination

Tuesday, 26 January 2021

The date of the next meeting was noted as Tuesday, 26 January 2020.