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 7 October 2021; and

(b)   To note the outstanding actions.

It was noted that paragraph numbers for items 5 and 6 were reversed and noted that Dr Chris Hilton did not attend the previous meeting. 

Councillor Richardson provided a brief update on the actions most of which had been resolved or would be covered later in the meeting.

RESOLVED

That subject to the above the minutes were agreed as an accurate record of the previous meeting held on 7 October 2021.

Apologies for absence were received from Councillor Jonathan Caleb-Landy, and co-optees Lucia Boddington and Roy Margolis.

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.

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

You can watch the meeting live on YouTube: Watch live on YouTube

The Chair reported that a request to ask a question in respect of Agenda Item 6 had been received from Merril Hammer (HAFSON).

For the Committee to receive a verbal update from the Director of Public Health on Covid-19 and Director  COVID-19 & Lead for Afghanistan refugees, with a focus on Covid vaccination.

5.1          Councillor Richardson welcomed Janet Cree, Linda Jackson and Dr Nicola Lang to the meeting to provide a verbal update.  Dr Lang reported that the rate of infection for H&F was 239 per 100k people which was slightly lower than the London average at 253 per 100k, placing the borough as the 19^th highest rate in London.  There had been 335 cases confirmed in the past seven days reflecting an identified pattern spanning the previous few weeks.

Infection rates had been highest within the 11-16 age group but were decreasing slowly across all groups.  There had been a number of outbreaks at the start of the Autumn term and a reduced number following the half term break.  The rates for the over 60’s cohort were higher than the rest of London at 167 per 100k people.   Testing rates were good but the positivity rate was 5 cases reported as positive for every 100 PCR tests, higher than previously recorded so this was being closely monitored.

5.2          Anticipating winter pressures, the focus had moved towards administering the booster jab for over 50’s in medical risk groups, and health and social care staff.  Dr Lang advocated for social distancing protocols, continued mask wearing in indoor and crowded spaces with limited social contact and good hand hygiene.  She also encouraged flu as well as booster jabs which would be key to maintaining lower rates of illness.  Linda Jackson reported that the number of pharmacies delivering vaccines had increased to 11 and also encouraged the take up of flu and booster jabs.

5.3          Janet Cree confirmed that there were four PCN sites (White City Community Centre, Brook Green Medical Centre, Hammersmith Surgery and West Kensington Tenants Hall) and briefly referenced Matt Meads role in supporting GPs in providing vaccinations in the borough.  Operationally, vaccinations had begun focusing on practice registration lists, aligning with the eligibility criteria.  It was important to maintain business as usual and balance practice activities with managing the recovery process post Covid.  The increased number of pharmacies widened the geographical area covered and lessons had been learned from the delivery of pop-ups.  The increase in pharmacy capacity would enable the delivery of more vaccine doses and also allow opportunities to vaccinate those who had not had either their first or second dose. The increase also compensated for the decommissioned Novotel site. The PCN sites together with CLCH had also begun to deliver vaccines to those that were housebound in addition to supporting the school’s programme. Janet Cree reported that there was also capacity in neighbouring boroughs.  In terms of vaccination figures, 65% of the borough population had received their first dose and 59.4% had received their second dose. Focusing on invited, registered patients, 20% had received their booster jab. A local booking system operated alongside a national booking system, but the latter was accessible to anyone who was eligible.  This ensured that local capacity was utilised and could also opportunistically administer first, and second doses offered to walk-in appointments  ...  view the full minutes text for item 5.

This report aims to provide members with insight into the range of available mental health services delivered for Hammersmith and Fulham residents and to improve opportunities to understand care pathways, and to provide a snapshot referral demand and service challenges.

6.1           Councillor Richardson welcomed Dr Chris Hilton and Helen Mangan from West London NHS Trust (WLT) and additional contributors which included Lisa Redfern, Jo Baty, Dominic Conlin and Dr Barbara Cleaver.  For ease of reference, Dr Hilton shared slides based on the appendix attached to the report.  He briefly outlined the remit of the Trusts work which encompassed the provision of forensic, high secure specialist local services.  The report focused on a broad range of provisions and borough related demographics as precursor to further reports to the committee. Dr Hilton outlined key points about individuals who wanted to access services and the volume of demand and the WLT response and how the Trust was positioned within the framework of the Integrated Care Partnership (ICP).

6.2           The PCN raw data indicated that there were currently 7409 H&F residents accessing local mental health services, of which 534 were receiving support from the WLT dementia services. WLT was working to improve access to services amongst particular cohorts and the appendix indicated a breakdown of service use by different PCNs. The access and entry points to the various services included walk ins and self-referrals.  The data indicated that access during the pandemic decreased significantly with a fall in activity across many services.  Going forward, Dr Hilton reported that there was long term planned investment to create opportunities to improve services such as CAMHs. Neurodevelopmental services including Autism and ADHD (Attention Deficit Hyperactivity Disorder) were not provided by WLT in H&F but was offered by Chelsea and Westminster Hospitals NHS Foundation Trust (ChelWest) and the Cheyne Child Development Centre. A mapping exercise across North West London was currently underway to identify the range in provision for adults with autism and ADHD to try and improve local pathways. Dr Hilton also highlighted aspects of the 24 hour liaison psychiatry crises services at Hammersmith and Charing Cross hospitals (full details of the presentation are accessible at 44:53, H&F Health, Inclusion and Social Care PAC | 10 November 2021 - YouTube).

6.3           Dominic Conlin advocated the development of a collaborative approach which offered an opportunity to reposition autism and ADHD services.  Integral to this more holistic approach with earlier intervention was the relationship with acute mental health services.  Commenting on the activity following lockdown there had been a notable increase in the volume and acuity of patient presentations. He highlighted two aspects: first, that patients who did require inpatient admission had significant wait times, often in unsuitable environments; and that this became fragmented if admission was required prior to transfer.  A joint approach was preferable to support paediatric mental health services which included early intervention enhanced by improved training, development and digital innovation.  This would offer better support for staff in identifying patient symptoms.  

6.4           Dr Barbara Cleaver explained that A&E departments were under significant pressure and seeing large numbers of patients presenting during a mental health crises with high acuity of need.  Approximately 5-8% of patients with complex needs waited for more  ...  view the full minutes text for item 6.

Disabled People’s Housing Strategy 2021 sets out the approach for meeting the housing needs of disabled people through the provision of a co-produced housing service shaped and influenced by, and for, disabled people.

7.1           Councillor Richardson introduced the item which demonstrated positive resident engagement in H&F and was an excellent example of coproduction. The strategy, launched in July 2021, set out an approach for meeting the housing needs of disabled people through the provision of co-produced housing services informed by the views of disabled people.

7.2           Glendine Shepherd explained that strategy was inclusive and coproduced with residents and embodied the council’s approach of doing ‘nothing about disabled people without disabled people’ (Disabled People’s Commission, June 2018).  The strategy was innovative in the way in had been informed by the voice of disabled residents and extended beyond the provision of an accessible housing register or adaptions.  Tara Flood outlined her role as one of the leads on coproduction together with Kevin Caulfield. The support and contribution of disabled resident Jane Wilmot, a Disabled People’s Commissioner was commended for leading the work on coproducing the strategy which was a unique in local government. Tara Flood briefly outlined the work of the commission, which she had chaired, and which sought to identify barriers to decision making and improve influence in housing services, a key priority given the difficulties experienced by many disabled residents.

7.3           Gerry Cowley outlined the key principles which were supported across four distinct objectives within the strategy: coproduction, working with residents; improved and clearer access to housing information; improved housing services (adaptations); and more accessible housing.  This was an innovative and challenging agenda to deliver and prioritised the needs of disabled residents. Tara Flood continued that the next stage was to implement the strategy, together with other initiatives.  A resident led disabled people’s housing strategy implementation group (title to be confirmed) would be chaired by Councillor Lisa Homan, Cabinet Member for Housing and which also included Victoria Brignell as a member. The group had recently met and was in the process of agreeing its remit and approach. As this work continued to evolve, it was important for the group and the implementation of the strategy to align with the service transformation work that was taking place within Adult Social Care on independent living. Glendine Shepherd anticipated that the group would steer and prioritise action plans devised for each of the four objectives.

7.4           Councillor Richardson thanked officers for their work and commended the innovative and ambitious aims set out in the strategy.  The measures section provided for each objective was an excellent provision as it built in evaluation and progress monitoring. It also facilitated engagement with disabled people’s organisations as the measures sought to include engagement data, including fresh voices, and teaching them advocacy skills.  Councillor Richardson welcomed an opportunity to be more engaged with the work, helping with feedback and scrutiny but given the challenges, she asked whether there was capacity to implement the strategy. Glendine Shepherd acknowledged that funding was an issue, but it would be the role of officers to engage with and navigate the process by securing either Cabinet or scrutiny member support to advocate for additional funding.  ...  view the full minutes text for item 7.

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

The committee discussed planned items for the remaining meetings of the current cycle which included the WLT MINT report and the medium term financial strategy reports for January 2022, and a thematic meeting on supported employment for March 2022.

26 January 2021

23 March 2023

Wednesday, 26 January 2022.