Agenda and minutes

Health and Adult Social Care Policy and Accountability Committee - Wednesday, 20th July, 2022 7.00 pm

Venue: Main Hall (1st Floor) - 3 Shortlands, Hammersmith, W6 8DA. View directions

Contact: Bathsheba Mall  Email:

Link: Watch the meeting on YouTube

No. Item


Minutes of the Previous Meeting pdf icon PDF 290 KB

(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 23 March 2022.


(b)   To note the outstanding actions.




That the informal notes of the previous meeting were noted and there were no matters arising.


Apologies for Absence


Apologies for absence were received from Councillor Ann Rosenburg, and co-optees Lucia Boddington and Roy Margolis.


Declaration of Interest

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 Patricia Quigley requested that her membership of the Safeguarding Adults Board be noted.


Public Health Update

This is a standing item for the Director of Public Health and the Director  COVID-19 & Refugee Lead to provide an update about health issues and services affecting the borough and it’s residents.


Dr Nicola Lang provided a verbal update on Monkey Pox and Covid 19.  There had been a steady increase in the number of Monkey Pox cases, 1735 reported in the UK, 1660 in England, of which 1229 were in London. The at-risk group comprised of men who identified as gay, bisexual or men who have sex with other men.  There had been a positive, whole systems approach which combined GUM (Genito Urinary Medicine) services as well as acute services.  Working with housing services, support had been provided to ensure that patients were safely discharged when they did not have a place in which they could safely isolate. 


There had been a concern that the capacity to continue delivering family planning activities in sexual health clinics would be displaced because of the response to Monkey Pox.  However, additional support had been offered at the John Hunter Clinic at Chelsea and Westminster Hospital, if they could not be seen at 10 Hammersmith Broadway which had been very welcome.  A small pox vaccine was now being made available and rolled out to vaccinate those in at risk communities.


Providing an update on Covid 19, Dr Lang confirmed that the number of cases across the UK continued to rise exponentially and that there had been many localised outbreaks in H&F nursing homes and care settings.  Fortunately, high rates of vaccination meant that most cases were asymptomatic or experienced mild symptoms.


Regarding Monkey Pox, Councillor Patricia Quigley enquired if there would be a similar communications or messaging provision as had been previously provided in response to Covid 19.  Dr Lang confirmed that there had not been as the response was being delivered through specialist communication channels deployed by sexual health charities. SASH (Sexual Health Outreach Service) was a mini consortium providing support for those in at risk communities.  The GUM service had also reached out to a local gay bar, Teds, in Fulham, to offer appropriate and sensitive support to encourage small pox vaccination.


Co-optee Victoria Brignell asked about the extreme heatwave and enquired if with the agreement of the other members, an update could be provided at the next meeting about how the heatwave had affected residents, what activities had been undertaken in response to help mitigate and what steps could be taken in the future. Dr Lang welcomed the proposal and expanded it to include contributions the emergency planning team. The heatwave had thrown into stark relief the question of preparation for extreme heat in the UK.  Measures had been implemented to protect vulnerable people in care homes and schools but there was a question about how to make buildings heat secure using white paint on reflective surfaces and awnings, using recyclable materials that did not retain heat.  Dr Lang reported that she was about to commence a large project with the environment department recognising that significant preparations would be needed to tackle climate change effectively.


ACTIONS: Update to be provided at the next meeting on how heatwave has affected the borough,  ...  view the full minutes text for item 4.


NWL ICS update on Community– based Specialist Palliative Care Services Improvement Programme pdf icon PDF 574 KB


This report sets out details of the North West London Integrated Care System (NWL ICS) ongoing review of the Community-based specialist palliative care (CSPC) services for Adults (18+) across eight NWL boroughs. It continues the palliative care review work undertaken in 2019/20 across Brent, West London, Central London and Hammersmith & Fulham CCGs.

Additional documents:


Councillor Natalia Perez welcomed colleagues from North West London Integrated Care System (NWL ICS).  These included:  Janet Cree; Robin Doran (who described her personal and professional experience and background as a carer and nurse, respectively); Phillipa Johnson, director, H&F borough-based partnership (previously a pharmacist); Andrew Pike, a communications lead for the NWL ICS; Sue Roostan; Michelle Scaife, delivery manager for the last phase of life program supporting with the delivery and transformation work on the review (an occupational therapist by background); and Chaksu Sharma, a programme manager for integration and delivery work in the borough, supporting the end-of-life engagement work. Contributions from co-optee Jim Grealy and Merril Hammer, from HaFSON to the engagement process on end-of-life care were commended for their invaluable input and support of this work.


Sue Roostan outlined the NWL ICS intention to ensure that the provision of specialist palliative care services for H&F residents, patients and family carers was improved.  A wider, NWL wide steering group had been established which included NHS providers, hospices, local authorities, and residents.  An issues paper published in November 2021 set out key reasons for the need to review the provision and integral to this was a conversation about future services.  An interim engagement outcome report had also been published setting out the feedback received to date locally in H&F.  Early engagement with local communities had allowed Chaksu Sharma and the borough team to work closely with lay partners and stakeholders such as HaFSON to design engagement materials. Early engagement with residents offered opportunities to work together to identify what matters to residents and how changes can be implemented to reflect this.  Listening events had been well attended and agreement obtained to extend the scope of the engagement. 


Robin Doran described the role of the model of care working group whose membership comprised of several stakeholders to help develop a framework and action plan to deliver high quality community-based specialist palliative which was sustainable across the whole of northwest London.  Input was being included from across the 8 London boroughs to reflect the patient voice from different communities, particularly those with protected characteristics.


Co-optee Keith Mallinson shared his personal experience of bereavement and commended the work of the Royal Trinity hospice who had provided support and assurance throughout.  It was important to sustain continuity of care and district nurse visits were an important part of ensuring consistent services.


Councillor Amanda Lloyd-Harris commented that four years had passed since the in-care patient service at Pembridge had been suspended. Councillor Lloyd-Harris sought an update about the lack of progress and the impact on residents, some of whom would need to travel out of the borough to visit terminally ill loved ones in hospices located out of the area.  Phillipa Johnson acknowledged that there had been a delay and explained that there had been continued attempts to recruit specialist staff since 2018 but a suitably qualified and experienced palliative lead consultant had not been identified. Councillor Patricia Quigley commented that families  ...  view the full minutes text for item 5.



This report sets out the Safeguarding Adults Boards annual report for 2020/21 and provides details about its work, progress and analysis of safeguarding priorities.

Additional documents:


Councillor Perez welcomed Mike Howard and Shazia Deen who jointly presented the Safeguarding Adults Board Annual Report for 2020/21.  The report set out the work of the Board based on identified priorities and offered excellent range examples of support provided, for example, to people who had experienced significant homelessness.


Focusing on one of the examples referred to in the report regarding people who smoked, Co-optee Victoria Brignell observed that in terms of personal choice, some individuals found that smoking offered a quality of life and joy that helped make life feel more bearable.  Given the increase in domestic violence cases and the focus on the Violence Against Women and Girls (VAWG) work, Victoria Brignell asked if this was an area of interest to the Board.  It was noted that this was beyond the remit of the Board which focused largely on carers committing an abuse, or the person being cared for experiencing abuse, and intergenerational abuse.


Co-optee Keith Mallinson highlighted the experience of a client through his work with the Shepherds Bush Families Support Service and who had ended their life.  Safeguarding concerns had been identified but it had been difficult to navigate the Crises Team pathway and his credentials as a support worker advocating for and supporting this individual had been questioned.  It was noted that the case, which was currently subject to a coroner’s investigation, was outside of the Boards remit. 


Councillor Amanda Lloyd-Harris enquired about the data on suicides and Dr Nicola Lang informed the meeting that work on the suicide prevention board was currently being concluded.  This contained data on the number of suicide or attempted suicides locally and would be shared on completion.  Councillor Amanda Lloyd-Harris referred to two fatalities caused by fire and linked to hoarding and asked how assessments were undertaken, and where for example, the individual was a smoker.  Mike Howard explained that this was a joint piece of work with the two dedicated fire officers based in housing and who liaised with the London Fire Brigade.  Councillor Lloyd-Harris also sought a definition of “income deprived” which could be interpreted relatively depending on individual circumstances. 


Action: A member recounted a resident experience with WLT which resulted in that individual taking their own life. The PAC considered this to be a serious matter that required a response from WLT.

Action: The completed annual report on local suicide statistics be shared.

Action: Definition of "income deprivation" to be provided to the PAC.




That the report was noted.


Healthwatch h&f Update pdf icon PDF 9 KB

This report provides an update about the activities and workstreams of Healthwatch h&f.

Additional documents:


This report was deferred to a later meeting and would be expanded to include the current work commissioned by West London Trust on patient engagement with and experiences of mental health services with Healthwatch H&F.


ACTION: For H&F to connect with Healthwatch to develop autism initiatives and this could be supported through co-production.

ACTION: For North West London ICS colleagues to contact West London Trust regarding borough-based partnership mental health campaign, and priority areas of work currently being delivered by WLT.





Work Programme pdf icon PDF 228 KB

The committee to discuss potential work programme items within the remit of the committee’s terms of reference (HASC is at page 110) and are included for information and noting.


The committee noted that the November meeting would include a Public Health update, Western eye services and scrutiny of ophthalmic services, and the orthopaedic elective hub.


Dates of Future Meetings

Wednesday, 16 November 2022

Wednesday, 25 January 2023

Wednesday, 22 March 2023



The date of the next meeting was noted as 16 November 2022.