Agenda and minutes

Health and Adult Social Care Policy and Accountability Committee - Wednesday, 25th January, 2023 7.00 pm

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

Contact: Bathsheba Mall  Email:

Link: Watch the meeting live on YouTube

No. Item


Apologies for Absence


Apologies for absence were received from Councillor Amanda Lloyd-Harris, Councillor Patricia Quigley, and Victoria Brignell.


The Chair, Councillor Natalia Perez, reported that Roy Margolis was stepping down from the committee. Roy joined the committee in October 2019 and had enjoyed his time as a co-optee, commending the commitment of the committee, officers and members in supporting the democratic interests of H&F residents. Councillor Perez thanked Roy for his work and wished him well for the future, welcoming his offer to continue to support the committee in relation to areas of digital services and health.


Declarations 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 Standards Committee.



There were no declarations of interest.


Minutes of the Previous Meeting pdf icon PDF 292 KB

(a)   To approve as an accurate record and the Chair to sign the minutes of the meeting held on Wednesday, 16 November 2022; and


(b)   To note the outstanding actions.


The Committee noted a point of clarification regarding the private finance initiative contract at Central Middlesex Hospital and whether it’s repayment would not have any financial implications for the new orthopaedic hub, which it would not.



That the minutes of the previous meeting held on 16 November 2202 were agreed as an accurate record.


Change to agenda order

The Committee agreed that items 6 and 7 take precedence.


Palliative Care - Model of Care Working Group Update pdf icon PDF 2 MB

This report provides an update from the North West London Model of Care Working Group on the robust data it has gathered on population need and workforce data, intended support resource planning for high quality care and service provision.


Councillor Perez welcomed health colleagues who provided an update from the Model of Care Working Group. Jane Wheeler described the work and remit of the Palliative Care Model of Care Working Group which constituted clinicians, managers and residents drawn from all eight North West London (NWL) boroughs. Clinical practice was being informed by the needs of residents through engagement to ensure the best outcomes. The work had been precipitated by the suspension of the inpatient service at Pembridge Hospice several years ago.


The workforce provision within the model of care was described in the report within the context of mapping future demand across the borough. There were significant workforce challenges in London that hospitals and community providers were working innovatively to address but further analysis was required to understand gaps in provision. A further element was to understand travel planning and how people accessed provision using both private and public transport.


Phillipa Johnson explained that Central London Community Healthcare (CLCH) was a provider of specialist palliative care and provision including the Pembridge unit. The service had been suspended due to the lack of consultant cover, despite attempts to recruit such as collaboration with acute trusts and other hospice providers. The day service at Pembridge had recommenced following the pandemic. In addition to the inpatient unit day service, there was also a community nursing provision, with specialist palliative care provided in people’s homes.


It was reported that there had been increased activity, which was welcomed, as it indicated that people’s needs were being met at home. Commenting on the positive engagement at borough level, the support and input provided by HAFSON (Hammersmith and Fulham Save Our National Health Service) and other contributors had influenced the way in which CLCH communicated with residents, details of which were also included in the report. The Working Group had two main priorities, the first was to establish a directory of local provision and care available from voluntary sector providers. A second priority was to improve the interface between adult social care provision and community nursing to ensure more holistic provision in a person’s home. It was also recognised that carers would also benefit from specialist end of life support, so that they would be more equipped to support family members at home.


Dr Lyndsey Williams, a MacMillan General Practitioner, explained that she worked closely with a forum of clinical leads across the eight NWL boroughs, and also working with the NWL Last Phase of Life program. She welcomed the high level of engagement she had experienced during the course of the review and reflected that this had changed its trajectory focusing both on current provision and what the patient’s journey should be in terms of responding to need.


 There was now a greater focus on understanding a person’s lived experiences of receiving care. This had changed the narrative significantly and recalibrated what future provision could look like. Engagement had been extensive but had already offered solutions such as increasing 24/7 access to Pharmacy for  ...  view the full minutes text for item 4.


2023 Medium Term Financial Strategy pdf icon PDF 394 KB

This report sets out the budget proposals for the services covered by the Health and Social Care Policy and Accountability Committee (PAC). An update is also provided on any proposed changes in fees and charges in the budget. 

Additional documents:


Cabinet Member overview


Councillor Rowan Ree introduced the Medium Term Financial Strategy 2023 (MTFS) presentation by commending officers and thanking member colleagues for their significant efforts and commitment to preparing the council’s budget proposals. This was a remarkable piece of work as final figures from the Local Government Financial Settlement were only released two days before the parliamentary Christmas recess. This was also the fifth consecutive year of having a single year financial settlement and many assumptions had informed the MTFS.


This was a balanced budget, in response to the difficult financial future predicted by the Bank of England, a 10.5% inflationary rate, and interest rates of 3.5%, all of which were expected to have a significant impact on council finances. For residents, financial pressures had seen no variation in the delivery of high quality services and the council had gone further by removing home care charges, providing free breakfasts for primary school children, maintaining weekly refuse collection and the introduction of the Law Enforcement Team. These were significant achievements and continued to be part of a package of proposals designed to protect frontline services for residents. Approximately £1 million in ring fenced funding had been provided as part of the council’s cost of living response to support residents and help to mitigate the financial difficulties.


Director of Finance – Corporate Overview


Sukvinder Kalsi explained that the proposed revenue budget strategy 2023/24 sought to preserve key front line service priorities which included weekly waste collections and free home care, recognising that this aligned with the expectations of residents and acknowledging that not all local authorities had been able to maintain them. The 2023/24 proposals reflected an increased growth investment of £10.7 million, of which £4.1 million would support social care (adult hospital discharges) and allowed for a cautious 5% inflationary uplift on prices.


With careful monitoring this could be managed through strategic procurement, and within council tax proposals. Savings of 2.9% (set out in the report) had been modelled based on how services were procured. This would ensure greater resilience, building in contingencies and continuity of provision in response to the current, difficult financial climate. H&F had frozen council tax for five out of the previous eight years. A 1% increase represented about £8 per year, per household, impacting about 53% of residents who did not qualify for exemptions.


Future risks included an anticipated budget gap in 2024/25 of about £17 million. Reserves represented 26% of the council’s overall budget and these were within the recommended range of between £19-25 million, some of which had been earmarked for an IT upgrade, necessary to protect business continuity and increase resilience. He anticipated that the fiscal environment for 2024/25 would continue to be challenging.


Co-optee Keith Mallinson sought further clarification about the treasury’s position on financial provisions to support homeless people in the borough and commented that the governments levelling up agenda had excluded urban areas like H&F. Councillor Ree felt that this was a political decision and that funding  ...  view the full minutes text for item 5.


Public Health Update


Dr Lang indicated that this had been covered under comments provided under the previous item.


Emergency Planning - Response to 2022 Heatwave pdf icon PDF 357 KB

This report outlines a robust suite of emergency plans and procedures in place formulated in response to different types of emergencies.  These are delivered in accordance with the Civil Contingencies Act to deliver a comprehensive workplan shaped by both national and regional frameworks.  


Additional documents:


Denise Prieto and Matthew Hooper jointly presented the report which was in response to an action point raised by Councillor Patricia Quigley at a previous meeting. The intention was to obtain a better understanding of the council’s emergency response to unexpected events such as summer heatwave in 2022, details of which were outlined in the report, which was welcomed by Councillor Quigley.


In the context of addressing pollution generated from highways and increased road traffic, co-optee Jim Grealy suggested that the implementation of emergency plans could be precluded by ensuring that a communications strategy about environmental pollution was prioritised in the government and the Mayor of London’s agendas. He also suggested that knowledge and information to raise awareness of climate change could be delivered through schools. Denise Prieto explained that such an approach was already in place and was within the scope of Children’s Services to deliver.


Merril Hammer commented that the nature of emergency events meant that local authorities were asked to respond to the unexpected. Given the effect of climate change, heatwaves were likely to be more seasonal and predictable, and it was possible to mitigate against the worst effects through education and improved communication. An antipodean solution in cities such as Sydney was to design dedicated “cool spaces” with the installation of civic water features and fountains. It was noted that local infrastructure solutions were being planned within the borough, the Lyric Square being a good example of this locally.


A suggestion from co-optee Lucia Boddington that a link providing details of locations where water bottles could be filled should be more prominent publicised was welcomed. It was noted that information about signposting was included as an appendix to the report and circulated across multiple council media channels. Similarly, it was important to address the accuracy of information about how residents could keep their homes cool, for example, it was known that radiant heat on glass increased the temperature of building which could be avoided by installing wooden shutter. It was recognised that drawing curtains was not as helpful in deflecting heat but installing things like sails in the garden was helpful in creating shade and cooling temperatures.


Councillor Natalia Perez enquire how an emergency planning response was co-ordinated across multiple agencies. Denise Prieto explained that an emergency response was co-ordinated through the borough resilience forum which included emergency planning officers from the local authority, police, fire and health services. The forum researched and planned responses to a range of emergency scenarios, sharing experiences and examples of good practice.




1.    That an online information link about where residents could refill water battles should be made more prominent on the council’s website.



That the report was noted.


Work Programme

The Committee is asked to consider future items for inclusion in its work programme.


The work programme was noted.


Dates of Future Meetings

Wednesday, 22 March 2023.


The Committee noted the date of the next meeting, scheduled for 22 March 2023.