Agenda item

Mr Jeff Maslen, Chair of Healthwatch Hillingdon (HH), advised that the organisation's Annual Report 2014/2015 had included a lot of detail about the work that it had undertaken during the last year.  This work had included a number of successes but HH was keen to question the impact of its intervention and had included evidence in the report to support this success.  Examples of work undertaken in the last year included:

·         acting as a strong independent advocate for the implementation of National Institute of Clinical Excellence (NICE);

·         CAMHS commissioning; and

·         improvements to the maternity service.

It was noted that HH's work was evidence based and sought to influence through providing constructive feedback and acting as a critical friend.  Mr Maslen advised that HH had worked hard to build its credibility with commissioners and providers but that it did publicise its findings when necessary.  For example, CAMHS had been failing in Hillingdon and the situation was becoming more serious through a lack of early intervention which could then impact on adulthood.  As well as not being in the patient's best interest, this, in turn, posed additional cost implications for other services.  The CAMHS report produced by HH (Seen & heard - Why not now?) had resulted from contact with young people who had received a dysfunctional service and had proved to be a powerful piece of work. 

HH worked on a two year cycle and was keen undertake do more projects that would have an impact.  To this end, new and innovative ways were being developed to gather individuals' thoughts and experiences of local services.  HH hoped to look into the following issues over the next two years:

·         unsafe discharges;

·         maternity services;

·         CAMHS;

·         Primary care - possibly something around the new model at the heart of all NHS strategic approaches;

·         Care homes; and

·         Shaping a healthier future (SaHF) - which was driving change across health services in North West London (NWL).

It was noted that there were issues with regard to patients finding it difficult to cancel their GP appointments.  Members were advised that HH was aware of issues around primary care (the organisation received more calls about primary care than anything else) and that this would be included as a future work stream.  Mr Maslen advised that HH and the Council were members of a primary care access group that had been established to look at these issues.  In addition, HH tended to contact specific surgeries in relation to issues raised by residents and that they were generally responsive.  It was noted that the External Services Scrutiny Committee would be looking to undertake a major review of primary care / GP issues during this municipal year.

Mr Maslen advised that HH had limited powers but that it was aware of the conflict of interest with the CCG joint commissioning services from other GPs.  He noted that HH's role would be to continue monitor these arrangements to ensure that the conflict was being dealt with appropriately and advised that he had attended a joint commissioning meeting that afternoon. 

HH was aware that CAMHS was underfunded on a national and local level and that additional funding to support the service would be welcomed.  However, Mr Maslen noted that not all service improvements had costs attached and that an inefficient organisation was also a high cost organisation. 

Members were advised that NHS England was driving service changes in NWL through the SaHF programme.  Although the programme had initially only included clinical indicators of success, HH influence had led to the inclusion of softer indicators which were now in place. 

Members congratulated HH on the work that the organisation had undertaken and the progress that it had made.  Mr Maslen advised that HH funding was more secure than Healthwatch in other parts of NWL as a result of good relations with the Council.  This had meant that HH had secured a two year contract with the Council, enabling the organisation to plan with the confidence and resources that it needed. 

Although HH had 'enter and view' powers, these had not yet been formally used.  However, should HH become aware of anything untoward, it would give notice and then go in to inspect the service.  Mr Maslen advised that, when HH had previously had concerns, the agency involved had been cooperative so there had been no need to use the 'enter and view' power. 

The Committee was advised that the Council had a care services inspection team which had responsibility under the Care Act to undertake announced and unannounced inspections.  These inspections were often informed by intelligence from HH.  Mr Maslen was not aware of any other local organisations that had this power. 

It was noted that CNWL had recently been inspected by the Care Quality Commission (CQC) and that the resultant report had not been particularly good.  Mr Maslen stated that CNWL provided services in a number of NWL boroughs as well as Milton Keynes and Camden but that Hillingdon did not seem to be getting a 'fair crack of the whip'.  This issue had been raised with CNWL's Chairman but had not yet been progressed.  

The Chairman noted that HH had contributed significantly to health improvements in Borough during a very short period.  Although some of the issues dealt with by HH could be deemed to be small, these were not insignificant matters to those that were facing them. 

RESOLVED:  That the report and presentation be noted.