Agenda and minutes

Apologies for absence were received from Councillor John Morgan.  Councillor Andrew Retter was present as a substitute.

Councillor Peter Kemp declared a personal interest in Agenda Item 7 – Hillingdon LINk: 3rd Progress Report, as he was a Governor at Central & North West London NHS Foundation Trust (CNWL), and remained in the room during the consideration thereof.

Councillor Phoday Jarjussey declared a personal interest in Agenda Item 7 – Hillingdon LINk: 3 rd Progress Report, as he was a member of the Shadow Board of The Orchard Medical Practice Community Interest Company and a member of CNWL, and remained in the room during the consideration thereof.

Councillor George Cooper declared a personal interest in Agenda Item 7 – Hillingdon LINk: 3rd Progress Report, as he was a Trustee of Groundwork Thames Valley, and remained in the room during the consideration thereof.

Councillor Judith Cooper declared a personal interest in Agenda Item 7 – Hillingdon LINk: 3rd Progress Report, as her husband was a Trustee of Groundwork Thames Valley, and remained in the room during the consideration thereof.

To confirm that all items marked Part 1 will be considered in public and that any items marked Part 2 will be considered in private

RESOLVED:  That all items of business be considered in public.

The Chairman welcomed those present to the meeting. 

Ms Helen Delaitre, Lead for Unscheduled Care at NHS Hillingdon, advised that Harmoni had been contracted to provide the NHS 111 service in Hillingdon. 

Mr David Penfold, Director of Operations for Harmoni, advised Members that research had shown that the public found it difficult to access NHS services when they developed unexpected health care needs.  The introduction of new services such as Walk In Centres and Urgent Care Centres had added to the complexity of the unscheduled health care system which meant that many individuals were unclear about the services that were available to meet their needs and how these could be accessed (particularly outside normal working hours).

It was proposed that NHS 111 would not be a replacement for the NHS Direct service or the 999 service and that it would provide access to unscheduled non-urgent care.  The service would be available 24 hours a day, 7 days a week, 365 days a year and would provide information about the services that were available at the time that the telephone call was made. 

Members were advised that NHS 111 had already been piloted in County Durham and Darlington, Nottingham City, Lincolnshire and Luton and would now be rolled out in Hillingdon.  A soft launch of the two year pilot in Hillingdon would take place on 25 October 2011 to ensure that any issues with the system were ironed out before the public launch in mid-November 2011.  It was anticipated that the service would achieve pan-London coverage by 2013 but it was unclear whether it would ultimately be commissioned as a pan-London or local service. 

A recent survey undertaken by Healthcare for London had identified that 88% of respondents would use the new service.  In addition to this public support, NHS 111 was supported by professional bodies such as the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP).  Hillingdon LINk had also been involved with the Hillingdon 111 Project Team in the development of the Communications and Engagements Plan. 

It was anticipated that the service, which was locally driven by GPs, PCTs, local authorities and other stakeholders, would make it easier for individuals to access unscheduled health care and would drive improvements in the way that the NHS delivered care.  The service would also enable call handlers to direct patients to the right local service first time and would be used by patients when they:

• thought they needed Accident & Emergency (A&E) or urgent care;
• thought they couldn’t wait for a GP appointment; or
• didn’t know who to call for medical help.

The NHS 111 call handlers would receive two weeks intensive training and would be based in Southall so would have local knowledge – they would be based at the site of the existing out-of-hours call handling centre.  However, Mr Penfold stressed that the handlers were not clinicians and that the service would assess the needs of a patient but not give  ...  view the full minutes text for item 11.

Mr Simon Williams, Divisional Director, North Western London at the London Specialised Commissioning Group, advised that the Safe and Sustainable review of children’s congenital heart services in England had been undertaken following requests from clinicians and parents for an improved service.

An independent panel of experts, chaired by Professor Sir Ian Kennedy, reviewed all 11 centres in England that provided these services against various criteria and scored each of them accordingly.  The children’s cardiac surgeons had agreed that the clinical evidence showed that each of the centres needed to be undertaking at least 400 procedures every year (preferably 500 with a push towards undertaking 700+ each year to match international levels) and that the team at each centre comprise at least four highly skilled surgeons. 

Of the 2,000+ possible combinations available, the Joint Committee of Primary Care Trusts (JCPCT) then narrowed the options to its preferred four which were then assessed by the following weighted criteria: access and travel times (14); quality (39); deliverability (22); and sustainability (25).

It was proposed that the number of centres providing children’s congenital heart services be reduced from 11 to 6 or 7 (this would include a reduction from 3 to 2 centres in London).  Currently, approximately 1,250 such surgeries were undertaken each year in the three London centres, which would mean that, in order to reach the number required, patients would need to be diverted from other areas. 

Mr Williams advised that, during the consultation period, the Royal Brompton & Harefield NHS Foundation Trust (RB&H) had raised concerns about the impact that the withdrawal of the service would have on other services provided by the Trust.  As a result, a further independent review of the proposals would be undertaken in September 2011 to look at the impact on RB&H.  The findings would then be compiled for the JCPCT in November 2011 so that a decision could be made. 

Mr Piers McCleery, Director of Strategy and Planning at RB&H, advised that closure of the Trust’s Paediatric Intensive Care Unit (PICU) would result in the closure of all its paediatric services.  He expressed concern that this would reduce the Trust’s income by approximately £10m and would take around 3-5 years to build additional services to regenerate this income.  Mr Williams believed that the PICU would be unviable without the provision of surgery and that its withdrawal should not impact on the Trust’s other services. 

Mr McCleery stated that he was unhappy about the business case behind the proposals as only two of the centres in England currently met the criteria for undertaking 400 procedures each year with a team of 4+ surgeons.  RB&H was one of these two centres (the other was Great Ormond Street Hospital (GOSH)) and yet it hadn’t been included in the JCPCT’s preferred options.  It was noted that RB&H had been granted a judicial review in this regard which would take place on 29 September 2011. 

Members were advised that RB&H had worked with  ...  view the full minutes text for item 12.

Mr Kevin Byrne, the Council’s Head of Policy and Performance, advised that Groundwork Thames Valley (GTV) had taken over as the Host for the Hillingdon LINk contract 18 months ago.  During the last year, significant progress had been made by the LINk.

Mr Trevor Begg, Chair of Hillingdon LINk, thanked GTV and Mr Graham Hawkes, Hillingdon LINk Manager, for their support over the last 12 months.  Work that the LINk had been involved in during this period included:

• the provision of support and assistance to the patients on Daniels Ward and their families;
• setting up in one of the units at the Pavilions Mall – this unit had been provided rent free to the LINk;
• the hospital discharge project;
• HESA Centre and Orchard GP Surgery projects;
• Somali Community Survey and EMAP report; and
• Responding to national consultations.

It was noted that the Lord Howe, Parliamentary Under Secretary of State for Quality, and representatives from the Department of Health had attended a meeting at the HESA Centre in Hayes Town Centre.  Consideration was given at this meeting to cross boundary working between the North West London LINks and the potential transition into Health Watch. 

Mr Ian Diamant, Vice-Chair of Hillingdon LINk, advised that future work included:

• A review of the Well-Being Centre at Boots in September 2011;
• Provision of community equipment; and
• Work towards the transition of the LINk into Health Watch.

Mr Diamant thanked Mr Keith Bullen, Borough Director at NHS Hillingdon, for his prompt responses to queries and Councillors East, Kemp and Major for their regular attendance at LINk Board meetings.  He stated that he would be recommending that these Councillors be made regular members of the Board which would enable them to remain in the room during the consideration of confidential information. 

Mr Gary Jacobs, Executive Director at GTV, advised that GTV had been pleased to take over as the Host for the LINk.  This role had complemented the other work that GTV had undertaken in the community.  Mr Jacobs thanked Mr Hawkes for the excellent work that he had completed at the front end of the operation.

Members congratulated the LINk and GTV for the improvements that had been made and the outcomes achieved over the last 12 months.  Work was ongoing with regard to carers’ respite funding that had been put in place by the Government in 2010.  The LINk would continue to pursue this funding and establish how many hours of respite were available to Hillingdon carers. 

With regard to publicity and advertising, it was noted that the LINk did not have a large budget and its success had been largely down to the dedication of staff and volunteers.  The LINk communicated regularly with the Gazette and had received publicity in the Hillingdon People. 

RESOLVED:  That the report and presentation be noted.

Consideration was given to the update on recommendations of previous External Services Scrutiny Committee major reviews.  It was noted that, with regard to action taken in relation to recommendation 10 of the Transition from Child to Adult Mental Health Services report, Ms Linda Sanders, the Council’s Director of Social Care, Health and Housing, advised that:

In Hillingdon, all complaints managers are independent of front-line services and offer support (including making arrangements for advocacy) should individuals need representation to make a complaint or raise a concern.  Arrangements for making a complaint are made at times and places which meet the needs of service users and their carers.  Actions to resolve complaints are agreed with the complainant and, where necessary, complaints managers work together across health and social care to ensure a resolution is reached.

RESOLVED:  That the report be noted.

Consideration was given to the Committee’s Work Programme and the four scoping reports.  Ms Sandra Brookes, Service Director at Central & North West London NHS Foundation Trust (CNWL), advised that dementia and children’s mental health were key issues for CNWL.  She went on to state that, with regard to dementia, the Committee could look at early intervention and how resources could be shifted from longer care to improve this intervention.  Furthermore, drugs and alcohol had strong links to reoffending and end of life care was linked to the NHS 111 work.

It was suggested that sentencing policy could be included in a review of re-offending.  Whilst this was something that could be investigated as part of the review, it was noted that the scope of reviews needed to remain focussed.

Members agreed that the Committee’s first major review during this municipal year would be on re-offending and that the second review would be on dementia.  Councillor Kemp requested that he be part of the Working Groups that would be set up to undertake each of these reviews.

Councillor Judith Cooper, Chairman of the Council’s Social Services, Health and Housing Policy Overview Committee, advised that she would discuss the children’s mental health scoping report with her Committee Members as a potential review topic. 

RESOLVED:  That:

1. the report be noted; and
2. the a Working Group be set up to look at re-offending as the Committee’s first major review of this municipal year.

RESOLVED:  That the minutes of the meeting held on 8 June 2011 be agreed as a correct record.