Agenda and minutes

Apologies for absence were received from Cllr Josephine Barrett.

Councillor Peter Kemp declared a non-pecuniary interest, as he was a Governor of Central and North West London NHS Foundation Trust, and remained in the room during the consideration thereof.  

Councillor Phoday Jarjussey declared a non-pecuniary interest, as he was a member of Central and North West London NHS Foundation Trust and Hillingdon Hospital Trust, and remained in the room during the consideration thereof.

RESOLVED: That the minutes of the meeting held on 11 October 2012 be agreed as a correct record.

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.

Verbal update

Central and North West London NHS Foundation Trust (CNWL)

Ms Natalie Fox, Service Director for Older Peoples Services, CNWL, updated Members on the recent consultation on proposed modernisation of Hillingdon Older People Mental Health Services in Hillingdon.  Ms Fox wished to have Members approval to move forward with the next steps of the consultation; staff consultation.

In May 2011 CNWL set out proposals to change the mental health services for older people in Hillingdon and in July 2012 the External Services Scrutiny Committee were informed that modernisation of the services was under consideration.

Ms Fox explained to Members that the 12 week consultation period started on 13 August 2012.  During this time period 2 public meetings were held on 25 September and 24 October. The consultation ended on 4 November and an external organisation (Verve Communications) were commissioned to undertake an independent evaluation of the consultation.

Ms Fox explained that during the consultation that 300 consultation documents were circulated to a range of stakeholder as well as 200 flyers were printed; which highlighted the consultation period and promoted the public meetings.  The consultation information was also detailed on the Trust’s website and was available to download online.  There were two advertisements placed in the Uxbridge Gazette which highlighted the dates of the public meetings.

The two public meetings were held in September and October where OPHA staff delivered a presentation on the proposed changes and answered queries and addressed concerns from the public.  Announcements regarding the consultation were made at both internal and external meetings within the CNWL, Hillingdon PCT, OPHA management meetings, Trust-level meetings, contract meetings with commissioners, Partnership Board meetings and Overview and Scrutiny meetings.

Ms Fox stated that a total of 37 attendees for the meetings held in September and October 2012.  These included councillors, carers, staff and representatives of different organisations.  6 responses were received during the consultation.  All comments and queries were recorded in the meetings and relayed to Verve Communications to include in their evaluation.

The types of issues raised were broken down into five broad categories which included; community care, reduction of beds/ward closures, treatment, financial resources and respite.  Although some questions did not relate directly to the consultation issues they were still answered by senior staff from the CNWL OPHA in attendance.

Concerns were made regarding the effect the proposals would have on community services and if they would have the ability to respond to increased demand.  It was also questioned whether the savings would be reinvested in community care, care homes and improved hospital care and if so these details should be communicated to those involved in care.

Concerns were made about whether there would be enough beds for patients who needed hospital care and whether this would increase waiting times for hospital care.  Suggestions were made to use beds earmarked for closure for respite care.

A range of questions about the effects on various treatments that patients would receive if the proposals were approved included concerns regarding drug administering,  ...  view the full minutes text for item 34.

Hearing Services report to follow

Jessica Brittin, Interim Chief Operating Officer at Hillingdon Clinical Commissioning Group (CCG) advised Members that Ceri Jacobs will be in post from the week commencing 26 November 2012.

Ms Brittin asked for clarity on what information exactly Members were requesting.  The Chairman asked what were ‘Hearing Services’ and what were the roles of the CCG and the High Street providers.  Members had little knowledge of the services available and what troubles residents were encountering with the service.  Ms Brittin explained that Hearing Services were more a high street service and this was different to audiology.  Hearing aids were not commissioned as part of the NHS remit, but by specialist.   That places such as Specsavers did offer hearing aids.

Members requested that the CCG provided the Committee with a further detailed report on the hearing service and the service it provided residents.

Ms Brittin explained that Opticians were part of Primary Care contracting services.  This year it was a North West London based team that was contracted to work on this service.  The CCG was led by GPs which made a split between commissioners and primary care. 

Ms Brittin explained that the CCG was operating in shadow form and will be fully commissioned in April 2013.  The CCG had commissioned services by working closely with Natalie Fox, Service Director, Older People Services, on ‘Shaping a Healthier Future’. 

Ms Brittin explained that the CCG was already managing budgets and commissions services directly onto the Borough.  The CCG ensured acute services were commissioned appropriately by looking at health trends of population for example and increase in dementia and diabetes.

Members asked whether there would be any change to the NHS voucher system.  Ms Brittin explained that the NHS voucher system was a government policy and would not be affected.  The voucher did not always cover the cost as the price is reflected on the type of lenses and the frame of the glasses.

Members requested feedback on quality control of the service and details of the complaints procedure which would highlight any potential issues.  It was agreed that a briefing note be supplied to Members.

RESOLVED:  That

1. the presentation be noted.
2. Members requested a briefing note which detailed the Hearing Service be provided by the new Chief Operating Officer, once appointed; and
3. Members requested feedback on quality control and the complaints procedure from CCG regarding the Opticians Service.

Dr Ellis Friedman, Joint Director of Public Health, PCT/NHS updated Members on Pharmacy and Prescription Services in the Borough.

Dr Friedman explained that his colleague, Neelam Bose, was responsible for the commissioning side and that the GP’s were providers.  Dr Friedman provided an overview of the various pressures in the community.  There was a formal requirement for a pharmaceutical needs assessment which concentrated on issues such as accessibility and out of hour’s services.  The last assessment was completed in 2011 which provided answers to Members questions.

Members had concerns about the prescription service not being transparent.  One of the concerns was that there were sometimes shortages of a drug given in comparison to what was on the prescription.  Dr Friedman said that was a serious matter and the pharmacist was obliged to prescribe the right number of tablets, if that was not done then the patient should complain. 

Members discussed repeat prescriptions and that these were given for some long standing conditions.  The individual would be required to be periodically reviewed and should have the correct medication and number prescribed each time.  Members also discussed loans for repeat prescriptions.

Members were also concerned about brands of medicines which then change which were not as good as the original and wondered whether this was because there was a cheaper supplier.  Dr Friedman explained that what was prescribed was what was written on the form.  A generic version was often used rather than a branded version as they were cheaper.  The generic drugs were tested for the same active ingredient used in the branded drugs.  If a patient had a particular reason for wanting a different drug, for example because they found the size or the shape of a tablet easier to swallow then it would be up to the patient to discuss with their GP.  If the GP changed the patient to the branded version then the pharmacy was obliged to dispense the branded version.  Ms Brittin stated that using generic drugs has saved the NHS millions of pounds.  Dr Friedman explained that it was rare that people did not take the generic forms of medicine when they were equally well tolerated and used as well as the branded versions.

Members asked how residents’ concerns were being monitored and addressed and why percentages quality feedback were lower in some wards than others and whether these percentages could be attributed to how many pharmacies were in a Ward.  It was noted that there was a pharmacy in one ward which had 20% feedback and others with 100%.  Dr Friedman explained that advice was given to pharmacies on how to improve the service offered.

Blood pressure measurements by pharmacists was discussed and Dr Friedman stated he would invite Ms Bose to provide Members with a written response on this – a lot of pharmacies did not provide this service.

Members asked if Hillingdon had too many chemists.  The national provision was 1 in 5000, whereas Hillingdon it was 1 in 3500.  Dr Friedman  ...  view the full minutes text for item 36.

Consideration was given to the Committee’s Work Programme.  It was agreed that the next review undertaken by the Committee would be Diabetes Services in the Borough.  The review would include 3 witness sessions and a stakeholder event, which was currently being organised by the Community Engagement Team.  Members had already been identified for the Working Group.

Members agreed that the Crime and Disorder update meeting which was scheduled for 19 February 2013 be swapped with Community Cohesion meeting which was scheduled for 19 March 2013.  This was due to Committee receiving a crime and disorder update at the October 2012 meeting.

The Committee agreed that a meeting scheduled for 19 February 2012 at 6pm to start at an earlier time of 4pm.

RESOLVED:  That:

1. the Work Programme be noted;
2. a stakeholder event for the Diabetes Working Group would be arranged for 30 January 2013; and
3. the Committee meetings for Crime and Disorder update to swap with the Community Cohesion update in February and March 2013.