Agenda and minutes

There were no apologies for absence.

There were no declarations of interest in items coming before this meeting.

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

RESOLVED:  That the minutes of the meeting held on 16 June 2021 be agreed as a correct record.

The Chairman welcomed those present to the meeting. 

Children & Young People Dental Steering Group (CYPDSG)

Ms Carol McLoughlin, Chairman of the CYPDSG, advised that the Group had been set up in 2019 with three aims:

1.    To roll out the supervised brushing programme in ten schools that had been identified in areas of deprivation where there had also been high levels of dental caries (tooth decay) in children.  This had been funded by NHS England but had stalled at the start of the pandemic.  However, the oral health promoter had continued to work with schools during this period to encourage schools’ participation once the initiative restarted.  As a result, eight schools would be implementing the scheme in September 2021;

2.    That the Brushing for Life programme be delivered by health visitors and in Early Years Centres and Children’s Centres.  This initiative had seen the distribution of toothbrush packs to those children who didn’t have toothbrushes (either because their parents could not afford them or because they did not see it as a priority).  If parents were not seeing tooth brushing as a priority, it was suggested that this might be an indicator that they were also neglecting other areas such as the intake of milk and fruit/vegetables.  The Children’s Centres had worked with parents on weaning and giving out messages; and

3.    To improve access to dental services / practices as part of the supervised brushing initiative.  It was noted that supervised brushing after meals was already undertaken in some nurseries on their own initiative and Members queried whether this could be encouraged in all nurseries.  Although Ms McLoughlin advised that this would come down to funding, it was argued that this could be part of the service that was being paid for by parents. 

The CYPDSG had brought together a range of partners to achieve these aims which had included a GP and links to Primary Care Networks (PCNs). 

Hillingdon Health and Care Partners (HHCP)

Ms Caroline Morison, Managing Director of HHCP, advised that HHCP’s interest in this issue was in relation to the prevention of ill health / disease and the integration of services.  She recognised that the good work that had been undertaken before the pandemic needed to be maximised and that this would be helped by the improvements that had been seen in working relationships, particularly in relation to children and young people’s (CYP) services. 

Members were advised that integrated working in Hillingdon had initially focussed on older people’s services.  As programmes had developed, it had become increasingly important to extend this to children and young people’s services.  To this end, more tangible discussions were being undertaken to include dental services in developments to make every contact count.  The CYP Transformation Board had also been looking at the messages that needed to be distributed through schools when the new academic year started in September 2021. 

Staying Well had been a pan-London pilot that had been funded by NHS England.  In Hillingdon, three dental practices had signed  ...  view the full minutes text for item 15.

Mr Richard Ellis, Joint Borough Lead Director Hillingdon at North West London Clinical Commissioning Group (NWL CCG), advised that phlebotomy was the taking of blood samples for testing and was a basic part of healthcare.  Each week, approximately 3,000-4,000 blood samples were drawn in Hillingdon.  Traditionally, this service had been based at Hillingdon Hospital and Mount Vernon Hospital but the pandemic had highlighted issues with the service in relation to cramped conditions, long waits and PPE, and the safety of the service had come under scrutiny. 

Covid had highlighted opportunities to change the service delivery to better suit patients.  As such, NWL CCG had looked to move to a practice based service which would be in line with how most of the rest of NWL offered the service.  This had been rolled out across Hillingdon between August 2020 and January 2021 and every practice in the Borough was now offering a phlebotomy service.  Mount Vernon Hospital was still providing specialist appointments. 

Now that the changes to service delivery had been implemented, the impact and effectiveness needed to be monitored (for example, waiting times for an appointment, volume of patients being seen at each practice, sufficient capacity for the age and condition of patients, etc).  It was agreed that the Committee receive an update on these issues at its meeting on 7 October 2021 with a pre and post Covid comparison of figures. 

Patients had immediately welcomed the changes that had been made.  However, it was recognised that there were some challenges with regard to some patients preferring a walk in service and high levels of demand for appointments in some areas.  Concern was expressed that some surgeries were only offering phlebotomy appointments before midday to enable to samples to be collected for testing and results made available the same day.  Mr Ellis advised that some practices were doing morning only appointments but that others were offering appointments in the afternoon and early evening.  This was all part of the current learning and conversations would need to be had with the practices so that the right level of resources could be put in place.  It was suggested that patients should be able to get a phlebotomy appointment in another surgery in the Borough if there was no capacity in their local practice. 

NWL CCG was looking at the best way to resource the new service delivery.  This was likely to mean the transfer some of the phlebotomy funding from The Hillingdon Hospitals NHS Foundation Trust (THH) to primary care.  This would also mean that costings would need to be established for the collection of samples from 45 GP practices rather than a single point of contact.  Consideration would also need to be given to the need for urgency on some tests. 

Members were assured that the staff that drew blood at the GP surgeries were trained phlebotomists.  Some had previously worked at Hillingdon Hospital. 

It was suggested that consideration be given to including phlebotomy as a community service.  For example, the  ...  view the full minutes text for item 16.

Consideration was given to the Committee’s Work Programme.  It had been agreed that an update on the effectiveness of the phlebotomy service changes be considered at the meeting on 7 October 2021. 

It was noted that Members would be considering crime and disorder in their next meeting on 15 September 2021.  In addition to the regular Safer Hillingdon Partnership performance report, they would be looking at the coverage and effectiveness of OWL and Neighbourhood Watch in the Borough.  Members asked that a less senior officer from the Safer Neighbourhoods Team be invited to attend the meeting to provide a practical perspective.  It was agreed that the issue of police community engagement with schools also be included as part of the discussion at this meeting. 

Members requested that a brief update on the Hillingdon Hospital redevelopment be provided at the meeting on 15 September 2021.  It was noted that this would be in addition to the meeting that had been scheduled for 27 January 2022 which would look at the redevelopment project. 

The draft final report for the Children’s Dental Services review would be circulated to Members outside of the meetings and would then be included on the agenda for agreement on 15 September 2021.  

RESOLVED:  That the Work Programme, as amended, be agreed.