Agenda and minutes

Apologies for absence had been received from Councillor Mohinder Birah (Councillor Jagjit Singh was present as his substitute).

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

It was noted that Councillor White had been recorded in the minutes as sending his apologies when he had actually been in attendance at the meeting. 

The Chairman advised that he had spoken to Mr Nick Hunt, Royal Brompton and Harefield NHS Foundation Trust, following the meeting and had requested additional information in relation to the proposals to withdraw paediatric heart services.  They had subsequently had a further conversation but little additional information had yet been produced.  Members were aware that the proposed withdrawal of the service would have (and already had had) and impact on things like recruitment and it would be important to ensure that the Committee was ready to respond once the consultation started. 

RESOLVED: That, subject to the above amendment, the minutes of the meeting held on 15 September 2016 be agreed as a correct record.

It was noted that, as the information had not yet been provided, the Interim Senior Democratic Services Manager would ask Mr Nigel Dicker for a breakdown of unresolved cases and the reasons why they had been unsuccessful. 

RESOLVED: That:

1.    the Interim Senior Democratic Services Manager ask Mr Nigel Dicker for a breakdown of unresolved cases and the reasons why they had been unsuccessful; and

2.    the minutes of the meeting held on 6 October 2016 be agreed as a correct record.

Ms Vicki Hirst, Stakeholder Engagement Manager at The London Ambulance Service NHS Trust (LAS), advised that Ms Pauline Cranmer, the LAS Assistant Director of Operations – NW London, had been unable to attend the meeting as she was meeting with staff to discuss progress made against the findings of the CQC inspection. 

In 2015/2016, there had been a significant increase in demand which had been about 5% greater than the increase anticipated.  Ms Hirst advised that there had been a 20% increase in seriously ill patients between September/October 2015 and September/October 2016, possibly as a result of a higher acuity of patients, more comorbidities, an older population (with more complex needs and little in the way of a support network) and improvements in identifying illnesses such as sepsis.  There had also been a societal change where residents had certain expectations about the services that they were entitled to - this also had an impact on community services and Hillingdon Hospital. 

With regard to Cat A8 calls (responding to seriously ill and life threatening calls within 8 minutes), performance had increased from 59.2% in 2014/2015 to 63.3% in 2015/2016 and performance in October 2016 had been 66.36% (although performance across the LAS had, in the past, been as low as 58%, Hillingdon was one of the better performing areas).  In Hillingdon, Cat A8 performance had increased from 62.58% in September 2016 to 66.85% in October 2016.  It was noted that 75% of Cat A8 patients in Hillingdon were reached within 9 minutes 45 seconds.  Work was underway to adjust resourcing to ensure that a 70+% was achieved across London in 2017/2018 against the Cat A8 target. 

It was noted that the number of patients managed by the LAS on the telephone was the highest in the country.  To try to further improve the service, the LAS had been working with the wider NHS to try to manage the pressure by focussing on frequent callers, HCPs, nursing and care homes and NHS 111. 

It was noted that individuals were not charged for making unnecessary calls to the LAS.  However, a lot of work had been undertaken to deal with frequent callers, many of whom suffered from mental ill health, substance misuse or were elderly.  It was noted that many mental health related calls to the LAS across London were made on Thursday evenings.  With many of these cases, a multi-disciplinary approach was needed.  The information collected by the LAS meant that the Trust could drill down to map out where the calls were coming from so that this could be analysed by the Business Development Department to identify whether the services needed were in place to meet the demand.  With regard to reducing demand, Members were advised that the LAS triaged calls to signpost or close down calls and 40% of patients that were visited by ambulance staff were left at home with further information about an alternative, more appropriate care pathway that they needed to follow. 

Ms Hirst advised  ...  view the full minutes text for item 23.

Consideration was given to the Committee's Work Programme 2016/2017.  It was noted that a scoping report for a review on Community Sentencing would be produced for consideration by the Committee at its meeting on 12 January 2017. 

The CQC would be undertaking a re-inspection of the London Ambulance Service NHS Trust (LAS) in February 2017.  Members requested that LAS representatives (including the Chief Executive) be invited to attend the External Services Scrutiny Committee meeting scheduled for June 2017 to discuss the resultant CQC re-inspection report. 

Councillor Jarjussey advised that he had been contacted by Orchard Medical Practice in relation to proposals to merge the two GP practices currently operating from the HESA Centre.  It was agreed that the Interim Democratic Services Manager would forward the documentation to Members of the Committee. 

RESOLVED:  That:

1.    a Community Sentencing scoping report be considered at the meeting on 12 January 2017;

2.    LAS representatives be invited to attend the Committee's meeting in June 2017 to discuss the CQC re-inspection report;

3.    the Interim Democratic Services Manager forward documentation regarding the proposals to merge the two GP practices at the HESA Centre to all Members of the Committee; and

4.    the Work Programme be noted.