Agenda and minutes

External Services Select Committee - Tuesday, 9th July, 2019 6.00 pm

Venue: Committee Room 5 - Civic Centre. View directions

Contact: Nikki O'Halloran  01895 250472

Link: Watch a LIVE or archived broadcast of this meeting here

Items
No. Item

13.

Apologies for absence and to report the presence of any substitute Members

Minutes:

Apologies for absence had been received from Councillor Nick Denys (Councillor Nicola Brightman was present as his substitute).

14.

Exclusion of Press and Public

To confirm that all items marked Part I will be considered in public and that any items marked Part II will be considered in private

Minutes:

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

15.

Minutes of the previous meeting - 12 June 2019 pdf icon PDF 152 KB

Minutes:

It was agreed that the following amendments be made to Minute 10 under the Cancer Screening and Diagnosis heading:

·         First paragraph, penultimate sentence to read: In a move to provide improvements to the service and more reliable results, a single laboratory on Euston Road was being established which would provide the new primary HPV screening test for process all cervical screening samples results in London by March 2020.

·         Third paragraph, second sentence to read: A new test (the FIT test) had been introduced from on 10 June 2019 which meant…

·         Fifth paragraph, third sentence: replace the word ‘test’ with ‘text’.

 

RESOLVED:  That, subject to the amendments noted above, the minutes of the meeting held on 12 June 2019 be agreed as a correct record. 

16.

Hospice Provision in the North of the Borough pdf icon PDF 86 KB

Minutes:

The Chairman welcomed those present to the meeting.  He noted that the Committee had last met to discuss the closure of Michael Sobell House on 28 February 2019.  At this meeting, agreement had been gained from all partners to reopen the inpatient unit: Hillingdon Clinical Commissioning Group (HCCG) would undertake a commissioning exercise which East and North Hertfordshire NHS Trust (ENH) would be involved in. 

 

However, it had recently become apparent to Members that progress had not been as forthcoming as had been hoped.  It was noted that it was still the aim of the Committee to see Michael Sobell House (MSH) reopened – this aspiration had the full backing of the Council.  As such, the Chairman had been involved in a number of informal meetings outside of the Committee meetings where he stressed the frustration that had been caused and the importance that partners move much more quickly.  He had established that a significant number of organisations had been involved in the process which had slowed progress down significantly.  The labyrinthine sequence of events had also made the process more complicated than it needed to be. 

 

Ms Caroline Morison, Managing Director at HCCG, advised that HCCG had confirmed its commissioning intentions in February 2019 and had written to ENH accordingly.  HCCG had then embarked on a governance process and, following OJEU procedures, Harlington Hospice had been awarded the contract.  It was at this point, where mobilisation was due to commence, that a number of meetings to progress the process had been cancelled by ENH at short notice.  The issue was escalated to ENH’s Chief Operating Officer and to East and North Hertfordshire CCG (ENH CCG).  ENH had advised that it would need to seek clarity from all of the service commissioners to ensure that they were happy with the proposed changes. 

 

Members were advised that Hillingdon accounted for approximately 44% of the activity undertaken by ENH on this contract.  Herts Valley CCG was the second highest user of the service; other commissioners included Ealing and Harrow.  A meeting of the commissioners was due to take place on Thursday 11 July 2019 to discuss a way forward.  Ms Morison confirmed that written representations from the Committee and MSHC might be helpful for this meeting with commissioners as ENH had questioned the public involvement in the process undertaken by HCCG.  She advised that she had asked that the following be included on the agenda for that meeting:

·         Timings and next steps;

·         ENH’s intentions regarding the MSH building; and

·         Viability and sustainability of the specialist palliative care service in the context of proposals relating to Mount Vernon Cancer Centre (MVCC) and MSH.  It was noted that there had been a recent review of services at MVCC.  As those present had not yet been privy to the outcome of the review, it would be important to ensure that they received clear guidance from ENH about the interdependencies. 

 

Mr Steve Curry, Chief Executive at Harlington Hospice (HH), advised that he had been involved in  ...  view the full minutes text for item 16.

17.

Health Updates pdf icon PDF 121 KB

Additional documents:

Minutes:

The Chairman thanked those present for attending the meeting. 

 

Central and North West London NHS Foundation Trust (CNWL)

Ms Kim Cox, Borough Director – Mental Health at CNWL, advised that the waiting times for the CAMHS service were now more stable that they had been.  Although there had been huge improvements over the last two years, there was still some way to go. 

 

An eating disorders community service was available in Hillingdon.  The performance of this service was consistently good even though demand was high and the referral to treatment targets were being met.  Only the occasional patient was referred to the inpatient unit in central London. 

 

Concern was expressed that a reduction in the capacity of Cognitive Behavioural Therapy (CBT) practitioners could impact negatively on the patient journey.  Ms Cox advised that the additional funding had been made available for CAMHS to clear its backlog and return to an even keel.  Funding was now being diverted to core pathways and the service was being more creative in relation to its activities. 

 

Hillingdon Health Care Partners (HHCP) CNWL in conjunction with Hillingdon CCG had bid for additional funding for mental and physical health nurses who would carry out Advanced Care Planning in care homes and extra care facilities.  Ms Cox would provide Members with an update on this at a future meeting.  It was noted that the Primary Care Mental Health Teams would be realigned to the eight neighbourhoods being developed as part of the Case for Change.  The GP confederation was identifying Clinical Directors for each of the neighbourhoods with a view to having a matrix style integrated management structure.  CCTs would expand their remit to include all adults and there would be an increase from 15 to 18 CCTs. 

 

Ms Cox advised that Life Line 24/7 had been successfully keeping people at home.  In the last six months, palliative care services had been used to help 60 people to stay at home. 

 

Members were advised that the number of Section 136 (s136) assessments undertaken had hit an all-time high (59) in April 2019.  CNWL had recently started the SIM project (Serenity Integrated Mentoring).  This project was being delivered jointly with the police to provide intensive interventions from both a health and criminal justice perspective for a caseload of service users.  The project enabled a full time police officer working in mental health to look at alternative (and more appropriate) interventions to a s136 when needed - about one third of people brought in by the police did not need a s136 as they were in distress rather than suffering with mental health issues.

 

In partnership with health commissioners, CNWL had bid for additional parity of esteem funding to increase the support in primary care for people with a mental health problem (the outcome of this bid was expected on 12 July 2019).  CNWL had also bid for funding for a service specifically for service users with a personality disorder. 

 

Ms Cox noted that Arch had been awarded a  ...  view the full minutes text for item 17.

18.

Work Programme pdf icon PDF 63 KB

Additional documents:

Minutes:

It was noted that the majority of the Committee’s meetings for the remainder of the municipal year had been moved into Committee Room 5.  The camera in this room would provide YouTube viewers with a better view of the proceedings during the meeting. 

 

As the agenda for this meeting had become quite full, the Chairman had agreed that, rather than the Committee considering it as an agenda item, a briefing note on the progress of the implementation of recommendations of the Council’s hospital discharges review be circulated to Members.  The briefing note had been shared with the Committee and Members were asked to provide the Democratic Services Manager with any comments, queries or questions that they might have about the issue so that she could pass them on to the relevant officer for response. 

 

The Committee’s next meeting on 5 September 2019 would be reviewing crime and disorder in the Borough.  Members requested that, as well as the usual general update, the following specific issues be addressed at that meeting:

·         Knife crime and safer neighbourhoods;

·         Drugs; and

·         Serenity Integrated Mentoring – a police perspective.

 

It was agreed that the Committee would hold a meeting to specifically look at the challenges being faced by The Hillingdon Hospitals NHS Foundation Trust.  This was likely to be organised for December 2019.  Members requested that a site visit be organised for them to Hillingdon Hospital just before this meeting took place. 

 

It was noted that a meeting of commissioners had been scheduled for Thursday 11 July 2019 in relation to the provision of inpatient palliative care services at Michael Sobell House.  Members agreed that they would like to provide Ms Caroline Morison, Managing Director of Hillingdon CCG, with a document setting out the evidence that they had gathered which would demonstrate the strength of feeling in relation to this issue within the local community.  If no agreement was reached at this meeting, there was little that the Committee could do. 

 

Members questioned why representatives from East and North Hertfordshire NHS Trust (ENH) had not been present at the meeting.  The Democratic Services Manager advised that Mr David Brewer had emailed her on 25 June 2019 stating that he would confirm attendance from the Trust the following week.  Although Mr Nick Carver, ENH Chief Executive, had subsequently advised that he would not be able to attend the meeting, confirmation of who would actually attend had not been forthcoming. 

 

It was noted that, when the Committee looked at the results of the Mount Vernon Cancer Centre (MVCC) review, consideration would also need to be given to the progress made in relation to the reopening of Michael Sobell House.  As concern was expressed about the possibility that the MVCC could close, Members would be carefully monitoring the progress of the review. 

 

RESOLVED:  That:

1.    Members forward any comments, queries or questions on the hospital discharges update to the Democratic Services Manager; and

2.    the Work Programme be agreed.