Agenda and draft minutes

External Services Select Committee
Wednesday, 9th October, 2019 6.00 pm

Venue: Committee Room 5 - Civic Centre, High Street, Uxbridge UB8 1UW. View directions

Contact: Nikki O'Halloran  01895 250472

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

Items
No. Item

24.

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.

25.

Minutes of the previous meeting - 5 September 2019 pdf icon PDF 144 KB

Minutes:

RESOLVED:  That the minutes of the meeting held on 5 September 2019 be agreed as a correct record.

26.

Dental Health Services pdf icon PDF 126 KB

Minutes:

The Chairman welcomed those present to the meeting.  He noted that this item had arisen from discussions raised at a previous meeting in relation to a review of children’s oral health that had been undertaken by the Council’s Social Services, Housing and Public Health Policy Overview Committee (SSH&PH POC) in 2015. 

 

Dr Andrew Read, Clinical Director Dental Services at Whittington Health NHS Trust (WH), advised that the Trust was an integrated care organisation providing community services across North London and acute services from the Whittington Hospital in Archway.  WH provided community dental services from 22 sites across 10 London boroughs in North Central and North West London, employing over 130 staff.  Hillingdon community dental services had transferred from Central and North West London NHS Foundation Trust (CNWL) to WH in April 2019. 

 

Community dental services provided treatment to patients with complex needs who were unable to be seen in general / high street dental practices.  70% of the services provided were in relation to paediatric dentistry with the remainder being made up of:

·         adult special dentistry – patients with complex disabilities, frail, learning disabilities, etc;

·         sedation and general anaesthesia;

·         domiciliary care – on demand;

·         community oral health promotion (OHP) preventative programmes – seen as one of the most important aspects of community dental services; and

·         epidemiology – surveys undertaken of local dental health, primarily of children.

 

WH had opened new premises at Redford Way on 17 June 2019.  However, community dental services were located on the first floor of the building and the lift construction, which should have been completed at the same time, had been delayed.  WH had written to patients to notify them of the delay and to advise them of alternative arrangements. 

 

Dr Read was advised that queries had been received from residents in relation to the service provided at Redford Way.  He affirmed that all patients had been contacted to advise them of the change in provider and about the new facility opening.  Only the patients who had needed the lift had been disadvantaged; it was anticipated that the lift construction would be completed by 14 October 2019.

 

Dr Read advised that WH provided high quality, community-based specialist dental services for children and adults with complex needs.  He stated that WH was a model provider of evidence-based oral health promotion and preventative programmes in the community which had been recognised by NICE and Public Health England (PHE).  WH had built effective partnerships with NHS England (NHSE), PHE and local authorities to address inequalities in dental health and access to care.

 

Members were advised that the dental services contracts had been changed by NHSE in 2017 so that paediatric patients were referred to community services rather than to hospital.  This had led to challenges with regard to paediatric dental demand versus available capacity.  Other challenges included the oral health of older people in care homes and the funding available for prevention / oral health promotion (which was an issue across London).

 

Research had illustrated the impact  ...  view the full minutes text for item 26.

27.

Mount Vernon Cancer Centre pdf icon PDF 81 KB

Minutes:

Ms Jessamy Kinghorn, Head of Communications and Engagement for NHS England (NHSE) Specialised Services, noted that three papers in relation to the Mount Vernon Cancer Centre (MVCC) strategic review had been circulated to Members: a covering report; Clinical Advisory Panel (CAP) Review and Recommendations; and the patient and clinical engagement report from Verve Communications Ltd.  Although the CAP Review and Recommendations report had been published in July 2019, it had more recently featured in an issue of the Guardian newspaper during the previous week. 

 

Whilst it was acknowledged that a significant majority of the patients treated at MVCC were from outside of the Borough (13% were from Hillingdon), it was queried where else Hillingdon residents were receiving cancer treatment.  Ms Kinghorn would find out and forward this information to the Democratic Services Manager for circulation to the Committee.  Patients and their families were very fond of the MVCC and the care that they received there so the review was never about access as patients were happy to travel for good cancer care.  Whilst it was highly unlikely that a brand new hospital would be able to be built on the same site with all of the services needed in it, it would be important to find as local a solution as possible. 

 

It was noted that, despite the work that had already been undertaken, no final list of options had yet been agreed.  The work had been narrowed into two work streams: a short term action plan and a long term action plan.  In the short term, there had already been changes implemented to the admission policy and ward rounds.  An increase in the number of staff for acute oncology had also been approved in principle. 

 

In the short term, a number of independently facilitated events and interviews had been held and a survey undertaken.  During the events, the need for collocation of services had needed some explanation but had been understood.  Feedback had highlighted concerns about the impact on staff of the service was required to move out of Mount Vernon Hospital (MVH).  In addition, although companion services at MVH (Lynda Jackson Macmillan Centre, Paul Strickland Scanner Centre and Michael Sobell Hospice) had not been included in the scope of the review, consideration would need to be given to the impact of any options on these companion services.  It would be important to ensure that any action was not taken in isolation. 

 

The long term work stream included the need to identify a specialist provider and develop options.  Although reviews of cancer services at MVH had previously been undertaken, they had not resulted in any action.  The CAP report had included a recommendation to transfer the accountability and ownership of the MVCC services from East and North Hertfordshire NHS Trust to a current tertiary cancer centre.  Three tertiary providers had already expressed an interest in overseeing the transition and providing clinical leadership at MVCC. 

 

The CAP report had also highlighted the need for:

·         services to be provided by a  ...  view the full minutes text for item 27.

28.

GP Pressures: Draft Final Report of the Select Panel pdf icon PDF 60 KB

Additional documents:

Minutes:

The Chairman praised Mrs Liz Penny for her work with the Select Panel Members on the review of GP pressures.  Consideration was given to the comprehensive report and the recommendations which, it was anticipated, would be presented to Cabinet at its meeting on 19 November 2019. 

 

It was noted that the review sought to address the pressures on GPs and look to signpost patients better.  During the course of the review, the Panel Members did identify solutions to some issues which had been put in place before the Panel had finished its investigations. 

 

Members queried the role of Hillingdon Clinical Commissioning Group (HCCG) in recommendation 8.  It was agreed that further details would be included in the text preceding this recommendation in the report to provide greater clarity about what this meant in practice. 

 

The Committee thanked the Select Panel Members for their work on this review. 

 

RESOLVED:  That, subject to the above amendment, the Select Panel review of GP Pressure be agreed.

29.

Work Programme pdf icon PDF 63 KB

Additional documents:

Minutes:

Consideration was given to the Committee’s work programme.  It was agreed that a Select Panel be established to look at children’s oral health as the Committee’s next in-depth scrutiny review. 

 

RESOLVED:  That:

1.    a Select Panel be set up to review children’s oral health; and

2.    the Work Programme be noted.