Agenda and minutes

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 remained in the room during the consideration thereof. 

Councillor John Hensley declared a non-pecuniary interest, as he worked for the Ministry of Justice, and remained in the room during the consideration thereof. 

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.

Mr Kevin Byrne, the Council’s Head of Policy and Performance, advised that the Hillingdon LINk had had a full and varied year.  As well as continuing to build strong partnerships, the LINk had developed a positive foundation for the development of Healthwatch from 1 April 2013. 

Mr Graham Hawkes, Chief Officer of Hillingdon LINk, advised that the complete 57 page version of the organisation’s annual report could be found on its website.  The link to the full report would be emailed to Members of the Committee.  Over the last year, the LINk had built stronger strategic partnerships with providers across the whole of the Borough which had helped its involvement in the development of services. 

It was noted that, as the LINk was still based in the Pavilions shop, a surprising number of residents had passed through the door.  The LINk provided an array of information in relation to services provided by voluntary sector organisations and acute and primary care services, e.g., information about dentists in the area.  Furthermore, if four of five individuals complained about a particular service or issue, the LINk would speak to the service provider to work out a resolution, e.g., delays in relation to podiatry appointments.

Mr Trevor Begg, Chair of the Hillingdon LINk, thanked Mr Hawkes and his staff for their exceptionally hard work over the last year.  However, he also expressed concern about the level of support being provided to doctors in the Borough with regard to the transfer of services from NHS Hillingdon to the Hillingdon Clinical Commissioning Group (CCG).  It was thought that the GPs did not currently have the resources to deal with their daily workload as well as the work created by the transfer of services.  Mr Begg went on to advise that he would be meeting with the Chief Executive of the National Commissioning Board London to raise this issue and, if required, he could return to a future meeting to update the Committee on any developments in this area. 

Ms Kathleen Healey, Operations Manager at Groundwork Thames Valley (GTV), stated that GTV had recently undertaken a review of the LINk’s structure and governance.  This review had confirmed that the current arrangements were sufficient. 

With regard to the issues around delayed discharges, Members were advised that The Hillingdon Hospitals NHS Foundation Trust (THH) had identified that delays were attributable to both THH and Social Services.  THH was now in the process of producing a report to identify possible resolutions and joint working initiatives to address these issues.   Ms Linda Sanders, the Council’s Director of Social Care, Health and Housing, advised that the current delayed transfers situation was basically “standard business as usual”.  She noted that, although it might sometimes not feel like it, the Council’s performance was good in relation to acute setting.  With regard to non-acute transfer of care and reablement processing, Ms Sanders confirmed that the Council was working with Central and North West London NHS Foundation Trust (CNWL) to make improvements.  She noted  ...  view the full minutes text for item 11.

Verbal Update

Dr Lawrence Woo was a Consultant Psychiatrist at CNWL and the organisation’s lead on the memory service.  Although the bulk of his work was in relation to Hillingdon, he also worked in Brent and Harrow. 

Consideration was currently being given to the modernisation of the service in Hillingdon to cope with the current and future demands of an ageing population.  It was noted that the service demand in Hillingdon was currently greater than the supply as there was no fully commissioned community memory service provided in the Borough.  The current service provision did not deal with the increasing number of service users. 

Members were advised that there were two wards at the Woodland Centre for older people with mental health issues.  A review of the organic inpatient ward (Cedar) had showed that the average length of stay was 119 days and that, although the majority of admissions were from patients’ own homes (62%), the majority of patients were discharged to nursing homes (64%).  This illustrated that the lengthy hospital stay was not adding value to the process as it did not help patients to get back home.  Furthermore, there was a consistent under-utilisation of beds (currently 50%). 

As such, a 12 week consultation was being launched on 23 July 2012 on a proposal to reduce the number of beds currently provided for this service and shift the resources to fund improvements in community services, e.g., in relation to early diagnosis.  Information flyers were being produced and two public events were being planned.  Residents would also be able to submit any comments on the proposal via email.

Ms Natalie Fox, Service Director for Older Adults at CNWL, advised that she would send a copy of the final version of the consultation document to Democratic Services next week for circulation to Committee Members.  Ms Fox offered to report back to a future Committee meeting on the results of the consultation. 

Ms Robyn Doran, Director of Operations at CNWL, noted that early dementia diagnosis would mean that work could be undertaken by the Council and other agencies to provide support for individuals to stay at home, e.g., Telecareline.  It was noted that carers also needed to be supported through the dementia pathway.  Although the service was currently deemed to be reactive, it was hoped that the proposals would make it more proactive. 

Ms Linda Sanders, the Council’s Director of Social Care, Health and Housing, stated that the Council currently placed 1,191 individuals in residential or nursing care in the Borough.  Although the majority of these individuals were thought to have dementia, most were undiagnosed.  Furthermore, approximately 4,500 individuals were supported in the community last year with an increasing percentage of these people having dementia.

Dr Ellis Friedman, Joint Director of Public Health, supported the idea of more timely and accurate dementia diagnosis as this would help people to live in the comfort of their own homes for longer – this was one of the key tasks of the Joint Strategic Needs Assessment  ...  view the full minutes text for item 12.

Verbal Update

Dr Ellis Friedman, Joint Director of Public Health, advised that immunisation was the single most effective public health intervention that had been undertaken.   Although the number of smokers had decreased, smoking continued to be the biggest preventable cause of ill health. 

Looking to the future, additional interventions would be needed to address challenging issues such as terrorism, obesity, lack of exercise and mental health.  Consideration would also need to be given to improving and protecting residents’ health and reducing health inequalities. 

Members were advised that there were 21 areas of responsibility which fell to the Council.  Although some of these were discretionary, there was an expectation that these would be undertaken by the Council.  It was noted that there was a tendency for the urgent issues to crowd out the good, e.g., on balance, it was more economical in the long term to use resources for smoking cessation than it for lung cancer treatment. 

With regard to local services, Members were advised that public health performance in Hillingdon was one of the best in London, and indeed in the country.  Dr Friedman stated that this good performance was attributable to the work of the public health team, GPs, health visitors, etc. 

It was noted that, of the £11m that would be transferred to the Council for public health, a small amount of the funding would go towards overheads, e.g., accommodation for the pubic health team at the Civic Centre.  Dr Friedman advised that the majority of the funding would be tied up in contracts with external organisations for the provision of services, e.g., immunisation. 

Concern was expressed that childhood obesity was getting worse.  However, Members were advised that Hillingdon was fairly average in terms of the national experience.  Dr Friedman confirmed that there were a range of tools available to help move the trends back in the right direction, e.g., the re-emergence of Healthy Schools London.  It was noted that the Committee had previously undertaken a major review of obesity and it was suggested that officers revisit the recommendations contained therein.

Members were advised that, with regard to tuberculosis, it looked as though Hillingdon had not performed very well.  However, it was mooted that this was as a result of thorough screening at Heathrow airport which resulted in a large number of visitors being attributed to the Council’s statistics as residents when they were clearly not resident in the Borough.  Insofar as the associated treatment was concerned, the Council was responsible for quite a large resultant bill. 

It was noted that take up of immunisation in Hillingdon was outstanding.  For example, 98% of looked after children had complete immunisation records – a large number of these children were asylum seekers. 

RESOLVED:  That the presentation be noted

Verbal Update

Mr Kevin Byrne, Head of Policy and Performance at the Council, advised that the consultation in relation to the proposed closure of the Hesa Walk-In Centre would end on 26 July 2012.  It was noted that this was part of the wider Shaping a Healthier Future consultation being undertaken by NHS North West London (NWL) which would end on 8 October 2012.  It was suggested that, once the wider consultation had ended, representatives from NHS NWL be invited to attend a Committee meeting to update Members on the results of the consultation and next steps.

Residents had expressed concern that the Hesa Centre was closing when in fact the proposal was just in relation to the closure of the Walk-In service.  Furthermore, there were many residents that were completely unaware of the proposals for the Centre.  Members were advised that the proposals would see the transfer of services from the Hesa Walk-In Centre to an Urgent Care Centre (UCC) which would be set up at Hillingdon Hospital.  The proposals would also see extended opening hours at GP surgeries to enable greater patient access (although the resourcing implications of this would need to be addressed).  It was anticipated that, if agreed, these measures would be in place before the Walk-In Centre closed.

Dr Friedman advised that the Walk-In service had not been well used and had not been reaching its high risk target group – the majority of individuals being seen by the service were male, aged 20 to 24 and from Hayes.  The service had originally been commissioned for 55 people per day but this capacity was not being realised which meant that the service was not meeting a significant health need.  Many residents were using the Walk-In for minor ailments when they were not prepared to wait 48 hours for an appointment with their own GP. 

Dr Friedman stated that the purpose of the consultation was to gauge residents’ feelings about the proposals and that he had not been aware that residents were under the impression that the proposal was to close the whole of the Centre.  However, there was a feeling that the resources to explain the proposals to members of the public had been lacking.  Mr Begg added that the LINk had approached NHS NWL to request funding for wider promotion of the consultation (as it was in relation to Shaping a Healthier Future) but the request had been refused. 

Members noted that the public attendance at the consultation events that had been held in the Borough had not been good (only 24 individuals had been involved so far).  It was thought that this might be partly due to the Hesa Centre not publicising the consultation or the consultation events.  However, there had been coverage in the Gazette on at least two occasions. 

Members were advised that the proposals were not a cost cutting exercise as there would be no financial savings from the changes.  It was anticipated that the proposals would mean that more  ...  view the full minutes text for item 14.

It was agreed that Councillor Fyfe’s declaration of interest be amended to state that he was a “governor” of THH rather than a “member”.

Concern was express that, despite officers contacting Ms Joan Veysey and Dr Ian Goodman with a request for information about the development of the Yiewsley Health Centre and proposals for investment in Cinderella services over the next year, nothing had been forthcoming.  Given the statutory duties provided within the Health and Social Care Act 2001, officers were asked to ensure that Ms Veysey and Dr Goodman were invited to attend the Committee’s next meeting so that they could provide Members with these updates and answer any resultant queries. 

RESOLVED:  That:

1. the minutes of the meeting held on 6 June 2012 be agreed, as amended, as a correct record; and
2. Ms Joan Veysey and Dr Ian Goodman be asked to attend the Committee’s next meeting to update Members on the development of the Yiewsley Health Centre and proposed investments in Cinderella services.

Consideration was given to the Committee’s Work Programme. 

Officers would make arrangements for the Committee to receive an update on the results of the consultation that was being undertaken by CNWL in relation to the proposed changes to the bed based mental health service at Hillingdon Hospital.  This would be scheduled for the meeting on 10 January 2013. 

It was noted that the NHS North West London Shaping a Healthier Future consultation would finish in October 2012.  Members requested that the results of this consultation be reported to the Committee’s meeting on 20 November 2012.

Members noted that the membership of the Special Constable Working Group would comprise Councillors Gilham, Kemp and Yarrow.  As confirmation had not yet been received with regard to the Labour membership, officers would contact the Labour Chief Whip.  It was agreed that the scoping report for this review would be circulated to Members for agreement before the next meeting.

With regard to the Committee meeting on 19 February 2013, it was suggested that the Police be asked to provide details of the number of cautions that had been issued and the number of prosecutions.  If possible, this information should be broken down by age group.

Members requested that they receive an update at the meeting on 13 September 2012 on progress made with regard to the Committee’s major review recommendations over the last four years.

RESOLVED:  That:

1. the Work Programme be noted;
2. the results CNWL consultation on proposed changes to the bed based mental health service at Hillingdon Hospital be reported to the Committee on 10 January 2013;
3. Labour membership be identified for the special constable review;
4. the special constable review scoping report be circulated to Committee members for agreement prior to the Committee’s next meeting;
5. the Police be asked to provide information in relation to cautions and prosecutions for the meeting on 19 February 2013; and
6. the Committee receive an update on actions taken to further recommendations made in its major review reports.