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.

It was agreed that resolution 5 in minute number 15 should be amended to read “19 February 2013”.

RESOLVED:  That, subject to the above amendment, the minutes of the meeting held on 17 July 2012 be agreed as a correct record.

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.

The Chairman welcomed those present to the meeting.

Royal Brompton and Harefield NHS Foundation Trust  (RB&H)

Mr Nick Hunt, Director Service Development at RB&H, advised Members that, at Month 4, the Trust was compliant with all of the targets that had been set by Monitor: the rating for Governance was green and the rating for Finance was 3 (which was in line with the Annual Plan).  Although the Trust was meeting the 18 week Monitor target for admitted patients in aggregate, it was not meeting the target that had been set by the commissioners at speciality level.

Members noted that Harefield Hospital had been inspected by the Care Quality Commission (CQC) on 20 April 2012 and had been found to be fully compliant with the essential standards of quality and safety that were assessed.  Royal Brompton Hospital had been inspected in April 2011 and had also been found to be fully compliant.

RB&H continued to work with the North West London Commissioning Support Unit to assist with understanding the establishment and development of Clinical Commissioning Groups (CCGs).  Although Mr Hunt expressed some concern with regard to the CCG’s formal process of engagement with the Trusts, it was anticipated that the recent appointment of Dr Andrew Rose as the Chairman of the Clinical Quality Group would alleviate this issue.  

Mr Hunt stated that the Trust was working with the London Specialised Commissioning Group (LSCG) on the implementation of the decision on the review of children’s congenital heart services.  RB&H was now in the process of establishing an international panel under Professor Hutton to provide a source of independent advice regarding the knock on effects of the Safe and Sustainable consultation; particularly with regard to paediatric respiratory services.  However, the changes expected as a result of this consultation were not anticipated to be implemented before April 2014.  It was noted that the Children’s Heart Surgery Fund (a Leeds-based charity) was expected to make an application for a judicial review a sit was in opposition to the decision to close Leeds paediatric congenital cardiac surgery unit and move the provision to Newcastle.  The relevant scrutiny committees at Leeds and Leicester councils had already referred the decisions made in their areas to the Secretary of State.  Members agreed that the Committee would reiterate its support of RB&H by writing to the new Secretary of State, Jeremy Hunt, in the same way as it had to his predecessor, Andrew Lansley. 

Other work being undertaken by RB&H included continuing work on the future re-development of both sites.  The Royal Brompton site was prime real estate with opportunities to leverage these assets. Decisions on Royal Brompton would not affect the viability or location of Harefied hospital.  This could result in the relocation of services from the Chelsea site to Royal Brompton Hospital but would not affect the delivery of services from Harefield Hospital.  A decision would be made by 1 January 2013. 

Hillingdon Clinical Commissioning Group (CCG)

Ms  ...  view the full minutes text for item 20.

Mr Kevin Byrne, the Council’s Head of Policy and Performance, introduced the report which outlined the compelling case for change and the key proposal to reconfigure hospital services.  Although the Council had not taken part in the North West London Joint Health Overview and Scrutiny Committee (NWL JHOSC), it was important that the Council’s voice was heard during the consultation. 

Mr DeGaris, Chief Executive at THH, advised that THH was in support of the preferred option.  He went on to state that, in theory, there would be no impact on the waiting times in Hillingdon Hospital’s Accident and Emergency if patients were transferred following the closure of A&E at Ealing Hospital.  This would be achieved by increasing the staffing and using the embedded funding.  It was noted that THH had already secured Government funding for improvements to its emergency services and that this work would include a rebuild of the emergency access.  Further work could include an increase in the A&E floor space or improvements to the Urgent Care Centre (UCC). 

Furthermore, Dr Susan La Brooy, Medical Director at THH, advised that she was currently chairing a pioneering working group that was looking at establishing a set of standards in relation to what a UCC would deliver and how.  As part of this work, Dr La Brooy would be attending meetings such as the Older People’s Forum. 

It was anticipated that any changes resultant from the review would not be implemented for about five years to ensure that the transition was smooth.  The consultation preferred option would result in approximately 5,000 additional patients at Hillingdon Hospital which would need to be planned for.  This option would also require additional capital investment in services such as maternity and paediatric. 

Ms Cranmer, Performance Improvement Manager at LAS, advised that the organisation had been fully involved in the consultation process.  She went on to note that the scoping work that had been undertaken to date was theoretical but that it was about getting patient care right first time.  The LAS would be measured on how quickly it responded to patient calls – as such, it would be important to ensure that patients were not taken to facilities further away than needed.  It was anticipated that proposed changes for dealing with an additional 164-174 patients each day in North West London would include an increase in ambulance journey times of 4½ minutes. 

Currently in Ealing, 63% of calls resulted in patients being taken to hospital (62% in Hillingdon) – 200 per month were taken to the UCC – this was expected to increase in Ealing and Hillingdon. 

Consideration would also need to be given to the provision of additional LAS staff, journey times, etc.  It was noted that the reconfiguration of the pan-London stroke and major trauma pathways had not impacted on the number of ambulances required in the Borough (this remained at 10).  Since implementation, these new pathways had been working well and had saved many lives.

Mr Hawkes  ...  view the full minutes text for item 21.

Consideration was given to the report regarding updates on the implementation of recommendations from the following major reviews undertaken by the Committee over the last five years:

a)     Dementia

b)     Re-offending

c)      Children’s Self Harm

d)     The Effect of Overcrowding on Educational Attainment and Children’s Development

e)     Parent Abuse

f)        The Transition from Child to Adult Mental Health Services

g)     Obesity

a) Dementia

Ms Linda Sanders, the Council’s Director of Social Care, Health and Housing, advised that, with regard to dementia services, the memory clinic was now up and running and had been well received.  Furthermore, work continued on the development of Care Place which had now been populated by 166 providers who were able to update their information on the portal. 

It was noted that Ms Fiona Davis, joint commissioner for the Borough, had been using the information collated during the Committee’s review of dementia services to develop the new dementia strategy which would be considered in due course by Cabinet and by the Health and Wellbeing Board (as well as other partner organisations).  Part of the strategy would look at valuing the voluntary services. 

Members were advised that the Council had commissioned WRVS to provide a friending service which would be launched in November 2012.  The WRVS was currently recruiting volunteers to support residents who would be able to dip in and out of the service. 

b) Re-offending

Ms Sanders advised that a £420k 2-year grant had been secured from the Department of health for the Court Diversion Service from April 2012. 

g) Obesity

Dr Ellis Friedman, Joint Director of Public Health, stated that, with regard to obesity, rates in Hillingdon were as expected given the Borough’s socio-economics.  However, this was not good news as the obesity rates in Hillingdon were worsening in adults and children.  The issue of obesity and how to address it had been included in the Joint Strategic Needs Assessment (JSNA) and in the Director of Public Health’s annual report. 

As one of the major risk factors for obesity in children and adults was less physical activity that expected, a physical activity strategy had been drafted for consideration by the Health and Wellbeing Board.  As obesity in children and adults needed to be considered and addressed separately, officers were visiting some schools to encourage them to work with the Council to tackle the problem.  With regard to adults, the NHS health checks programme was being expanded to identify middle aged people who were higher risk. 

RESOLVED:  That the updates be noted. 

Consideration was given to the Committee’s Work Programme.  It was agreed that the first major review undertaken by the Committee would be in relation to the role of special constables in the Borough.  It was anticipated that the review would comprise two meetings and a site visit.  Officers would liaise with the Labour Whips to identify Members for the review and then look at setting the meeting dates. 

It was agreed that Ms Natalie Fox, Service Director for Older Adults at CNWL, would be invited to report back on the results of the consultation in relation to the proposed reduction of beds on two wards for older people with mental health issues at the Woodland Centre at the Committee’s meeting on 20 November 2012.  The consultation was due to close on 4 November 2012. 

RESOLVED:  That:

1. the Work Programme be noted;
2. officers liaise with the Labour Whips to identify Members for the special constable review and then make arrangements for the meetings; and
3. Ms Natalie Fox be invited to report back on the results of the consultation on the reduction of beds for older people with mental health issues at Woodland Centre to the meeting on 20 November 2012.