Agenda and minutes

Apologies for absence were received from Councillors John Morgan and John Major.  Councillors Judy Kelly and Beulah East were present as substitutes.

Councillor Phoday Jarjussey declared a non-pecuniary interest in Agenda Items 6 (“Health Changes and Priorities for the year ahead”) and 7 (“Hillingdon Hospital A&E”), as he was a member of The Hillingdon Hospitals NHS Foundation Trust, and remained in the room during the consideration thereof.

Councillors Mary O’Connor and Peter Kemp declared a non-pecuniary interest in Agenda Item 8 – Work Programme and Scrutiny Reviews, as they were trustees of Hillingdon MIND, and remained in the room during the consideration thereof.

RESOLVED: That the minutes of the meetings held on 18 April 2013 and 9 May 2013 be agreed as correct records. 

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.

External representatives from the CCG, Healthwatch Hillingdon, THH, along with relevant Council Officers, will be invited to attend and give short remarks.

The Chairman welcomed those present to the meeting and asked that everyone introduce themselves.

Mr Shane DeGaris, Chief Executive of The Hillingdon Hospitals NHS Foundation Trust (THH), advised that the organisation had met all of its Monitor performance targets during 2012/2013 and had achieved a financial risk rating of 3.  The Trust had also received an unannounced inspection from the CQC during this period and had remained fully compliant with the quality and safety standards.

Mr DeGaris advised that the Trust would be facing a number of challenges over the forthcoming year in relation to issues such as financial constraints, an increasing level of activity and high public expectations.  It was noted that, although the Trust held a zero tolerance policy, there had been one instance of MRSA during the previous year. 

For the current year, the Board had set four strategic priorities which included the delivery of high quality care in the most efficient way.  Achieving this priority would help the Trust to deliver local savings as well as meeting Government savings targets.  It was noted that the Trust was aiming to break-even during 2013/2014 with a target of 1% surplus for 2014/2015.

Members were advised that the Trust would be working closely with the Hillingdon Clinical Commissioning Group (CCG), particularly with the GPs.  It was noted that this work would include the development of care pathways and solutions to ensure a sustainable health economy.

Dr Abbas Khakoo, Joint Medical Director at THH, stated that the Trust had successfully bid for £12m for the redevelopment of Emergency Care at Hillingdon Hospital.  The full business case for this work had been agreed by the Trust Board in March 2013 and would include a new building that would support a fundamental change to the model of care currently provided.   A new Acute Admissions Unit was also planned to improve the quality of care and reduce the length of inpatient stay and was being tested with a multi-disciplinary team within the current set up.  It was anticipated that the redevelopment would provide an improved working environment for staff and enhance privacy and dignity for patients. 

In 2012/2013, 4,205 babies were delivered at Hillingdon Hospital – this had increased significantly since 2004/2005 when 3,200 babies were delivered.  It was anticipated that the developments resultant from Shaping a healthier future proposals would increase the total by 1,500-1,800.  The Trust had successfully bid for £741k of Government funding which was being used to refurbish and modernise the ten delivery rooms on the ground floor delivery suite.  It was noted that this funding was completely separate from any funding that might be forthcoming as part of the Shaping a healthier future proposals to increase maternity capacity at Hillingdon. 

Members were advised that the average length of stay for maternity was 24-48 hours – although, if it was not their first child and there had been no problems, their stay could be as little as 6 hours.  This time increased if the patient underwent  ...  view the full minutes text for item 6.

Given recent developments, to receive an oral update on the operation of the Borough’s local Accident and Emergency Unit.

Mr Karl Munslow Ong, Chief Operating Officer at The Hillingdon Hospitals NHS Foundation Trust (THH), stated that performance of A&E departments across London during Q4 of 2012/2013 had been poor and that Q1 of the current year had been a significant challenge.  It was noted that, as well as there being a 12% increase in the number of ambulance arrivals during Q3 and Q4 and a 34% increase in patients admitted by ‘blue light’ and requiring immediate admission to the resuscitation unit during the same period, there had also been a general increase in the acuity of patients attending.  This had been a similar picture across the country.  Furthermore, there had been a 23% increase in the number of elderly patients (aged 75+) over the last two years. 

It was thought that residents would often go to A&E as they knew they would receive a good service - even though this was not necessarily the most appropriate course of action.  Ms Jacob advised that a new Urgent Care Centre was being provided at Hillingdon and it was hoped that it would go live in October 2013. 

Members were advised that THH was reorganising patient pathways and that new ways of working would be introduced in June 2013.  Work was also being undertaken around GP patients bypassing A&E and being admitted directly to the Emergency Assessment Unit (EAU). 

There was also an integrated care pilot which saw THH working with community partners around enabling patients to be discharged earlier.  Ms Jacob advised that the CCG recognised the need to improve and join up the discharge process more effectively and align the service appropriately.  This would also involve strengthening the social care capacity and support, e.g., the provision of more night time sitters for the first couple of nights that an elderly patient was at home after being discharged from hospital to help them settle in.  Ms Jacob would pass a copy of the plan to Democratic Services for circulation to the Committee. 

Mr Munslow Ong advised that there had been an increase in the number of THH admissions during April and May 2013 but that this number had reduced during June 2013.  However, Members were advised that the average length of each stay had decreased.  It was noted that, with regard to elective surgery, Enhanced Rapid Recovery planning had meant that patients had been better prepared so that they were clear about the processes and any support they would need after surgery had been identified in advance.  This had worked effectively in Hillingdon to help reduce the average length of stay as well as reducing readmission rates. 

Mr Chris Miles, Lead Duty Station Officer for the London Ambulance Service (LAS), advised that, although there were times when ambulances had been queuing at the hospital, Hillingdon had a better than average track record.  However, any such additional waiting time meant that the coverage in the area was depleted and the LAS then had to move its vehicles around  ...  view the full minutes text for item 7.

To consider and agree the Committee’s activity over the forthcoming municipal year, including scoping activity for the first major review. Report includes:

Appendix A – work programme

Appendix B – previous reviews

Appendix C – draft Scoping report major review

Consideration was given to the Work Programme report and appendices.

As it had been proposed to hold the next Member Development day on Thursday 5 September 2013, Members agreed to reschedule the Committee’s September meeting for 6pm on Thursday 19 September 2013 (in Committee Room 5). 

It was noted that the Committee would be considering community cohesion at its meeting on 18 February 2014 and that the meeting would start at 5pm.  Furthermore, it was agreed that the meeting on 18 March 2014 would start at 6pm.

To ensure that the NHS Trusts had adequate time to produce their quality reports, the Committee agreed to reschedule its April meeting for 5pm on 29 April 2014 (in Committee Room 6).

The Committee had commissioned a review in 2012/2013 in relation to diabetes.  Members agreed that Democratic Services work with the current Committee Chairman to finalise the report then circulate it to them for information. 

Members agreed the stigma scoping report that had been drafted in relation to the Committee’s first major review for the municipal year, subject to clarification that it would specifically focus on the mental and physical effects of stigma rather than looking at the stigma itself.  Furthermore, it was agreed that consideration be given by the Chairman and the Democratic Services Manager to developing a list of witnesses for the meetings which could include representatives from the Disability Assembly, schools and Central & North West London NHS Foundation Trust.

Following debate, it was agreed that the Committee’s second (minor) review for the year would be in relation to Anti-Social Behaviour (ASB).  Members were asked to contact the Democratic Services Manager with any ASB issues that they would specifically like to concentrate on.

RESOLVED:  That:

1. the September meeting be rescheduled for 6pm on Thursday 19 September 2013;
2. the meeting on 18 February 2014 start at 5pm;
3. the meeting on 18 March 2014 start at 6pm;
4. the April meeting be rescheduled for 5pm on 29 April 2014;
5. the Democratic Services Manager work with Councillor O’Connor to finalise the diabetes report;
6. the stigma scoping report be updated and the list of potential witnesses be developed by Councillor O’Connor and the Democratic Services Manager; and
7. Members contact the Democratic Services Manager with suggestions for the focus of the ASB review.