Agenda and minutes

It was noted that Councillors Nick Denys and Ali Milani would be arriving a little late. 

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

Members were advised that a response had been received from Ms Sarah Lucy James at East and North Hertfordshire NHS Trust on 17 September 2018 in relation to queries regarding the closure Michael Sobell Hospice that had been submitted on 31 July 2018.  The Democratic Services Manager would forward the response to the Committee.  It was noted that the provision of hospice services in the North of the Borough would be considered by the Committee at an additional meeting that had been scheduled for 30 October 2018.  The Cabinet Member for Social Care, Housing, Health and Wellbeing, Councillor Philip Corthorne, had been invited to attend this meeting.

With regard to the human resources strategy for A&E at Hillingdon Hospital (Minute 16, Resolution 2), the Democratic Services Manager had been advised that the additional space in the Emergency Department (ED) would accommodate the same number of patients within ED to prevent overcrowding and ensure safe flows through the department.  Hillingdon Hospital would be using its current allocated resources but with a more robust operational process to ensure effective transition times through the department.  The workforce plan would therefore be strengthened with better clinical and operational processes.  A dedicated workforce model review was also planned across emergency care pathways, led by the Medical Director, which would focus more specifically around ambulatory care and ward decision making.  Both would serve to manage demand and flow into/out of ED.

A response had been received in relation to Minute 16, Resolution 3.  It was noted that, as set out in the s106, a structural survey of the canteen building on the Nestle site was expected from Barratts by the end of December 2018.  This document would be used to cost the essential repairs to the building.  Once this information had been obtained, Member approval for the services that would be located in the building would need to be sought.  The CCG had been asked to set out its requirements so this could be one of the options put forward.

Superintendent Ricky Kandohla had provided a response to the resolutions in Minute 17.  This information would be forwarded to Members of the Committee. 

RESOLVED:  That:

1.    Ms James’ response be forwarded to Members of the Committee;

2.    Superintendent Kandohla’s response be forwarded to Members of the Committee; and

3.    the minutes of the meeting on 6 September 2018 be agreed as a correct record.

The Chairman welcomed those present to the meeting and thanked them for attending.  He advised that he had attended the Quality Summit meeting held at Brunel University on 25 September 2018 to discuss The Hillingdon Hospitals NHS Foundation Trust’s (THH’s) recent CQC inspection report.  Dr Abbas Khakoo, Medical Director at THH, advised that there had been good engagement and support from all stakeholders at the summit meeting where the following key themes had been discussed:

·         Managing activity pressures and capacity;

·         Managing an aging estate;

·         Governance and accountability;

·         Supporting the workforce and improving culture – although maternity and paediatrics had a fairly stable workforce, only approximately 40% of Surgery staff were permanent; and

·         Infection prevention and control including sepsis care. 

The Trust was commended for the excellent work that had been undertaken to improve maternity, services for children and young people and end of life care.  However, Members of the Committee had received comments from residents regarding what Hillingdon Hospital being rated as ‘Inadequate’ meant for them.  Mr Richard Sumray, Chair of the Trust Board, stated that it was right that THH should be held to account.  He advised that the Board felt that the Trust’s performance had been unsatisfactory and had met the day after the report had been published to discuss a way forward.

Staff meetings had been held to discuss findings such as the presence of blood on beds between seeing patients.  There had also been an incident where the code for a lockable medicines cupboard had been written on a post-it note and left next to the cupboard.  These practices were not acceptable.  Mr Sumray acknowledged that some changes had not been properly embedded in some areas of the Trust. 

Although Hillingdon Hospital had received more ‘Good’ ratings than during the previous inspection in 2014, two areas in the Safe domain had been rated as ‘Inadequate’ which Mr Sumray believed had led to the hospital also being rated as ‘Inadequate’ for the Well-led domain.  He stated that it was the Board’s role to deal with the ‘Inadequate’ ratings that the Trust had received. 

It was essential that staff at THH did not jeopardise patients’ safety and policies and procedures had been put in place to prevent patients being put at risk of harm.  There had been some consultants that had not followed hand washing protocols or did not adhere to bare below the elbows.  Failing to uphold these basic safety standards and adhere to corporate policies was unacceptable.  Ms Jacqueline Walker, Director of Nursing at THH, advised that the Trust was one organisation and consideration was being given to how one department was able to achieve ‘Good’ in all domains whilst others were not.  It was recognised that the level of service demand at the hospital at the time of inspection was extraordinarily high but that was no excuse for unsafe behaviour which was unacceptable.  Furthermore, it was thought that there would be some members of staff that would, for example,  ...  view the full minutes text for item 23.

Consideration was given to the Committee’s Work Programme.  It was noted that GP pressures had been the subject of a previous review but that there had been some significant changes in the interim.  As such, the issue was to be reconsidered by the GP Pressures Select Panel.

Members considered the GP Pressures Select Panel scoping report and the membership thereof.  The Select Panel would be made up of two Labour and three Conservative Councillors.  It was agreed that the Labour membership would comprise Councillors Kuldeep Lakhmana and Kerri Prince and that the appointment of the three Conservative members would be delegated to the Head of Democratic Services in consultation with the Chairman and Chief Whip.  The Committee requested that the Select Panel’s final report be ready for its consideration by May 2019.  If required, this date could be altered. 

It was agreed that the Committee meeting scheduled for 10 April 2019 be cancelled and that two meetings on successive evenings at the end of April 2019 replace this to enable the Committee to scrutinise the Quality Account reports of the local Trusts.

RESOLVED:  That:

1.    the GP Pressures Select Panel scoping report be agreed;

2.    the Labour membership of the GP Pressures Select Panel comprise Councillors Lakhmana and Prince;

3.    the appointment of the Conservative Members to the GP Pressures Select Panel be delegated to the Head of Democratic Services in consultation with the Chairman and the Chief Whip;

4.    the meeting on 10 April 2019 be cancelled and two meetings on successive evenings been scheduled for the end of April 2019 to scrutinise the Quality Account reports; and

5.    the Work Programme be noted.