Agenda and minutes

Health and Social Care Scrutiny Sub-Committee - Tuesday 5 March 2024 6.30 pm

Venue: The Auditorium - Harrow Council Hub, Kenmore Avenue, Harrow, HA3 8LU. View directions

Contact: Rita Magdani, Senior Democratic & Electoral Services Officer  Tel: 07707 138582 E-mail:


No. Item


Attendance by Reserve Members

To note the attendance at this meeting of any duly appointed Reserve Members.

Additional documents:


RESOLVED:  To note that there were no Reserve Members in attendance.


Declarations of Interest

To receive declarations of disclosable pecuniary or non pecuniary interests, arising from business to be transacted at this meeting, from all Members present.

Additional documents:


RESOLVED:  To note that there were none.


Minutes pdf icon PDF 137 KB

That the minutes of the meeting held on 12 December 2023 be taken as read and signed as a correct record.

Additional documents:


RESOLVED:  That the minutes of the meeting held on 12 December 2023, be taken as read and signed as a correct record.


Public Questions

To note any public questions received.


Questions will be asked in the order in which they were received.  There will be a time limit of 15 minutes for the asking and answering of public questions.


[The deadline for receipt of public questions is 3.00 pm, Thursday 29 February.  Questions should be sent to  

No person may submit more than one question].

Additional documents:


RESOLVED:  To note that no public questions had been received.



To receive petitions (if any) submitted by members of the public/Councillors.

Additional documents:


RESOLVED:  To note that no petitions had been received.


References from Council and Other Committees/Panels

To receive any references from Council and/or other Committees or Panels.

Additional documents:


RESOLVED:  To note that no references from Council or other committees/ Panels had been received.

Resolved Items

Additional documents:


Winter Pressures pdf icon PDF 131 KB

Report of Borough Director Harrow Mental Health.

Additional documents:


The Sub-Committee received the Harrow Health and Care System Pressures report from the Managing Director Harrow Borough Based Partnership.  Which provided an update on demand and activity in the Harrow Health and Care system during the winter period and progress on the measures planned by the Harrow Partnership to meet them.


The following keys points were reported on during the presentation:


·                 Pressure on the health and care system had peaked during the first week of January, when the post-Christmas surge in presentations and the Junior Doctors’ strike impacted simultaneously.

·                 A&E attendances now averaged 2,170 per week, an increase on last winter’s average attendance and a level that, pre-Covid would have been an unusually high peak in demand.

·                 Non-elective admissions to Northwick Park Hospital averaged 600 per week, as high as during the previous winter.  Admissions peaked in the week before Christmas at 718.

·                 London Ambulance Service handover delays had reduced following stricter limits being placed on the time that ambulance crews would support patients at the hospital before handing over to A&E staff.  One consequence of this had been an increase in long waits in A&E: the number of 12 hour waits in A&E had averaged 395 per week since October, compared to 313 during the previous winter.

·                 During November and December an average of 97% of beds were occupied; in addition, patients were routinely being ‘boarded’ i.e., managed on wards before beds became available for them.

·                 The number of people on social care caseloads post-discharge from hospital was now three times that in the pre-Covid period.

·                 Although health and care staff in the hospital and community, including primary care, had coped during this period it was necessary to acknowledge and address the impact on patients, staff and services working under this level of pressure.

Following the presentation, the Sub-Committee made comments and asked questions.


·                 Concerns were raised about the impact of the junior doctors strike on elective care and the stress experienced by staff.  It had affected elective care and planned procedures, but emergency and cancer care were not significantly impacted.

·                 Clarification was sought on what was meant by boarding. – and it was explained that Patients were offloaded from ambulances into corridors with clinical oversight until officially admitted, it was not ideal but allowed the ambulances to respond to other emergency calls.

·                 The 12-hour waiting time in A&E had not reduced since the last report and Members questioned why this was and commented that in neighbouring boroughs, the wait time was considerably less. – Northwick Park Hospital was the busiest hospital in the country and people from other different boroughs used this hospital.  48% of people who used the hospital were from within Harrow Borough and the reminder from neighbouring areas.

·                 The community services staff sickness rates had increased, and members questioned the reason for this and was there support in place if the absences was off due to stress. – The Sub-Committee was advised the sickness was averaging 3.9% and this period  ...  view the full minutes text for item 57.


Harrow Mental Health - CNWL pdf icon PDF 563 KB

Report of the Borough Director Harrow Mental Health.

Additional documents:


The Sub-Committee received the CNWL Mental Health – update from Dr Deepti Shah-Armon, Harrow, and Trust-wide Clinical Perinatal Director which summarised mental health services available in Harrow to explain the pathway for service users.

The following keys points were reported on:


·                 Harrow Talking Therapies

·                 Community Mental Health offer

·                 Perinatal Mental Health Services

·                 Crisis Care

·                 Inpatient Services

·                 Older Adult Mental Health Services

·                 Community learning disability services (LD)


Officers outlined the content of the report.


Following the presentation Members asked the following questions.


·                 Apart from pregnant women and new mothers with mental health issues, clarification was sought as to the other kinds of mental health conditions addressed and their causes – The Sub-Committee was advised that a variety of mental health services were addressed such as anxiety, depression, and reactions to major life events.  These conditions were quite common, and many people experienced periods of feeling low or anxious in their lives.  Generally, these issues improved either on their own or with support from friends and families, and the voluntary sector.  The service also offered Talking Therapies, including behavioural therapy for anxiety and depression.  Additional support for more severe conditions such as psychosis, schizophrenia, and entrenched depression was advised.  As for the causes, whilst there was a psychosocial and biological aspect, there was an increased understanding of the role of adverse events in peoples’ lives.  These events, whether extreme abuse or traumatic experiences like migration or isolation, could have an impact on and a person’s ability to cope.  Economic crises also played a big role in mental health and, as such, suicide rates tended to increase during such periods, affecting both individuals with and without prior mental health histories.


·                 Information about the support offered to older people and their families was sought and Members were advised that in addition to the services for the older people, the service offered support for their families and carers.  There was collaboration with voluntary partners to provide the support.  However, the memory services faced challenges as they had limited staff and were primarily commissioned for the diagnosis of dementia.  While advice was offered to diagnosed individuals and families, the service lacked the resources to provide further assistance.  Admiral Nursing funding had been sought, but unfortunately recruiting Admiral Nurses proved difficult, although this had improved in Harrow in the last couple of months.  The service identified that a crucial need for support for the funding of Admiral Nurses.


·                 In response to a question in relation to the approach of the pilot high integration service – The Members were advised that the mental health service operated as one system, whether its acute services or community care.  Meetings were held on a weekly basis where they discussed complex cases with GP’s, police, and non-state agencies, ensuring a collaborative approach.  The service aimed to minimise hospital admissions and put on emphasis on community support, following a recovery model to enhance individual lives.  Although hospitalisation was necessary, the services focus was on developing robust community support.  The service had observed that  ...  view the full minutes text for item 58.