Agenda and minutes

Health and Social Care Scrutiny Sub-Committee - Monday 2 July 2018 7.30 pm

Venue: Committee Rooms 1 & 2, Harrow Civic Centre, Station Road, Harrow, HA1 2XY. View directions

Contact: Frankie Belloli, Senior Democratic Services Officer  Tel: 020 8424 1263 E-mail:

No. Item


Attendance by Reserve Members

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


Reserve Members may attend meetings:-


(i)                 to take the place of an ordinary Member for whom they are a reserve;

(ii)               where the ordinary Member will be absent for the whole of the meeting; and

(iii)             the meeting notes at the start of the meeting at the item ‘Reserves’ that the Reserve Member is or will be attending as a reserve;

(iv)              if a Reserve Member whose intention to attend has been noted arrives after the commencement of the meeting, then that Reserve Member can only act as a Member from the start of the next item of business on the agenda after his/her arrival.


RESOLVED:  To note the attendance at this meeting of the following duly appointed Reserve Member:-


Ordinary Member


Reserve Member


Councillor Michael Borio

Councillor James Lee



Declarations of Interest

To receive declarations of disclosable pecuniary or non pecuniary interests, arising from business to be transacted at this meeting, from:


(a)               all Members of the Sub-Committee;

(b)               all other Members present.


Agenda Items 9 to 13:


Councillor Chris Mote declared a non-pecuniary interest in that his daughter is employed at Northwick Park Hospital.  He would remain in the room whilst the matters were considered and voted upon.


CouncillorVina Mithani declared a non-pecuniary interest in that she works at Public Health England.  She would remain in the room whilst these matters were considered and voted upon.


Appointment of Vice-Chair

To appoint a Vice-Chair of the Sub-Committee for the 2018-19 Municipal Year.


RESOLVED:  To appoint Councillor Vina Mithani as Vice-Chair of the Health and Social Care Scrutiny Sub-Committee for the 2018/2019 Municipal Year.


Minutes pdf icon PDF 177 KB

That the minutes of the meeting held on 14 March 2018 be taken as read and signed as a correct record.


RESOLVED:  That the minutes of the meeting held on 14 March 2018, be taken as read and signed as a correct record.


Public Questions and Petitions

To receive any public questions received in accordance with Committee Procedure Rule 17 (Part 4B of the Constitution).


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, 27 June 2018.  Questions should be sent to  

No person may submit more than one question].


RESOLVED:  To note that no public questions or petitions were received at this meeting.


References from Council and Other Committees/Panels

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


RESOLVED: To note that none were received.


Appointment of Advisers pdf icon PDF 114 KB

Report of the Director of Legal and Governance Services.


RESOLVED:  That the following nominees be appointed as Advisers to the Sub-Committee for the 2018/19 Municipal Year:


1.            Mr Julian Maw (Healthwatch Harrow)

2.            Dr Nizar Merali (Harrow Local Medical Committee)



Scrutiny Review of Access to Primary Care in Harrow - follow up on implementation of recommentations pdf icon PDF 174 KB

Report of the Divisional Director, Strategic Commissioning.

Additional documents:


The Sub-Committee considered a report on the implementation of recommendations arising from a review of Access to Primary Care with a particular focus on those recommendations which involved the NHS Harrow CCG.   Javina Seghal, Chief Operating Officer of the CCG, addressed each of the relevant recommendations of the scrutiny review as follows: 


Recommendation 1:  In total, there had been 1,455 visits to the Harrow CCG website and Health Help Now app in May 2018 by 739 users. Of the 739 users, 385 users were new to the app and website.  Since its launch in  December 2016, the app and website had been used almost 36,000 times by nearly 22,000 users.  There had been 2,596 downloads of the Health Help Now app in that period. 70 users had come direct to the Harrow Health Help Now website and 106 had been referred by other websites.  Ms Seghal asked councillors to help increase awareness of the website and app in local communities. 


Recommendation 2:  A data sharing agreement had been put in place in April  2017 for all three walk-in centres. 


Recommendation 3:  not for the CCG.


Recommendation 4:  The reconfiguration of the first floor at Belmont Health Centre remained a priority scheme for the NHS.  There had been some delay due to the funding route changing from NHS England to NHS Property Services.  However, tenders had now been returned and adjudicated for the approved scheme, lease terms with the practices were being negotiated and, once these were agreed construction contract would be awarded.  The work to reconfigure the first floor of the Belmont centre, estimated to take 5 months, would bring all of the void space back into use, creating additional clinical capacity for each of the GP practices and the Walk-in Centre.


Recommendation 5:  There were a number of different engagement forums  organised by the CCG; these included monthly peer group meetings where GP practices convened on a geographical basis to discuss topics such as patient experience, access and quality of services.  There were also regular respective GP, Practice Manager and Practice Nurse forums which reinforced the collaborative environment.  These offered an effective medium through which practices were able to share best practice with a particular focus on improving the patient experience.


Recommendation 6:  All Harrow GP practice websites were being refreshed, and the new design of websites would not only contain a ‘Self-Help’ section, but also a signposting service for patients on conditions that they may have or services that they may require.  The new websites would link to the Harrow Help Now website and app download pages.  In addition, further designs were being explored, to be implemented within the Health Help Now app, to allow patients to self-refer to services.  The CCG would centrally manage the information displayed on GP screens in Harrow and regularly populate it with information about services such as GP extended access, as well as local events in the community and information about public health campaigns.  ...  view the full minutes text for item 8.


Dementia Friendly Housing Scrutiny Review - discussion with Harrow CCG on the Review's findings and recommendations pdf icon PDF 118 KB

Report of the Divisional Director, Strategic Commissioning.

Additional documents:


The Chair invited Councillors Vina Mithani and Chris Mote, who had both served on the scrutiny review panel, to introduce the item. 


Councillor Mithani outlined the findings of the review and the recommendations arising, one of which concerned refreshing the joint dementia strategy between the Council and the CCG.  She explained the examples of good practice from other boroughs which had been observed by the review panel.  Councillor Chris Mote spoke of his personal experiences recently of a family member with dementia receiving treatment at Northwick Park Hospital.  There had been gaps in the information provided and a lack of coordination between agencies; he also considered that the whole “journey” of the person with dementia was not addressed well enough and opportunities were thereby missed, for example, by not coordinating hospital discharges and care at home.  He had also encountered a reluctance among some medical professionals to share information with family members even in a case where a Power of Attorney was in place. 


Councillor Mithani argued for better integration of services across different agencies to meet the needs of patients more effectively and to make better use of resources.  She suggested that more could be done to spread awareness in certain communities, including by visits to places of worship and faith groups; these could complement initiatives undertaken by Public Health England.  She referred to the plight of very elderly carers who were faced with difficult, highly emotional situations of their loved-ones’ dementia.  Councillor Chris Mote added that, with so many different languages spoken in the Borough, more needed to be done to get messages across to all communities. 


Javina Seghal, Chief Operating Officer of the NHS Harrow CCG, thanked the councillors  for their rich narrative of issues arising from the scrutiny review, including the important reflection of personal experiences.  She referred to the positive atmosphere for and attitude to partnership working in the Borough, and to the active engagement of Members and officers of the Council with the CCG to develop better coordination and integration of services.  The intention was to report to the Health and Wellbeing Board on plans and specific proposals, and these would include provision for dementia sufferers and their families.  The CCG’s performance framework included targets on this area of work. 


Lennie Dick, Head of Mental Health Services at the CCG, addressed the meeting, having tabled a document summarising key information and issues. He referred to the national target of maintaining a diagnosis of at least two-thirds as part of the Prime Minister’s dementia challenge 2020.  The rate in Harrow had been doubled in recent years to reach 64% though there had been some modest slippage in the last year; performance was monitored by an inter-agency group of stakeholders.  Mr Dick confirmed that the refresh of the dementia strategy would be brought to the Sub-Committee’s next meeting.  This would address the challenge of improving awareness of and access to services.  In the interim, some new resources had been applied to improve the diagnosis rate  ...  view the full minutes text for item 9.


Home First and Hospital Transfer Red Bag Schemes

At the last meeting of the Subcommittee, it was agreed that the CCG to be asked to report to the Subcommittee on the Home First and Hospital Transfer Red Bag schemes. For context, please see the minutes of the last meeting here (under minute item no. 123).


On behalf of the CCG, Adam Macintosh outlined the operation of the Hospital Transfer Red Bag scheme.  He advised there were currently 13 Harrow care homes which had gone “live” with the scheme and there were plans for a further 3 homes to join the scheme within the next few months.  The scheme was working well, though he considered there was room for some improvement, particularly in the consistency of the use of the bags.  It was hoped it could be extended to frail elderly people living alone at home.  It had been claimed in Sutton that the scheme was reducing hospital stays by up to three days, though the position in Harrow was not clear as yet.  However, it was reducing readmission rates and admissions for non-elective treatment.  While funding was due to end shortly, the CCG was addressing how to continue the scheme.  In response to a Member’s question about tackling isolation of elderly people, Mr Macintosh agreed that this was a central issue to health and well-being, and that the scheme was part of a package to reduce this factor.  Ms Seghal added that the Council and the CCG was funding and organisation called Lateral to work on community resilience and cohesion in health and social care.


Mr Macintosh explained that Home First was not a separate service per se, but a number of different strands of work which served to create “wraparound” care for patients at home.  The initiative was operating well and, as with the Red Bag scheme, it was hoped funding could be continued.  It was part of the frailty pathway which included  a short-stay ward at Northwick Park Hospital which targeted returns home within five days.  Ms Seghal underlined the importance of the Council’s support in commissioning services in an integrated way.  The challenge was to see the value of investment in a high level of care when patients first returned home as this was effective in reducing longer-term needs and costs.  A Member referred to the Council’s Infinity project as a possible means for more flexible purchasing of care in future. 


The Chair thanked the CCG representatives for their report.


RESOLVED:  That the report be noted. 


Healthwatch Harrow Annual Report 2017-18 pdf icon PDF 3 MB

Report of the Chair, Enterprise Wellness (Healthwatch Harrow).


Ash Verma, Chair of Healthwatch Harrow (Enterprise Wellness Ltd.) introduced the report, outlining the key achievements of the organisation.  He referred to the significant budget reductions which had meant that an original annual budget of £175,000 had now reduced to £75,000.  As a result, the service was now essentially part-time with a heavier reliance of volunteers.  He considered that, despite this, the levels of activity remained high even if the organisation was not in a position to pursue some issues in as much detail as they wished.  Mr Verma pointed out that the budget reduction for Healthwatch Harrow was disproportionate when compared to other similar organisations.  His Board had commissioned a 360 degree review of the service, as a result of which a merger with Harrow Mencap had been proposed.  The Board had decided this would make sense given the value of polling resources and volunteers and given that the organisations were already co-located.  He underlined that Healthwatch Harrow would still remain a separate legal entity. 


Members commended the work of Healthwatch Harrow as set out in the report.  In response to a Member’s question about alternative funding options, Mr Verma advised that income generation options were being developed, including a link with Brunel University in delivering some of their courses.


Ms Seghal commended the work of Healthwatch Harrow and described the report as robust and rich in its narrative.  The CCG very much valued the organisation’s support in reflecting the views of patients and public and thereby playing a key part in shaping effective services. 


While congratulating Healthwatch Harrow for its detailed and thorough report, a Member suggested that the organisation should examine the issues of access to GP services and the maternity services offered at Northwick Park Hospital, as these featured consistently in matters raised with her by the public.  Mr Verma explained that it was only possible for Healthwatch Harrow to focus on two or three priority issues at a time, as it was otherwise impossible to maintain the quality of the work given current resources.  Ms Seghal suggested that the Sub-Committee invite the Northwick Park Hospital Trust to attend one of its meetings to discuss maternity services there; the CCG could also attend to contribute to the discussions.


The Chair thanked Mr Verma for his report. 


RESOLVED: That the report be noted. 


Diabetes Care - Report by Healthwatch Harrow pdf icon PDF 686 KB

Report of the Chair, Enterprise Wellness (Healthwatch Harrow).


Ash Verma, Chair of Healthwatch Harrow (Enterprise Wellness Ltd.) introduced the report, thanking the CCG for its support for the work involved.  He reported that this was an important area of service as indicated in enquiries from the public and Healthwatch Harrow’s own investigations.  The research had been carried out between November 2017 and May 2018, and had included focus groups and online submissions; inevitably, it represented a snapshot of the position in this period, but was still helpful in identifying key issues and priorities.  Diabetes was significant in Harrow, with the third highest diagnosis rate in the country; it was a particular issue among certain BME communities as had been reflected in the excellent turnout at the launch of the study.  Mr Verma pointed to the report’s recommendations and suggested that a Borough-wide campaign was needed to raise awareness of the condition and its impact, particularly as it was projected to increase over the coming years.  He proposed a coordinated effort between local agencies to ensure the best outcome for such a campaign. 


A Member suggested that the message about the condition should be put forward robustly, even to the extent of explaining that people could be faced with amputation of legs and loss of sight if they did not take steps to address their diets and lifestyles.  Similar challenging messages had worked in the case of addiction to cigarettes, so he did not consider the approach to be inappropriate.  He considered that many people realised the risks too late and there would be benefits in an early, robust message.  As he had the condition himself, the Member had been interested in becoming a trainer in this area, but the course demanded three consecutive days’ attendance which he could not manage. 


Mr Verma reported that Healthwatch Harrow had organised a yoga session during which information on diabetes had been communicated.  He commended such innovative ways of getting the message across.


Ms Seghal commended the report by Healthwatch Harrow which had been considered at the CCG Board.  She underlined the importance of building on its findings and recommendations. 


The Chair thanked Mr Verma for his report. 


RESOLVED: That the report be noted.