Agenda and minutes

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

Contact: Daksha Ghelani, Senior Democratic Services Officer  Tel: 020 8424 1881 E-mail:  daksha.ghelani@harrow.gov.uk

Items
No. Item

13.

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.

Minutes:

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

14.

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.

Minutes:

RESOLVED:  To note that the following interests were declared:

 

Agenda Items 6 and 7- Reference from Cabinet – Response to the Scrutiny Review on Dementia Friendly Housing and Draft Dementia Strategy 2018/2021

Councillor Chris Mote, a member of the Sub-Committee, declared a non-pecuniary interest in that a member of his family suffered from dementia.  He would remain in the room whilst the matters were considered and voted upon.

 

Agenda Item 10 - London North West Healthcare NHS Trust and Care Quality Commission Inspection Report

During consideration of the item, Councillor Chris Mote, a member of the Sub-Committee, declared a non-pecuniary interest in that his daughter was employed at Northwick Park Hospital.  He would remain in the room whilst the matter was considered and voted upon.

 

All Agenda Items

Councillor Maxine Henson, a member of the Sub-Committee, declared an interest in that she was a Portfolio Holder Assistant to the Portfolio Holder for Adults and Public Health.  Her remit was Adult Social Vision.  She would remain in the room whilst matters were considered and voted upon.

 

Agenda Item 8 - Changes to Walk-in Services at Alexandra Avenue Health and Social Centre

An attendee, Dr Genevieve Small, Chair of Harrow Clinical Commissioning Group (CCG), declared an interest in relation to the item.  She participated in the discussion and responded to questions from Members of the Sub-Committee, including the Leader of the Council who was invited to speak on this item.

15.

Minutes pdf icon PDF 146 KB

That the minutes of the meeting held on 2 July 2018 be taken as read and signed as a correct record.

Minutes:

RESOLVED:  That the minutes of the meeting held on 2 July 2018, be taken as read and signed as a correct record.

16.

Public Questions

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, 11 October 2018.  Questions should be sent to publicquestions@harrow.gov.uk  

No person may submit more than one question].

Minutes:

RESOLVED:  To note that no public questions were received.

17.

Petitions

To receive petitions (if any) submitted by members of the public/Councillors under the provisions of Committee Procedure Rule 15 (Part 4B of the Constitution).

Minutes:

RESOLVED:  To note that no petitions had been received.

RESOLVED ITEMS

18.

Reference from Cabinet - Response to the Scrutiny Review on Dementia Friendly Housing pdf icon PDF 141 KB

Additional documents:

Minutes:

Members received a reference and report considered by Cabinet in relation to the responses to the recommendations made in the Dementia Friendly Housing Report from the Sub-Committee.

 

RESOLVED:  That the reference and report be noted.

19.

Draft Dementia Strategy 2018 - 2021 pdf icon PDF 735 KB

Draft Joint Dementia Strategy 2018-2021, Harrow CCG and Harrow Council.

Minutes:

The Sub-Committee received the Draft Dementia Strategy 2018-2021, prepared jointly by Harrow Clinical Commissioning Group (CCG), Harrow Council and Public Health Harrow, which was committed to improving the patient’s journeys in terms of living well with dementia.  There had been an increasing focus on the Dementia Diagnosis Rate, to enable easy access to care, support and advice following diagnosis.  The intention of the Strategy was to increase the level of diagnosis to ensure appropriate post diagnostic support for patients and carers with a view to creating a more Dementia friendly borough.

 

A representative from Harrow CCG introduced the Draft Strategy and outlined, in brief, its key components.  He explained that the original Strategy had been refreshed and invited questions and comments from Members of the Sub-Committee and other partners present at the meeting.

 

Members of the Sub-Committee asked questions relating to:

 

-               the status of the Draft Strategy prior to its adoption and how it would be launched;

 

-               the plans in place to help raise awareness about dementia, the support available locally and the cultural and stigma barriers associated with the illness;

 

-               the support available to carers;

 

-               the gap between the current position and one that the partners would want to be in with regard to the Strategy and local actions.

 

Representatives from the CCG responded as follows:

 

-               the CCG would initiate meetings with the Council with a view to drilling down some 50 recommendations which needed addressing.  Additional funding was required and needed to be approved, including the commissioning intentions of the partners.  For example, a balance between the use of Admiral Nurses or Enhanced Practice Nurses would need to be considered;

 

-               work to raise awareness in the community was underway and a launch was being planned;

 

-              guidance from NHS England had been sought regarding the issues surrounding cultural and stigma barriers and boroughs with diverse populations, such as Newham, were cited and were being studied. Harrow too had a diverse population in that it had a large BAME group with 50% of the group being made up of people from South Asia.  Some work had been done on how residents could be educated and these measures would be included as part of the recommendations and action plan;

 

-              carers would be suitably supported and work with Age UK would continue in this regard.

 

A Member stated that scrutiny was a ‘critical friend’ and that, in that capacity, he was concerned that the Council’s website did not make reference to the work being undertaken in relation to dementia.  It was important that both the CCG and the Council sign posted this key document on their respective websites.  Another Member asked if any gaps had been identified.  Officers took note of the importance of using the website as a vehicle to ensure public awareness.  It was noted that joint working amongst partners was helping to identify gaps and work with the providers was underway.

 

Another representative of the CCG reported that the information and  ...  view the full minutes text for item 19.

20.

Changes to Walk-in Services at Alexandra Avenue Health and Social Care Centre

Minutes:

The Chair reported that the Council had recently learnt that:

 

-               from 1 November 2018, the Alexandra Health and Social Care Centre would become a GP Access Centre dedicated to treating patients registered with a Harrow GP practice only;

 

-               the new service would require patients to have booked an appointment before arriving at the Centre and this would ensure that patients would not need to spend time in the waiting area in order to be seen by a GP.  Appointments would be available from 8.00 am – 8.00 pm on all days of the week and could be made by patients by either contacting their GP surgery or calling 111 for an appointment;

 

-               patients who had used the Centre but were registered with a GP in other boroughs such as Ealing or Hillingdon would be able to book a same day appointment in a GP Access Centre located in their respective boroughs on all days of the week, including weekends and evenings, by calling their own GP or 111.

 

The Chair stated that the Council was extremely disappointed that it had not been consulted and asked representatives of the NHS Harrow CCG about the consultation exercise.  It was unfortunate that the implementation dates were close and that the Council had not been given any opportunity to voice its concerns on behalf of its residents.

 

Having been invited to speak, the Leader of the Council cited examples of how the new service would impact adversely on the residents of Harrow and was concerned that the appointment process would reduce the number of available appointments drastically.  He added that the Centre was situated in one of the most deprived areas of the borough and the new service would have an adverse impact on the disadvantaged.

 

The Leader stated that there had been a form of an engagement exercise with the Council’s Health and Wellbeing Board but that the CCG was not able to share some of the information at that time due  to commercial sensitivity.  It was essential that the CCG consulted in a meaningful way with the appropriate bodies of the Council on such important issues and that the relationship between the Council and the CCG needed to improve.  There were a number of opportunities for partnership working and these ought to be explored.  The CCG ought to have engaged fully with the Council in this regard as free and easy access to health was important.

 

Members of the Sub-Committee also expressed their disappointment about the lack of any meaningful consultation and made comments and asked questions as follows:

 

-               the proposal went against the direction of travel;

 

-               what was the rationale behind the reduction in walk-in centres, why and how had this Centre been selected as it was in a deprived area and whether other options had been explored;

 

-               was the lack of funding a major driver;

 

-               who had the CCG consulted;

 

-               would the CCG be proposing other changes and when would these be  ...  view the full minutes text for item 20.

21.

Harrow Safeguarding Adults Board (HSAB) Annual Report 2017/2018 pdf icon PDF 191 KB

Report of the Interim Director of Adult Social Services.

Additional documents:

Minutes:

Members received a report of the Interim Director of Adult Social Services, which provided an overview of safeguarding adults activity undertaken in 2017/2018 by the Council and its key partners through the work of the Harrow Safeguarding Adults Board (HSAB).  It set out the progress made against objectives, analyses the referrals received and outlined priorities for the current year (2018/2019).  The report also included the Harrow Safeguarding Adults Board (HSAB) Annual Report 2017-18.

 

An officer introduced the report and informed Members that, overall, Harrow was performing well against the national average.  She invited questions from those present at the meeting.

 

Members of the Sub-Committee asked questions relating to:

 

-               areas of safeguarding where reported incidences had noticeably increased or decreased over the last year and why this had been the case;

 

-               the training provided to the professionals in identifying victims of modern slavery, sexual exploitation and domestic violence and mechanisms for referrals;

 

-               how Councillors could support the safeguarding agenda.  Were there any particular areas of concern that Councillors could assist with as part of their role as community leaders?

 

In response to the questions, the officer reported that there had been a year on year rise in referrals from 2009/2010 which indicated that more professionals were identifying abuse and/or neglect.  There then followed a 38% rise in concerns for the financial year 2015/2016 due to the threshold being lowered and widened with Care Act 2014 implementation.  There had been an increase in referrals when the Care Act 2014 was implemented but referrals had since levelled off.

 

The officer acknowledged that modern slavery was a new issue and therefore more awareness raising was needed but that there had been four concerns 2017/18 which suggested that staff were more confident in this area of work than previously.  She cited an example of a case for 2018/19 which, unfortunately, the National Referral Mechanism had declined to pursue.  The Council had picked up this case to ensure that the vulnerable person concerned was placed in a safe environment.

 

Members were asked to support in their safeguarding role by bringing the booklet titled “The Little Book of Big Scams” to the attention of their constituents.  The booklet had been produced by the Metropolitan Police and the Home Office and it covered such issues as distraction burglary/door step crime and scams.  The officer undertook to provide the booklet to Members and to share these widely to help ensure community safety.  A Member referred to the services provided by the Fire Brigade to sections of the community such as fitting smoke detectors and making available Smart Water kits.  He acknowledged that raising public awareness was a challenge for public bodies.

 

RESOLVED:  That the work undertaken by the Harrow Safeguarding Adults Board (HSAB) in 2017/18 and the action plan for 2018/19 be noted. 

22.

London North West Healthcare NHS Trust - CQC Inspection Report pdf icon PDF 273 KB

Report of the London North West University Healthcare NHS Trust and Care Quality Commission Inspection Report.

Additional documents:

Minutes:

The Sub-Committee received a report of the London North West University Healthcare NHS Trust in response the Inspection Report of the Care Quality Commission (CQC).  In addition, the Trust also tabled a document setting out the context, ratings, responses to warning notices, steps proposed and its Transformation Programme to help make improvements in the way care was provided.  The Sub-Committee accepted the additional document as the slides provided context to the documents circulated with the agenda.

 

Representatives of the Trust introduced the report and informed Members that the CQC had undertaken an announced inspection of London North West University Healthcare NHS Trust for three days from 5 to 7 June 2018.  Scheduled inspections took place across four sites:  Northwick Park, Ealing, Community Inpatients-Willesden and Clayponds and Community Dental.

 

The CQC had also undertaken a ‘Well-Led’ specific inspection of the entire service from the 3to 6 July 2018 through tours and scheduled interviews with senior managers, service leads and the Executive team.  An unannounced inspection took place between 8 to18 July 2018.

 

Members noted that, as part of the inspection, the CQC spoke to patients, visitors, carers and staff (in the hospitals, in focus groups and formal interviews) to gain a view of London North West University Healthcare NHS Trust’ 8 core services; Surgery, Critical care, Maternity/Gynaecology, Services for Children and Young People, Medical care, Urgent & Emergency Care, Community and Community Dental Services.

 

A representative of the Trust stated that it was disappointed with the report of the CQC and identified the opportunities provided to put measures in place.  The majority of the areas had had improved significantly since the last CQC Inspection in 2015.  He drew attention to the overall ratings and outlined issues at Ealing Hospital’s Emergency Department and Medical Services, and Critical Care at Northwick Park.  He outlined the measures that had been put in place, details of which were included in the tabled document.

 

The representative identified the steps that the Trust would be taking forward to address the recommendations of the CQC and the following measures were planned:

 

-               a Quality Summit would be held at Ealing Hospital on 6 November 2018.  He alluded on the proposed programme and informed Members that key stakeholders had been invited to the Summit;

 

-               work would continue with various sectors of the hospitals to develop and implement action plans, identify further improvements, design suitable solutions and carry out governance reviews;

 

-               move forward with the Transformation Programme to embed quality improvement methodology across all services.  The Transformation Programme would look at the following areas:

 

(a)          innovation and improvement: developing staff to lead on improvements which would include training to help develop long-term solutions to local issues as well as championing a culture of quality improvement across the Trust;

 

(b)          work on core safety issues to offer safe and a high quality of care;

 

(c)          a seamless care service for patients across acute and community services assisted by new technology;

 

(d)          ensure that the Trust was fit for the  ...  view the full minutes text for item 22.

23.

North West London Joint Health Overview and Scrutiny Committee - Update

Minutes:

The Chair reported that the North West London Joint Health Overview and Scrutiny Committee (JHOSC) had met on 19 September 2018 and that the meeting had been hosted by Brent Council.  She reported that:

 

-               JHOSC would be extending its terms of reference to include scrutiny of regional Sustainability and Transformation Plans;

 

-               Councillor Mel Collins from Hounslow Council had been re-elected as Chair;

 

-               Hillingdon Council would be invited to join JHOSC;

 

-               the next meeting of the JHOSC would be hosted by Westminster Council on 4 December 2018;

 

-               Harrow Council would be hosting the JHOSC on 12 March 2019.

 

RESOLVED:  That the verbal report be noted.

24.

Date of Next Meeting

Monday, 4 February 2019 at 7.30pm (Harrow Civic Centre).

Minutes:

RESOLVED:  To note that the next meeting was scheduled to be held on Monday 4 February 2019 at 7.30 pm (Harrow Civic Centre).