Agenda and minutes

Health and Social Care Scrutiny Sub-Committee - Tuesday 29 November 2022 6.30 pm

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

Contact: Kenny Uzodike, Senior Democratic & Electoral Services Officer  E-mail:


No. Item


Attendance by Reserve Members

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

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RESOLVED:  To note that no Reserve Members were 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.

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Councillor Maxine Henson declared a non-pecuniary disclosable pecuniary interest in that she was mentioned in the report.


Minutes pdf icon PDF 138 KB

That the minutes of the meeting held on 27 June 2022 be taken as read and signed as a correct record.

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RESOLVED:  That the minutes of the meeting held on 27 June 2022, 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, 24 November 2022.  Questions should be sent to   

No person may submit more than one question].

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



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

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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.

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

Resolved Items

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System Winter Plan pdf icon PDF 113 KB

Report of the Deputy Chief Executive, London North West University Healthcare NHS Trust


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Members received a report from the Deputy Chief Executive of London North West Healthcare NHS Trust. Mr Simon Crawford.  The report and supporting appendix set out the progress made in preparation of the Trust’s winter plans in recognition of the on-going emergency demand and pressures faced by acute Trust hospitals.


Members asked the following questions:


A Member asked if there was a follow up after the patient was directed to the community as detailed on page 16 of the agenda.  It was explained that there was collaborative working in place with partners in community or social services to confirm that care was in place before a patient was discharged.  There were home visits arranged once a patient is discharged and an advance package of care for them to go back into the community.


A Member questioned about what would happen if the patient was alone.  It was explained that an assessment of a patient’s dependencies would be made in advance, by health and social services and if house visits were required, they would be arranged in advance so there was a service in place which could give additional care and support.


The chair commented that it would be interesting to review the data at some point for future purposes.  It was explained that in Northwick Park in a week, 65 to 100 patients were discharged everyday over the different discharge pathways:


·                 Pathway 0, - would be those who could go home without a package of care,

·                 Pathway 1 - Community Package of care in their own home

·                 Pathway 2 - a typical low-level care - care homes or social services provision

·                 Pathway 3 – this was more complex.


There were discharge meetings with the local authority, with community providers as well as the patient and families to discuss the appropriate package of care needed, so there was a robust process in terms of engagement, assessments, chasing up care homes to assess a patient in terms of whether they could take them, given their clinical care criteria.  All this was done through daily escalated discharge calls between health, social care and discharge statistics could be shared with the Committee perhaps in future.


It was agreed that a review of system plans would be beneficial.


Another Member asked about reports that patients were being discharged after 10 pm.  The Member was concerned about the impact on elderly patients.  It was explained that it was not a policy or the intention to discharge patients late at night.  Though there were exceptional cases, where patients had been discharged between 8 and 10 pm.  Efforts were made to discharge most patients by 5pm at the latest.  In some cases, patients could still be waiting for transport.  It was the practice to avoid discharges after 5 pm wherever possible.


A member questioned about waiting times at the A&E and clarity was provided.  It was confirmed that the standard waiting time was 4 hours to be seen and to be admitted from A+E within 12 hours.  ...  view the full minutes text for item 19.


LNWHT Strategy pdf icon PDF 114 KB

Report of the Deputy Chief Executive, London North West University Healthcare NHS Trust


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Members received the report with an introduction from the Deputy Chief Executive of London North West Healthcare NHS Trust, Mr Simon Crawford.  The report and supporting appendix set out the progress with the Trust’s development of its new five-year strategy with the following highlights:


·                 A three phased approach had been adopted to help build a strategy to overcome the critical obstacles facing LNWH; diagnose any issues, develop a focused response and actions.


·                 The strategy had been informed by extensive input from our employees, patients and the local population and input was gathered through online events, in person events and a multilingual community survey. A diverse set of respondents completed the survey which showed they valued the latest treatments, improved timeliness of follow ups and results.


Members asked the following questions:


A Member questioned if more administrative staff would be needed when the new patient record system was implemented or would doctors access patients’ information directly.  It was explained that the information would be on an electronic system and easy to access.  A completely integrated process that would be updated with every step of the patient’s journey that would feed into bed management and share the discharge list everyday with partners.  In future this would reduce the demand for administrative resources but create different roles.


The chair questioned how implementation of the strategy would affect the backlog and waiting lists.  It was explained that the backlog was already being dealt with and the Trust was already delivering more activity month on month than it was PreCovid, there were more elective operations, more first outpatients and diagnostic activity, national targets were yet to be achieved but activity was over 100% of pre-Covid levels.  There was a lot being done to reduce inefficiencies, improve, effectiveness, quality, and communication.  This should lead to more outpatient appointments, diagnostic testing, and elective care operations.


A Member asked and received clarity on the diversity of the survey response statistics.  It was explained that efforts were made to increase representation from underrepresented groups through community partners which led to a significant increase.


The Chair asked about the timing for training staff for the new systems and the challenges facing the Trust in the attraction, support, and retention of staff.  Simon explained overall vacancy rates compare favourably with other Trusts in North north-west London, they were not significantly better, but neither were they significantly worse at staff retention.  A big focus in the Strategy was the health and wellbeing of staff and support and career development.  Improvement was needed with staff retention and there were efforts being made such as recruiting staff from the local population, improving the ethnicity representation of our staffing profile, access to apprenticeships, and development programmes, collaborative appointments for more senior staff such as secondment, training or joint working or joint appointments so that staff do not necessarily need to leave the Trust to get that experience.


A Member raised concerns that the impact of Covid-19 had on hospital staff especially doctors and  ...  view the full minutes text for item 20.


Update on St Mark's Hospital - Relocation of Services pdf icon PDF 136 KB


Report of the Deputy Chief Executive, London North West University Healthcare NHS Trust


Additional documents:


Members received an introduction to the report by Mr Simon Crawford, the Deputy Chief Executive, London North West University Healthcare NHS Trust and a presentation from Mr John Watson, the divisional director of operations for St Mark's services.


Members asked the following questions: 


A Member questioned how the c50 in-patient beds released at NPH would be utilised and when as the emergency department was under unrelenting pressure.  It was explained that the beds had already been converted to additional non-elective emergency admission capacity and had been vital in supporting the Trusts response to emergency demand.


The Chair questioned if the success of the move was corroborated by feedback from patients and residents who may have had concerns about the increased travel time.  It was explained that as St Marks is a national service where patients come locally and from all over the country, many of St Marks patients have chronic long term conditions requiring on-going treatment and support and where it is possible, patients will still be able to attend the site of their preference although all the most complex surgery cases requiring possible access to a critical care bed will still be undertaken at Northwick Park Hospital.  The main benefit of moving to Central Middlesex was to provide protected capacity where the less complex operations can be planned and completed without risk of cancellation due to demand from emergency patients requiring theatre time.  Planned procedures at CMH are now reliably delivered so people have waited less time because of the move than they otherwise would have.  Mr Watson explained over 2,000 procedures have taken place successfully since the move to CMH and patient feedback has been very positive.


The Chair questioned about the expected net impact of the additional capacity that would be created by the £10m capital redevelopment, for five new endoscopy suites at CMH.  It was explained that at Northwick Park there was a facility with six rooms, which were too small and no longer met the requirements for a modern effective endoscopy suite.  There was not enough recovery space.  For Northwick Park the Trust has plans to refurbish the existing department to create four modern appropriately sized rooms, meeting latest dignity and infection control standards.  In addition the 5 new endoscopy suites being built at Central Middlesex, will give a net overall increase of 3 endoscopy suites in total which is necessary to support the increased referrals for endoscopies in line with National demand and capacity forecasts as well as local population growth modelling.


The Chair questioned about the terms of the importance of JAG accreditation for endoscopy services.  It was explained that JAG was a national accreditation system for endoscopy services which involved inspection of physical facilities, the way the service was run and patient feedback.  The Trust now had full accreditation for Central Middlesex Hospital and for Northwick Park hospital this currently conditional on the capital scheme that was outlined being progressed over the course of the next 12 months.  Every other element of  ...  view the full minutes text for item 21.