Agenda and minutes

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

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

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

RESOLVED:  To note that there were no declarations of interests made by Members.

That the minutes of the meeting held on 5 March 2024 be taken as read and signed as a correct record.

RESOLVED:  That the minutes of the meeting held on 5 March 2024, be taken as read and signed as a correct record.

To appoint a Vice-Chair of the Sub-Committee for the 2024/2025 Municipal Year.

RESOLVED:  To appoint Councillor Maxine Henson as Vice-Chair of the Health and Social Care Scrutiny Sub-Committee for the 2024/2025 Municipal Year.

Report of the Strategic Director of Legal and Governance

RESOLVED:  To appoint Julian Maw as a non-voting adviser to the Health and Social Care Scrutiny Sub-Committee for the 2024/2025 Municipal Year.

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 July 2024  Questions should be sent to publicquestions@harrow.gov.uk  

No person may submit more than one question].

RESOLVED:  To note that no public questions, petitions or deputations had been received.

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

None received.

Presentation from the Director of Public Health, Harrow Borough Council.

The Director of Public Health provided a detailed presentation on the comprehensive tobacco control strategy.  The presentation emphasised the following key points:-

·                 That tobacco use was a leading cause of premature mortality in the UK, contributing to 74,600 deaths annually.

·                 The Director discussed the continuation of existing tobacco control policies, including the proposal to raise the legal age of sale for tobacco, as outlined in the recent King's Speech.

·                 The significant disparities in smoking prevalence, with higher rates observed in deprived areas (16% compared to 10% in less deprived areas).  Additionally, the tobacco industry's targeting of adolescents was addressed.

·                 The Director underscored the severe health impacts of smoking, including its role in causing cancer, cardiovascular diseases, and respiratory diseases.

The Public Health Strategist for Tobacco, Peter Marriott, presented a needs assessment specific to the Harrow area, highlighting the following:-

·                 Harrow experienced approximately 303 smoking-related deaths annually, predominantly due to lung cancer, cardiovascular disease, and respiratory diseases.

·                 There were notable disparities in smoking rates, with higher prevalence among Eastern European communities and in deprived areas.

·                 The challenges such as the limited capacity of local stop-smoking services and the need for tailored support for different communities, particularly addressing language barriers faced by Romanian speakers.

·                 The issue of illicit tobacco, with concerns about the lack of comprehensive local data and the additional dangers posed by counterfeit products.

·                 concerns regarding the rise in vaping among school children, despite the absence of detailed local or national surveys on the issue.

The Health Strategist outlined a provisional tobacco strategy with four key components as follows:-

1.                  Increasing Capacity and Tailoring Services:  The strategy included the recruitment of additional workforce, the introduction of workplace services, and the promotion of vaping as a safer alternative to smoking.

2.                  Enforcement of Illicit Tobacco Laws:  Collaboration with Trading Standards, police, and customs would be strengthened to combat illegal tobacco sales and to encourage community reporting of such activities.

3.                  Preventing Youth Smoking:  Efforts would be made to prevent smoking initiation among youth through outreach programs in schools and youth services.

4.                  Partnership Working:  The strategy emphasises leadership in tobacco control, collaboration with London-wide initiatives, and the utilisation of government funding to enhance resources.

The Chair thanked the Director of Public Health and the Public Health Strategist for their thorough and informative presentations.

Members enquired about national efforts to restrict tobacco advertising, particularly in foreign media and online channels, and whether the Council would receive a specific report on this issue.  Officers acknowledged that controlling tobacco advertising had become increasingly complex due to global media access.  They noted that while EU countries had strict regulations, many non-EU countries, especially in Asia and Africa, lacked such controls.  Officers agreed to consider bringing the issue back for further discussion and to take submit a report to the Health and Wellbeing Board.

Members asked about strategies to prevent the next generation from using tobacco products.  Officers advised that the UK's proposed legislation aimed at preventing future generations from purchasing tobacco.  They also highlighted the  ...  view the full minutes text for item 66.

Presentation from the Managing Director of Harrow Borough Based Partnership.

Lisa Henschen, Managing Director of the Harrow Borough Based Partnership, presented the report on Harrow’s discharge rates and winter planning.  She outlined the high discharge rates in Harrow compared to Northwest London, noting that Harrow’s rate was 22% above the Northwest London average in March, although it had slightly decreased since then.

The Managing Director of the Harrow Borough Based Partnership, explained the discharge pathways as follows:

1.                  Pathway 0: Discharged with no additional support.

2.                  Pathway 1: Discharged with a home care package.

3.                  Pathway 2: Short-term rehab in units like Buchanan Court and Woodlands Centre.

4.                  Pathway 3: Discharged to residential placements.

The Managing Director highlighted that more hospital admissions inevitably led to higher discharge numbers, which adversely affected hospital flow and patient experience.  She attributed the root cause to Harrow’s older population, which had a higher proportion of elderly residents, leading to increased admissions.  When data was adjusted for age, Harrow's performance aligned more closely with other boroughs.

The Managing Director advised that ongoing support for discharge processes and better-funded community services were essential to prevent admissions.  She emphasised that addressing both admissions and discharge pathways was crucial for improving hospital flow.  Ongoing advocacy for enhanced funding for community-based services was necessary.

The Chair asked if the primary issue lay with admissions rather than discharges, seeking clarification on what the research indicated.  The Managing Director confirmed that the main challenge was the high number of admissions, primarily due to Harrow’s older population and a significant number of residents with multiple long-term conditions.  She assured the sub-committee that the criteria for hospital admissions were stringent, ensuring only those in need of hospital care were admitted.

The Chair enquired whether all alternatives to hospital admissions had been explored.  The Managing Director responded that Harrow had a robust community service, including the rapid response service and the care home response team, to prevent unnecessary hospital admissions.  However, she noted that these services were underfunded compared to other areas in Northwest London.  Advocacy for better funding to enhance these services was ongoing.

Members raised questions about whether response services were shared across Northwest London or kept separate by borough.  The Managing Director advised that currently, each borough had its own response team, but they were exploring the possibility of sharing resources, such as a joint Harrow and Brent rapid response team, to increase capacity and efficiency.  She explained that the current structure was due to historical commissioning practices, but they were working towards more integrated services.

In response to a question from Members about the feasibility of sharing response teams across boroughs, officers advised that it would be a straightforward process, as management teams already supported multiple boroughs.  They noted that sharing resources could improve efficiency and allow for greater investment in clinical teams.  Transition towards a more integrated system under the Northwest London commissioning framework was underway.

The Chair thanked the Managing Director for the comprehensive update and responses. Officers emphasised the need to analyse the reasons behind high  ...  view the full minutes text for item 67.