Agenda and minutes

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:-

To receive declarations of personal or prejudicial interests, arising from business to be transacted at this meeting, from:

(a)               all Members of the Committee, Sub Committee, Panel or Forum;

(b)               all other Members present in any part of the room or chamber.

RESOLVED:  To note that the following interests were declared:

Agenda Item 8 – The Village Practice Pinner and Buckingham Road Surgery, Agenda Item 9 – NHS Harrow Results and Responses from Consultation on a Polysystem of Primary Care for East Harrow,

Agenda Item 10 – The North West London Hospitals NHS Trust Quality Account.

Councillor Ann Gate declared a personal interest in that she worked in a General Practitioner Surgery in Harrow.  She would remain in the room whilst the matter was considered and voted upon.

Councillor David Gawn declared a personal interest in that his mother worked in a General Practitioner Surgery in the borough.  He would remain in the room whilst the matter was considered and voted upon.

Councillor Mrs Vina Mithani declared a personal interest in that she worked for the Health Protection Agency.  She would remain in the room whilst the matter was considered and voted upon.

Councillor Simon Williams declared a personal interest in that his wife was a Community Psychiatric Nurse for North West London Mental Health Trust.  He would remain in the room whilst the matter was considered and voted upon.

Agenda Item 9 – NHS Harrow Results and Responses from Consultation on a Polysystem of Primary Care for East Harrow

Councillor Barry Macleod-Cullinane declared a personal interest in that he was a Councillor for the Belmont Ward.  He would remain in the room whilst the matter was considered and voted upon.

To appoint a Vice-Chairman of the Sub-Committee for the Municipal Year 2010/11.

RESOLVED:  That Councillor Mrs Vina Mithani be appointed as Vice?Chairman of the Sub-Committee for the Municipal Year 2010/11.

To receive questions (if any) from local residents/organisations under the provisions of Overview and Scrutiny Procedure Rule 8.

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

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

There were none.

Report of the Divisional Director, Partnership Development and Performance.

[The Clinical Director and Head of Contracts for NHS Harrow will be in attendance for this item]

The Director of Development and System Management, Harrow Primary Care Trust (PCT), introduced the report and explained that there were 6 key themes which they had identified as a result of concerns raised about the closure of the Pinner Village Practice.  These issues related to:

·                     why the Village Surgery had closed;

·                     whether the Village Surgery would re-open;

·                     whether a specific doctor would be practising at the new surgery;

·                     why there had been no consultation;

·                     what would future consultations involve;

·                     where could patients now register for GP surgery.

The issues were addressed by the representative who informed the Sub?Committee that:

·                     the PCT previously held a contract with 3 partners at the Village practice.  General Practitioners were independent contractors.  By mid February, two partners had resigned.  However whilst they had left the practice, they were still liable under the contract for provision of services.  The PCT wrote to all three partners to ask for clarity to ensure patient safety and continuity of services.  No joint response was received.  This concerned the PCT and concerns were raised by patients about access to appointments.  The PCT issued a contract notice to attempt to remedy the situation.  The remaining General Practitioner then decided to resign, which left no contract holders on?site.  Subsequently all partners agreed to terminate the contract.  As a result, Pinn Medical Centre was identified to provide temporary cover.  The PCT reported that the General Practitioners worked with them to support a smooth transition;

·                     the Pinner Village practice was not owned by the PCT and it was unlikely that any practice would open at this location in the future.  This decision would have to be made formally by the PCT board following an engagement process with patients;

·                     not having consultation prior to the closure of the surgery was unfortunate.  However there was not enough time given the speed at which events unfolded;

·                     the PCT were committed to consulting on future plans and sought views from the Sub-Committee on how to perform this;

·                     patients from the previous Village Surgery could register at Pinn Medical Centre or other surgeries if they so wished.

During the discussion on this item, Members raised a number of issues, which representatives from the PCT responded to as follows:

·                     figures relating to costs of providing services in one location would be provided to the Sub-Committee;

·                     funding provided to surgeries was largely based on the size of their registered patient lists. Income was received per patient.  The same number of patients would still be registered so funding would remain the same.  Any potential saving would only come from a notional rent which was provided to surgeries by the PCT;

·                     future consultation would aim to gain an understanding from patients of any difficulties they may have in using Pinn Medical Centre and to understand what their general views were;

·                     Pinn Medical Centre was 320 metres away from the Pinner Village practice.  It was a new build which complied with the Disability Discrimination Act.  Car Parking was an issue but there  ...  view the full minutes text for item 6.

Report of the Divisional Director, Partnership Development and Performance.

[The Clinical Director and Head of Contracts for NHS Harrow will be in attendance for this item]

The Sub-Committee were informed that a public consultation had been conducted in relation to the establishment of a polysystem of primary care for East Harrow and the redevelopment of Belmont Health Centre.  The Director of Development and System Management, Harrow Primary Care Trust, explained that a range of feedback had been received.  Patient groups had also been consulted.  The overall response was that over two-thirds endorsed a polysystem and the redevelopment of a Belmont Health Centre.  It was also highlighted however that North West London Hospitals Trust could not fully support the plans for a polysystem model as it could destabilise their financial model.  Harrow General Practitioner community also had some concerns regarding the cost of new service provision.

The results of the consultation had been discussed at PCT board meetings.  A final business case was requested in relation to the redevelopment of Belmont Health Centre.  General Practitioners were key stakeholders and would be fully consulted on the model of care provided at Belmont Health Centre.

During the discussion on this item, Members raised a number of issues which representatives responded to as follows:

·                     the theme of polysystems was about improving care and access for patients closer to home;

·                     the current location for the Belmont Health centre was currently owned by the Local Authority.  There was a proposal to buy the land and discussions were taking place with General Practitioners to see if a sustainable business case could be developed;

·                     consideration would be given to travel arrangements to Belmont Health Centre for those who were elderly, frail and with young children;

·                     Belmont Health Centre was well placed to accommodate a large health centre.  The location was not in a residential area and had good transport links.

The Chairman commented that broadly the Sub-Committee were in agreement with the proposals and asked that they be kept informed of future developments.

RESOLVED: That the report be noted and that Harrow PCT keep the Sub?Committee informed of future developments in relation to a polysystem of care for East Harrow.

Report of the Chief Executive, North West London Hospitals NHS Trust.

[The Chief Executive of the North West London Hospitals NHS Trust will be in attendance for this item]

The Chief Executive of the North West London Hospitals NHS Trust introduced the item and explained that they were required to publish the quality accounts on the website.  The NHS was required to consult with their partners on the Quality Accounts and they were requesting a written statement from the Committee to highlight that this had taken place.

Three main targets had been identified as part of quality improvement for 2010/11.  These were:

·                     reducing mortality rates;

·                     improving patient safety through reducing Healthcare Acquired Infections and increasing incident reporting;

·                     improving the experience of patients in our hospitals by reducing numbers of complaints and improving results in patient experience indicators.

During the discussion on this item, Members raised a number of queries, which the representative responded to, which included that:

·                     MRSA rates had reduced dramatically.  The target was to only have a maximum of 8 cases for this year but to date, there had been no reported cases.  Virtually all patients were screened for MRSA;

·                     there had been a significant reduction in C difficile cases for 2009/10;

·                     there were two main financial issues: ongoing expenditure levels and historic debt which amounted to about £25 million.  The NHS trust had met their financial controls for the last few years and were confident of breaking even for this year.  Additionally improvements were continuing to be made even on reduced resources;

·                     there had been a reduction in complaints in a number of areas.  Complaints were reported to a public board meeting and were being utilised as a tool to gain knowledge and improve performance;

·                     patients’ experiences were monitored by the use of a Link group and the trust’s own patient group called The Hub.  The Hub comprised of over 200 Members;

·                     most of the targets in relation to waiting times were embedded in contracts so there were penalties for not adhering to these;

·                     data relating to the We Care Programme, designed to empower staff to understand the changing needs of patients and make changes necessary to improve the patient experience, was obtained with the assistance of a professional organisation.

RESOLVED:  That the North West London Hospitals NHS Trust be provided with a written statement from the Committee confirming that consultation had taken place regarding the Quality Accounts 2009/10.

Which the Chairman has decided is urgent and cannot otherwise be dealt with.

In accordance with the Local Government (Access to Information) Act 1985, this item was admitted late as details of Health Service Reconfiguration had only just been published.  Accordingly the Sub-Committee received a tabled document which provided details on the Secretary of State for Health’s plans relating to Health Service Reconfiguration.

RESOLVED: That the tabled document be noted.