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 that there were no Reserve Members in attendance at this meeting.

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

(a)               all Members of the Sub Committee;

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

Agenda Item: 8 Outline Business Case for Ealing Hospital Trust and North West London Hospital Trust Potential Merger; Agenda Item: 9. HealthWatch; Agenda Item: 10. Adult Social Care – Local Account

Councillor Ann Gate declared a personal interest on the above items in that she was employed by the Pinn Medical Centre.  She would remain in the room whilst these matters were considered and voted upon.

Councillor Mrs Vina Mithani declared a personal interest in the above items in that she was employed by the Health Protection Agency.  She would remain in the room whilst these matters were considered and voted upon.

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

That the minutes of the meeting held on 24 October 2011 be taken as read and signed as a correct record.

RESOLVED:  That the minutes of the meeting held on 24 October 2011 be taken as read subject to:

The first line of Minute Item 66, paragraph two being amended to read: ‘Mr Simon Crawford, Senior Responsible Officer for the Organisational Futures Programme for Ealing Hospital NHS Trust and the North West London Hospitals NHS Trust …’

To receive questions (if any) from local residents/organisations under the provisions of Committee Procedure Rule 17 (Part 4B of the Constitution).

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.

RESOLVED:  To note that there were no references.

Report of the North West London NHS Trust.

Mr Simon Crawford, Senior Responsible Officer for the Organisational Futures Programme for Ealing Hospital NHS Trust and the North West London Hospitals NHS Trust introduced the Outline Business Case (OBC) for the Ealing Hospital Trust (EHT) and North West London Hospital Trust (NWLHT) potential merger.  The OBC, titled ‘STRONGER Together’, put forward the case for the creation of a single trust by July 2012.

Mr Crawford stated that the OBC had been approved by both Trust Boards in November 2011 and contained four key chapters.  Chapter 3 - Commissioning Strategy in North West London, provided an overview of the health needs of Brent, Ealing and Harrow, the three boroughs served by the Trusts.  It examined the priorities of the Commissioners, the financial challenges and the potential impact on services.  He added that the Commissioning Strategy had been formed with input from GPs and community groups, seeking to place a greater emphasis on shifting care from hospitals into the community.

Chapter 4 - Implications for EHT and the NWLHT, investigated the implications for each hospital should it remain independent, and outlined the visions of both Trusts to deliver the highest quality of care.  It examined the latest guidance issued by bodies such as the National Institute for Clinical Excellence and the Care Quality Commission (CQC), for example.  The chapter concluded that reasons such as the increased availability of appropriate staff and services would serve to demonstrate why a merger would be beneficial to patients.

Chapter 6 - Clinical Vision for a Combined Organisation, discussed how the potential merger would make better use of equipment and resources.  It provided the clinical vision to deliver the benefits of an integrated healthcare service through increased partnership with GPs and social care sector, for example.  The chapter also included an appendix which was devised with input from senior clinicians and GPs within the Trusts to highlight scenarios in response to the future commissioner’s plans for services.

Chapter 7 - Financial Evaluation, inspected the historical performance of both Trusts. Responses to the financial challenge had been developed through a Finance Working Group.

In response to a question by a Member relating to how many redundancies would result from the merger, Mr Crawford advised that there would be employment implications for roles associated across the merged organisations.  Mr Peter Coles, Interim Chief Executive of North West London Hospitals Trust, added that there were no detailed workforce plans at this stage, and stated that efficiencies would be sought from non-clinical staff to protect patient service delivery.

A Member queried the reduction in the physical footprint of the hospitals involved in the potential merger.  Mr Crawford advised that the intention was to place a greater emphasis on providing services in the community, and added that work with GPs and those from the community sector would be continued to help develop outreach services.  Estates planning exercises would be conducted as part of the Full Business Case (FBC), which was under construction.

In response to a question by a  ...  view the full minutes text for item 75.

Presentation of the Assistant Chief Executive, Harrow Council.

The Sub-Committee received a presentation of the Assistant Chief Executive which outlined the establishment of local HealthWatch by October 2012, subject to the Health and Social Care Bill.  The officer advised that:

·                    HealthWatch would be the local consumer champion across health and social care;

·                    Local HealthWatch would not be a network but a ‘body corporate’, independent of the Authority.  ‘Body corporate’ would include companies with limited or unlimited liability, companies limited by guarantee, charter companies and bodies created by statute;

·                    Overseeing HealthWatch would be HealthWatch England, the national independent champion for health and social care consumers.   HealthWatch England would sit within the Care Quality Commission (CQC) to provide support to local HealthWatch organisations.

In response to a question by a Member regarding the accountability of HealthWatch, the officer advised that an option was for the Management Group, which included representatives from Adult Complaints and the voluntary and community sector, to become more robust to help scrutinise performance and an options paper will be put together to address this.  An adviser to the Sub-Committee suggested that as HealthWatch was independent, it would operate outside of Council scrutiny system.  The  officer asserted that it will be even more important to build a more robust management group to monitor performance as HealthWatch would have a great deal of responsibility.  This was acknowledged by Members.

A Member queried the percentage of income that would be awarded to HealthWatch.  The officer responded that the money awarded would be dependant on the services HealthWatch were expected to deliver.  The officer added that HealthWatch would be shaped through intensive consultation exercises within the community.  A rigorous tendering exercise, similar to that conducted when founding LINk, would ensure the establishment of a prosperous Local HealthWatch.

RESOLVED:  That the presentation be noted.

Report of the Corporate Director of Adults and Housing.

The Corporate Director for Adults and Housing introduced a report which set out the Directorate’s historical approach to Quality Assurance and how this had led to the development of a Local Account for Adult Social Care.

The officer advised that the importance of robust quality assurance remained as the Care Quality Commission (CQC), the regulator of home care and residential inspections, had ceased assessing all local authorities work with vulnerable people.  Harrow’s Quality Assurance framework, which had received national acclaim, had been developed around four key areas:

1.                  Independent Challenge;

2.                  Consumer/Citizen Challenge;

3.                  Provider Challenge;

4.                  Professional Challenge.

All quadrants were continually being monitored to ensure the best performance from a variety of perspectives.

In response to a question by a Member, the officer advised that user views were essential.  Those using the services had the opportunity to provide direct feedback on how services should work and improvements they would like to see implemented. 

In relation to a question by a Member relating to the potential merger, that officer stated that the Ealing Hospital Trust and North West London Hospital Trust potential merger had not had an impact on services.  The situation surrounding the potential merger would be monitored. 

In response to a question by a Member regarding personal budgets, the officer advised that it was hoped the Council would commit to all eligible residents in the borough receiving personal budgets, although choice was at its heart and personal budgets were by no means mandatory.  Consideration would be given to utilising Local HealthWatch to help interpret the Adult Social Care Local Account.

A Member queried how the Local Account would be made more accessible.  An officer advised that more digestible versions would be available once the document had been transferred to Easy-Read.  In addition, in response to consultation, a DVD had also been produced to make the Local Account accessible to all areas of the community.  The officer added that continuous dialogue with customers and regular meetings with service users ensured that management were kept fully engaged with what was happening in the community.

RESOLVED:  That the report be noted.