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 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.

RESOLVED:  To note that the following interests were declared:

Agenda Item: 4 - Shaping a Healthier Future for Harrow

Councillor Krishna James declared a disclosable non pecuniary interest in that she was a Registered Nurse and had relatives who were in the medical profession.  She would remain in the room whilst this matter was considered.

Councillor Mrs Vina Mithani declared a disclosable non pecuniary interest that she was employed by the Health Protection Agency.  She would remain in the room whilst this matter was considered.

Councillor Ben Wealthy declared a disclosable non pecuniary interest in that he was an employee of a Patients Association.  He would remain in the room whilst this matter was considered.

To receive deputations (if any) under the provisions of Committee Procedure Rule 16 (Part 4B) of the Constitution.

RESOLVED:  To note that no deputations were received at the meeting under the provisions of Committee Procedure Rule 16.

Presentation from NHS NW London.

The Chairman welcomed Tina Benson, Deputy Director of Operations, Dr Amol Kelshiker, Harrow CCG, Javina Sehgal, NHS Brent and Harrow, Marcel Berenblut, NHS Brent and Harrow, David McVittie, North West London Hospital NHS Trust and Dr Mike Anderson, Medical Director, Chelsea and Westminster Hospital NHS Foundation Trust to the meeting.

Dr Kelshiker, the Chair of the Harrow Clinical Commissioning Group supported by Javina Seghal, acting Harrow Borough Director gave an overview of the proposals for out of hospital care.  The following comments were made:

·                     there was a commitment to providing care and services as close to a patient’s home as possible through primary or community care;

·                     patient access to GPs services would be important to ensure timely interventions and to prevent unnecessary admissions to hospital;

·                     the new 111 system would provide a single point for patients to receive advice and to be signposted to other services;

·                     the integrated care pilot had involved case management of those patients at a higher risk of being admitted to hospital.  There was multi-agency support to prevent undue risk of an admission to hospital.

The Corporate Director of Community, Health and Wellbeing stated that one of the positive advantages of the new CCG for Harrow was that it included the whole of the borough and all of the GP practices.  There would be six neighbourhood areas and all of these would have an integrated team.

Members raised several points which were responded to by the representatives as follows:

·                     an emergency admission of a patient to hospital should be foreseen and safety nets should be in place involving various agencies such as social services.  Consideration should be given to what had failed to result in a patient presenting to a GP as a crisis and being admitted to hospital;

·                     a pilot had taken place in inner London which had shown that intervention prevented unnecessary admissions to hospital.  A similar arrangement was being considered for other outer London areas including Harrow and Ealing.  The focus was putting patients first and there was a need to make people aware of the arrangements;

·                     this would be the largest integrated care programme in the world involving two million people;

·                     the 35 GP practices in the borough would be included in the six neighbourhood groups, which would have the skills to support patients who previously might have gone to hospital.  Services would be developed to enable other health problems such as diabetes and cardiac problems to be treated in this way;

Members expressed concern about accessibility under the proposed new arrangements and Dr Kelshiker responded by making comments, including the following:

·                     accessibility issues would be addressed as part of the Shaping a Healthier Future programme as the approach would be coherent and integrated.  A key issue was how primary and community care complimented hospital care.  There would need to be investment in primary and community care;

·                     it was accepted that not all services could be delivered from all surgeries and centres but in many cases care and services would be  ...  view the full minutes text for item 119.