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 Members:-

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 10 - Outcome of Public Consultation Exercise:  "Proposal for Redistribution of Resources from Day Assessment Unit to Memory Services in Harrow"

Councillor Krishna James declared a non-pecuniary interest in that her son was a patient at Northwick Park Hospital.  She had also been a mental health service user and had been an employee of RETHINK.  She would remain in the room whilst the matter was considered.

That the minutes of the meeting held on 11 February 2014 be taken as read and signed as a correct record.

RESOLVED:  That the minutes of the meeting held on 11 February 2014 be taken as read and signed as a correct record.

To receive any public questions received in accordance with Committee Procedure Rule 17 (Part 4B of the Constitution).

Questions will be asked in the order notice of them was received and there be a time limit of 15 minutes.

[The deadline for receipt of public questions is 3.00 pm, 16 April 2014.  Questions should be sent to publicquestions@harrow.gov.uk  

No person may submit more than one question].

RESOLVED:  To note that 2 public questions had been received and responded to, and in line with the statement made by the Leader of the Council (see Note 2 above) the recording for the first question had been placed on the website.

The Chair advised the second public questioner that the response to her question would be covered during discussions of agenda item 7.

To receive petitions (if any) submitted by members of the public/Councillors under the provisions of Committee Procedure Rule 15 (Part 4B of the Constitution).

RESOLVED:  To note that no references or petitions were received at this meeting.

Report of the Associate Director for Quality & Service Improvement, Central & North West London NHS Foundation Trust.

The Sub-Committee received a report of the Chief Executive of the Central and North West London NHS Foundation Trust (CNWL), which set out its Quality Accounts for 2013/14.  The Service Director of Psychological Medicine and the Chief Operating Officer at CNWL took turns to respond to Members questions.

Members asked the following questions:

·                     what support and training was available for carers of those suffering from dementia and whether a carers’ Champion had been identified;

·                     why there was no carers’ representative on the Health & Wellbeing Board;

·                     whether public confidence in the maternity unit at Northwick Park Hospital had been restored and whether there were any specialist measures in place for high-risk pregnancies;

The Chief Operating Officer advised that:

·                     he would circulate information regarding support and training of carers to Members after the meeting;

·                     there was evidence that increasing numbers of expectant mothers were choosing to have their children at Northwick Park Hospital and the hospital had delivered 5,300 babies in the previous year.  However, patient surveys had flagged up some concerns regarding staffing levels and the midwife to birth ratio.  The service would be inspected by the CQC in May 2014; 

·                     the hospital was working closely with the Clinical Commissioning Group (CCG)  and had commissioned a study to look at demographic and other issues with a view to improving the process of identifying high-risk pregnancies.  The high rate of Caesarian sections carried out could be an indicator of insufficient obstetric hours.

RESOLVED:  That the report be noted.

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

The Sub-committee received a report of the Chief Executive of the North West London Hospitals NHS Trust (NWLHT).  It was noted that the agenda incorrectly listed NWLHT as a Foundation Trust.

The representatives from NWLHT made the following points:

·                     there was evidence to support the view that NWLHT had failed its patients and staff;

·                     there had been some improvement in A&E waiting times, however, this needed to be managed better;

·                     one possible reason was that those patients who were admitted on a Friday, tended to have longer stays in hospital as less work was carried out at the weekends;

·                     there was evidence to show that a number of patients were occupying acute beds at Northwick Park hospital because there was no other bed space for them, demonstrated a major system failure that needed to be tackled;

·                     the hospital was undertaking measures to improve both the staff and patient experience.

Members asked the following questions:

·                     what were the key factors for consideration in the post-Francis landscape;

·                     were A&E waiting times likely to improve;

·                     what engagement with board members would there be regarding  Foundation Trust status for the hospital;

·                     how soon would the A&E facilities at Northwick Park be available;

·                     whether there were adequate clinical staff to meet increase in patient numbers and patients’ increasingly complex needs.

The Chief Operating Officer & Deputy CEO of CNWL stated that the Francis report had been a salutary experience for any board Member.  Key challenges ahead included understanding of staffing levels, the need to identify the best nurse to patient ratio.  He added that:

·                     membership of the hospital board should be more representative;

·                     additional A&E capacity planned at Northwick Park would help with planned changes at the Central Middlesex Hospital;

·                     discussions with the Board had flagged up that there were significant issues to be tackled prior to submission for Foundation status;

·                     CNWL’s A&E would close late in the summer of 2014 and it was anticipated that A&E facilities at Northwick Park would be available in October 2014.  NWLHT needed to be confident that all potential risks had been managed in order to avoid any decline in service and ensure its resilience.

RESOLVED: That the report be noted.

Report of the Assistant Director of External Compliance and Quality Assurance.

RESOLVED:  That this item be deferred until the next meeting to allow the representative from the Royal National Orthopaedic Hospital to respond to Members’ questions regarding the report.

Report of Service Director, Older People & Healthy Ageing (OPHA) Service Line, Central & North West London NHS Foundation Trust (CNWL).

The Sub-Committee received a report of the Service Director of the Older People and Healthy Ageing Service Line at the Central and North West London NHS Foundation Trust (CNWL).  The Chief Operating Officer at the Central & North West London NHS Foundation Trust did a presentation based on the report.

Members asked the following questions:

·                     what was being done to address the issue of service users who were or felt isolated socially, for example, those whose first language was not English?

·                     how many users had responded to the paper copy of the consultation document?  Was there a dementia lead officer at the Council?

·                     what measures were being undertaken to engage the community and relevant partners?

The Chief Operating officer advised that:

·                     some language specific assessment tools, for example, visual, non-language specific tests and the obtaining of a detailed patient history from family members and carers and scans contributed to the current diagnosis rate of between 70-80%;

·                     currently there was no dementia lead at the Council, and this would be looked into;

·                     NWLHT had taken a whole system approach whereby the Clinical Commissioning Group, GPs’ surgeries, Pharmacists and other relevant community partners were being engaged with.

RESOLVED:  That the report be noted.

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

In accordance with the Local Government (Access to Information) Act 1985, the following item was included late on the agenda as its regulator, Monitor, was looking into whether the NWLHT was in breach of its licence conditions as a result of enforcement action by the Care Quality Commission, in order to address Members concerns.

The representatives from NWLHT advised that, in addition to the CQC, Foundation Trust hospitals were also overseen by the regulator, Monitor. NWLHT acknowledged that it had been non-compliant on this occasion and was actively seeing what lessons could be learnt from the experience.  Their issues related to staffing levels and staff competencies.  He undertook to feedback the outcome of Monitor’s investigations to a future meeting of the Sub-Committee.

RESOLVED: That the discussion above be noted.

In accordance with the provisions of Committee Procedure Rule 14.2 (Part 4B) of the Constitution:

RESOLVED:  At 9.59 pm to continue until 10.30 pm.