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.

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:

All Agenda Items

Councillor Mrs Vina Mithani declared a non-pecuniary interest in that she was employed by Public Health England.  She would remain in the room whilst all matters were considered and voted upon.

Councillor Chris Mote declared a non-pecuniary interest in that his daughter was employed at Northwick Park Hospital.  He would remain in the room whilst all matters were considered and voted upon.

That the minutes of the meeting held on 24 November 2014 be taken as read and signed as a correct record.

RESOLVED:  That the minutes of the meeting held on 24 November 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, Monday 2 February 2015.  Questions should be sent to publicquestions@harrow.gov.uk  

No person may submit more than one question].

RESOLVED: To note that none were received.

Report of the Director of Public Health.

The Sub-Committee received a report of the Director of Public Health which looked back over 50 years at a selection of topics which were public health issues fifty years ago and remained issues currently and contained proposals to address these.

Following a brief overview of the report, an officer responded to the following questions from Members:

·                    Obesity had a number of other conditions such as type 2 diabetes associated with it.  What strategy was in place to deal with the high levels of diabetes among residents in Harrow?

There was an obesity strategy in place.  Local analysis had shown that Harrow had one of the highest rates of diabetes nationally, which was prevalent mainly among those residents of South Asian origin.   However, GPs provided excellent advice and services which were focussed on prevention.  Harrow had the lowest complication rates for diabetes in the Country.

·                    Had the take up rate for NHS Health Checks trialled by Barnet and Harrow improved and had these been sufficiently publicised to the residents of both boroughs?  Harrow had the highest rate of TB in London.  What screening process was there for migrants who came to the UK who may be carriers?

The take up rate for Health Checks in both boroughs had improved since 2014.  Point of care testing equipment had been rolled out to local pharmacies, where only a single visit, (as opposed to two or three visits to a GP) was required.  These were also being offered at community venues.

Health checks for TB were required under visa conditions for travellers coming to the UK from south Asian countries.  However, this would not eliminate those who had latent TB which could be exacerbated by a poor diet and living conditions and may be expressed at a later stage.  Public Health England was rolling out a latent TB test which was being trialled at the clinic in Wealdstone.

·                    What was the strategy in relation to smoking cessation and deterring young people from starting smoking in the first place.  Was there any evidence that e-cigarettes were less harmful than tobacco products?

The evidence base for or against e-cigarettes was not sufficiently strong to provide a definitive answer.  Officers carried out test purchases of e-cigarettes and prosecuted any one found to be selling them to those under age.  The National Institute for Clinical Excellence had set up London-wide and nationwide initiatives to look into this and was working in partnership with ASH and the National Centre for Smoking Cessation and Training (NCSCT).

·                    Were home STI testing kits being promoted?

The home testing kits were being promoted and were available for a number of different STIs.  Early HIV testing was being promoted at clinics.

·                    Had the take up rates for the measles vaccination improved in Harrow?

In recent years there had been a national decrease in the take up rates for the measles vaccination.  The take up rate in Harrow in percentage terms was in the low 90s.  There was a targeted programme to  ...  view the full minutes text for item 36.

Report of the Chief Nurse, London North West Healthcare NHS Trust.

The Sub-Committee received a report of the Chief Nurse at London North West Healthcare NHS Trust (LNWHT) which provided an update on the Trust’s emergency pathway and the action it was undertaking to address the underperformance of the core A&E performance targets.

Following a brief overview of the report by the Chief Operating Officer at LNWHT, he responded to the following questions from Members:

·                    Had the recent introduction of a Golden Hour ward round helped to improve weekend discharges and reduce the length of stay or had this led to patients being discharged at odd hours, i.e. late at night?

Patients were not discharged at odd hours.  The high rate of re?admissions at Northwick Park Hospital was average in comparison to other hospitals but this figure was rising.  High re-admission rates may be due to patients being discharged too early, patients’ difficult home circumstances and inadequate community based support. 

·                    Why were the current levels of A&E waiting times so high?

This had been due to winter pressures i.e. illnesses such as flu outbreaks.  However, the levels had not been as high as in previous years.

·                    Had penalty clauses for delays in delivering the construction of the modular unit been written into the building contract?

Penalty clauses had been written into the contract as there were inherent risks associated with working on such a complex site, however, he did not anticipate any major challenges which would lead to delays in completion by December 2015.

·                    What was being done to ensure better signage for and access to the A&E unit?

The estates service at Northwick Park was aware of the situation and was working to resolve it.

·                    What measures were in place to ensure that those patients who were not eligible for free treatment were being charged accordingly?

There was a well-developed incmome protection policy in place.  However, this would not apply to emergency care as it was the ethos of the NHS to provide emergency care to everyone.

·                    What would be the net increase in bed capacity after the building works were completed at Northwick Park Hospital?

There had been an increase of 40 beds in the current financial year and there would be 66 additional beds once the modular build was complete.  Although this increase represented an increase in capacity that would bring the hospital on par with other A&E provision in London, it should be noted that demand at peak times would continue to exceed bed capacity, though this would occur with less frequency than previously.

·                    Ealing Hospital had recently extended the level of consultant cover at weekends.  Was there sufficient weekend consultant cover at Northwick Park Hospital?

Yes, as it was the Trust’s policy that working arrangements and working conditions for staff at all three hospital sites should be the same. 

·                    The Capita report of May 2014 suggested that an additional 100 beds were needed at Northwick Park Hospital – would this be sufficient?

The figures quoted in the report  ...  view the full minutes text for item 37.

Follow up action from the Sub-Committee meeting of 24 November 2014, for further discussion.

At its meeting of 24 November 2014, the Sub-Committee Members had indicated a desire to submit evidence and comments from the Sub-Committee to be fed back to the Care Quality Commission (CQC) in relation to its inspection of the CNWL planned for 23 February 2015.

An adviser from Harrow Healthwatch stated that Harrow Healthwatch had already forwarded comments to the CQC, which would inform the work of the inspectors.  Patients’ groups and user groups had also fed back to the CQC regarding improvements they would like to see made to local services.

In view of the above, the Sub-Committee decided not to send any additional comments to the CQC and requested that a copy of the inspectors findings and any subsequent compliance action plan be forwarded to Sub-Committee Members as soon as they were available.

RESOLVED:  That the CQC be requested to forward a copy of the inspector’s findings and any subsequent compliance action plan to Sub-Committee Members as soon as they were available.