Agenda and minutes

Members considered a report of the Assistant Chief Executive, which proposed changes to the terms of reference of the Committee, largely to reflect changes arising from the Local Government and Public Involvement in Health Act 2007.  It was

Resolved to RECOMMEND: (to Council)

That the revised terms of reference of the Overview and Scrutiny Committee, as set out at Appendix 1 to these minutes, be approved.

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 Items 9/10/11/12 – Annual Health Checks – Developing Scrutiny’s Commentaries on NHS Trusts’ Declarations to the Healthcare Commission/Overview of Cost Improvement Programme/Interim Report on Fire Incident on 11 February 2009/Provision of Primary Care Services in Harrow East

MrRamji Chauhan, a representative of parent governors on the Committee, declared personal interests in items 9-11 in that his son was being treated at Northwick Park Hospital.

Councillor B E Gate declared personal interests in items 9-12 in that his wife worked for a General Practice in the borough, his daughter worked part-time in another, and he was an outpatient at Northwick Park Hospital.

Councillor Vina Mithani declared personal interests in items 9-12 as she worked for a Health Protection Agency.

Councillor Janet Mote declared personal interests in items 9-11 as her daughter who was a nurse worked for a Trust.  She also declared a personal interest in item 12, as her mother lived in Harrow East.

Councillor Anthony Seymour declared personal interests in items 9-11 in that he had been a patient at Northwick Park Hospital and a relative had been treated at St Mark’s Hospital.

Councillor Rekha Shah declared personal interests in items 9-12 in that she was employed by Brent Council in the Community Health Team.

Councillor Stanley Sheinwald declared personal interests in items 9-11 in that he was receiving treatment as an outpatient at Northwick Park Hospital.

Councillor Dinesh Solanki declared personal interests in items 9-11 as his daughter worked at Northwick Park Hospital.

Councillor Yogesh Teli declared personal interests in items 9-11 in that he had been a patient at Northwick Park Hospital, and his uncle was a user of the services offered by Harrow Primary Care Trust and the Council.

Councillor Mark Versallion declared personal interests in items 9-11 as he was a non?Executive Director to the North West London Hospitals NHS Trust.  He did not envisage his personal interests to become prejudicial during the course of discussions on the items.

They would remain in the room and take part in the discussion and any decision on the items.

That the minutes of the meeting held on 10 February 2009 be taken as read and signed as a correct record.

RESOLVED:  That the minutes of the meeting held on 10 February 2009 be taken as read and signed as a correct record.

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 at the meeting under the provisions of Overview and Scrutiny Procedure Rule 8.

To receive petitions (if any) submitted by members of the public/Councillors under the provisions of Overview and Scrutiny Procedure Rule 9.

RESOLVED:  To note that no petitions were received at the meeting under the provisions of Overview and Scrutiny Procedure Rule 9.

To receive deputations (if any) under the provisions of Overview and Scrutiny Procedure Rule 10.

RESOLVED:  To note that no deputations were received at the meeting under the provisions of Overview and Scrutiny Procedure Rule 10.

(if any).

RESOLVED:  To note that there were no references from Council or Cabinet.

Following a proposal from the Conservation Group, it was

RESOLVED: That Councillor Mrs Eileen Kinnear be replaced by Councillor Vina Mithani as 4^th Reserve on the Performance and Finance Scrutiny Sub?Committee.

Cover Report of the Assistant Chief Executive

The Chairman welcomed representatives of the Trusts that served Harrow to the meeting.

An officer introduced the report of the Assistant Chief Executive, which set out the background to the Healthcare Commission’s Annual Health Check for NHS Trusts with suggestions for the role of scrutiny in providing commentaries to Trusts.  She referred to the requirement for NHS Trusts to declare compliance with standards set by the Department of Health and an assessment based on national indicators.  The Healthcare Commission encouraged commentaries from third parties as a reality check.

She stated that commentary from scrutiny had to be based on evidence and submitted to the Trusts by 1 May 2009 for inclusion in their submissions to the Healthcare Commission.  The Commission’s response was expected in October 2009.

Rob Hurd, Chief Executive of the Royal National Orthopaedic Hospital, and Charlie Sheldon, Director of Nursing; Dr Alex Lewis, Medical Director of the Central and North West London NHS Foundation Trust; Sarah Crowther, Chief Executive of the Harrow Primary Care Trust, and Fiona Wise, Chief Executive of the North West London Hospitals NHS Trust, each addressed the meeting and introduced their draft declarations of compliance against core standards for the 2008/09 Annual Health Check.

Royal National Orthopaedic Hospital

The Committee was informed that the Trust was reporting compliance with 21 core standards.  Three core standards had not been met:  C13b (obtaining consent) due to insufficient audit evidence at present, and a decision at Board level would be taken during the following week as to whether C20 (a safe and secure environment which protected patients, staff and visitors of their property and physical assets of the organisation) and C21 (environments which promoted effective care and optimised health outcomes by being well?designed and well?maintained with cleanliness levels in clinical and non?clinical areas that meet the national specifications for clean NHS premises) would be declared not met or partly met.  C20 and C21 had been met on some aspects and not on others so the discussion would be on whether the standards were partly met overall.  In light of the age of the buildings, it was likely that C21 would be declared as being non?compliant.

In response to Members’ questions, Rob Hurd reported that the timetable for achievement of Foundation Trust status was 1 December 2009 but was subject to a significant degree of risk.  The viability of delivering a new hospital was in question.  2010 could therefore be a more realistic timescale.  Since the previous year, the Trust had already improved on its use of resources and quality of services and was already on target to deliver another surplus in 2008/09.  The major issue was the weakness in quality due to access times and not in the quality of care provided.  Significant progress had been made regarding access times in the last year and the prediction was for a fair score.  

With regard to core standard C13, two audits to check compliance had been undertaken but there had been no  ...  view the full minutes text for item 506.

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

Members received a report from Fiona Wise, Chief Executive of North West London Hospitals NHS Trust, which set out an outline of the proposals to reduce costs and increase income for the Trust.  In so doing, the Trust was mindful of the need to minimise the impact on staff and to ensure that reductions in the pay bill were enduring and sustainable.

Fiona Wise stated that savings of £32m needed to be identified, and that all Trusts were required to make efficiency savings of £10m in the context of their budgets.  Additionally, a redistribution of revenue into Teaching Hospitals would reduce the Trust’s budget by £4m. The Trust had identified a saving of £16m, and consultations with staff were continuing.  Whilst the Trust was looking to reduce the number of staff employed, it was also actively seeking to recruit some specialist staff.

Members were concerned about the impact of the proposals on junior doctors and pharmacy posts, whether care for the elderly would be affected, the cost associated with employing temporary and agency staff, the support available to staff to find employment elsewhere and the changes proposed to Information Technology.  Fiona Wise was also asked if comparisons with other hospitals had been undertaken, and to provide brief comments on the outcomes of any bench-marking exercises carried out.  A co-opted member was concerned as to how the Trust intended to ensure that it remained clinically and patient focussed during these challenging times.

Fiona Wise informed the Committee that the Trust would not fund the training of junior doctors, as this was the responsibility of the Deanery, which had recently announced that, because of a lack of funds available, it could not support junior doctor posts.  The Trust employed 110 pharmacists and would examine processes to ensure that resources were used as efficiently as possible.  There was scope to become more efficient in the provision of care for the elderly.  The Trust was looking to provide care for the elderly in two wards at Northwick Park Hospital instead of the three at present.  The proposals were expected to enhance patient care and there were no proposals to introduce a charging policy for patients.  £10m was spent on ‘bank’ staff and £5m was spent on agency staff, such as midwives who were in short supply nationally.  Ms Wise undertook to provide data and targets.

The Committee was informed that an employee assistance programme was in place to support staff who were seeking alternative employment.  Costs associated with the provision of services to other Trusts would be reviewed in order to ensure that actual costs were charged.

A number of changes in the IT system were envisaged, such as automated responses and booking?in systems.  Support services would also be reviewed.  The number of managers and administrative staff employed by the Trust was low.  These posts were considered necessary to provide support to other staff.

Fiona Wise stated that the North West London NHS Trust compared favourably with similar Trusts but it needed to  ...  view the full minutes text for item 507.

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

Fiona Wise, Chief Executive of North West London Hospitals NHS Trust, introduced the report on the fire at Northwick Park Hospital on 11 February 2009.  She informed Members that the Trust’s Board would consider a further report on this matter in late?March.  She described the lessons learnt and stated that these would be discussed with other agencies, including the emergency services, which had provided support during the incident.  Some independent sectors had helped with the carrying out of routine operations.

Fiona Wise described how the fire had occurred in one of the three main electrical sub?stations at the hospital, as a result of which the safety of the other two sub?stations had been examined and essential repairs undertaken. 

Members were concerned about the general safety of electrical sub-stations and queried whether the damage done by the fire would be covered by insurance.  They asked what alternative arrangements had been put in place and whether a Continuity Plan had been drawn up.  The charging policy of the hospitals that had helped during the emergency and whether the cost would be covered by insurance were queried by Members.  Health and safety concerns within the perimeter of the Hospital blocks were raised by a co?opted member, who also asked if the Children’s Ward had re?opened.

In response, Fiona Wise stated that the Children’s Ward would re-open on 1 May 2009.  A Continuity Plan was in place but the public needed to be mindful that these were exceptional circumstances faced by Northwick Park Hospital.  A number of bed?spaces had been reduced at the Hospital following the fire.  She requested details of the health and safety issues raised by a Member and undertook to investigate these concerns.  Members were informed that, during the emergency, staff had also been moved to other hospitals to care for patients that had been transferred and this had proved challenging.  It was hoped that additional costs incurred during the emergency would be covered by insurance.

Members were informed that the final report would be issued in due course but that no date could be given at this stage.

A Member stated that during such times, it was important to acknowledge that the NHS was the best service in the world.  Staff at Northwick Park Hospital had excelled, particularly during the fire incident.

Fiona Wise thanked the Member for the recognition, which she would pass to the staff at the Hospital.

RESOLVED:  That the report be noted.

Report of the Chief Executive, Harrow Primary Care Trust

Sarah Crowther, Chief Executive of Harrow Primary Care Trust (PCT), introduced a report, which updated Members on the development work being undertaken on the proposals for a new model of care for Harrow East, following approval by the PCT Board to proceed with the planning of a programme and preparation of a consultation plan.  A further report would be submitted to the PCT Board at the end of March 2009 and it was expected that consultation would commence in May 2009.  The PCT Primary and Community Care Strategy outlined the model of care proposed for Harrow and, as part of its proposals, had identified the need for polyclinics to be located in Harrow Town Centre and Wealdstone Centre.  Discussions with the Council’s Corporate Director of Place Shaping were continuing with regard to the suitability of various sites.

Sarah Crowther informed Members that, whilst lessons had been learnt from the establishment of a polyclinic at Alexandra Avenue, the project, on the whole, had been a success.  The opening hours had been extended and, whilst the PCT continued to lobby the Transport for London (TfL) for better public transport facilities, it was mindful that, when compared to many other sites, Alexandra Avenue Polyclinic was situated on a bus route and the premises were within walking distance from a tube station.  She acknowledged that easy access was desirable and the demographics of areas ought to be taken into account when siting similar services.  However, all public sector bodies, including the PCT, were restricted in the number of parking spaces that could be made available due to planning policies. 

A Member who was back-benching and speaking on behalf of his constituents stated that the lack of information on the proposals for Harrow East was causing anxiety in the community.  It was essential that information on the proposals, the timetable for redevelopment and details of engagement with local residents be in the public domain.

In response, Sarah Crowther stated that that were no specific proposals for Harrow East and for the future redevelopment of the closed Kenmore Clinic site, but she reiterated that the PCT Board would consider proposals in April 2009 for a Harrow East Poly?system and would take the Kenmore Clinic site into consideration as there had been a clear commitment from the PCT to redevelop the site.  A Clinical Reference Group had been established and would advise the Board on these matters.  It was not possible to predict timescales beyond the procurement timetable or comment on the size and design of the proposals at this early stage.

A Member pointed out that it was not always convenient for patients to travel by bus, particularly the elderly and those with young children.  A waiting area for those collecting patients by car and disabled parking spaces ought to be provided.  In response, Sarah Crowther stated that broader modes of transport needed to be considered.  It was important that the correct levels of services were available, for example in a  ...  view the full minutes text for item 509.

Report of the Assistant Chief Executive. A draft of the report that will be considered by Cabinet on 26 March 2009 is attached.

In accordance with the Local Government (Access to Information) Act 1985, this item was admitted late to the agenda to enable consideration of the report prior to its consideration by Cabinet on 26 March 2009.  A paper setting out the responses to the consultation together with officer comments and recommendations about the inclusion of the comments was tabled at the meeting.  This was not available at the time the agenda was despatched as the end of the consultation period was after its despatch.  Officers also needed to give consideration to the comments received from the consultation before making their recommendations.

An officer introduced the draft Sustainable Community Strategy and referred to the paper tabled at the meeting.  He added that from the 161 comments received, 56 had been taken on board by officers and would be recommended to Cabinet. 

The officer described the level of consultation carried out and was pleased to report that more interest had been received in the draft Strategy than in previous years.

A Member asked questions about the link between the Sustainable Community Strategy and the Sustainable Communities Act 2007 and whether the Strategy was driven by the Act.  He asked whether any attempt had been made to link submission of proposals required by the Act with the Strategy.  Another Member questioned the number of penalties issued by the Council for littering.

In response, the officer stated that the Strategy and the Act were not directly linked, but the Council should have regard to the Strategy in considering whether to forward submissions under the Act to the Local Government Association.

In relation to the question on penalties issued for littering, the officer undertook to make enquiries and respond to Members.  He noted that the penalties issued might require publicity.

Members sought clarification on some of the many actions recommended in the paper tabled at the meeting.  In relation to Wealdstone Town Centre, officers were recommending that the Strategy did not require amending further.  A great deal of energy had been spent recently in re-opening Wealdstone High Street to 2-way traffic to increase passing trade for shops and there was no capacity at present for further regeneration.  The comment that Wealdstone needed investment in attracting small businesses was considered to be an unrealistic aspiration in the current economic climate.

RESOLVED:  That the report be noted.

Report of the Assistant Chief Executive

In accordance with the Local Government (Access to Information) Act 1985, a report of the Assistant Chief Executive was admitted late to the agenda in order that the Committee could consider the new the Councillor Call for Action (CCfA) provisions before they came into effect on 1 April 2009.  The report had been produced after the main agenda was despatched to enable the inclusion of further detail about CCfA, which was provided at an Improvement and Development Agency (IDeA) event hosted by Harrow Council on 6 March 2009, and in light of the fact that the CCfA provisions would come into effect on 1 April 2009.

An officer introduced the report, which proposed a mechanism for adoption of a CCfA in line with that envisaged in the Local Government and Public Involvement in Health Act 2007 and the Police and Justice Act 2006.  The officer stated that the process of CCfA should always be viewed as a measure of last resort and should be considered after the Council’s robust Corporate Complaint Policy had been exhausted.  She drew Members’ attention to the process map for CCfA.

Members asked questions about the role of the Scrutiny Lead Members in the CCfA process, and the impact of the CCfA on community safety issues.  With regard to the latter, the Policy Scrutiny Lead Member for Safer and Stronger Communities had requested a briefing from the Council’s Crime Reduction Unit.

The officer responded that fear of crime was an issue for the borough and that the CCfA process identified the Joint Agency Tasking Co-ordination Group (JATCG) as an appropriate forum for the raising of community safety issues.  She added that the Scrutiny Lead Members would serve as a filter in the first instance for CCfA referrals.

A Member stated that it was important that the process was used effectively and that this new opportunity was publicised.  Training was an essential component and ought to be included in the Member Development Programme.

RESOLVED:  That (1) the report be noted;

(2)  the officer working group be advised of any local issues around the implementation of the Councillor Call for Action, which might affect its practical implementation;

(3)  the officer working group be authorised to progress local plans around the implementation of CCfA; and

(4)  training be included in the Member Development Panel for 2009/10.

Report of the Assistant Chief Executive

Further to Recommendation 1, it was

RESOLVED:  That the revised terms of reference be agreed.

Report of the Assistant Chief Executive

The Committee considered a written report of the issues considered by the Scrutiny Lead Members for Children and Young People, Safer and Stronger Communities and Adult Health and Social Care at their quarterly meetings in January and February 2009.  The Lead Members had considered various issues, as follows:

Scrutiny Lead Members for Children and Young People

Overview and Scrutiny Committee Meetings held on 10 February and 21 April 2009, the latter focusing on Children and Young People Issues

Transition from Children to Adults

Safeguarding

Scrutiny Lead Members for Safer and Stronger Communities

Community Safety

Harrow Strategic Assessment 2008/09

Community Cohesion

Scrutiny Lead Members for Adult Health and Social Care

Adults and Housing Transportation Programme Plan

Safeguarding Adults

Local PCT Issues

Scrutiny Work Programme.

The Scrutiny Policy Lead Member for Adult Health and Social Care provided an update on the work undertaken since the report was written.  As the Council’s representative on the pan?London Joint Overview and Scrutiny Committee, she had recently attended a meeting, which had considered the Healthcare for London proposals on acute stroke services and major trauma care.  The Royal Free and Imperial Hospitals had attended the meeting to give evidence and a number of issues had been highlighted at the meeting.  There had been some discussion on running an international campaign similar to the one that had been run in the USA.

The same Member stated that, together with the Scrutiny Performance Lead Member for Adult Health and Social Care, she had visited the Central and North West London NHS Foundation Trust’s unit at Northwick Park Hospital.  The 25?bed acute in?patient unit was well managed and they were pleased to see that a complaint procedure was in place.

In response to a question about a blue badge scheme, the Scrutiny Policy Member for Adult Health and Social Care stated that discussions about the abuse of the system had taken place with the Corporate Director of Adults and Housing who had undertaken to investigate the situation.

RESOLVED:  That (1) the transition from children’s to adults’ services be included in the Committee’s work programme for 2009/10 with a view to work, starting in September 2009 and that, in the meantime, research be undertaken to identify good practice elsewhere;

(2)  in relation to safeguarding children, further meetings be held with the Head of Service for Safeguarding and Family Support, the Joint Head of Learning Disability Services and other key officers;

(3)  the evaluation of the Individual Budgets scheme be presented to the Committee after its consideration by Cabinet in March 2009 and that, in the meantime, the Scrutiny Lead Members for Adult Health and Social Care receive a briefing from the Divisional Director of Community Care on the findings which had informed the report to Cabinet;

(4)  a report and action plan on the joint commissioning of the learning disabilities service be included on the scrutiny work programme and submitted to the April 2009 meeting of the Committee.

Information Report of the Assistant Chief Executive

The Chairman of the Performance and Finance Scrutiny Sub-Committee introduced the report, which set out the items that had been considered by the Sub-Committee at its meeting on 21 January 2009.

A Member, referred to recent press reports alleging that Kier Group Ltd, the Council’s Partner in delivering the asset management programme, had traded in the illegal exchange of builders’ personal data, and suggested that these ought to be examined as the allegations impacted on the reputation of the Council.  The Chairman of Performance and Finance Scrutiny Sub?Committee agreed to discuss the concerns expressed by the Member outside the meeting.

RESOLVED:  That the issues set out in the report of the Performance and Finance Sub?Committee meeting held on 21 January 2009 be noted.

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

In accordance with the provisions of Overview and Scrutiny Committee Procedure Rule 6.6(ii) (Part 4B of the Constitution) it was

RESOLVED:  At 10.00 pm to continue until 10.20 pm.