Agenda and minutes

PART I – RECOMMENDATIONS – NIL

PART II – MINUTES

To note the appointment at the Special meeting of the Overview and Scrutiny Committee on 15 May 2003 of Councillor Marie-Louise Nolan as Chair of the Sub-Committee for the Municipal Year 2003/04.

RESOLVED:  To note the appointment at the special meeting of the Overview and Scrutiny Committee on 15 May 2003 of Councillor Marie-Louise Nolan as Chair of the Health and Social Care Scrutiny Sub-Committee for the Municipal Year 2003/04.

To note the attendance at this meeting of any duly appointed Reserve Members.

RESOLVED:  To note there were no Reserve Members in attendance at the meeting.

To receive declarations of interest (if any) from Members of the Committee arising from business to be transacted at this meeting.

RESOLVED:  To note that there were no declarations of interest made by Members in relation to the business to be transacted at the meeting.

To consider whether any of the items listed on the agenda should be considered with the press and public excluded on the grounds that it is thought likely, in view of the nature of the business to be transacted, that there would be disclosure of confidential information in breach of an obligation of confidence or of exempt information as defined in the Local Government (Access to Information) Act 1985.

RESOLVED:  That (1) all items be considered with the press and public present;

(2)  under the provisions of the Local Government (Access to Information) Act 1985 the following information be admitted to the agenda as a result of the special circumstances and reasons for urgency set out below:

Agenda Item 12:  Final report of the Review of Support to Carers

Special Circumstances:  The report was not completed when the agenda was published.

Grounds for Urgency:  To enable Members to conclude the review in this cycle of meetings.  The next ordinary meeting of the Sub-Committee is not scheduled to take place until 18 September 2003.

To appoint a Vice Chair of the Sub-Committee for the Municipal Year 2003/04.

RESOLVED: That Councillor Eric Silver be appointed Vice Chair of the Sub-Committee for the Municipal Year 2003/2004.

That the minutes of the ordinary meeting of the Sub-Committee held on 24 March 2003, having been circulated, be taken as read and signed as a correct record, and that the signing of the minutes of the special meeting of the Sub-Committee held on 8 May 2003 be deferred until printed in the next Council Bound Minute Volume.

RESOLVED:  That (1) the minutes of the ordinary meeting of the Sub-Committee held on 24 March 2003, having been circulated, be taken as read and signed as a correct record.

(2)  the signing of the minutes of the special meeting of the Sub-Committee held on 8 May 2003 be deferred until printed in the next Council Bound Minute Volume.

To receive questions (if any) from local residents or organisations under the provisions of Committee Procedure Rule 15 (Part 4B of the Constitution).

RESOLVED:  To note that there were no public questions received at this meeting under the provisions of Committee Procedure Rule 18 (Part 4B) of the Constitution.

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 there were no petitions received at this meeting under the provisions of Committee Procedure Rule 15 (Part 4B) of the Constitution.

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

RESOLVED:  To note that there were no deputations received at this meeting under the provisions of Committee Procedure Rule 16 (Part 4B) of the Constitution.

Review of the Promotion of Healthy Lifestyles in Mainstream Schools

The Sub-Committee received a reference from the Lifelong Learning Scrutiny Sub-Committee, relating to the Review of the Promotion of Healthy Lifestyles in Mainstream Schools.  The Chair advised that, as a Member of the Lifelong Learning Scrutiny Sub-Committee, she had been involved with the review.  She advised that the review group had visited two first/middle schools and two high schools.  One of the concerns highlighted by the Head teachers related to the allocation of school nurses. 

Members discussed the role of school nurses and considered them to be approachable health professionals who could make a valuable contribution to school life by virtue of their interaction with pupils, parents, teachers and staff, and as a linkage between these groupings. 

The reference requested that the Health and Social Care Sub-Committee work with the Primary Care Trust (PCT) to examine ways in which resources allocated to school nurses could be increased.  The Advisor to the Sub-Committee informed the meeting that school nurses in Harrow were not provided by the PCT, but were provided by North West London Hospitals Trust (NWLHT), who employed the school nurses, as part of the paediatrics team.  Dr Peter Lachman of the NWLHT was currently leading a review of the service provided by school nurses.  The review would include examination of the job description.  The Department of Health was producing a School Nurse Practice Development Resource Pack, which was likely to be influential.  The review would also consider the targeting of the resource, for fair access did not necessarily equate to identical access for all.  Members agreed that some schools would need to be targeted more than others.  There would also be liaison with the Council’s new Children and Young People’s Strategic Executive.  The Advisor added that there were plans to consult school governing bodies on the matter, and it was hoped that the review would be completed within the financial year. 

A Member raised the important health promotion role that school nurses could play.  He added that asthma was a big issue in that children were often not using their inhalers properly.  Pharmacists had visited schools to demonstrate their proper use, and proposed that this be suggested.  Members also discussed changing approaches towards dealing with head lice.

RESOLVED:  That (1) the reference for the Lifelong Learning Scrutiny Sub-Committee on the Review of the Promotion of Healthy Lifestyles in Mainstream Schools be noted;

(2)     the Sub-Committee note that the North West London Hospitals Trust, who had responsibility for the provision of school nurses were in the process of carrying out a review;

(3)     the Sub-Committee request that the findings of the North West London Hospitals Trust review be presented to the Health and Social Care and Lifelong Learning Scrutiny Sub-Committees;

(4)     the Sub-Committee request that the North West London Hospitals Trust review group be requested to consider the role of the school nurse in the correct use of asthma inhalers by children and treatment of head lice.

To receive verbal updates (if any) from Members.

(i)         Scrutiny Review of Delayed Discharges

The Chair provided a verbal update on the scrutiny review.  She informed the meeting that two meetings had taken place on the management framework of delayed discharges.  The timescale for the review had changed as a result of the wish of the Sub-Committee to focus on consultation papers produced by the Bedfordshire and Hertfordshire and North West London Strategic Health Authorities, and the limited resources available to the Sub-Committee.  It was intended that work on the scrutiny review recommence in September after the submission of the responses to the consultation papers.

Members informed the meeting of themes with which they had chosen to be identified.  The Chair advised that this information would enable officers to check availability when arranging future visits and meetings.  The Chair and Nominated Member agreed to consult the Reserve Members as to whether they wished to be involved with the review. 

Theme 1:  Pre-hospital admission

·         Preventable causes of strokes and falls           

·         From primary care to hospital admission

Members:Cllrs Myra Michael and Silver

Theme 2:  Management of the patient within hospital

·         Patient characteristics of those who experience delayed discharge

·         Size of the problem and reasons for waiting

·         From admission to discharge planning

·         Rehabilitation

Members:  Cllrs Choudhury and Anjana Patel

Theme 3:  Management of the patient when discharged from hospital

·         Intermediate care

·         Nursing and residential home care

·         Multidisciplinary management

·         Seamless care

Members:  Cllrs Ann Groves and Thammaiah

Theme 4:  Management framework

·         The National Service Framework for Older People

·         Targets for reducing delayed discharge

·         Performance management of delayed discharge

·         The role of social services

·         Models of partnership

Members:  Cllrs Ann Groves, Myra Michael, Marie-Louise Nolan, Anjana Patel and Silver

The Chair advised that she would endeavour to attend as many of the review group meetings as possible.

The Chair invited Dr Stephen Farrow, the consultant supporting the work of the Sub-Committee who was present at the meeting to discuss the four themes.

Theme 1:  Pre-hospital admission

The Advisor to the Sub-Committee had agreed to speak to Members on the first theme.  A Member suggested that Age Concern and Harrow Association for Disabled People should be contacted to contribute on strokes and falls.  Dr Farrow suggested that the Chair of the PCT’s professional executive committee (PEC) might be suitable, as both a practising GP and as a representative of the PCT.  The Advisor suggested that due to Dr Ken Walton’s heavy commitments, it might be appropriate to invite Dr Chris Jenner to contribute.

Theme 2:  Management of the patient within hospital

Dr Farrow pointed out that patient choice had emerged as a key reason for delays in recent discussions.  Members agreed that they would like to have some contact with users, as a means of engaging local people and adding a human perspective to the review.

Dr Farrow enquired as to whether the work of the Care Standards Commission would be of interest to Members.  An officer advised that the Commission focused on the quality of care not the quantity available; in Harrow  ...  view the full minutes text for item 74.

Report of the Review Group.

The Chair of the review group, Councillor Marie-Louise Nolan, thanked Councillors Myra Michael and Eric Silver, who had formed the review group, for their work and commitment, and the review group extended its gratitude to the officers who had supported and contributed to the review.  Members agreed that cross-party working had been effective.

A Member felt that the review had collected a lot of disparate information into one source, and as such was a useful document.  A Member pointed out that there was no mention of dementia.  The Chair of the review accepted the point, and Members agreed that even a comprehensive record would be likely to miss some areas.

Findings included the need to monitor the assessment process as it was found to be cumbersome.  There was a need to improve the quality of and access to information available to carers and the review group recommended the setting up of a carers register.  The review identified that the transport service was restricted and felt that resources such as premises could be used to greater effect. 

RESOLVED:  That (1) the Sub-Committee adopt the report of the review group, with the addition of the request that the recommendations be considered as part of the Carers’ Strategy as it was identified that work was already underway on this matter;

(2)  that the Acting Chief Social Services Officer be asked to produce an action plan with a timetable for its implementation and details of funding implications in response to the recommendations given in the report and that the Acting Chief Social Services Officer be requested to report back to the December meeting of the Sub-Committee;

(3)  that the report, as amended, be distributed to the individuals and organisations listed in the report, and also to the Portfolio Holder for Social Services.

Report of the Chief Executive.

Members discussed the draft report and the workload of the Sub-Committee over the past year.  Officers advised that the full report, to include sections on the other Sub-Committees, would be considered by the Overview and Scrutiny Committee and then the next ordinary meeting of Council.

RESOLVED:  That the Sub-Committee approved the draft Chair’s report of the Sub-Committee’s work over the past year for inclusion in the 2002/03 scrutiny annual report.

Under any other business, the Chair reminded the Sub-Committee of the evidence gathering meeting to be held on Thursday 3 July at 7:30 pm.  Members agreed to hold a pre-meeting at 6:30 pm on 3 July to consider the line of questioning that would be followed.  Officers intended to provide the Special Meeting of the Sub-Committee arranged for Thursday 24 July with a summary document to enable them to consider their response based on the evidence received so far. 

RESOLVED:  That a pre-meeting be arranged on Thursday 3 July at 6:30 pm.

Under any other business, the Chair reminded the meeting that the Sub-Committee was to hold a Joint Meeting with the Lifelong Learning Scrutiny Sub-Committee to consider the Audit Commission Review of Certain Learning Disability Services (Progress against the Recommendations), Early Years SEN and the Gatsby Project.  Members would be notified of the date of the meeting in due course, which was likely to be held in mid-September.