Agenda and minutes

The Chair welcomed Members to the Sub-Committee and introduced all representatives in attendance. In particular, the Chair noted changes to the advertised list of attendees, and welcomed Professor Arulkumaran, who had led the Maternity Services Support Team at Northwick Park Hospital.

The Chair also noted that Garth Goodier, Chief Executive at the North West London Strategic Health Authority, had offered his apologies, and that no representative from Hillingdon PCT had been able to attend.

RESOLVED:  That the above be noted.

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)             after notifying the Chair at the start of the meeting.

RESOLVED:  To note the attendance at this meeting of the following duly appointed Reserve Members:-

To receive declarations of personal or prejudicial interests, arising from business to be transacted at this meeting, from all Members present.

RESOLVED:  To note the following declaration of interests made by Members present at the meeting relating to business to be transacted at this meeting:

(i)                   Councillor Lammiman declared that she had recently been a patient at the Royal National Orthopaedic Hospital and Northwick Park Hospital. Councillor Bluston also declared that he had been a patient at Northwick Park Hospital.  

(ii)                 In relation to agenda item 8, “Royal National Orthopaedic Hospital – Redevelopment Plans”, Councillor Bluston wished it to be noted that he would probably be sitting on Harrow Council’s Development Control Committee when it considered the Royal National Orthopaedic Hospital planning application.

(iii)                the following Members declared a personal interest in the items indicated, and remained and took part in the discussion relating to those items:

(iv)                Councillor Silver declared an interest in that he was a contractor with the Harrow PCT.

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 all items be considered with the press and public present.

That the minutes of the meeting held on 6 June 2005, having been circulated, be taken as read and signed as a correct record.

RESOLVED:  That the minutes of the meeting held on 6 June 2005, having been circulated, 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.

Eric Fehily (Project Director, Royal National Orthopaedic Hospital)will be in attendance at the meeting for the above item.

Members received a report and verbal update on the redevelopment of the Royal National Orthopaedic Hospital (RNOH) from Mr Eric Fehily, Project Director at the RNOH.  The Sub?Committee was informed that the RNOH NHS Trust had organised a series of consultations to seek support for the outline planning application, which was to be determined by the Development Control Committee on 11 October 2005.  In summarising the redevelopment plans, Mr Fehily emphasised that they must be deliverable, affordable and flexible.  He also emphasised the need to work within the constraints of the green belt location.

Members enquired about access to the site, the scope of the consultation and the funding for the programme.  Mr Fehily responded as follows:

·                     alterations had been made to the road layout to facilitate access to the site;

·                     public buses would be provided from stations to the site, to complement a free bus service;

·                     wider consultation was promoted through advertisements in local newspapers, a patient website, and through the PCT and PPI forums;

·                     the consultation with local residents was addressing issues surrounding housing, car-parking and the green belt location;

·                     additional funding would be required to develop the grounds to run the clinical model, which was not considered a core NHS function.

Members were invited to review the Trust’s outline planning application and meet with representatives from the RNOH Trust and Design Team at a consultation event on Monday 19 September 2005. The Chair requested feedback on the responses from the consultation with local residents, citing the importance of local opinion.

RESOLVED:   That the above be noted.

The Portfolio Holder will be available to answer any questions Members of the Sub-Committee may have.

Councillor Margaret Davine, the Portfolio Holder for Social Care and Health, was in attendance to answer Members’ questions regarding her portfolio. The Portfolio Holder said that her work was characterised by a ‘hands-on’ approach, and that she encouraged strong partnership working that was user-focused.

Members addressed the Portfolio Holder as detailed below:

Questions were also asked relating to the Strategic Performance Report, and it was suggested that it would be useful to indicate trends in the Comments column on the report.

The Chair thanked the Portfolio Holder for her contribution on behalf of the Sub?Committee, and added that she would be welcome to remain for the rest of the meeting.

RESOLVED:   That the above be noted.

Gareth Goodier (Chief Executive, NWLSHA) and Barbara Gill (Executive Director of Strategy, NWLSHA) will be in attendance at the meeting for this item.

The Sub-Committee received a verbal report from Ms Barbara Gill, Acting Executive Director of Strategy at the North West London Strategic Health Authority (NWLSHA), which outlined the development of a strategy for healthcare in North West London.  Members were asked for their support and comments on the reasons and principles underpinning the change.  A full discussion had been arranged for the Joint Overview and Scrutiny Committee for the Redevelopment of Northwick Park Hospital to be held the following week.

Members were informed that some broad options for the reconfiguration of services would be available by late November 2005, as a basis for further engagement.  Formal consultation on the Sector Strategy would not take place before June 2006.

In response to Members’ questions, the following clarification was provided:

·                     the Healthcare Commission provided the overall performance management framework and quality standards that the NWLSHA operated within, whilst the NWLSHA monitored organisations locally;

·                     the financial deficit within organisations under the NWLSHA would need to be addressed by improving efficiency in services;

·                     once the principles underpinning the review had gained support, the implications on services would be developed in greater detail.

A Member challenged the focus on medics ‘achieving targets’, and suggested that these pressures prevented staff from performing their jobs effectively.  Ms Jean Bradlow stressed that targets weren’t inhibiting patient care, but highlighting inefficiency and underlying system problems that needed addressing.

Members expressed concern about the affordability of drugs, and encouraged stronger partnership with drug agencies.  In particular, Members stressed that there should be equal opportunities for patients accessing drugs.  It was reported that the National Institute for Clinical Excellence (NICE) was investigating the cost and clinical effectiveness of drug procurement, in addition to the equality issues of drug supply.

A Member supported the principle of providing certain types of healthcare in a community setting, but suggested that a challenge facing the NWLSHA would be where to locate such ‘community hospitals’.  It was further suggested that health education should be emphasised in the principles of the strategy.

The Chair thanked Ms Gill, on behalf of the Sub-Committee, for attending the meeting.

RESOLVED:   That the above be noted.

Mary Wells (Chief Executive, North West London Hospital NHS Trust) and Mai Buckley (Director of Midwifery, Royal London Teaching Hospital) will be in attendance at the meeting for the above item.

Members received a collective verbal report from Ms Mary Wells (Chief Executive, North West London Hospital NHS Trust), Ms Mai Buckley (Director of Midwifery, Royal London Teaching Hospital) and Professor Arulkumaran (Professor of Obstetrics and Gynaecology, St George's Medical School), which focused on the maternity services provided by Northwick Park Hospital.  It was reported that although there had been a delay in the publication of the Healthcare Commission’s report, the Trust was progressing well with the delivery of its action plan for the maternity unit.  The report covered the following issues:

·                     Capacity – using capacity at other Trusts during the refurbishment was reducing the number of women treated, which was making an impact.

·                     Recruitment – the recruitment campaign was going well, and vacancies were falling rapidly. Twenty additional midwife posts had been filled. Whilst their was a marginal shortfall in the overall complement of staff, it compared favourably with the shortfall within other London hospitals. The number of consultants employed had increased, and consultants were working in parallel to ensure that experienced people were always on the floor.

·                     Training and maintaining quality – regular training sessions had been created. Links had been established with the teaching hospitals in London, to help maintain standards and facilitate recruitment.

·                     User-involvement – a group had been established to create a Women’s Partnership Unit, that would link in with the other PPI forums. A women’s adviser would also be provided.

The Sub-Committee was thanked for its understanding and support of the problems faced by the maternity unit. Professor Arulkumaran reported that he was working with the unit to ensure that changes were implemented and executed, and added that the unit needed to focus not only on becoming safe but also improving standards and quality. The Sub?Committee was invited to view the unit once the refurbishment had been completed.

The Chair thanked all three representatives for attending, and also thanked them for their continuing involvement with the Sub?Committee.

RESOLVED:   That the above be noted.

Caroline Lowdell (North West London Strategic Health Authority) and Nick Evans (West Hertfordshire Hospitals) will be in attendance at the meeting for this item. A representative from Hillingdon PCT has also been invited to attend.  

Mr Nick Evans, representing West Hertfordshire Hospitals, and Ms Caroline Lowdell from the NWLSHA had been invited to discuss the redesign of the burns and plastic services at Mount Vernon Hospital, and the implications of moving ambulatory radiotherapy from Mount Vernon Hospital, with particular reference to the broader implications on cancer services.

Mr Evans reported that a report commissioned by Bedfordshire and Hertfordshire Hospitals had recommended that the burns and plastic services should be relocated from Mount Vernon Hospital.  This change was recommended because the buildings at Mount Vernon were considered too old, and the gradual loss of other services placed constraints on the use of the burns and plastic services, with a ‘co-location’ of services preferred.  It was advised that a formal public consultation would be completed before any ideas were finalised.

Ms Lowdell referred the Sub-Committee to papers circulated prior to the meeting on the outcome of the Mount Vernon ambulatory feasibility study and the cancer strategy.  She highlighted the need to properly resource and manage the Mount Vernon cancer services through the transitional period whilst they were being relocated. 

Members commented on the excellence of the services provided by Mount Vernon hospital. In response to a question about the potential of the site for redevelopment, it was stated that those present had not been involved in any discussion of this matter, and that Hillingdon Hospital Trust as owner of the site, as well as provider of local acute services there, would be better placed to inform members on overall site issues.  Members requested more information on the background of the decision not to redevelop the hospital.  

The Chair thanked Mr Evans and Ms Lowdell on behalf of the Sub-Committee for attending the meeting.

RESOLVED:   That the above be noted.

Andrew Morgan (Chief Executive, Harrow PCT) and Neil Ferrelly (Director of Finance and Information, Harrow PCT) will be in attendance at the meeting for this item.

Members received a report from Mr Neil Ferrelly, the Director of Finance and Information at Harrow PCT, which advised the committee on the PCTs distance from the NHS target allocation, and the financial position for 2004/05 and 2005/06. Mr Andrew Morgan, the Chief Executive at Harrow PCT, was also in attendance to answer Members’ queries.

Mr Ferrelly advised that the PCTs recurrent allocation was approximately £20,000 above the NHS target allocation at the start of 2006/07, which resulted in Harrow being in receipt of more than its ‘fair share’ of the funding available to PCTs. By maintaining growth beneath the national average, it was hoped to reduce the distance from target to £18,600 by 2007/08.  The PCT had exceeded its resource limit by £969,000 in 2004/05. In 2005/06, an overall savings plan had been identified to ensure the PCT remained within the resource limit in 2005/06.

A Member suggested applying for additional grants to support the financial position. Mr Ferrelly advised that London healthcare was in receipt of more than its fair share of funding available to the PCTs, and that Harrow PCT would not be considered for any additional grants.  In response to concerns regarding the potential loss of primary services and conversion of primary services into secondary services, Members were informed that services needed to be provided in the most appropriate setting and at an appropriate volume.

RESOLVED:   That the above be noted. 

Report of the Director of Community Care.

The Sub-Committee received a report of the Director of Community Care, which advised Members of the Council’s formal response to the Government’s recent consultation on the Adult Social Care Green Paper.  However, Members agreed that it was too late in the evening to consider the report thoroughly, and it was agreed to defer the item to a Special Meeting of the Sub-Committee.

RESOLVED:  That the report be deferred until a Special Meeting of the Sub?Committee in October 2005.

[See also Minute 264 below].

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

(i)                   Special Meeting of the Health and Social Care Scrutiny Sub-Committee

Members were informed that the three NHS Trusts for Harrow needed to consult with the Sub?Committee on their performance assessments.  The deadline for completion was October, and so the work could not be incorporated into the established work programme of meetings.  The Sub-Committee agreed to hold a Special meeting on 6 October 2005 at 6.00 pm to address the consultation, and also to conclude discussions on the Green Paper on Adult Services and address the items on the information circular which could not be covered in the time available for this meeting.

RESOLVED:  That the Health and Social Care Scrutiny Sub-Committee hold a Special Meeting on 6 October 2005 at 6.00 pm to discuss the items identified above.

In accordance with the provisions of Overview and Scrutiny Procedure Rule 6.7 (Part 4F of the Constitution) it was

RESOLVED:  (1) At 10.00 pm to continue until 10.30 pm;

(2)  at 10.30 pm to continue to 11.00 pm;

(3)  at 11.00 pm to continue to 11.15 pm;

(4)  at 11.15 pm to continue to 11.30 pm;

(5)  at 11.30 pm to continue to 11.45 pm; and

(6)  at 11.45 pm to defer item 14, Green Paper on Adult Services, to another meeting of the Sub-Committee.