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 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:

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 Part 1 of Schedule 12A to the Local Government Act 1972 (as amended).

RESOLVED:  That all items be considered with the press and public present.

That the minutes of the meeting held on 20 March 2007 be deferred until printed in the Council bound minute volume.

[Note:  The 20 March 2007 minutes are published on the Council's intranet and website].

RESOLVED:  That the minutes of the meeting held on 20 March 2007 be deferred until printed in the Council Bound Minute Volume.

To receive questions (if any) from local residents/organisations under the provisions of Overview and Scrutiny Procedure Rule 8.

RESOLVED:  That the following questions be received under the provisions of Overview and Scrutiny Procedure Rule 8:

1.

2.

[Notes:  (i)  The Chairman noted that Joan Penrose was unable to attend, and so permitted Patrick Stoup to submit the question on her behalf;

(ii) in accordance with Overview and Scrutiny Procedure Rule 8.3 the Chairman nominated the Portfolio Holder for Adult Community Care Services and Issues Facing People with Special Needs to provide an oral response to the above questions;

(iii) both questioners asked supplemental questions, which were answered].

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.

Fiona Wise, Chief Executive North West London Hospitals Trust, and Elizabet Robb, Director of Nursing, Northiwck Park Hospital, will be in attendance for this item.

The Sub-Committee received an update from the Chief Executive, North West London Hospitals, and the Director of Nursing, Northwick Park Hospital, concerning the Maternity Services Unit at Northwick Park Hospital.

The Sub-Committee was informed that the Trust had completed the specific actions set out for it in the Action Plan, and that Special Measures had been lifted in September 2006.  The Trust was recruiting two additional Obstetricians to meet the remaining standard. In addition, a Maternity Action Plan Board met on a monthly basis to monitor key performance indicators.

The Chief Executive stated that the Trust had recently appointed a Consultant Obstetrician, and that a recent recruitment campaign for midwives had reduced vacancies to 20 across the Trust, a vacancy rate which was lower than the London average.  Funding for appointments to these posts was being considered.

The Director of Nursing added that the Nursing and Midwifery Council had recommended that students be allowed to return to the Unit, and that there had been a reduction of 32% in the number of complaints received in 2006/07 when compared to 2005/06.

On opening the item to questions, the Sub-Committee heard that of those complaints referred on to the Health Care Commission, no independent reviews had been instigated.  In addition, training had been undertaken with staff which included working relationships within the Unit, and relevant training on leadership skills and customer care skills had been provided.  The Chief Executive stated that challenges remained, particularly considering the diversity of residents in the Borough and their corresponding cultural expectations.

In response to a question from a Member, the Director of Nursing stated that the Hospital was looking into ways of ensuring that all visitors, patients and staff took appropriate precautions to prevent the spread of infections, such as the use of disinfectant hand-gels.

RESOLVED:  That the report be noted.

Report of the Director of Adult Community Care Services.

The Sub-Committee received a report of the Director of Adult Community Care Services, which outlined the outcome of the Annual Performance Rating for Adult Social Services, published by the Commission for Social Care Inspectorate (CSCI) on 30 November 2006.

The Sub-Committee heard that Adult Social Services in the Borough had achieved a rating of 1 star, or Level 2 for CPA purposes, and was serving some residents well, although there were uncertain prospects for improvement.

The Director explained that, in spite of the Council’s recent financial difficulties, the latest scorecard as of January 2007 indicated that recent improvements to Adult Social Services had been maintained, with no signs of deterioration.  However, the Council’s financial position was an obstacle to better prospects for improvement.

On opening the item to questions, the Sub-Committee heard that the main issues for Adult Social Services centred on capacity, and the need to invest to attain improvements.  However, the Director for Adult Community Care stated that every team involved with the services had a performance plan and identified lead officers for targets.

RESOLVED:  That the report be noted.

The Portfolio Holder for Adult Community Care Services and Issues facing People with Special Needs, and the Portfolio Holder for People First – Children’s Services will be in attendance for this item.

The Portfolio Holders for Adult Community Care Services and Issues Facing People with Special Needs, Lifelong Learning, Cultural Services and Issues Facing Older People, and People First - Children’s Services were in attendance to answer questions from the Sub?Committee.

The following questions were addressed:

Question 1:  How do the portfolio holders view the co-operation between Harrow PCT, North West London Hospitals Trust and the Council?  How are working relationships especially given each organisation’s financial difficulties?

The Portfolio Holder for People First – Children’s Services confirmed that officers from the Council and Harrow PCT continued to have regular dialogue about matters of shared interest, with joint work in both adult and children’s areas.  The Portfolio Holder added that work had been jointly commissioned by Adults and Children Council services and the PCT for an independent review of the Joint Commissioning Service.

The Portfolio Holder for Adult Community Care Services and Issues Facing People with Special Needs stated that the Council remained committed to joint working with North West London Hospital Trust (NWLHT) for adults in the provision of intermediate care services and through the Hospital Social work service at Northwick Park Hospital.  He added that national pressures to divert increasing number of patients away from Hospitals was creating pressures for all Local Authorities.

The Portfolio Holder for Lifelong Learning, Cultural Services and Issues facing Older People stated that both the Council and Harrow PCT were aware of their respective financial pressures, but that it was important that a joint working relationship was maintained.

Question 2:  With regards to the difference between critical and essential care and the change to payments for continuing care, what percentage of people now find their circumstances changed?  What is now the percentage of people who will not be included under ‘continuing care’ criteria?  What level of complaints has there been for service users with regard to the recent changes?

The Portfolio Holder for Adult Community Care Services responded that complaints relating to individuals no longer eligible for continuing care would not come to the Council as the Council was not able to challenge the decision.  Instead, complaints would be presented to the Primary Care Trust and addressed through the appeals process, which might conclude with a stage 3 Strategic Health Authority (SHA) review panel.

The Portfolio Holder indicated that there had been an escalating trend for people previously eligible for Continuing Care funding no longer qualifying, with an average of approximately 10 people per month between November 2006 and March 2007.  Harrow PCT and the Council were in dispute over some of these cases, and some more recent cases were subject to the appeals process.

Question 3:  How many stakeholders/service users have been visited/contacted to ascertain the impact of the changes?

The Portfolio Holder for Adult Community Care Services and Issues Facing People with Special Needs responded that any service user reviewed under the NHS continuing care criteria and determined as no longer being eligible for free NHS continuing care criteria was reassessed by the  ...  view the full minutes text for item 84.

Report of the Director of People, Performance and Policy.

The Sub-Committee received a report of the Director of People, Performance and Policy, which set out the draft of the Sub-Committee’s section of the Overview and Scrutiny Committee’s annual report to Council.

An officer explained that the draft section detailed the Sub-Committee’s work over the Municipal Year, and asked the Sub-Committee for its comments.  On discussing the draft, the Sub-Committee agreed that the draft was an accurate reflection of its work.

RESOLVED:  That the draft section be approved for inclusion in the Overview and Scrutiny Committee’s annual report.

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

(i)         Vote of Thanks

The Chairman thanked officers from the NHS Trusts who had attended meetings of the Sub?Committee and contributed to its work in the current Municipal Year.  Thanks were also offered to the advisers to the Sub?Committee, the Committee Administrator, and the Scrutiny Officer.

RESOLVED: That the above be noted.

(ii)         Scrutiny Obesity Review Group

The Chairman informed the Committee that the first meeting of the Scrutiny Obesity Review Group would be held on Monday 9 May 2007 in Committee Room 3 at the Civic Centre.

RESOLVED: That the above be noted.