Agenda and minutes

Apologies were received from Wendy Mead.

Dhruv Patel declared a non-pecuniary interest in item 10 by virtue of his family’s pharmacy business within the City and Hackney CCG (but not within the boundaries of the City).

To elect a Chairman in accordance with Standing Order 29.

Members were invited to elect a Chairman in accordance with Standing Order 29. A list of Members eligible to stand was read out and Wendy Mead, being the only Member indicating her willingness to serve, was declared to have been elected for the ensuing year.

To elect a Chairman in accordance with Standing Order 30.

Members were invited to elect a Deputy Chairman in accordance with Standing Order 30. A list of Members eligible to stand was read out and Dhruv Patel, being the only Member indicating his willingness to serve, was declared to have been elected for the ensuing year.

To elect one INEL JHOSC representative.

RESOLVED – That the Chairman be appointed as the Inner NE London Joint Health Overview and Scrutiny Representative, with the Deputy Chairman deputising where necessary.

It was noted that the next meeting of the INEL JHOSC was scheduled for 6.30pm on 10 July 2014 at East Ham Town Hall.

To co-opt two representatives from Healthwatch in line with the Sub Committee’s terms of reference.

RESOLVED – that David Simpson and Lynn Strother be co-opted as representatives for Healthwatch.

The Deputy Chairman (in the Chair) welcomed new Members of the Committee, Ann Holmes, Adam Richardson, Tom Sleigh and Philip Woodhouse, and thanked the outgoing Members, Deputy Billy Dove and Randall Anderson.

To agree the public minutes and non-public summary of the meeting held on 4 February 2014.

RESOLVED – That the minutes of the meeting held on 4 February 2014 be agreed as a correct record.

Matters Arising

Clinical Commissioning Group – Commissioning Intentions Update

The Director of Community & Children’s Services reported that two meetings had been held and discussions were ongoing. Members noted that future updates would be provided to this Sub Committee.

Community Nursing Services

The Assistant Director, Partnerships and Commissioning reported that, subsequent to the presentation given at the last meeting, the implementation date had been deferred for approximately 3 months until further discussions had taken place. Members noted that a report would come to the next Sub Committee.

Cancer and Cardio

In response to a Member’s question the Assistant Director, Partnerships and Commissioning reported that although the original consultation was over, this had subsequently turned into a broader study. Members noted that this was ongoing and a written response would be provided to the Sub Committee once concluded in September/October 2014.

CQC Inspection of Barts Health NHS Trust

In response to Members’ questions Ms O’Callaghan, Director of Strategy for Barts Health reported that bullying observed in the Trust had been of staff by staff, and was being taken very seriously. She confirmed that work was underway to resolve these issues including staff communications on how to raise concerns, improving executive visibility, and ensuring appreciation for frontline staff was conveyed.

Report of Chair Healthwatch City of London.

The Sub Committee received a report from Lynn Strother from Healthwatch.

Visits to Newham Hospital

Healthwatch had made observations in elderly ward and written to the Trust suggesting the implementation of more activities for engagement. Members noted that a positive response had been received.

GP survey

A priority for Healthwatch was Community Services, which was incorporated in the wider Healthwatch City of London GP survey. This went out to approx. 2,000 people and Healthwatch were now contacting the surrounding GP practices.

Hospital discharge

Owing to concerns about patients and discharge procedures, Healthwatch were doing a broad survey and investigation into discharge policies across London.

Services for City Residents

Healthwatch had concerns over City residents who were registered with a GP outside of the City. The Director of Community and Children’s Services reported that the Sub Committee had been looking at this issue for some time and work was being done on identifying a proposal for integrated care. He advised that the Corporation was confident that residents were not going without services, but there were issues with communications between the three CCGs City residents had access to (Islington, City & Hackney, and Tower Hamlets).

Members had several questions regarding the details of the Healthwatch GP survey and comments from service users of Homerton University Hospital NHS Foundation Trust, and it was agreed that all questions be forwarded to the Committee and Member Services Officer who could liaise with Ms Strother and circulate the answers electronically.

RESOLVED – That all questions be forwarded to the Committee and Member Services Officer.

Presentation by Barts Health.

The Deputy Chairman welcomed Frances O’Callaghan (Director of Strategy), Dr Chris Gallagher (Lead Consultant in Medical Oncology) and Mark Mann (Acting Director of Communications and Engagement) from Barts Health NHS Trust.

Ms O’Callaghan reported that the development of the King George V building to accommodate cancer and cardiovascular services was ongoing. All cardiovascular services from The London Chest Hospital would move to St Bartholomew’s in early 2015 and services from The Heart Hospital, part of UCLH, would join these if proposals were approved. This would create one of the largest cardiovascular centres in Europe, benefitting patients from the increased research and academic work. With regard to cancer services, Barts Health would remain a key provider of a significant amount of cancer care, with less than 1% of all Barts Health’s cancer activity moving to UCLH and the Royal Free.

Ms O’Callaghan advised Members of the proposal for a Maggie’s Centre; Members were reminded that the Corporation was the Planning Authority for this application and therefore all discussion should be on health related issues. Although the proposal for the Maggie’s Centre was still in flux, Ms O’Callaghan reported that this would be a purpose-built space to help provide a holistic approach to cancer care, open to cancer patients who live or work in the City of London, even if they were being treated elsewhere. In response to Members’ questions, Ms O’Callaghan reported that the Maggie’s Centre was fully funded and would take approximately 2 years from start to finish. With regards to working relationship between the Trust and The Friends of the Great Hall and Archive of St. Bartholomew's Hospital, Ms O’Callaghan advised that this needed improvement but that a commitment had been made to work closely to secure the best possible outcome for everyone.

In response to further questions it

Presentation by Boots UK.

The Sub Committee received a presentation from Beneeta Shah, from Boots UK, and Rohit Kotecha, from Niemans Chemist Ltd, which gave an overview of the pharmacy services in the City.

Ms Shah reported that there were three tiers of pharmacy services – Enhanced (commissioned by the Local Authority), Essential (NHS commissioned) and Essential (NHS England commissioned). Under the latter tier, an electronic prescription service had begun which saw prescriptions being sent directly from the Doctor to the pharmacy. This offered more flexibility to the patient, and Members noted that there were a significant number coming in from outside London.

With regard to the role of community pharmacy, Ms Shah detailed the three main intersecting divisions: self-care (empowering patients to take control, i.e. pharmacists prescribing over the counter medicines to reduce GP workload), Public Health and Wellbeing (commissioned by the Local Authority, i.e. smoking cessation, sexual health, and weight management), and Medical Optimisations (i.e. how to take medication properly and medicine use reviews). Members noted the wide range of services provided in the City, for example a trial by Barts Health of a walk-in sexual health clinic at Boots in Liverpool Street station, and a smoking cessation trial targeting recipients of FPNs for littering with cigarette butts.

In response to Members’ question, Mr Kotecha advised that trials had received relatively little general publicity in order to ensure demand was kept at a manageable level, but assistance was needed to support the promotion of services to targeted groups in the wider community. The Director of Community & Children’s Services reported that officers would continue to work with Healthwatch to address this and advised Members that officers were looking at establishing income streams to support additional services. In response to a Member’s question regarding review mechanisms on repeat prescriptions, Mr Kotecha confirmed

CQC Inspection report.

The Sub Committee received the Executive Summary of the Care Quality Commission’s inspection of the Homerton University Hospital NHS Foundation Trust which had concluded that the services were very good.

RESOLVED – That the Executive Summary and result of the inspection be noted. 

Report of the Director of Community and Children’s Services.

The Sub Committee received a presentation from Nicole Klynman, Public Health Consultant for City & Hackney, which outlined areas identified by the Joint Strategic Needs Assessment (JSNA) for attention over next year.

Tackling Health Inequality
Dr Klynman advised that City Workers were a diverse group, including cleaners, baristas and support staff, who would have long working and commuting hours limiting their access to health services.

A Smokefree Future
Dr Klynman reported that good services were operating but work was needed to communicate their availability and access times.

Healthy Weight
Members noted that work was being done in one school, but as submitting data for state maintained school was not formally required and the City had such small numbers, it was difficult to draw robust conclusions.

Mental Health
Dr Klynman reported that Children and Adolescent Mental Health Service (CAMHS) and mental health services for adults were in place, and that City workers and residents would have different issues that needed to be addressed depending on their circumstances, i.e. income.  Members noted the need to ensure vulnerable and Looked After Children were accessing services in the Borough they’re living in.

Dementia
Members noted that it was harder to gauge an accurate picture of dementia patients in the City owing to the relatively small number. The Director of Community & Children’s Services reported that 300+ Dementia Friends were now trained who could help support people with dementia and their carers.

Air Quality
Members noted that significant work was being done to address these issues.

In response to Members’ questions, Dr Klynman reported that a priority was improving communication of and access to services; some patients were unable to access services, some not aware of what they could access. With regard to smoking, Dr Klynman advised that a Public Health consultant was working

Briefing note from the North East London Commissioning Support Unit.

RESOLVED – That the review be considered by the INEL JHOSC.

There were no questions.

The Deputy Chairman reported on two conferences he had attended on behalf of the Sub Committee since the last meeting concerning the Care Quality Commission’s consultation on a new approach to inspecting, regulating and rating services. He reported that the new rating system will be an improvement on the current compliant/non-compliant model, and would have four possible ratings: Outstanding, Good, Requires improvement, and Inadequate. A middle rank of satisfactory was likely to be excluded to prevent it becoming a default position. The Deputy Chairman advised that for hospital trusts it was proposed to provide these ranks in 3 dimensions:

1. Across their different sites
2. Across their different core services
3. Across five key questions: Is it safe, Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?

The Deputy Chairman expressed his concern that this may result in ratings being granular and difficult for the public to easily understand, but it was agreed that this would still be an improvement on the current system.

MOTION - That under Section 100(A) of the Local Government Act 1972, the public be excluded from the meeting for the following items on the grounds that they involve the likely disclosure of exempt information as defined in Part I of the Schedule 12A of the Local Government Act.

RESOLVED – That, under Section 100A of the Local Government Act 1972, the public be excluded from the meeting for the following items on the grounds that the involve the likely disclosure of exempt information as defined in Part 1 of Schedule 12A of the Local Government Act.

            Item Nos.                                                        Exempt Paragraph(s)  
              17-18                                                                           3

There were no questions.

There was no other business.