Agenda and minutes

Apologies were received from the Chairman, Christopher Boden and Michael Hudson, Deputy Chairman, took the Chair.

There were no declarations.

To agree the public minutes and non-public summary of the meeting held on 16^th  July 2019.

RESOLVED – That the public minutes and non-public summary of the meeting held on 16^th July 2019 be agreed as a correct record.

Matters arising:

Access to chiropody services for elderly/less mobile clients

Following a question raised at the last meeting, the Assistant Director had liaised with the commissioner and provider of such services and Members suggested that they be invited to a future meeting.

Members were reminded of the Committee’s wider scrutiny remit, which did not include individual casework, and asked if the Director of Community and Children’s Services could provide a guidance note, for all Members, advising them how to progress casework on health matters generally.

Training Support for Carers

The Assistant Director advised meeting that training support was offered on an individual basis and tailored to specific needs. Details of the support groups and activities for carers will be shared with Members.

Potential Topics for Further Scrutiny

A Member suggested that the following be included:

·         GP services: The Chairman suggested, and Members agreed, that a representative of the Neaman practice should be invited to attend the Committee to give an update on delivery, sustainability and other issues at the Practice. It would provide an opportunity to address a question raised at the Community and Children’s Services Committee in relation to urgent appointments. An invitation will be extended to the Chairmen and Deputy Chairmen of the Community and Children’s Services and Health and Wellbeing Committees. 

·         A review of sexual health services in the City.

·         Reporting any untoward incidents within the health providers which work with the City Corporation.

Members are asked to consider the Committee’s Forward Plan and potential topics for meetings in 2020.

Members noted the Committee’s Forward Plan and potential topics for meetings in 2020, together with the discussion set out above in respect of future potential items. 

Deputy Director Estates & Facilities, Barts Health NHS Trust to be heard.

The Committee welcomed two Public Health Directors from Barts NHS Trust to the Committee, following Members’ discussion on air pollution at St Bartholomew’s Hospital at the last meeting.  The Directors briefly explained the workings of the combustion plant in the energy centre. Members noted that they were working with Skansa, and holding monthly review meetings, to keep emissions of pollutants at an appropriate level.  Members also noted that Bartshad met with City Corporation officers in August and, whilst there had been some drop in emission levels during the summer, they had recently picked up a little. 

During the discussion, the following points were noted:

1.    Members expressed concern that the works had been ongoing for some time. before the matter had come to the attention of the Health and Social Care Scrutiny Committee. Furthermore, the area surrounding Barts is already densely populated.   Members accepted that all of the London hospitals are in areas of high pollution generally and noted that the Trust provided information for vulnerable patient groups in respect of asthma and other respiratory illnesses.  However, the Trust also had a responsibility to promote walking, as a healthy lifestyle choice. There was some discussion on the various apps available, which identified higher pollution areas, particularly ‘CityAir’.

2.    Ideally, Barts would like a higher stack to the plant but were limited by St Paul’s heights.  Engineers were considering work to the flue, in order to increase exit velocity and increase dispersal. Engineers had considered alternative control systems but there were no compatible versions available and the system in use was the lowest emitting of its kind.  Further options included stand-by generators, which ran on diesel oil but were used less frequently, and the new types of bio-fuel available for these.  The site will be replacing all

Report of the Independent Chair of the City and Hackney Safeguarding Adults Board.  

The full Annual Report can be found at http://democracy.cityoflondon.gov.uk/ieListDocuments.aspx?CId=120&MId=19492&Ver=4

Members received a report of the Independent Chair of the City and Hackney Safeguarding Adults Board, which was presented by the Adult Social Care Service Manager.  Members noted that one of the statutory duties of the Board was to complete an Annual Report outlining its achievements and to provide a forward look to the following year’s priorities.   Members particularly noted the focus on rough sleeping, as a strategic priority.  In respect of the difficulties in identifying former safeguarding clients to share their experiences, and whilst fully understanding the reasons behind this, the Healthwatch Co-optee offered to try and identify someone willing to participate.

RESOLVED, that – the report be noted.

Report of the Head of Performance, City and Hackney Clinical Commissioning Group.

 Members received a report of the Head of Performance, City and Hackney Clinical Commissioning Group, which provided headline assessments against indicators for the 2018/19 CCG Annual Assessment, the headline ratings for CCGs in North East London and areas for future focus.  Members commended an excellent report and noted that the City and Hackney was one of only 24 CCGs nationally rating as outstanding and just one of three in London.    

In response to a question about tackling isolation and loneliness, the Assistant Director advised that the City Corporation commissioned ‘social prescribing’ as part of early intervention and noted a Members suggestion about the various free events at the Barbican and Guildhall School.

RESOLVED, that – the report be noted.

A presentation from the East London Health and Care Partnership.

The latest overall draft can be found at https://www.eastlondonhcp.nhs.uk/ourplans/draft-response-to-the-long-term-plan.htm

Members received a presentation from the East London Health and Care Partnership (ELHCP), presenting their local response to the NHS Long Term Plan and next steps.  Members noted that this would also receive Scrutiny at the Joint Inner North East London Scrutiny Committee.  It was on today’s agenda due to the Plan’s timescale for submission.

Members noted the priority in relation to workforce and expressed concerns about pressures on existing staff that may be exacerbated by the larger footprint of the ELHCP. In response, the officers confirmed the CCG’s commitment to promoting work/life balance and were keen to explore pathways from local schools into healthcare professions. 

In concluding, Members noted that the plan was iterative, would be subject to regular monitoring and further suggestions were welcomed. 

RESOLVED, that – the report be noted.

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

Members received a report of the Director of Community and Children’s Services which provided a high-level update on the occurrence of Delayed Transfers of Care (DToCs), from hospital to continuing health care/social care provision, for residents within the City of London.

Members particularly noted Appendix 2 to the report, setting out ‘awaiting completion of assessment’ as the largest factor in delays.  As this was attributed to the NHS, it was difficult for City Corporation officers to challenge the data without knowing the detail behind it.  Members noted that a national target had been set for no more than 15% of assessments taking place within hospitals.  Members also noted how the City Corporation’s appointment of a Care Navigator had been key in achieving good social care figures and officers were able to challenge and correct these where necessary.  In concluding, officers advised that they would continue to monitor the situation and report regularly to Members.

RESOLVED, that – the report be noted. 

In response to a question about defibrillators, which had been considered by the Health and Wellbeing Board in February 2019, Members noted a recent incident in which a Barbican resident had suffered a heart attack on the podium.   The nearest defibrillator had not been available as it was stored in an ‘out-of-hours’ location. 

The HR Health and Safety Manager had not been available to attend this meeting and Members noted the minute from the HWB had resolved that: - ‘The City Corporation take no further action regarding the installation or promotion of additional public access defibrillators in the City, where there was no first aid need’.   The Health and Safety Manager had further advised that they continued to work internally with stakeholders to maintain and update the survey of corporate defibrillators.  This had led to additional defibrillators for some sites based on first aid need.

Whilst not wishing to make a formal representation to the Health and Wellbeing Board, Members suggested that defibrillators could be placed in the car park offices at Golden Lane and the Barbican and asked if there was one installed in the Golden Lane Gym. Members noted that the City Police vehicles carried them and they were very easy to use, with no training required.

There was no other business.

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 No.                                                        Exempt Paragraph(s)  
            13                                                                  2, 3 & 4

Report of the Director of Strategic Service Transformation, East London NHS Foundation Trust.

Members received a report of the Director of Strategic Service Transformation, East London NHS Foundation Trust. 

There were no questions.

There was no other business.