Agenda and minutes

Apologies were received from Wendy Mead.

The following declarations were made;

·         Barbara Newman is a resident in the City.

·         Vivienne Littlechild is a resident in the City.

·         Steve Stevenson is a resident in the City and is a patient of the Neaman Practice.

To note the order of the Court.

The Committee received the Order of the Court of Common Councilof Thursday 16 July 2020, appointing the Committee and approving its Terms of Reference.

To elect a Chairman in accordance with Standing Order 29.

The Committee proceeded to elect a Chairman in accordance with Standing Order No. 29. Michael Hudson being the only Member expressing willingness to serve, was duly elected Chairman for the ensuing year.

To elect a Deputy Chairman in accordance with Standing Order 30.

The immediate past Chairman intends to exercise his right under Standing Order No. 30. (3) (a) to serve in this position for the ensuing year, and as such, there was  no election for the position of the Deputy Chairman.

To co-opt one representative from Healthwatch City of London.

The Committee proceeded to elect a Co-Opted Member as a Health Watch Representative. Steve Stevenson, the only Member expressing willingness to serve, was duly elected to the position for the ensuing year.

At this point in the proceedings, Vivienne Littlechild delivered a Vote of Thanks to the immediate past Chairman.

RESOLVED UNANIMOUSLY, that –

Members of the Health and Social Care Scrutiny Committee wish to place on record their sincere appreciation to:

CHRISTOPHER PAUL BODEN

for the dedication he has shown in all aspects of his work on their Committee, and the exemplary manner in which he has presided over the Committee during his three years as Chairman.

CHRISTOPHER HAS DEMONSTRATED the utmost care and commitment to the well-being of City residents and workers. His experience outside of the Square Mile has informed a detailed knowledge of the challenges faced by social care and health services that have proved invaluable in his role.

UNDER HIS LEADERSHIP, the Committee has maintained the highest level of scrutiny for health and social care services. In overseeing a robust and ambitious workplan, Christopher has ensured that the Committee’s scrutiny is wide-reaching. He has led the Committee in ensuring measurable improvements in the health and social care services offered to City residents and workers.

HIS TERM IN OFFICE has seen active engagement with stakeholders and partners in health and social care in the City, Hackney and further afield, including serving on the Inner North East London Joint Health Overview and Scrutiny Committee, ensuring the City Corporation exercised effective scrutiny of health and social care services throughout London.

THE COMMITTEE WISHES TO PLACE ON RECORD its recognition of Christopher’s distinguished contribution to the Committee and the health services accessible to City residents and workers, in thanking him for his three years in office. His colleagues would like to convey their gratitude and best wishes for the future.

To agree the minutes of the previous meeting held on 26 February 2020.

RESOLVED,that the Public Minutes of the meeting held on 16 July 2020 be approved as a correct record.

Matters arising

The Air Quality Manager has asked that a vote of thanks be noted to the Committee for its work around the remedial work and changes of operation plants in St Barts, which had resulted in a very positive impact.

To appoint representative(s) to the Inner North East London Joint Health Overview

and Scrutiny Committee, noting that the Chairman and Deputy Chairman are typically appointed, however other Members had expressed interest at the previous meeting.

The Committee proceeded to elect a representative to the Inner North East London Joint Health Overview and Scrutiny Committee. The Chairman of the Committee will continue to act as a representative at the Inner North East London Joint Health Overview and Scrutiny Committee with Wendy Mead acting as a Substitute.

To note the Committees workplan.

The Committee noted the work plan and agreed that the following items are discussed in future meetings;

1.    St Bartholomew's Hospital (Barts) Minor Injuries Unit.

2.    Neighborhood model for health and social care.

3.    Delayed Transfers of Care, including the outcome of the ‘Discharge to Assess’ pilot.

4.    Mental Health services and support for children and young people.

5.    GP Services in East of City not provided by Neaman Practices.

Head of Podiatric Medicine, Homerton University Hospital NHS Foundation Trust and Clinical Commissioning Group representative to be heard.

The Committee received the verbal update from the Head of Podiatric Medicine, Homerton University Hospital NHS Foundation Trust, and the Clinical Commissioning Group representative.

The Committee was advised that the services are now back up and running but had to make a significant adjustment to ensure that the building was covid-secure.  This means that the patients are being managed safely, but it is time-consuming compared to the past. The services continued to provide critical and emergency care as well as making urgent home visits when required during the pandemic. This was followed by the Head of Podiatric Medicine, clarifying that at the moment, the service which is provided is a podiatrist specialist service and not chiropody services. Moreover, the Head of Podiatric Medicine assured the Committee that the vulnerable patients who required a chiropody provision were being serviced through partner organizations such as Hoxton Health.

The Committee was further informed that as CCG, the Group had increased its home visits for the extremely vulnerable patients. Since the last meeting, health centres such as the John Scott Health Centre, Kenworthy Road Health Centre, and the Neaman Practice have resumed its operations.

Additionally, the Committee was informed that urgent priority cases of 1000 patients who were at risk of having the legs amputated were contacted and offered appointments for them to be seen. It is anticipated that by the end of November 2020, most of the outstanding appointments will be provided to the patients. At present, the Podiatric team visits the Neaman Practice every six weeks for a podiatrist’s services and has a list of 44 patients who are being treated. For all the other services, patients, young and elderly, have to go to the specialist services based in St Leonard's Hospital for dedicated services. A lot of patients do not turn

Neaman Practice Manager to be heard.

The Committee received the verbal update on the Neaman Practice appointments from the Neaman Practice Manager.

The Chairman agreed that items 12 and 15 be taken together.

The Neaman Practice Manager informed the Committee that during COVID-19, the Neaman Practice continued to remain open and provide its services to the vulnerable patients. It continues to do so by ensuring that all the safety protocols are met. Neaman Practice continues to open up more and more of its services, such as the stop smoking campaign, substance misuse programme, podiatry services, and family action services. The Social Prescriber's services, which were halted in the past, is also slowly resuming its services. The Centre continues to be available to its patients either online or via its telephone services. The website allows patients from 5 am every day to book appointments in advance.

A Member raised concerns that some patients may not be able to go online and register for an appointment. The Practice Manager reassured the Committee, some appointments are kept in reserve to allow patients to call in at 8 am to book in appointments.   The Neaman Practice Manager also reminded the Committee that the Neaman Practice is also providing a service to 111 services. The emergency services can refer patients to the Neaman Practice for consultation who are not a registered patient of Neaman Practice.

The Neaman Practice continues to liaise with its housebound patients and ensuring that they are being seen to. Some of the housebound patients have also received their winter flu, and the service will continue to be provided to other patients. In terms of the patient’s access, at the beginning of April 2020 the Neaman Practice was at 28.9%, and the Practice continues to advertise the app, which will allow patients to access their medical records, at

NHS City and Hackney Clinical Commissioning Group to be heard.

The Committee received a verbal update on the City and Hackney restoration and recovery plan post-COIVD-19.  The CCG’s Managing Director informed the Committee that the CCG is expecting a phase 4 letter, which will explain the mandate from NHS England for practices in terms of adhering to its statutory responsibilities during the pandemic, as the country awaits another lockdown. The phase 4 letter will maintain elective surgeries during the next peak. The CCG City and Hackney has a strong plan for managing a number of hubs sites across North East London, taking a specialism approach in specific parts of elective surgeries. The capacities identified within the Trusts will allow the medical professionals to continue to run elective surgeries and manage the critical care aspect of the services, should the need arise. The Royal London Hospital has its 14^th and 15^th floor on standby to run any critical care services from there.

The Managing Director informed the Committee that there are two concerns that the CCG needs to be aware of, the first being the risks of transmission to NHS staff and frontline workers; hence the testing regime and the turnaround around the testing are very crucial to ensure a smooth running of services. The second point of concern is the worries around mental health, which requires public health orientated work to provide support for people to assist around their mental health and wellbeing.

At this point the Chairman asked that the report states that 98% of the CCG allocation will be retained locally with teams and resources continuing to deliver to local agenda and what is the 2% figure which will which are to be allocated North East London. The Managing Director informed the Committee the North East London is allocated £10 million. Additionally, the City and Hackney

NHS City and Hackney Clinical Commissioning Group to be heard.

The Committee received a verbal update on the integrated care system for North East London from the City and Hackney from the CCG's Managing Director.

The CCG’s Managing Director informed the Committee that some of the issues raised today concerning the Portsoken ward and the North and South of the City regarding accessing services. The proposed single CCG model gives the City a better chance to influence services in the City and in Tower Hamlets along with the other sides of the City. This may play into some of the contemporary issue’s colleagues in terms of access and boundaries.

RESOLVED – that, the verbal update be received.

Joint report of the Director of Community & Children’s Service and the Director of Public Health.

The City of London Health Profile 2019 was received with item 13.

There were no questions.

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 Nos.                                                        Exempt Paragraph(s)  
                        19                                                                             3

22                                                                              3

To agree the non minutes of the previous meeting held on 26 February 2020.

RESOLVED - That the non-public minutes of the meeting held on 16 July 2020 be approved as a correct record.

There were no questions.

There was no other business.

To agree the confidential minutes of the previous meeting held 26 February 2020.

RESOLVED - That the confidential minutes of the meeting held on 16 July 2020 be approved as a correct record.

There was no other questions.

There was no other business.