Agenda and minutes

Apologies were received from Wendy Mead.

Deputy Edward Lord declared a general, non-pecuniary interest in respect of Agenda Item 9, Air Quality Strategy, as his brother, Oliver Lord, is a senior member of the Mayor of London’s Clean Air Team.  Deputy Lord would therefore not participate in the debate and discussion on this item. 

Members are asked to note the Order of the Court dated 25 April, appointing the Committee and confirming its Terms of Reference.

Members received the order of the Court dates 25 April 2019, appointing the Committee and confirming its Terms of Reference.

The Committee elected a Chairman in accordance with Standing Order 29. 

RESOLVED, that – being the only Member willing to serve, Christopher Boden be elected as Chairman of the Health and Social Care Scrutiny Committee for 2019/20.

The Committee elected a Chairman in accordance with Standing Order 29. 

RESOLVED, that – being the only Member willing to serve, Michael Hudson be elected as Deputy Chairman of the Health and Social Care Scrutiny Committee for 2019/20.

RESOLVED, that – Mr Steve Stevenson be appointed as the Healthwatch Co-optee for 2019/20.

RESOLVED, that – The Chairman and Deputy Chairman be appointed to the Inner North East London Joint Health Overview and Scrutiny Committee, with the Deputy Chairman being the primary representative and the Chairman as substitute. 

To agree the public minutes and non-public summary of the meeting held on 27 February 2019.

RESOLVED – That the public minutes of the meeting held on 27 February 2019 be agreed as a correct record, subject to an amend removing Emma Edhem, who was no longer a Member of the Committee

Matters arising

The Assistant Director agreed to investigate:

•           the reported complexity of the process for securing access to chiropody services at the GP practice for  elderly and/or less mobile clients.

•           reported difficulties in securing a timely discharge from hospital due to delays in, and the level of,  Occupational Therapy service input.

Members noted there had been some lag in aligning data of resident and worker use of the Sexual Health Clinic, which had opened in 2018, with the City of London’s 2018 Health Profile The officer was hopeful that this would improve in due course.

Report of the Director of Markets and Consumer Protection.

 Members received a report of the Director of Markets and Consumer Protection in respect of the 2019-24 Air Quality Strategy, which was being presented to the Port Health and Environmental Services Committee, for decision, on 23rd July 2019.

In response to a challenge as to whether the Strategy might lack ambition, Members noted that over 75% of PM10 and PM2.5 particle pollution, measured in the City of London, originated from outside the City of London boundary, as did approximately 40% of NO2.  The City Corporation aims to meet safe nitrogen dioxide limits in 90% of the Square Mile.  Despite these challenges, Members commended a thorough and objective Strategy which had been very well received by the GLA.

RESOLVED, that:

1.         The content of the Air Quality Strategy for 2019-24 be noted.

2.         The Committee continue to provide support for improving air quality and reducing the impact of poor air quality on public health. 

Director of Markets and Consumer Protection

Members considered a report of the Director of Markets and Consumer Protection in respect of air pollution at St Bartholomew’s Hospital.  Members noted that in March 2019, the Chairman had written to Bart’s Health NHS Trust’s Chief Executive enquiring as to the hospital’s plans to mitigate high levels of air pollution.  The letter resulted in a site visit, which found that the combined heat, cooling and power plant (CCHP) had not been operating as expected and this was rectified in May 2019. During the site visit, officers became aware of significant fumes in the car park.

During the discussion and questions, the following points were raised:

•           Monitoring data was not currently available to establish whether the modifications undertaken had been effective in reducing levels of air pollution. The City Corporation would continue to work with Bart’s in producing sound data. 

•           The recommended safe level for annual average concentration of nitrogen dioxide levels are 40 per cubic metre and St Barts had shown 60 per cubic metre in 2017.  This increase had co-incided with the operation of a new energy centre located South West of the monitoring site. Members noted Barts was increasing further in size, with two new blocks planned.

•           Chemiluminescent analysers (CLAs), which are used widely across the Square Mile, provide a much finer detail that diffusion tubes, which cannot detect peaks and troughs.  Diffusion tubes are in place at Barts’ and Members noted that CLAs would need to be hired and calibrated fortnightly and, therefore, they could only be installed with Barts’ approval.  There was a suggestion that, given that nearby business premises were likely to be affected, could they be asked to accommodate the equipment?  Members noted that the equipment would need to be placed very close to the source and

 Members received a presentation on City Worker Health Research, which had also been presented to the Health and Wellbeing Board and the Safer City Steering Group.  There was a suggestion that Bloomberg be contacted to provide examples of best practice relating to the consideration of staff health and wellbeing in the design of their new City offices.  Members noted the significant amount of private healthcare provided by some City businesses.  

In concluding, the Chairman and Members commended an interesting and insightful presentation.

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 Members with indicative performance outcomes from the Adult Social Care Survey and Carers’ Survey for 2018-19.

During the discussion on this item, the following points were noted:

• The invaluable role of carers and their need for support and training to deliver their caring role. Officers agreed to identify what training support was currently offered.

• Members were pleased to note that overall, satisfaction levels were very high when compared with the rest of the UK.

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 considered the impact of the City of London Mental Health Strategy 2015-18 over its three-year lifespan. An impact assessment was provided as an appendix to the report. 

Members commended a very good report and action plan, which evidenced the City Corporation’s high priority for mental health services.  Members also noted the Lord Mayor’s Exhibition, which had opened at St Lawrence Jewry the previous evening.  The Dragon Café at Shoe Lane Library was quoted as a further example of good practice, which had been extremely valued by City workers.  The officer explained that the service was intended to provide support, in conjunction with the rest of the City Corporations mental health offer and other services offered at the Library.  .

RESOLVED, that – the report be noted

Report of Healthwatch Hackney.

Members received Healthwatch Hackney’s Annual Report and noted that the Chair’s introduction was now available and would be circulated to Members and added to the City Corporation’s web page for this Committee. Members recognised the strength of Healthwatch and thanked them for this report.  The Chairman made a couple of observations and suggestions, going forward, noting that this report was a backward look:

•           A balanced consideration of both residents and workers in the City.

•           More focus on the East of the City.  Members noted that the current City of London Healthwatch Board was being supported by the City Corporation in providing a stronger focus on the East of the City.

RESOLVED, that – the report be noted.

Report of City and Hackney Public Health Intelligence.

Members received a report of the Public Health Consultant, which provided intelligence on the uptake of the Babylon GP at Hand – a web-based GP service.  Members noted that a new interim Public Health Consultant was now in place; Andy Liggins. 

During the discussion on this item, in which there was a mixture of views expressed as to the pros and cons of on-line GP consultations; Members noted that the service was more popular with men and young people, and take up within these groups had increased considerably. However, the potential impact on GPs was also noted; i.e. young people might de-register in order to use on-line services, leaving practices with an older and more expensive cohort of patients.

RESOLVED, that – the report be noted.

Report of the Director of Community and Children’s Services

Members considered a list of potential future topics for discussion by the committee and added the following suggestions:

·       The Long Term Plan submission of the North East London Sustainable Transformation Partnership.

·       An issues paper considering the impact of promoting the right to choose/patients charter/patients first approach to City workers.  In the case of City workers, appointments close to their place of work were likely to be more convenient.  There was an argument presented in that this could put considerable pressure on the Royal London and Homerton.

·       An examination of the discharge protocols from, and the rate of call backs to, Intensive Care Units (ICU’s) that might be under financial pressure to release patients too soon.  Members note that, 15 days after discharge, a patient was treated as a ‘new condition’, if re-admitted.  The Chairman and Members agreed that this topic was very worthy of further scrutiny. 

Further topics for inclusion in October’s agenda:

·       Barts air quality – as discussed earlier on this agenda

·       Adult Safeguarding Annual Report

Suggested for a future agenda:

·       personalised budgets in Social Care

·       assurance that the NHS bodies were meeting their statutory duty to consult the local health Overview and Scrutiny Committee on substantial developments in, or variations to, the health service in the Authority’s area.

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)  
              20,21                                                                         -

There were no questions.

There was no other business.