Agenda and minutes

Venue: Hendon Town Hall, The Burroughs, London NW4 4BQ

Contact: Edward Gilbert, Email: edward.gilbert@barnet.gov.uk, 020 8359 3469 

Note: Public Questions and Comments must be submitted by 10am on the third working day before the meeting. The deadline for this meeting is 10am on Wednesday 30 November. 

Items
No. Item

1.

Minutes pdf icon PDF 139 KB

Minutes:

The Chairman welcomed Councillor Alison Moore to the Committee and thanked Councillor Arjun Mittra for his contribution to the Committee as a former member.


The Chairman then congratulated the Governance Service Team Leader who had previously supported meetings of the Committee, Anita O’Malley, on the arrival of her baby, William Patrick O’Malley.


The Chairman also welcomed Edward Gilbert, Governance Service Team Leader and Abigail Lewis, Governance Officer to the Committee meeting.

 

The Chairman provided the Committee with the following update from Healthwatch Barnet in regard to the tongue tied issue which was raised at the last meeting of the Committee:

 

"There is a need to review the training of both midwives and junior medical staff cross-site regarding the recognition and management of tongue ties within the Royal Free London. This will be incorporated into the training programme." – Mai Buckley, Director of Midwiferty, Royal Free London, 23 August 2016

 

The Chairman informed the Committee that they were awaiting a response from Mr Leigh Griffin, Director of Strategic Development Barnet CCG, in respect of the outline approach for charging patients from overseas. At the last meeting Mr Griffin stated that he would pursue this data from the Royal Free London NHS Foundation Trust and the Royal National Orthopaedic Hospital (RNOH).

 

2.

Absence of Members

Minutes:

Councillor Laurie Williams was absent and was substituted by Councillor Anne Hutton.

 

3.

Declaration of Members' Interests

a)      Disclosable Pecuniary Interests and Non Pecuniary Interests

b)      Whipping Arrangements (in accordance with Overview and Scrutiny Procedure Rule 17)

 

Minutes:

Councillor Caroline Stock declared a non-pecuniary interest in relation to item 9 by virtue of her husband being an Elected Public Governor of the Council of Governors at the Royal Free London NHS Foundation Trust.

 

4.

Report of the Monitoring Officer

Minutes:

None.

 

5.

Public Question Time (If Any)

Minutes:

None.

 

6.

Members' Items (AGENDA ITEM 6) pdf icon PDF 274 KB

Minutes:

Councillor Phil Cohen introduced his Member’s item in relation to NHS Property Services Ltd charging market rents.

 

The Committee expressed the following concerns in relation to the issue:

-          Uncertainty over how many services would be affected in any new negotiations of rental agreements;

-          Uncertainty over whether GPs and other health providers are aware of the 2016 change to the market rent system;

-          Uncertainty over whether the public is aware of the new rent system in operation.

The Chairman invited Mr Neil Snee, Interim Director of Commissioning Barnet CCG, Debbie Frost, Chairman of the Barnet CCG and Councillor Helena Hart to the table to discuss the issues.

 

Mr Snee informed the Committee that the East Barnet Centre, CLCH and the landlord had come to an agreement whereby the services had been reinstated that morning.

Mr Snee informed the Committee that the only impact on the local area from the new rental system was in respect of East Barnet Health Centre. He stated that discussions are ongoing with Finchley Memorial Hospital in respect of charging arrangements under the new system and how these will be dealt with.

 

He informed the Committee the reason behind the changes was due to unfair competition of some NHS services over the open market, which could leave the NHS open to challenge and that this new system was a standard method of charging in the property industry.

 

Ms Frost updated the Committee on rents at Finchley Memorial Hospital and stated a more detailed plan would be confirmed in the New Year. She stated that CCG are still committed to filling the vacant spaces as soon as possible.

 

During the course of discussion, Councillor Alison Moore declared a non-pecuniary interest in relation to the item by virtue of the fact that her GP service is at Squires Lane, Finchley. Further to this, Councillor Anne Hutton then declared a non-pecuniary interest in relation to item 6 by virtue of the fact that Finchley Memorial Hospital is within her ward.

 

Councillor Graham Old inquired about the rates of vacancy and under-utilisation of space and requested a report be brought to a future Committee about this issue as resources do not appear to be being used as effectively as they should be.

 

Councillor Hutton stated that transport issues regarding Finchley Memorial Hospital continue to be a concern for constituents in her ward. Mr Snee informed the Committee that an experienced programme manager had been appointed to look at the detailed plans, and these included transport issues and conversations with TfL(Transport for London). Mr Snee said he was willing to return to a future Committee to provide an update on the plans.

 

RESOLVED –The Committee noted the report

 

RESOLVED – That a report be brought back to a future meeting of the Committee with an update on the issue.

 

7.

Update Report: Cricklewood Walk-in Centre Service (AGENDA ITEM 10) pdf icon PDF 276 KB

Additional documents:

Minutes:

The Chairman welcomed Mr Neil Snee, Interim Director Clinical Commissioning Barnet CCG to the table. He provided an update on the report and informed the Committee that there has been an extension to the contract until March 2019.

 

Councillor Graham Old queried whether the hours of provision at the Cricklewood Centre (as outlined on page 70 of the agenda pack point 1.9) were accurate or just a snapshot of what is currently available somewhere in the Borough.  Mr Snee said he would provide an answer to the Governance Officer to clarify this so that the information could then be circulated to the Committee.

 

8.

Cover Report for Quality Accounts - Mid Year Review (AGENDA ITEM 9) pdf icon PDF 290 KB

Additional documents:

Minutes:

The Chairman gave an overview of the report and thanked the Trusts for listening to the Committee’s comments earlier in the year.

 

Royal Free NHS London Trust

 

The Chairman then invited James Mountford, Director of Quality at the Royal Free NHS Foundation Trust, to the table:-

 

-          Mr Mountford updated the Committee on the winter pressures and challenges around the 5% increasing demand on A&E.

-          He further noted that on 19th December 2016, the new adults and surgical assessment centre will open which will increase the number of available beds and will also increase capacity for ambulance arrivals and GPs. He informed the Committee that the Royal Free Hampstead site has ongoing A&E redevelopments and the children’s department has now opened. The developments will be ongoing until January 2018, and will increase the number of beds at the site from eight to 22.

-          Mr Mountford updated the Committee on the Safer, Faster, Better programme. This will involve a better discharge programme and which should improve the flow of patients through the hospital.

 

The Committee asked for a written report on the winter pressures to be submitted to a future meeting. Councillor Alison Moore asked that the potential for rehabilitation spaces also be included within this report.

 

Councillor Gabriel Rozenberg asked about a new technology available called ‘Streams’, he requested more information be provided from the Royal Free about this innovation and that the item be brought to a future Committee. The Chairman proposed it be a future item on the Committee’s forward work programme.

 

Centre London Community Health Care (CLCH)

 

The Chairman then invited Kate Wilkins, Interim Assistant Head of Quality and Cathy Morgan, Divisional Director for Operations in Barnet CLCH to the table.

 

Councillor Anne Hutton raised a point in regard to point 14 in the Trust’s written update regarding services provided by the Trust to prisons. The Committee were informed that this contract was discontinued in March 2016.

 

Councillor Graham Old then inquired about the incidents that resulted in harm; Ms Wilkins said she would write to Councillor Graham Old regarding this issue, as she did not have the relevant information to hand.

 

Councillor Graham Old inquired about the success stories that had been included within the report and how these were relevant to bullying and harassment. Ms Morgan informed the Committee that these were anonymous real life stories collected from staff which were used for training and development.

 

Councillor Phil Cohen asked whether the high proportion of ethnic minorities feeling bullied and harassed from the results of the previous survey had been looked into. Ms Morgan informed the Committee that the results had been incorporated into training. The Committee were also informed there are no pre-booking systems available at CLCH walk-in centres, although patients may have scheduled follow-up appointments.

 

North London Hospice

 

The Chairman then invited Ms Fran Deane, Director of Clinical Services from the North London Hospice Trust to the table.

 

The Chairman asked for the results of the Handwashing  ...  view the full minutes text for item 8.

9.

Eating Disorders & Body Dysmorphia (AGENDA ITEM 8) pdf icon PDF 266 KB

Additional documents:

Minutes:

The Chairman invited the following officers and representatives to the committee table:

 

·         Chris Munday, Commissioning Director, Children and Young People, London Borough of Barnet.

·         Eamann Devlin, CAMHS Joint Commissioning Manager (Interim)

·         Dr Berelowitz, Lead Clinician for the Eating Disorder Service at the Royal Free NHS Foundation Trust.

Mr Munday informed the Committee that on the 18th November 2016 schools and colleges in the Borough held an event on eating disorders in order to improve communications. He noted that the event was a success in terms of engagement.

 

Mr Devlin told the Committee the event had been held for both schools and primary care and that the feedback from the event had been positive. They were happy with the content of the seminar however; they felt that the advanced publicity of the event could have been improved. He noted that although five schools in total had attended, there are nevertheless difficulties with getting staff at schools and GPs to attend. He noted that several seminars will be held over the coming year to target different schools including topics such as depression and anxiety, which are common issues for young people.

 

The Chairman asked if Governors could  be involved in attending and helping to publicise these events where possible. Mr Munday agreed that the role of Governors is important and said that they were willing to broaden the seminars to include Governors and Councillors.

 

Councillor Caroline Stock asked whether the seminars could be opened up to private schools and whether they would accept requests from schools to do free seminars. Dr Berelowitz said that they do already go to private schools.

 

Councillor Anne Hutton inquired whether there is any literature from the seminars that could be circulated to the councillors. Dr Berelowitz said that literature will be made based on the seminars and that he would circulate this to members following the meeting.

 

Councillor Phil Cohen asked whether access to Cognitive Behavioural Therapy (CBT) could be expanded, as he believed that this is the main therapy for those with Body Dysmorphia Disorder (BDD).

 

Councillor Graham Old asked whether BDD involved people being concerned with their appearance or whether there was also a sexual element (for instance size of sexual organs) and whether those with BDD could be referred to other specialist services such as plastic surgery practitioners or sexual health clinics.

 

Dr Berelowitz informed the Committee that there were very few experts in the country on BDD. He noted that CBT is currently insufficiently available and that he is unsure whether a specialist service would be possible due to the co-morbidity of the condition with depression and anxiety.

 

Councillor Val Duschinsky asked how many residential places are available for people living locally with eating disorders. Dr Berelowitz said that recent changes mean that there is no local provision. Places are allocated nation wide on a first come first serve basis although place of residence is taken into account as far as possible.  Councillor Duschinsky asked if there is any funding  ...  view the full minutes text for item 9.

10.

Legal Highs (AGENDA ITEM 7) pdf icon PDF 254 KB

Additional documents:

Minutes:

The Chairman invited the following officers and representatives to the table::

 

·         Bridget O’Dwyer, CCG Senior Commissioning Manager (Substance Misuse Service, Barnet and Harrow Public Health Team)

·         Sophia Cassettari, Substance Misuse Service, Barnet and Harrow Public Health Team

·         Bob Ryan, Assistant Director at Barnet, Enfield and Haringey Mental Health Trust (BEHMHT)

·         DevikaBoodram, Head of High Intensity Ward at the BEHMT

·         Alex Ewings, Quality, Governance and Assurance Manager at the London Ambulance Service

·         Chris Munday, Commissioning Director (Children and Young People), London Borough of Barnet.

The Chairman introduced the report.

 

Ms O’Dwyer and Ms Cassettari gave a presentation to the Committee on the topic, concerning prevalence, origins and issues that legal highs present. The Committee requested that the presentation be circulated to them after the meeting.

 

The Chairman asked about the difficulties the London Ambulance Service had experienced as a result of legal high use. Mr Ewings said one of the biggest problems was the uncertainty around the 280 plus permutations of the substances contained within legal highs, making it hard to treat patients. Mr Ewings mentioned that Barnet CCG receive two or three reports a month about verbal or physical abuse but it is not known how many of these reports related to new psychoactive substances (NPS). He informed the Committee that many are associated with other conditions such as mental health. The Chairman thanked the ambulance service for all their hard work.

 

Ms Boodram informed the Committee that many of the patients who come to the unit at BEHMHT have displayed very aggressive behaviour whilst in the Trust’s care. She clarified that the incidences of patients being admitted as a result of NPS use had risen but noted that it is hard to distinguish between genuine mental health issues and issues arising from the use of NPS. She informed the Committee that there is currently no screening available for NPS in the way that illegal drugs can be tested for. The uncertainty concerning exactly what patients have taken also makes it difficult to medicate.

 

Ms O’Dwyer told the Committee that work was being done to try and tackle the problem. A more streamlined referral system and one point of contact were some of the solutions. Also, she thought a higher emphasis on educating people about the dangers of taking these substances.

 

Mr Ryan agreed that education was the key to tackling the problem but pointed out some individuals are not willing to engage with help offered to them. Services are now being more proactive in promoting care, approaching individuals rather than waiting for them to seek help themselves.

 

Mr Munday stressed that it was important to ensure schools were engaged with such services as part of an overall programme rather than it being treated as an isolated topic. Ms O’Dwyer and Ms Cassettari explained that Middlesex University and Barnet College had been approached in order to help raise awareness of the problem.

 

Councillor Anne Hutton asked whether there was a tie-up across other London Boroughs.  ...  view the full minutes text for item 10.

11.

Health Overview and Scrutiny Forward Work Programme (AGENDA ITEM 11) pdf icon PDF 228 KB

Additional documents:

Minutes:

The Chairman invited Councillor Helena Hart, Chairman of Barnet Health and Wellbeing Board and Dr Andrew Howe, Director of Public Health (Harrow and Barnet Councils) to the table.

 

Councillor Helena Hart commented that she would have liked there to have been more involvement from the schools in regard to the youth drugs and alcohol briefing.

 

Councillor Helena Hart then gave her views on issues concerning the Sustainability and Transformation Plan (STP) views which she had previously expressed to a recent Policy and Resources Committee (P&R).

 

 

-          The lack of public and residential engagement about the project and also the lack of engagement with Barnet Council Members;

 

-          There does not appear to be a commitment to obtaining adequate social care or an explanation about the resources that will be made available to the Local Authority;

 

-          Changes to commissioning and delivery models should only be made for clinical reasons and not as a way to cut costs;

 

-          Does not do enough to explain the effects on existing services and how these will be kept adequately up and running during these changes.

The Chairman said members of the Joint Health Overview and Scrutiny Committee (JHOSC) had written a letter to the Secretary of State raising these concerns and the JOHSC was holding an additional meeting about the STP on 9th and 14th December 2016.

 

Councillor Helena Hart told the Committee that the Health and Wellbeing Strategy Plan had been discussed at the last HWBB. Topics of particular concern which had been raised included TB, STIs, childhood obesity and an increase in violent crime.

 

Dr Andrew Howe addressed the Committee on the following points:-

 

-           An MMR campaign from Public Health England targeting women of child bearing age and teenagers would commence in the New Year.

 

-          The need for more emphasis on alcohol issues within the STP as alcohol related incidents now account for a third of all hospital admissions and should be reflected in the STP.

 

-          Barnet was still worse than average for TB but numbers were coming down due to testing for latent TB.

 

-          Childhood obesity was still a big issue and it was essential that Barnet focused on educating families.

 

-          Barnet is currently procuring new sexual health services as Barnet had higher rates in comparison to the rest of London

 

-          Work was being done concerning the Gangs to try and reduce the number of violent crimes. He also added the fear of violence is a significant contributor to poor health and wellbeing.

 

RESOLVED: The Committee noted the work programme.

 

12.

Any Other Items that the Chairman Decides are Urgent

Minutes:

The Chairman wished everyone a Happy Christmas, Hanukkah and Festive Season.

 

 

The meeting finished at 22.00