Agenda and minutes

The Chairman updated the Committee in relation to outstanding responses referred to at the 12 February 2013 meeting:

i)                                Corrected data relating to A&E attendances by PCT for the years 2011/12 and 2012/13 had been supplied by Barnet and Chase Farm Hospitals NHS Trust;

ii)                              Dr Rounce had been contacted by Barnet and Chase Farm Hospitals NHS Trust to discuss the issues she had experienced and had attended a meeting with Rick Strang, General Manager for Emergency Medicine at Barnet and Chase Farm Hospital NHS Trust, on 21 March 2013.  It was noted that Dr Rounce had not received a letter detailing the meeting outcomes by the end of April as she had been advised she would by the Trust; and

iii)                            Data on maternal and baby deaths at Barnet and Chase Farm Hospitals NHS Trust for the years 2010/11 and 2011/12 had been supplied by the Trust.

Resolved that:- 

1.      the minutes of the meeting held on the 12 February 2013 be agreed as a correct record.

2.      the Scrutiny Office be requested to obtain the information requested from Health Partners in relation to the following minute items from the 12 February 2013 meeting:

i)          Item 6 (1) – details of the Barnet, Enfield and Haringey Clinical Strategy Transport Assessment

ii)        Item 9 (1) – Barnet Clinical Commissioning Group Savings Plan

Apologies for absence had been received from:

·         Councillor Kate Salinger (who had been substituted by Councillor John Hart);

·         Councillor Reuben Thompstone (who had been substituted by Sury Khatri); and

·         Councillor Julie Johnson

a)      Disclosable Pecuniary Interests and Non Pecuniary Interests

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

A request to make public comments had been received from Mr Daniel Hope in relation agenda item 9 (GP Services – Brunswick Park Health Centre and Finchley Memorial Hospital).  The Chairman advised the Committee that public comments would be taken at agenda item 9.

The Chairman reported that she had agreed for the Committee to consider a Members’ Item submitted by Councillor Geof Cooke in accordance with Overview and Scrutiny Procedure Rule 8.  She advised the Committee that this item had been circulated with the additional report pack and would be considered at Agenda Item 12 (Any Other Items the Chairman Decides are Urgent).

The Overview and Scrutiny Manager presented a report which detailed future arrangements and the amended terms of reference for the North Central London Sector Joint Health Overview and Scrutiny Committee and sought approval to refer these to full Council for adoption.

RESOLVED that:-

1.             the Committee approve the proposed arrangements, amended terms of reference and procedures for the North Central London Joint Health Overview and Scrutiny Committee as set out in the report and refer these to Council for adoption. 

2.             Officers be requested to review the legislation relating to joint health overview and scrutiny committees and provide guidance regarding whether participation in a joint committee affects the entitlement of the individual boroughs health overview and scrutiny committees to hold health partners to account. 

The Committee considered the minutes of the North Central London Sector Joint Health Overview and Scrutiny Committee (JHOSC) which had taken place on 14 March 2013. 

The Chairman updated the Committee in relation to the following items:-

Urological Cancer

Members were advised that University College London Hospital (UCLH) had submitted a formal expression of interest to host the specialist centre for bladder and prostate cancer surgery and the Royal Free Hospital had submitted a formal expression of interest to host the specialist centre for renal (kidney) cancer surgery.

Travel Impact - Royal Free Hospital

The Committee noted that the JHOSC had been advised that approximately 170 patients per year would have to make a longer journey to use the Royal Free Hospital.  The proposed changes would mean people would have access to a fuller range of services.  Local units would provide a comprehensive diagnostic service led by a consultant urological surgeon and would be linked to the specialist centre.

Resolved that the Committee note the minutes of the meeting North Central London Sector Joint Health Overview and Scrutiny Committee held on 14 March 2013 and the updates set out above.

The Overview and Scrutiny Manager introduced a report on the Francis Report and the implications for the Health Overview and Scrutiny Committee. 

At the invitation of the Chairman, the Director for People, Kate Kennally, noted the timeliness of the report and emphasised the role of the Committee as the eyes and ears of the borough.  Referring to the commentary from Francis in relation to the health scrutiny in Staffordshire, the Director for People emphasised the importance of the Committee not being over-dependent on information from the provider rather than other sources such as patients and the public (paragraph 9.5.2).   

The Committee noted the importance of developing relationships with the new HealthWatch.  The Chairman requested that representatives from HealthWatch receive a standing invitation to all future meetings of the Committee.

A Member suggested that Officers should consider ways that other forums could make references to the Committee or other bodies, such as the Health and Wellbeing Board, where there were concerns in relation to health services.  The Director for People supported this, adding that the Committee should use multiple information sources including data, advice and complaints to support their work.

The Cabinet Member for Public Health advised the Committee that the Health and Wellbeing Board has received a report on 25 April 2013 detailing the actions taken by NHS trusts to respond to the recommendations in the Francis Report.  Members were advised that the Clinical Commissioning Group had been receiving bi-weekly updates from the Trust and that a six monthly update would be reported to the Health and Wellbeing Board.  

RESOLVED that:-

1.             the Scrutiny Office be requested to prepare detailed responses / actions to the recommendations made in the Francis Report in relation to Patient and Public Involvement and Scrutiny as set out in the Appendix to the report and prepare a further report for submission to the next meeting.

2.             the Committee note the update from the Cabinet Member for Public Health on reports received by the Health and Wellbeing Board in relation to the Francis report recommendations as set out above.

3.             the Committee receive a report from Barnet HealthWatch on their planned activity for 2013/14 and their response to the Francis Report.

The Committee received public comments from Mr Daniel Hope, Chairman of the East Barnet Residents Association, in relation to the Brunswick Park Health Centre.  Members commended the work of the Association in highlighting this issue and seeking a resolution to enable GP services to return to the Brunswick Park Health Centre. 

The Committee welcomed Neil Roberts (Head of Primary Care (North, Central & East London), NHS England) who provided an update on GP services at Brunswick Park Health Centre and Finchley Memorial Hospital.

Brunswick Park Health Centre

Mr Roberts reported that he had attended a meeting with the two displaced practices on 8 May 2013.  Members noted that NHS Property Services, the landowners, had been unable to attend.  Members noted that NCL London, the body which had been replaced by NHS England as of 1 April 2013, had failed to conclude negotiations in relation to the surgery. 

The Committee were informed that NHS England and NHS Property Services had been working on a two track approach to returning services to the Centre.  Track one was based on the two displaced practices (Dr Okonkwo and Dr Lakhani)merging, relocating back to the Health Centre and for the premises to be sold to the GPs.  Track two was to enter into an arrangement with Dr Okonkwo, with the centre being partially occupied.  Members noted that unless the premises was fully occupied there would be an ongoing cost to the practice in relation to void space.  It was noted that the preferred option was to enable the two practices to return at the same time.

Members questioned why the GPs were claiming in the local media that they would be subject to additional services charges for moving back into the Centre.  Mr Roberts advised the Committee that service charges were governed by premises regulations which were defined by the District Valuer.  It was noted that the last time that service charges had been levied was in 2009.  Charges had been subject to inflationary increases which had resulted in the increased costs referred to by the GPs.  He added that the GPs would be provided with a detailed breakdown of the figures. 

Finchley Memorial Hospital

Mr Roberts updated the Committee on GP services at Finchley Memorial Hospital.  He reported that the Chief Officer of Barnet Clinical Commissioning Group (CCG) had been updating local practices on the available space, adding that NHS England and NHS Property Services would soon be meeting with them too.  Members noted that it was planned that all GP space at the hospital would be used. 

Responding to a question regarding planning the location of GP practices, Mr Roberts advised the Committee that mapping software was used to identity local demand and capacity and that these measures were used to identify the preferred location for expanded or new practices.  Members noted that the GP premises at Finchley Memorial Hospital were owned by LiftCo not NHS Property Services. 

RESOLVED that:-

1.             the update from NHS England on GP Services  ...  view the full minutes text for item 9.

NORTH LONDON HOSPICE

The Committee scrutinised the North London Hospice Quality Account 2012/13 and wishes to place on record the following comments:

·           The Committee noted the high quality of care provided by the Hospice and welcomed the patient focus.

·           The Committee supported the use of volunteers and the training that the Hospice provided for them. 

·           The Committee noted that a large proportion of the Hospices’ income was derived from fundraising activity and commended this. 

·           The Committee welcomed the participation of the Hospice on the End of Life Care Board and Frail Elderly Group

·           The Committee supported the introduction of a target of a 75 – 80% bed occupancy rate for 2013/14.

·           The Committee welcomed the decrease in the number of closed bed days from 156 in 2011/12 to 85 in 2012/13.

·           The Committee welcomed the Hospice beginning to work within a local five hospice consortium to benchmark performance.

·           With reference to Information Governance Assessment, the Committee noted that the Hospice had achieved an overall score of 60% and had been graded ‘not satisfactory’.  Hospice staff reported that this had been due to issues regarding connecting IT systems to the NHS Intranet which had very high security requirements.  Members were advised that was an action plan in place to ensure that the required score of 66% was achieved for 2013/14.  The Committee noted the response and supported the actions taken to improve performance.

·           The Committee noted that staff had been considering recommendations made in the Francis Report and how the Hospice would respond to these.  

·           The Committee highlighted the increase in pressure sores (an increase from one in 2011/12 to four in 2012/13) and noted that these were attributable to an increased number of patient days in the hospice and the medical conditions suffered by the patients which made regular movements painful.

ROYAL FREE LONDON NHS FOUNDATION TRUST

The Committee scrutinised the Royal Free London NHS Foundation Trust Quality Account 2012/13 and wishes to place on record the following comments:

·           The Committee welcomed that all targets, with the exception of C.difficile infection cases, had been met for 2012/13.  The Committee noted that the Infection Control Team had been undertaking detailed analysis of cases and steps were being taken to address this increase.

·           The Committee welcomed the move towards patient rather than clinician defined performance metrics.

·           The Committee noted that the hospital had been found to be non-compliant with one outcome relating to medicine management following a CQC inspection in October 2012 and that an action plan was being implemented to address this area of improvement.

·           The Committee noted work being undertaken by the Trust to ensure there was sufficient capacity for emergency operations. 

CENTRAL LONDON COMMUNITY HEALTHCARE NHS TRUST

The Committee scrutinised the Central London Community Healthcare NHS Trust Quality Account 2012/13 and wishes to place on record the following comments:

·           The Committee welcomed the continuing involvement of the Quality Stakeholder Group.

·           The Committee commended the award winning work of the Central London Community Healthcare NHS Trust staff.

·           The Committee  ...  view the full minutes text for item 10.

The Cabinet Member for Public and Director for Public Health advised the Committee that a Public Health / Health Improvement Month would be held during June.  As part of this, a Member Induction Session would be held introducing the Public Health team, introducing the Health & Wellbeing Strategy and setting out commissioning intentions. 

The Overview and Scrutiny Manager reported that the Council had been successful in obtaining support from the Centre for Public Scrutiny for scrutinising the NHS Health Checks programme.  It was noted that this would be joint project with Barnet and Harrow. 

RESOLVED that:

1.            The Health Overview and Scrutiny Committee Forward Work Programme be noted.

2.            The Committee receive reports at their next meeting on 4 July 2013 on the following items (as referred to above):

·         report from Barnet HealthWatch on their planned activity for 2013/14 and their response to the Francis Report

·         NHS England and NHS Property Services provide an update report on the Brunswick Park Health Centre at the next meeting of the Committee. 

3.      The Committee receive a report at their meeting on 3 October 2013 on Health and Social Care Integration projects

Councillor Geof Cooke presented a Members’ Item in relation to bus services at Finchley Memorial Hospital.  Councillor Cooke requested an update on discussions between the relevant NHS body and Transport for London (TfL) regarding the need for a bus service calling at Finchley Memorial Hospital in view of the distance from existing stops including the distance from the entrance in Granville Road to the hospital building. In particular, he requested that consideration be given to providing a service by a small hopper type bus similar to that operating elsewhere in the borough.

Councillor Cooke also requested an update on any previous consideration by the Health Overview and Scrutiny Committee on bus services in the context of reorganisation of health services between Barnet Hospital and Chase Farm Hospital, in particular the complete lack of any direct TfL service from any part of Barnet to Chase Farm.

RESOLVED that the Committee receive a full report at the next meeting of the Committee on 4 July 2013 to include an update on any discussions between the GLA Member for Barnet and Camden (Andrew Dismore AM) and Transport for London on this issue.

The Vice-Chairman, Councillor Old, thanked the Chairman, Councillor Alison Cornelius, for her work during the 2012/13 municipal year.