Agenda and minutes

Venue: Virtual Meeting

Contact: Email: tracy.scollin@barnet.gov.uk Tel 020 8359 2315 

Link: Click here for the meeting

Items
No. Item

1.

Minutes pdf icon PDF 192 KB

    Minutes:

    Corrections to the Minutes of the Meeting held on 22 February 2021:

     

    None.

     

    Matters arising from the Minutes of the Meeting held on 22 February 2021:

     

    Agenda Item 9 Page 5 of the Minutes - ‘Flu vaccination update/lessons learnt and potential future Covid-19 vaccination’ Section 4.4 ‘Homelessness Outreach’. A Member had enquired whether this group had been accessed and Dr Stephens had responded that she would ask Nicolas Ince for the information and forward it after the meeting.

     

    The Chairman reported that she had recently sent the information to the Committee and proceeded to read out the response for the benefit of the public: “As a result of Covid, the local Barnet Clinical Commissioning Group (CCG) Team undertook more targeted engagement with our homeless population to ensure that they registered with a Barnet GP Practice this year. In addition, two Barnet Practices are commissioned via the Unregistered Service Level Agreement (NHS England) within the Borough to vaccinate all remaining rough sleepers. These Practices work closely with ‘Homeless Action in Barnet’.

     

    Also, North Central London Clinical Commissioning Group (NCL CCG) has worked closely with Barnet Council and commissioned a local pharmacy to undertake in-reach work into Homeless Hotels to vaccinate those sheltered within these facilities as a result of the Covid Housing Policy”.

     

    RESOLVED that the Committee approve the Minutes of the meeting held on 3 December 2020 as an accurate record.

     

2.

Absence of Members

    Minutes:

    The Chairman noted apologies from Cllr Bokaei who would be late joining the meeting.

     

3.

Declaration of Members' Interests

    Minutes:

    None.

4.

Report of the Monitoring Officer

    Minutes:

    None.

5.

Public Question Time (If Any) pdf icon PDF 454 KB

    Additional documents:

    Minutes:

    A public question had been received from Mr Ben Samuel, which was included in the papers, asking about shielders (clinically extremely vulnerable individuals) and when they would need to return to the workplace.

     

    Dr Tamara Djuretic, Director of Public Health apologised for her late response which was published with the papers. She reported that shielders have been notified by letter that they should continue to shield until 31 March while this group is being vaccinated. North Central London Clinical Commissioning Group (NCL CCG) and Barnet Council have invited people from Priority Group 6 (including those clinically vulnerable) for vaccination and national guidelines are being followed. People who are shielding will need to continue shielding until then, even after vaccination.

     

    Mr Ben Samuel had not asked to attend the Meeting so there was no supplementary question.

     

    RESOLVED that the Committee noted the public question and response.

     

6.

Members' Items (If Any)

    Minutes:

    None.

7.

Minutes of the North Central Sector London Joint Health Overview and Scrutiny Committee pdf icon PDF 410 KB

    ·       27th  November 2020

     

    Minutes:

    RESOLVED that the Committee noted the Minutes of the JHOSC Meeting held on 27 November 2020.

     

8.

Coronavirus and Vaccine Update

    Minutes:

    The Chairman invited the following to the meeting:

     

    ·       Dr Tamara Djuretic, Director of Public Health, London Borough of Barnet

    ·       Dr Charlotte Benjamin, Vice Chair, North Central London Clinical Commissioning Group (NCL CCG)

    ·       Dr Deborah Sanders, Chief Executive, Barnet Hospital

     

    Dr Djuretic reported that infection rates have been increasing nationally and that Barnet currently were just under 100 per 100,000 population. Barnet is testing in the region of 15,000 people and seeing about 350 positive cases each week. However, there are fewer outbreaks in Care Homes, schools and houses of multiple occupation. The Council is continuing to work with these group in order to contain any outbreaks as soon as possible.

     

    Barnet has significantly increased its number of Enforcement Officers and this had shown improved compliance. The Council has worked with places of worship to ensure that good Covid-secure systems are in place. In addition, Barnet has around 200 Covid Champions and is putting great effort into engaging with all communities across the Borough.

     

    Testing sites are available in Barnet and capacity is being retained to ensure surge testing can be carried out if needed to continue to keep infection rates low in the case of new variants.

     

    Dr Djuretic reported that 95,000 people have been vaccinated in Barnet so far and 3,500 have received a second vaccination. The uptake in residents over 75 years old is 80%. There is a lower uptake in more deprived communities and Black African and Black Caribbean residents. There is a good uptake amongst the Asian population. Barnet continues to work with faith leaders and Covid Champions to promote vaccination. In addition, Dr Djuretic reported that, together with Dr Benjamin, she sits on the NCL Vaccination Board and the Barnet Vaccination Oversight Group which includes the Director of Adults, Public Health and Social Care colleagues. The group meets regularly to look at ways of promoting the vaccine.

     

    A Member commented that she had had very positive feedback from residents complimenting the way that the vaccination programme was being rolled out.

     

     Another Member asked whether the lower uptake of the Covid vaccine correlated with the same areas where ‘flu vaccination and childhood vaccination was lower and therefore there is a long-term driver around that work. She also asked whether people were largely hesitant or opposed to the vaccine.

     

    Dr Djuretic responded that much of the work focused on people who were hesitant rather than opposed to vaccination. Feedback showed that there were different barriers to immunisation such as childcare and Clinic opening hours so Barnet is working to improve access. She would bring a further update on vaccination to the next HOSC meeting.

     

    The Member then asked whether increasing the opening hours of some vaccination centres to support ‘out of hours’ workers might help. Dr Benjamin responded that a pilot is currently underway with Cullimore Pharmacy.

     

    A Member reported that Cullimore Pharmacy is in their Ward and there had been problems getting sufficient people to attend when they had a lot of vaccines available. Dr  ...  view the full minutes text for item 8.

9.

Post Covid Syndrome

    Minutes:

    The Chairman invited the following to the meeting:

     

    ·       Dr Charlotte Benjamin, Vice Chair, North Central London Clinical Commissioning Group

    ·       Ms Deborah Sanders, Chief Executive, Barnet Hospital

     

    Dr Benjamin described Post Covid Syndrome as defined by the National Institute for Health and Care Excellence (NICE): signs and symptoms that develop during or following an infection of Covid-19 which continue for more than 12 weeks. The condition presents with clusters of symptoms which can affect any area of the body. Many people can experience generalised pain, fatigue, persistent high temperature, psychiatric problems, breathlessness, anxiety, depression and ‘brain fog’.

     

    Just under 4,000 people in Barnet remain unable to work up to three weeks following Covid and almost 2,000 people cannot work 12 weeks after contracting Covid. A total of 396 individuals have so far been identified as having serious debilitating Post Covid Syndrome in Barnet according to data from January. 

     

    Dr Benjamin reported that patients have reported feeling dismissed and not being taken seriously and having difficulties accessing rehabilitation. NCL CCG is working to meet the needs of these patients, often identifying them through GP notes or through self-referrals. A swab or antibody test to confirm that individuals have had Covid is not needed as not everyone shows antibodies in their blood. A single point of access is needed for this cohort and many require a multi-disciplinary approach. From April, there will be a national specification and funding for these patients, although it is not yet clear how much NCL CCG will receive. A pilot is taking place in Camden with University College Hospitals NHS Trust (UCLH) and learning will then be shared from this. GPs are trying to encourage people to access self-management. The Royal Free is also working with CLCH.

     

    The chairman invited Dr Sanders to speak on Post Covid Syndrome from a hospital perspective. Dr Sanders noted that the Trust had not so far identified staff with the Syndrome, although some patients are being admitted or readmitted with the Syndrome. Care mostly involves therapy teams which are working closely with UCLH. 

     

    A Member asked whether there were any significant differences in the number of male and female patients with the Syndrome had been identified. Dr Benjamin responded that there was insufficient data at this stage, although Covid-19 has tended to affect more men than women. 

     

    RESOLVED that the committee noted the two verbal updates.

     

10.

CQC Maternity Report Update pdf icon PDF 140 KB

    Minutes:

    The Chairman invited to the meeting:

     

    ·       Ms Sanders, Chief Executive, Barnet Hospital

     

    The Chairman asked Ms Sanders to provide an update following a maternal death in February 2020 at the RFH. The Care Quality Commission (CQC) had undertaken an inspection of the Trust in October 2020 and the Report is attached with the supplementary papers.

     

    Dr Sanders reported that the patient was given the wrong dose of a drug in February 2020. There was also a concern about her deterioration regarding doctors in escalating problems in accordance with the guidelines and the CQC had noted in its Report published in January 2021 that safeguards had been put in place across all three hospitals to prevent this incident happening again.  Dr Sanders stated that this event has caused great concern but she wished to emphasise that a comprehensive plan is in situ.

     

    A major issue had been communication with the patient for whom English was not her first language, including printed leaflets on reduced foetal movement which should have been provided to her. A lot of work had been carried out to ensure that staff knew how to signpost patients in such cases. This was being shared across NCL.

     

    Dr Sanders reported that the CQC had also found that staff had not been able to demonstrate to them that they had learnt from previous incidents. The Trust has since improved its communications on this and is holding staff briefings, keeping a log of who has attended.

     

    Dr Sanders explained that the apology, which is normally included in the standard letter which is sent out following an incident, was unfortunately missing, as it had been removed in error in this case.

     

    The CQC had also expressed concern around IT systems including an alert system that looks at women’s observations. At BH it is done electronically but the RFH had moved to paper due to concerns with its IT infrastructure. Some work has been done at the RFH to resolve this and it is hoped that the CQC will come back again this month to review the situation.

     

    A Member asked whether there had been concerns about the RFH Maternity Unit prior to the CQC Report. Dr Sanders responded that the IT issues had been known about and efforts were being made to resolve these. However, the issue regarding translated leaflets had not been as high on the Trust’s radar as it should have been. 

     

    The Member further commented that items had been on the Risk Register for some time and asked whether this was a concern as it was highlighted in the Report. Dr Sanders responded that a workaround had been found on the IT issue so that should have been removed from the Risk Register. Ideally, the Trust should have the option to automatically extract data from the IT system but this had not been possible so it was being done manually. 

     

    Another Member asked whether there is a statutory requirement to supply leaflets in certain languages. Dr Sanders responded that  ...  view the full minutes text for item 10.

11.

Alternative Provider Medical Services (APMS) Cricklewood pdf icon PDF 554 KB

    Minutes:

    The Chairman invited the following to the meeting:

     

    ·       Mr Ian Sabini, Managing Consultant Lead, London GP Partnerships

    ·       Ms Vanessa Piper, Head of Primary Care, North Central London NHS England, London Region

     

    Ms Piper reported that an invitation to tender for the new Cricklewood Health Centre had been sent to interested bidders during the autumn of 2020. Bidders were asked to respond by January 2021 and were advised that the premises should ideally be located within one mile of the current site and no more than two miles away. An evaluation of the bidders’ responses had been carried out and the award of the contract would be approved on Friday 26 February 2021 by the Primary Care Commissioning Committee. Following this, there would be a ten-working day challenge period for bidders. The CCG would then write to patients with details of their new provider. The contract would commence on 1 April 2021. All existing staff in Barndoc will be TUPE transferred to the new provider.

     

    Mr Sabini reported that his role in the project was to support the CCG on the estates and property aspects of the scheme. A lease extension had been agreed with the current landlord to 31 August 2021 in order to align with the service contract. This provided some leeway also for the new premises to be prepared.

     

    A Member asked whether a move away from the area was a temporary solution and noted that there are large development plans for the B&Q site just behind the current GP Practice. Mr Sabini responded that this was realistically a permanent move because at present there was little clarity from the developer. The CCG is open to discuss options for a new facility in the area and there may be an opportunity to return to the area.

     

    The Chairman enquired about the length of the contract with the new provider. Ms Piper responded that the contract will be awarded for 15 years with a five-year break clause every five years. The Chairman asked whether there would be an opportunity to move the Practice after five years. Ms Piper noted that this depends on the solutions provided by the bidders and how fit for purpose their proposals are.

     

    A Member asked whether stakeholder notification would include Ward Councillors including those in Brent, Harrow and Camden. Ms Piper responded that they would be notified. The Chairman requested that she be notified by the CCG when the information becomes public knowledge so that she could notify the Committee. The date mentioned that this information should be available was 12 March 2021.

     

    A Member noted that there would be CIL money in the future regarding the B&Q site. Mr Sabini noted that he is working with the Section 106 Officer on this but the decisions would need to align with the Brent Cross development and any potential for a new health facility there.

     

    The Chairman enquired whether a meeting had taken place with Cllrs Zinkin, Clarke and Ryde as recommended  ...  view the full minutes text for item 11.

12.

Children and Young People's Oral Health in Barnet pdf icon PDF 520 KB

    Additional documents:

    Minutes:

    The Chairman invited the following to the meeting:

     

    ·       Ms Clare Slater-Robbins, Senior Children and Young People Commissioner, London Borough of Barnet

    ·       Ms Susan Yadin, Clinical Director for Community and Specialist Dental Services, Central London Community Healthcare

    ·       Dr Tamara Djuretic, Director of Public Health, LBB

     

    Ms Slater-Robbins reported that the Public Health Team had commissioned an Oral Health Promotion Service as part of the Healthy Child Programme which has a contract with Central London Community Healthcare (CLCH) for £59,000. The aim is to raise awareness among parents and other professionals about the importance of healthy teeth in children up to around age five. This involves training practitioners to supervise tooth brushing, give key messages to parents and to promote the public health programmes around free dental care during pregnancy as well as free dental care for children.  The service links in with breastfeeding services, early years providers and schools and has a suite of sessions run in those settings. Covid has impacted on this but the service has swiftly adapted to a virtual service and continues to deliver tooth brushes to food banks, as Children’s Centres are currently closed. There will be a ‘blended’ model in the future as the virtual offer has been successful.

     

    The Chairman commented that she had been informed that some dentists had run out of their NHS dental units and enquired whether these could be transferred between dentists. Ms Yadin noted that the Units of Dental Activity (UDA) are negotiated between dentists and NHS England (NHSE). Covid has had a huge impact on dentistry and the issues have been taken up at a national level. 

     

    A Member noted that there had been positive feedback from parents on dental health promotion even though the data show no improvement on four years ago. He also asked about the recognition of possible safeguarding concerns in cases of tooth decay not only among the under-fives but also among older children.

     

    Ms Yadin reported that safeguarding is part of mandatory training for dentists. It is commonly known that there is a link between dental neglect and safeguarding. There are also processes for dentists to follow if parents repeatedly don’t bring their children to attend dental appointments.

     

    Ms Yadin noted that it has been continuously difficult to improve oral health in children, despite ongoing efforts, and this is particularly frustrating for the dental profession. The model being followed involves the oral health promoter, general dental practitioner and referral on to community services and is a well-trodden one with the aim of reducing hospital admissions. 

     

    Ms Slater-Robbins added that data is used to work out which schools to target for health promotions, although the team is happy to engage with all schools who request their services whether they show poor figures in oral health, weight management and infant feeding or not. 

     

    Dr Djuretic reported that the service is small in relation to the Borough’s size and alternative models need to be developed as part of a bigger response towards preventing obesity, including  ...  view the full minutes text for item 12.

13.

Birth Registrations and Childhood Inoculation pdf icon PDF 188 KB

    Minutes:

    The Chairman introduced the written report provided by Dr Janet Djomba who would be attending the HOSC in May with a further report. The Chairman suggested that the Committee contact Dr Djomba if they had any queries regarding the report.

     

    A Member noted that in the past children could disappear from the system and there is a concern this could happen due to the challenges in birth registration. It would be helpful if the report could comment on this as in some cases there may be pregnancies where there are safeguarding concerns. 

     

    RESOLVED that the Committee noted the written report.

     

14.

Forward Plan pdf icon PDF 77 KB

    Minutes:

    10 May 2021

     

    ·       Coronavirus and Vaccination Update

    ·       Quality Accounts: Royal Free London NHS Foundation Trust, Central London Community Healthcare and the North London Hospice

    ·       Royal Free London NHS Foundation Trust Update on data collection issues at the RFH.

    ·       Childhood Inoculation and Birth Registration

     

    7 July 2021

    ·       Coronavirus and Vaccination Update

     

    To be allocated

    ·       Children and Young People’s Oral Health Update (early 2022).

     

15.

Any Other Items that the Chairman Decides are Urgent