Agenda and minutes

The Chair announced that Item 10 (NHS Estates update) would be deferred to the next meeting as the speaker could not attend.

Cllr Cornelius noted that she had spotted some typos. The Chair asked that she send these to the Governance Officer following the meeting.

Action: Cllr Cornelius

RESOLVED that the minutes of the meeting held on 19^th October 2022 were agreed as a correct record.

Apologies were received from Cllr Zakia Zubairi, who was unwell. The Chair requested that the Governance Officer wish her well.

Action: Governance Officer

None.

None.

None.

None.

To follow

The Committee received the minutes of the JHOSC, 30^th September 2022.

The Chair noted that there had been an interesting discussion on workforce and the difficulty in recruiting nurses.

RESOLVED that the JHOSC minutes were noted.

(10 min presentation and 10 min discussion)

The Chair invited Dr Maeve Gill, Public Health Specialty Registrar, and Dr Emma Waters, Public Health Consultant, to present their report.

Dr Gill reported that the implementation of the forthcoming Barnet Oral Health Action Plan would be overseen by the Health and Wellbeing Board. The Committee is asked to note the Children and Young People’s Oral Health Needs Assessment.

Dr Gill reported that the National Dental Epidemiology Programme Oral Health Survey 2019 estimated that just under a quarter of children under 5 have tooth decay. The HOSC had requested more information so the Public Health team is developing the needs assessment and some recommendations for Barnet. This has focused on 0-19 year olds, looked after children as a known vulnerable group, looked at the national context and at national guidance on effective preventative interventions. Barnet commissioned the Oral Health Promotion Service on 1^st April 2022.

Dr Gill added that the team conducted a focus group with parents of 3-4-year-old children in a nursery setting, in a deprived Ward in the borough. Further to this some recommendations had been made.

Dr Gill reported that oral health remains a problem nationally; preventable tooth decay is the leading cause of hospital admissions for 5-9-year-olds. There is good evidence on effective interventions based on prevention.

In Barnet there has been a reduction in access to dental services since the pandemic and  there is evidence of inequality by deprivation, which echoes the London-wide picture. Enhanced sampling has been undertaken in some Wards and it was found that in Burnt Oak 4/10 children experienced tooth decay. London-wide there was evidence of differences by ethnic group. Looked- after children are a known vulnerable group and pilots had been put in place to try to enhance access to dental services for looked after children. Also the community dentistry service had emphasised that children with Special Educational Needs (SEN) and children living in poverty were more at risk.

Dr Gill added that knowledge was found to be necessary but not sufficient. Parents reported knowing the key health messages but in practice not having sufficient time or not carrying out intended actions for other reasons. Also sugar preferences of children are partly shaped by the environment, and there is national evidence about the need to focus on shaping the environment children are in. Training needs in early years, social care and foster care staff were identified.

Dr Gill reported that the pandemic had impacted on partnerships, and the new oral health provider is currently settling in.

The main recommendations could be met with the current resources, and focused on:

• developing the Barnet Oral Health Partnership to renew relationships
• implementing the co-produced Barnet Oral Health Action Plan and focusing on how to maximise the impact of the oral health promotion service
• training for health, education and social care workforces as part of the Healthy Child Programme
• Quality assuring the  supervised toothbrushing pilot.
• Ensuring the toothbrushing pilot targets areas of deprivation.
• Reviewing the provision of toothbrush and toothpaste in response to  ...  view the full minutes text for item 8.

Post Covid User Group

(10 mins presentation and 10 mins discussion)

The Chair reported that speakers were unable to attend so would be invited to the next meeting in February.

Dr Djuretic presented her slides providing information on post Covid cases up to March 2022 and care provided.

She reported that in Barnet Dr Kola Akinlabi, Clinical Lead for Post Covid Syndrome at the Royal Free London NHS Trust works collaboratively with Dr Patrick Mallia at Barnet Hospital and Dr Martin Harris in Primary Care. Dr Malia also leads a multi-disciplinary team.

Most patients with Post Covid in Barnet are between 20-65 years old, of white ethnicity and from less deprived areas, and Barnet has the highest recorded number of Post Covid cases in London. Barnet has effective referral pathways and is well known which may be part of the reason for the higher number of cases. A lot of training had been provided to help primary care clinicians to recognise the signs and symptoms of post Covid syndrome.

Cllr Chakraborty asked whether it would be worth writing to the Secretary of State for Health to ask for support for Post Covid services in Barnet. The Chair responded that some specialist services are already provided.

Dr Djuretic stated that it could be that more funding is needed. Clinicians report a 4-6 week waiting list for Post Covid services in Barnet but this is higher in many other Boroughs. The HOSC could enquire directly with clinicians when they attend a future meeting. The Governance Officer would follow up and invite clinicians to the February meeting.

Action: Governance Officer

RESOLVED that the Committee noted the verbal update and slides.

(10 mins presentation and 10 mins discussion)

The Chair reported that he and Cllr Hutton had attended the meeting of JHOSC held in November, where an item on Estates was discussed.

The Chair added that there is a local Estates Forum for each NCL Borough. Section 106 CIL money is used for Boroughs to jointly plan Primary Care Estates delivery, and Barnet has an allocation of £6million for various healthcare projects. He noted that NHS colleagues are keen to work closely with local authorities to find affordable and creative ways to bring Primary Care into housing schemes.

On the Local Estates Forum Barnet is represented by a Section 106 Planning Officer – the Chair suggested that a health representative should also attend. He would be raising this with the speaker on Estates at the next HOSC.

RESOLVED that the Committee noted the verbal update. 

·         Royal Free London NHS Foundation Trust

·         North London Hospice

·         Central London Community Healthcare

(20 minutes)

The Chair reported that representatives from the three Trusts would attend the May meeting of the HOSC to present the end-of-year quality accounts.

The Chair asked the Committee for their comments on the mid-year quality accounts:

Royal Free London NHS Foundation Trust

The following comments were noted and would be fed back to the Trust:

• Infections overall were rising and this was a concern
• Establish a world-class dementia care service – could there be joined-up thinking with partners on this?
• Is there liaison follow-up between the Trust and community when dementia patients are discharged?
• Healthy living - Task and finish groups in Barnet to integrate pathways – what does this mean – do GPs know what the hospital is doing? Can we have more information on this – page 2.
• Cllr Cornelius A&E in May 2022 report 75% meeting targets. Fourth worst in London. What is the situation currently?
• What are ambulance waiting times at both A&E’s, Barnet Hospital and the RFL?
• What number of people are catching Covid whilst in hospital, at Barnet and the RFL?

Central London Community Healthcare NHS Trust

• The mobile phones that were provided for homeless people during the pandemic was an excellent idea. Could the HOSC please have an update from the Trust Equalities Group on how mobile phones can be provided for homeless people, since Tesco has stopped providing these?
• Could the Freedom to Speak Up programme be adopted by other Trusts?

North London Hospice

• Are the recruitment issues affecting delivery of care?

RESOLVED that the comments were noted.

The Governance Officer would send the comments and queries to the organisations.

Action: Governance Officer

(5 minutes)

The Chair introduced the Forward Plan. The Governance Officer would speak to the Barnet Assistant Director for Sustainability about attendance at the February meeting. Ms Zoe Garbett was already scheduled to attend to speak about NHS Sustainability.

Mr Ian Sabini would attend to speak about NHS Estates.

Cllr Hutton noted that it was proposed that young people from all five Boroughs be invited to the next JHOSC on 6^th February, to speak about their experiences on mental health services. Cllr Hutton noted that she has been in contact with Barnet officers to try to arrange this.

It was noted that Dr Akinlabi had been invited to attend the February meeting to provide an update on post covid services.  

None.