Agenda and minutes

Venue: Virtual Meeting

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No. Item


Minutes of the previous meeting pdf icon PDF 575 KB

    To follow.


    The Chairman welcomed everyone to the virtual meeting of the Committee.


    Matters arising from the Minutes of the meeting held on 24 February 2020:                             


    ·       Agenda Item 8 – Article in The Guardian 19 February 2020. The Chairman noted that the Action Plan and Cerner Report are not yet available due to delays caused by the Covid-19 pandemic.


    ·       Agenda Item 9 – Update on Surplus Land at Finchley Memorial Hospital. The Chairman noted that Cllr Hutton had attended a meeting on 19 March 2020 with Mr Eugene Prinsloo, who had confirmed that currently discussions are continuing about flats for key workers on the site. (P.8). The Chairman added that Mr Prinsloo would return to update the HOSC on 5 October following submission of an outline Planning Application which was due to be submitted in September.


    Corrections to the Minutes of the meeting held on 24 February 2020:


    ·       P.8 Para 2 Mr Prinsloo would return to the HOSC in ‘October’ rather than ‘September’.


    RESOLVED that the Committee approve the Minutes of the meeting held on 24 February 2020 as an accurate record subject to the above amendment.



Absence of Members


    Apologies were received from Cllr Barry Rawlings.



Declaration of Members' Interests


    Cllr Cooke declared a non-pecuniary interest: his daughter is employed by University College London Hospital and his wife’s employment includes working on a contract with St George’s Hospital.


    Cllr Cornelius declared a non-pecuniary interest: she is a Council-appointed Trustee and Vice Chairman of Eleanor Palmer Trust which has a 33 bed Residential Care and Nursing Home, Cantelowes House.


    Cllr Don declared a non-pecuniary interest: she is the Registered Manager of Dillon Care Home.


    Cllr Hutton declared a non-pecuniary interest: she is a Trustee of Barnet Carers’ Centre.




Report of the Monitoring Officer




Public Question Time (If Any)




Member's Item in the Name of Cllr Geof Cooke - Deployment of Defibrillators in Barnet pdf icon PDF 495 KB


    The Chairman invited the following to the meeting:


    ·       Dr Tamara Djuretic - Director of Public Health, London Borough of Barnet (LBB)

    ·       Cllr Caroline Stock - Chairman, Barnet Health and Wellbeing Board (HWBB)


    Cllr Cooke’s Member’s Item and a written response from Dr Djuretic were received.  Cllr Cooke thanked Dr Djuretic for her report and welcomed the recommendation that defibrillators be installed in Barnet’s public libraries. Cllr Cooke suggested that defibrillators be installed throughout the Borough including encouraging private owners to install them in private premises. After the rollout to public libraries he suggested that other venues should be sought for installation of defibrillators such as shopping centres and the Arts Depot.


    Dr Djuretic noted that the priority would be public libraries but this would commence when the Covid-19 pandemic ceased to be urgent. She would then work with the British Heart Foundation (BHF) and other voluntary organisations to take this forward and she would report back to a future meeting. The first step would be a feasibility study on providing defibrillators at Barnet’s public libraries. 


    Cllr Stock reported that she had discussed this matter with Dr Djuretic and had received a list of defibrillators in the Borough from the London Fire Brigade. A member of staff at Hendon Town Hall was fully trained in their use and Middlesex University had a full crash team. The Health and Wellbeing Board was also focusing on this important issue. 


    RESOLVED that the Committee noted the report and verbal update.



Minutes of the North Central Sector London Joint Health Overview and Scrutiny Committee pdf icon PDF 313 KB

    To follow.


    RESOLVED that the Committee noted the Minutes of the North Central London Joint Health Overview and Scrutiny Committee held on Friday 31 January 2020.



Coronavirus Update

    Director of Public Health


    .. The Chairman invited the following to the meeting:


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

    ·       Ms Dawn Wakeling - Executive Director, Adults and Health, London Borough of Barnet

    ·       Dr Chris Streather – Group Chief Medical Officer, Royal Free London NHS Foundation Trust


    Dr Djuretic presented her slides on the Coronavirus pandemic in Barnet. She reported that Barnet has a high infection rate with currently 1250 confirmed cases. Scientific research showed that around 1% of the population has Covid-19 which would mean there are around 4000 cases in Barnet. The peak of the pandemic had been reached in Barnet by the end of March 2020. At the end of the week beginning 20 April, 277 deaths had been registered in Barnet with Covid-19 as the primary cause. In the last week, there had been only a small number of new cases, despite an increase in testing across the Borough. In Barnet 52 Care Settings had been affected although no new cases or deaths had been reported in the last few days.


    Dr Djuretic reported that Barnet had been able to secure a good stock of Personal Protective Equipment (PPE) locally and had also joined the West London Alliance Framework which provided regular deliveries of PPE. Dr Djuretic commented that even though the experience of lockdown had been devastating for everyone, there were some positive outcomes which should be preserved. Self-care had been well promoted and care for vulnerable residents had been provided promptly, including those being shielded and homeless people. The voluntary sector had also stepped up very well. Another positive point was the increase in awareness around infection control.


    Dr Djuretic added that further guidance was awaited on social distancing from Public Health England (PHE). Barnet Council would undertake full risk assessments to enable services to be restored to their full functions. Local Authorities had been asked to scale up testing in Care Settings and the introduction of a national portal had been announced just prior to the HOSC meeting, on which Dr Djuretic awaited further information. She noted that she is a representative on the Testing and Contact Tracing National Working Group. Contact tracing was due to commence on 18 May led by NHS Test and Trace and, London, the London Coronavirus Response Cell for incidents in specific settings, with local Directors of Public Health having oversight of this process.


    A Member stated he had read that vulnerable people, including those in Care Homes, had been approached by GPs to encourage them to agree a ‘Do Not Attempt to Resuscitate’ (DNAR) Order. This would mean that those patients would not be considered for hospital treatment if they became ill. He awaited a response to an enquiry that he had sent to the Clinical Commissioning Group (CCG).  He felt this was a concern considering the large elderly population in Barnet. Dr Djuretic reported that anecdotally all patients, in either care homes or hospitals, who exhibit Covid-19 symptoms are given a choice: one of the  ...  view the full minutes text for item 8.


Royal Free London NHS Foundation Trust Updates on the Cerner Review and CQC Report


    The Chairman invited to the meeting:


    ·       Dr Streather – Group Chief Medical Officer, Royal Free London NHS Foundation Trust


    Cerner Review


    Dr Streather reported that further to the update that Caroline Clarke, Group Chief Executive, Royal Free London (RFL) NHS Foundation Trust, gave at the February HOSC, 15,000 letters out of 22,000 had been sent to GPs. By the time of the Covid-19 outbreak doctors had reviewed 11,000 of the letters and assessed ‘harm’ to patients. So far, no ‘moderate’ or ‘severe’ harm had been found because of the incident. A lot of ‘low’ harm had been found and those actions had been dealt with. There had been a delay due to Covid-19 but the process had begun again three weeks ago and a further 4000 letters had been reviewed. The CCG and GP Leadership in Barnet and other relevant Boroughs had been informed about the progress so far and had been told that the Trust would release all 22,000 letters since in the 50% examined so far, no ‘moderate’ or ‘severe’ harm had been found. The Trust had discussed the Review with the Clinical Quality Review Group at Barnet CCG and with GP Clinical Leaders. Dr Streather added that the error is reprehensible and the Trust has apologised.


    Care Quality Commission (CQC) Report Update


    Dr Streather reported that the CQC follow up inspection due in July had been postponed due to Covid-19. The inspection was likely to go ahead towards the end of 2020 or in the Spring of 2021. Regular meetings between the Trust and the CQC would continue. Dr Streather reported that Cllr Zinkin, a Governor of the Trust, had asked it to make a correction in the previous year’s Quality Account in that the Trust had underplayed the improvements that were needed prior to the next CQC inspection.


    The Chairman noted that the CQC inspection is mentioned in the current draft Quality Account 2019/2020. The CQC had made 93 recommendations:  11 ‘Must Do Actions’, 6 of which had been completed and 5 due to be achieved by mid 2020/21. Out of 82 ‘Should Do Actions’, 44 had been done with 38 remaining. The Chairman asked why the measures were taking so long to be implemented. Dr Streather responded that the delays were due to a requirement for recruitment or capital. Also, the data were slightly out of date and all the ‘Must Do Actions’ are either completed or have a firm plan. The Trust is in dialogue with the CQC about some of the ‘Should Do Actions’ and these are not compulsory (it was recommended that 90% are completed). Dr Streather offered to update the HOSC again in the future.


    RESOLVED that the Committee noted the verbal updates.



Department of Health: Quality Accounts - A Guide for Overview and Scrutiny Committees pdf icon PDF 68 KB


    RESOLVED that the Committee noted the Department of Health’s Guide.



NHS Trust Quality Accounts 2019/20 pdf icon PDF 5 MB

    ·       Appendix 1 - Royal Free Hospital (RFH) Quality Account 2019/20

    ·       Appendix 2 - Central London Community Healthcare (CLCH) Quality Account 2019/20

    ·       Appendix 3 - Minute Extract (RFH and CLCH Quality Accounts Item) HOSC May 2019

    ·       Appendix 4 - Mid-year Quality Accounts 2019/20, RFH

    ·       Appendix 5 – Mid-year Quality Accounts 2019/20, CLCH


    Additional documents:


    Royal Free London NHS Foundation Trust Quality Account 2019-20

    The Chairman invited to the meeting:


    ·       Dr Streather – Group Chief Medical Officer, Royal Free London NHS Foundation Trust


    The Committee scrutinised the Draft Royal Free London NHS Foundation Trust Quality Account 2019/20 and wished to put on record the following comments:


    • The Committee was pleased to see positive outcomes and a lower mortality rate in Chronic Obstructive Pulmonary Disease in the Royal Free Hospital.
    • The Committee commended the Trust on its specialist training courses on understanding the needs of patients with dementia and learning difficulties who have no mental capacity. The CQC has found improvements in urgent and emergency care for these patients across all three hospital sites. Understanding the needs of someone with no mental capacity, for example advanced dementia, is very difficult and challenging. Whilst it is pleasing that the Trust has Dementia-friendly Wards, it is important to ensure that staff are fully trained to understand how to care for patients with advanced dementia regardless of which Ward the patients are in, especially as it can also be difficult with staff changing shifts.
    • The Committee was impressed that the Trust held an interactive workshop with the Chickenshed Theatre Company and over 100 members of staff had completed an innovative Study Day.
    • The Committee was pleased to see the use of tele dermatology and high quality photographic work at the Trust, reducing the need to travel to larger hospitals and helping with capacity.
    • The Committee congratulated the Liver Transplant Team at the Royal Free Hospital, which has one OrganOx machine, for their quick-thinking decision to ‘borrow’ a second machine from the University Hospitals Birmingham NHS Foundation Trust so that they could keep two livers ‘alive’ while performing two liver transplants in quick succession.
    • The Committee thanked the Trust for the reduction in gaps in the data and the improved accessibility of the report. There are helpful explanations of the charts and the ‘lollipop’ chart presentation is much more accessible for people who are not used to viewing detailed data, making benchmarking much easier than in previous reports. 
    • The Committee noted the stabilisation in the C.Diff infection rate although there is some variability since April 2019. However, this is lower than benchmarked organisations. The Committee also noted the explanation that more C.Diff was being detected due to robust measures taken and a more sensitive test being used. The new ways of working in general are clearly demonstrated in this report and the Committee hoped the Trust will continue to develop the report in this way in future. It is helpful to understand the depth beneath some of the stories.


    • The Committee congratulated the Patient and Risk and Resuscitation Team for winning a National Patient Safety Award for developing and pioneering a kidney care ‘Streams’ app in conjunction with Google Health.


    • It was noted that ‘Joy in Work’ was launched in June 2019. This showed positive

    outcomes from 4 out of 15 teams showing a 50% increase in the ‘good day’  ...  view the full minutes text for item 11.


Health Overview and Scrutiny Forward Work Programme pdf icon PDF 181 KB


    The Chairman reported that the July HOSC meeting might be reinstated or an alternative date set. She explained that the North London Hospice had deferred submission of its Quality Account due to Covid-19 but a further meeting would be necessary when the Quality Account becomes available and other items which were not delayed would also be included.


    RESOLVED that the Committee noted the Forward Work Programme.




Any Other Items that the Chairman Decides are Urgent



    The Chairman invited to the meeting:


    ·       Cllr Caroline Stock - Chairman of Barnet Health and Wellbeing Board (HWBB)

    ·       Dr Tamara Djuretic – Director of Public Health, London Borough of Barnet (LBB)


    Cllr Stock reported that the HWBB had not met since the Covid-19 pandemic but that she was speaking to Dr Djuretic on a weekly basis. Dr Charlotte Benjamin, Vice Chairman of Barnet’s HWBB had been appointed as Vice Chairman of the new North Central London Clinical Commissioning Group (NCL CCG) and reported that it was working well. The NCL CCG had been set up since 1 April 2020, replacing Barnet’s CCG, and an initial meeting of the Governing Body had already been held. Dr Clare Stevens is also on both Barnet’s HWBB and the NCL CCG. Each of the HWBB Chairmen from the five Boroughs of Barnet, Enfield, Haringey, Islington and Camden could also attend each CCG meeting.


    Cllr Stock informed the Committee that, due to the Covid-19 outbreak, funding had become fairer across the five Boroughs as it had become evident that Barnet had insufficient funding given its large number of Care Homes. As the system moves into the recovery phase, the CCG had agreed that careful consideration needs to be given to local variations. A Member noted that in a few weeks’ time it would be helpful to find out where Barnet sits within the wider scope of the new NCL CCG and to try to ensure that funding in future is transparent and fair.


    Dr Djuretic reported that the main meetings of the NCL CCG would begin in two weeks’ time and there would be a workshop. Directors of Adult Social Care as well as Directors of Public Health for the five Boroughs will be representatives on the NCL CCG and Dr Djuretic is also a member of the Oversight Group.


    It was agreed that great efforts should be made via the HWBB to make sure resources are being distributed as fairly as they should be. Dr Djuretic added that there were some developments currently around Care Settings with work across the new NCL CCG    to provide multidisciplinary in reach service for all Care Settings in Barnet supported by colleagues from CLCH. It is hoped that a model would be in place in the next few weeks.  Cllr Stock commented that this issue could be added to the agenda of the HWBB in July and then she would report back to the Committee.

    Action: Cllr Stock


    Cllr Stock informed the Committee that Sarah D’Souza and Ruth Donaldson had left Barnet CCG where they were joint Directors of Commissioning and have been replaced by Daniel Morgan. Collette Wood is in charge of Transformation at Barnet.


    Cllr Stock also mentioned that Dr Charlotte Benjamin was happy with the updated computer systems for GPs which make online consultations easier.


    RESOLVED that the Committee noted the update.



                                           The meeting finished at 9.46 pm