Agenda and minutes

To follow

Corrections to the Minutes of the meeting held on 7 December 2021:

Agenda Item 11, Page 7 of the Minutes of the meeting held on 7 December 2021- Accessing GPs remotely. The Chairman wished to insert the following paragraph at the beginning of the item: ‘At the previous Committee Meeting held on 12 October 2021, the Chairman had asked Cllr Lisa Rutter if she could bring a couple of carers from Dementia Club UK to the meeting to be held on 7 December 2021 to provide an account of their experiences with accessing GPs remotely. Cllr Rutter brought two carers and also read out an account from another carer who was unable to attend’.

Matters arising from the Minutes of the meeting held on 7 December 2021:

• Agenda Item 8, Page 4 of the Minutes of the meeting held on 12 October 2021 - Uptake of the ‘flu vaccination. The Chairman noted that the data was circulated on 10 February and Dr Djuretic apologised for the late circulation. A Member noted that it was pleasing to see a small uplift in uptake.

•  Agenda Item 5, Page 2 of the Minutes – Public Question Time. A question had been received from a member of the public. The Chairman reported that the Royal Free London NHS Foundation Trust had responded to the resident and that their response had also been circulated to the Committee as follows:

‘Royal Free London NHS Foundation Trust (RFL) is committed to ensuring staff and patients receive the best possible experience.  The Trust has prioritised capital investment in digital transformation and IT infrastructure. In October 2021, a new Electronic Patient Record (EPR) was launched. Staff at Barnet Hospital and Chase Farm Hospital had been using EPR since 2018. In October, we upgraded the system across all of our hospitals, and introduced it to the Royal Free Hospital.

EPR is an innovative new system that has replaced paper records at the Royal Free London. It means staff caring for patients always have access to accurate and up-to-date information to ensure patients get the best care.  With all healthcare information in one place, it means staff can access patients’ test results, and details of their care, more quickly. There are no longer paper records and our staff are now using computers and laptops to input information directly. 

The Trust also has a patient portal, (My RFL Care), with approximately 160,000 patients registered. This is web-based and enables patients to view their appointments and letters online in one place, anytime and anywhere.’ 

A Member commented that it could be difficult to get information about loved ones, as often Trusts do not have the information to hand. She hoped this would help staff to access information when relatives request it. The Chairman noted that this could be discussed when the Quality Accounts are discussed at the HOSC in May.

·         Agenda Item 8, Page 3 of the Minutes – Covid Update and Flu Vaccination Verbal Update. The Chairman reported that an apology had  ...  view the full minutes text for item 1.

Apologies were received from Councillor Golnar Bokaei, who was substituted by Councillor David Longstaff.

Apologies were received from Councillor Linda Freedman.

Cllr Cornelius and Cllr Longstaff declared an interest by virtue of being Trustees of Eleanor Palmer Trust.

Cllr Hutton declared an interest by virtue of being a Trustee of Barnet Carers’ Centre.

None.

None.

None.

A Member enquired whether there had been an update at the recent JHOSC meeting on support for GP Practices with online booking systems. The Chairman suggested that Cllr Moore email Councillor Connor, the Chairman of the JHOSC for an update. The Chairman noted that two GP Surgeries had thanked her for bringing this matter to the HOSC as they had changed to the PATCHES system from eConsult, which was more user friendly for the public.

A Member enquired whether there were any plans to make changes to the form that had to be completed by the patient, as it contained many irrelevant questions. The Chairman responded that Dr Charlotte Benjamin had noted that the individual Surgeries could choose their system and could change it if patients complained that it was not working well. 

Another Member asked why all GP Practices didn’t use a single system. Dr Djuretic, Director of Public Health, responded that GP Practices operate as private businesses, so they purchase a licence for what they think will be the most appropriate system for their Practice.

The Minutes of the meeting of the North Central London Joint Health Overview and Scrutiny Committee held on 26 November 2021 were noted.

The Chairman invited Dr Djuretic to speak on the item.

Dr Djuretic presented the report on Children’s Oral Health. She noted that Barnet has had a stubborn rate of tooth decay in children under five years of age which had not changed over many years, despite efforts to improve this. A needs assessment would be undertaken to review the current offer and to find out where additional interventions would need to be introduced, including a review of best practice in other local authorities.

Dr Djuretic reported that details of the Young Brushers’ Project were provided in the report. Barnet had successfully bid for funding from the North Central London Integrated Care Partnership Inequalities Fund for the project, which is targeting 40 Early Years settings, involving up to 3200 children, and has so far agreed a commitment with 11 Early Years settings, reaching 317 children. Dr Djuretic noted that the provider had received a good response so far and was chasing the remaining settings. She added that this was also providing an opportunity to train people and was focusing on more deprived areas where rates of tooth decay are much higher.

Dr Djuretic reported that CLCH already trains all Early Years staff, who then train parents, and CLCH has been commissioned to take part in the project. Packs with brushes are provided for families but also education from breastfeeding onwards, improvement of access to dental services and food intake are also important. The Healthy Early Years London Award has a component on tooth brushing and oral health and Barnet has carried out initiatives with schools so that they offer water only and no fizzy drinks.

A Member asked whether childminders are also educated as part of the contact with the 40 Early Years settings and suggested distributing tooth brushing packs at food banks.

The Member also enquired about the metrics, baseline, and methodology to be used as part of the mini oral health needs assessment, and how Solutions 4 Health could be used to enable the implementation of changes. They felt it would be helpful to have more information after the meeting if possible.

Dr Djuretic agreed to take back the helpful suggestion about food banks as this would not be difficult to implement.

Action: Dr Djuretic

Dr Djuretic stated that her team had been chasing Public Health England (PHE) for six months to try to get data on children’s oral health across the whole of Barnet and had also been trying to get data from NHS England (NHSE) on equalities in access to dental services in Barnet, ideally from before the pandemic as the pandemic data would not be typical. Dr Djuretic added that then an evidence review would be carried out on interventions that work best, as well as discussions on best practice with other local authorities. Additional support would then be provided for those with the poorest outcomes.

A Member stated that for those families in dire circumstances, their situation is likely to get worse over the coming  ...  view the full minutes text for item 8.

Verbal update

The Chairman invited Dr Djuretic to speak on the item.

Dr Djuretic spoke to her slides, which had been circulated to the Committee, and to a written update on ‘flu vaccination that she had received from Colette Wood, Director, Barnet Clinical Commissioning Group (Barnet CCG).

Dr Djuretic reported that Covid testing had been decreasing due to there being fewer cases of Covid-19. Hospital admissions had also decreased with currently 130 patients in hospital with illness related to Covid-19, and 16 patients at the Royal Free Hospital requiring mechanical ventilation. Dr Djuretic noted that cases were decreasing slowly with a few in Care Homes but with schools in particular being hit the hardest. There are currently 61 reported Covid-19 cases in Barnet Schools, though Dr Djuretic noted that reporting lines to the Department for Education had recently changed, so there may be more.

She reported that the Covid-19 vaccination uptake is currently 74.4% in Barnet, with ‘flu vaccination uptake at 45%. There appear to be fewer inequalities than at the beginning of the programme. A Vaccine Clinic for people with learning disabilities had also been set up in Barnet.

A London Draft Strategy for living with Covid-19 had been produced and would be published by the end of March. Local contract tracing was likely to stop and testing would also be reduced from June. She noted that it was not yet clear whether local authorities would have additional health protection responsibilities in the future. When the National Strategy is published, the Barnet website would be updated with new policies for Care Homes and hospitals.

A Member stated that the current policies were out of date on the Barnet website as residents had informed her that they did not know that they could visit relatives in hospital, as hospitals themselves were not aware of the policies. Dr Djuretic asked the Member to send her specific details and she would check this. She added that Care Homes are open for visits.

The Member enquired about the number of patients requiring mechanical ventilation currently and whether they were vaccinated. Dr Djuretic noted that anecdotally two-thirds of patients who were hospitalised with Covid-19 were unvaccinated. She was unable to provide more information due to data protection given that the numbers were small and so individual identities might be revealed by discussing this. However, she added that the evidence suggests that those vaccinated and having had a booster jab typically experience very mild illness with Covid-19. Also, nine out of ten Covid-19 patients who die with any of the variants, have underlying health conditions.

RESOLVED that the written and verbal updates were noted.

Verbal Update

The Chairman introduced the Forward Plan which had been published with the Agenda,

25 May 2022:

•      Covid-19 and ‘flu vaccination Update

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

•      Edgware Walk In Centre, APMS Cricklewood and Finchley Memorial Hospital Update

•      Long Covid Update

6 July 2022

•      Barnet Healthy Child Programme Update

•      Solutions4health

To be allocated:

Suicide Prevention Strategy Update

Mini Oral Needs Assessment (during the second half of 2022)

RESOLVED that the Forward Plan was noted.

The Chairman reported that she had had an update on the Edgware Walk In Centre from Beverley Wilding and Colette Wood, Barnet CCG.

The Walk In Centre had been closed on 26 December 2021 because of omicron. The decision was taken by North Central London GOLD and the Staff had been redeployed to administer booster vaccinations to the housebound.

On 10 February 2022, the date of the HOSC meeting, NCL GOLD had met to discuss the date of reopening the Walk In Centre and redeploying the staff. The Centre is currently due to reopen on 28 February 2022, at the latest. Beverley Wilding and Colette Wood would confirm the exact date as soon as they know.

They also informed the Chairman that they will attend the HOSC on 25 May, together with a representative from Central London Community Healthcare (CLCH), in order to give a further update to the Committee.