Agenda and minutes

Before introducing the item the Chair said he was delighted to be chairing HOSC and was well aware as a previous member of the important work it did to hold the NHS to account and keep the council informed of health-related issues. He wanted to record  his thanks to the previous Chair, Cllr Cornelius, and to Cllr Stock who were very committed to the work of the committee. One of the current challenges will be to establish the implications of the Government’s legislation setting up Integrated Care Systems and what this will mean for patients, users and local authorities.

The Chair noted that he was keen to discuss the public health agenda and for the HOSC to invite patient and user groups to future meetings so that the Committee could become a forum for local users of services. It is important to bear in mind the pressure GPs and health services are facing also.

Minutes of the previous meeting

Dr Djuretic, Director of Public Health, noted that 25% (rather than 1/3 as stated in the report) of young children in Barnet have tooth decay. She noted that the 40 settings identified to take part in the Young Brushers project had been circulated to the Committee following the meeting.

Cllr Cornelius enquired which schools had had an Awareness Day. She hoped these would take place more frequently and asked whether one had taken place since the last meeting. Dr Djuretic would provide a response after the meeting.

Action: Dr Djuretic

RESOLVED that the minutes of the meeting held on 10 February 2022 be agreed as a correct record.

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Apologies were received from Cllr Hutton. The Chair thanked Cllr Velleman for standing in at short notice.

Cllr Alison Cornelius declared in an interest by virtue of being Vice Chairman and a Trustee of the Eleanor Palmer Trust.

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To follow

Cllr Cornelius commented that at meeting of the JHOSC held on 28^th January 2022 there had been an update on the Estates Strategy (item 20). Representation was requested from the JHOSC on the Estates Board – she enquired whether the Chair would consider sitting on the Board. The Chair noted that he would consider this.

Cllr Cornelius also asked whether the Chair would attend meetings of the Estates Forum for Barnet, which included around 20 partners and a member from Barnet. She recommended that the Chair ask Nicola Theron, NCL Director of Estates, for further details.

Action: Chair

Cllr Cornelius suggested that an update on disposable assets be brought to the HOSC. The Chair would consider this.  

Action: Chair

Cllr Innocenti asked whether sustainability could be discussed and asked where would be the most appropriate committee. Dr Djuretic responded that sustainability sits within the Environment and Climate Change Committee’s Terms of Reference. She suggested that it be added to the Forward Plan for HOSC as a lot of work was taking place with Trusts.

RESOLVED that the minutes of the JHOSC, 28^th January 2022 were noted.

·         Beverley Wilding – Deputy Director, Urgent & Emergency Care, NCL CCG

·         Dr Tamara Djuretic – Joint Director of Public Health and Prevention, LBB

Ms Wilding presented the report on behalf of Colette Wood, Director of Integration at NCL CCG.

Ms Wilding reported that the CCG had run a successful vaccination programme in Barnet with two vaccines and a booster being offered. There had been a good uptake in Barnet with national targets met within the timescales set by central government. Vaccinations had also been offered in the community to housebound residents and a programme had been set up for residents with learning disabilities, all children aged five and above. Also the CCG has been working with Barnet Council to target the homeless and asylum seeker population and offer them vaccinations.

Dr Djuretic reported that £485k funding had been provided from the Department of Housing and Communities to recruit Vaccine Champions and improve vaccination uptake. The council is focusing on areas where uptake was lower, including Cricklewood, Hendon and Burnt Oak, and also on Jewish and Muslim faith groups and other groups where evidence suggests a lower uptake.

Dr Djuretic noted that there continues to be a decrease in Covid-19 cases, with currently 86 per 100k population compared to 400 cases per 100k two months previously. Also hospital admissions due to Covid-19 had decreased.  Also the Flu Programme continues via the CCG, with around 75% uptake this year.

Cllr Innocenti enquired whether the vaccination programme had been promoted in schools. Ms Wilding responded that it had in senior schools, but the programme did not include primary schools due to clinical governance issues, though promotion for children with underlying conditions was allowed.

Cllr Velleman enquired whether the hotel accommodation offered to asylum seekers during the pandemic had continued after January 2022. Ms Wilding would respond after the meeting as she did not have this information to hand.

Action: Ms Wilding

Cllr Stock asked whether monkey pox was a concern with most cases being in London. Dr Djuretic responded that research is ongoing, but that monkey pox though not recognised as a sexually transmitted disease was affecting men who have sex with men and through close contact. It was therefore having a big impact on sexual health clinics.

RESOLVED that the update was noted.

The item was deferred due to the NCL Healthwatch representative being unable to attend.

• Kay Isaacs, Director of Operations, North Central Division, CLCH
• Beverley wilding. Deputy Director, Urgent and Emergency Care, NCL CCG
• Dawn Wakeling, Executive Director, Adults & Health, LBB

Finchley Memorial Hospital and Edgware Walk-In Centre

Ms Issacs reported that Edgware Community Hospital (ECH) had closed during the Covid-19 pandemic. It was chosen as the centre to close due to its limited capacity to retain social distancing whereas Finchley Memorial Hospital (FMH) remained open throughout the pandemic, with reduced services. The ECH reopened on 25^th February 2022 and prior to this in October 2022 before being forced to close in December 2021 due to another wave of the pandemic.

Ms Isaacs reported that currently ECH sees approximately 76 patients daily, just over half the number who attended prior to the pandemic. FMH sees 133 daily, 86% of the attendance prior to the pandemic. Ms Isaacs reported that waiting room capacity and staff recruitment continued to be challenges faced by the ECH, but work was ongoing on these. The staff vacancy levels are causing some difficulties with resuming usual services. She added that some Covid restrictions remain in place, but as national infection prevention and control (IPC) guidance is updated, adjustments are made.

A Member enquired about whether health inequalities appeared to have worsened due to the pandemic. Ms Isaacs responded that there remained gaps in some services, so this is possible. She offered to report back with more detail on the WICs if helpful.

A Member enquired why ECH rather than FMH was chosen to be closed during the pandemic. Ms Isaacs stated that this was due to redeployment of staff and also the nature of the building being less amenable to safely caring for patients during the pandemic. Ms Wilding noted that the decision had to be made quickly due to the speed of the pandemic. It remained closed as staff were redeployed to support the recovery programme. Ms Wakeling added that staff supported care homes and later on the Covid vaccination programme, including for housebound patients. There were high levels of absence across health and care staff nationally and staff had had to be prioritised in this way. She added that there are no plans to close ECH.

A Member enquired about the current staff vacancy rates. Ms Isaacs responded that FMH has 20% of vacant positions and ECH is slightly higher. Agency staff are being deployed whilst substantive recruitment is an ongoing process. There is a dedicated focus group working to attract staff. Due to the long closure of ECH, some staff had left, so efforts were being made to attract staff back in.

Alternative Personal Medical Services (APMS) Contract

Ms Wilding reported that the GP Practice which had been reprocured in December 2021, would move to a new premises a small distance over the border into the Borough of Brent, on Edgware Road, between Barnet, Brent and Camden Boroughs. The Practice currently has 4000 patients registered and the new premises would give them capacity to expand to cater  ...  view the full minutes text for item 10.

·         Appendix 1a – Minute extract, QA, Royal Free London (RFL) NHS Foundation Trust

·         Appendix 1b - mid-year QA, Royal Free London (RFL) NHS Foundation Trust

·         Appendix 1c – RFL NHS Foundation Trust Draft QA 2021/22

·         Appendix 2a – Minute extract, QS Central London Community Healthcare (CLCH) NHS Trust

·         Appendix 2b mid-year QA, CLCH

·         Appendix 2c – CLCH Draft QA 2021/22

·         Appendix 3a – Minute extract, QA North London Hospice

·         Appendix 3b, mid-year QA, North London Hospice

·         Appendix 3c – North London Hospice Draft QA 2021/22

Royal Free Hospital NHS Foundation Trust

·         Professor Derralynn Hughes, Director Clinical practice groups and Clinical director research and development 

Further to a presentation by Professor Hughes, the Committee discussed the Quality Account. They then put on record the following comments:

·         The Committee congratulated the Trust on its continued recovery from the Covid-19 pandemic, including its successful research and development and Covid-19 vaccination programme, and for its continued support to the community during a very difficult time.

·         The Committee was pleased to see the improvements in patient records meaning that records could easily be shared across all three sites in the Trust.

·         The Patient Experience Strategy as part of priorities for improvement, 2020-21, was welcomed by the Committee, in particular additional tools in relation to dementia practice and the cross-Borough Carer Steering Group. The Committee was pleased that support was being provided for patients in understanding their care. The Committee would be interested to receive information on outcomes for patients.

·         The Committee welcomed the advanced care planning as part of End-of-Life Care.

·         The improvements in clinical effectiveness were noted

·         The Committee welcomed the improvements in patient safety, with the reduction of never events down from five to one.

·         It was noted by the Committee that the action taken to improve data quality was a positive step.

·         The Committee complimented the Trust on reducing the 18-week waiting times.

·         The Committee welcomed the progress on improving maternity services.

·         The restart of kidney transplantation at the Royal Free Hospital was welcomed.

·         The Committee congratulated the Trust on reducing its cancer waiting times and referrals backlog caused by the pandemic. The speed of  treatment being offered to patients is impressive.

·         The Committee was pleased to see that there was an improvement in the number of C.Diff cases since the report in 2019-20 rates.

·         It was noted that the Trust was given no ‘must do’s but has ‘should do’s’ which is an improvement. 

However:

·         It was noted that the avoidable harm targets had not been met and that the Trust had achieved less than it had hoped and was well below the score. The Committee would be interested to know whether the approach to this would be reviewed.

·         The target to reduce inpatient falls had not been met and the Committee enquired what action could be taken to improve this as it is important for elderly, patients with dementia and with learning difficulties.

·         The Committee wondered what could be done to meet national cancer waiting times targets in relation to GP referrals.

·         The Committee had been informed that patients still reported having difficulties contacting a hospital doctor even whilst on the wards. They reported leaving their contact details and then not being contacted and having to wait around to try to speak to a doctor. The Committee requested that this be fed back to the Trust.

·         The Committee was concerned that mental health support in maternity services, antenatal check-ups and midwife and health visitor check-ups did not receive good feedback in the questionnaire and wondered what  ...  view the full minutes text for item 11.

To follow

The Chair spoke to the draft Forward Plan and noted that any ideas from the Committee on additional items would be welcome at any time.

None.