Agenda and minutes

Venue: Hendon Town Hall, The Burroughs, London Nw4 4BQ

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

Items
No. Item

1.

Absence of Members

    Minutes:

    Apologies were received from Cllr Lisa Rutter, who was substituted by Cllr Felix Byers.

     

    The Chairman welcomed Cllr Barry Rawlings as a new Member of the HOSC Committee.

     

2.

Minutes of the previous meeting pdf icon PDF 165 KB

    Minutes:

    The Committee RESOLVED to AGREE the minutes as an accurate record.

     

    Matters arising from the minutes:

     

     

    The Governance Officer would contact Kate Wilkins of Central London Community Healthcare (CLCH) to request the outstanding information on the Quality Account.

    Action: Governance Officer

     

    The Governance Officer would follow up an action required of the North London Hospice (NLH). Note: following the meeting Fran Deane, Director of Clinical Services at NLH, confirmed that the two services that are fully funded are the Palliative Care Support Service and the Haringey Community Team. The North London Hospice had contacted Homeless Action in Barnet regarding the referral process to the Hospice.

     

    A Member referred to the HOSC’s feedback to CLCH (detailed on Page 9 of the Minutes of the HOSC meeting held in May 2019):

     

    The Committee noted that the Trust had received a CQC rating of ‘Requires Improvement’ in the ‘Safe’ domain in Community Health Services for Children and Young People, which was due mainly to higher-than-recommended caseloads within the Health Visiting Service.

     

    Given the higher than average caseload how could it be ensured that families at risk are prioritised? The Chairman asked Cllr Hutton, as a Member of the Children, Education and Safeguarding Committee, to note this. The Chairman would also email Cllr Longstaff about this.

    Action: Chairman

     

     

     

     

3.

Absence of Members

    Minutes:

    The Committee RESOLVED to APPROVE the Minutes of the meeting held on 15 May 2019 as an accurate record.

     

     

4.

Matters arising from the minutes

5.

Declaration of Members' Interests

    Minutes:

    None.

6.

Report of the Monitoring Officer

    None.

    Minutes:

    None.

7.

Public Question Time (If Any)

    Minutes:

    None.

8.

Members' Items (If Any)

    Minutes:

    None.

9.

Minutes of the North Central Sector London Joint Health Overview and Scrutiny Committee

    To follow.

    Minutes:

    Minutes of the meeting on 21 June were not published at the time of the meeting but would be circulated to the HOSC as soon as they were available and also would be included with the 28 October Agenda.

     

10.

Royal Free London NHS Foundation Trust pdf icon PDF 808 KB

    ·         CQC Report

    ·         Quality Account 2018-19

    Additional documents:

    Minutes:

     

     

    • CQC Report
    • Quality Account 2018-19 update

     

    The Chairman invited the following to the table:

     

    ·         Dr Chris Streather - Chief Medical Officer and Deputy Chief Executive, Royal Free London NHS Foundation Trust

     

    Dr Streather reported that the final version of the RFH Quality Account was on the Trust’s website with both Barnet and Camden HOSCs’ comments incorporated. He presented his Briefing Paper on the CQC Inspection Report and referred to the HOSC’s comments on their Quality Account.

     

    Dr Streather noted that the Trust has a one-year contract with the Community Care Foundation which is working to help to formally engage patients in its improvement work.

     

    The Chairman noted that it was helpful to see the actions outstanding but that some of the issues raised by the CQC were avoidable as they had already been noted as requiring action. Dr Streather agreed that some of the criticisms were ‘own goals’. The ‘must do’s’ from the recent CQC inspection were all complete – this included mandatory training and medicines management issues. Each of the three Trust’s sites had developed an improvement plan following the report as detailed on his Briefing Paper.

     

    At a meeting with the CQC following the publication of its Report, ‘should do’s’ had also been discussed by the Trust. These were good practice but not compulsory; Trusts not doing the actions had to give reasons for not doing them. Unfortunately, the Trust had failed to provide these explanations in some areas.

     

    The CQC had noted that staff were adequately trained and safeguarding was good.

     

    The Chairman asked about actions and how the public would be notified, for example in an online report? Dr Streather reported that an Action Plan would be circulated to commissioners and this was discussed with the CCG monthly. He would respond following the meeting on what might be the best public forum for sharing the information.

    Action: Dr Streather

     

    A Member asked about the Trust’s position on Never Events and equipment maintenance. Dr Streather responded that the CQC had fed back in its Report that the Trust did well in investigating serious incidents and this was an example of ‘very good practice’. The Trust had had two Never Events in the past eight months and had previously gone a whole year without one Never Event, which was good for a large complex site. Previously there had been a cluster of Never Events so this demonstrated that the learning is embedded.

     

    Dr Streather reported that money had been spent on equipment to ensure that patients could not be given air instead of oxygen, as this had previously been raised as a concern. As Chairman of the Medical Equipment Board, Dr Streather had secured a small increase in the budget for medical equipment. In addition, the Trust’s Lead for Clinical Governance, who was in contact with the CQC, had been invited to sit on the Medical Equipment Board. New criteria for prioritising medical equipment had been adopted so that the ‘should do’s’ could be prioritised. A Member asked  ...  view the full minutes text for item 10.

11.

Suicide Prevention in Barnet pdf icon PDF 237 KB

    ·         Draft Action Plan 2019-20

    ·         Report

    Additional documents:

    Minutes:

     

     

    • Draft Suicide Prevention Plan 2019-20
    • Report

     

    The Chairman invited the following to the table:

     

    • Dr Jeff Lake - Consultant in Public Health, LB Barnet
    • Dr. Patricia McHugh - Barnet, Enfield and Haringey Mental Health Trust
    • Professor Liza Marzano – Associate Professor in Psychology, Middlesex University
    • PC Carl Ford -  Mental Health Police Liaison Officer, Metropolitan Police
    • Ms Sharon Thompson – Community Services Manager, Barnet, Enfield and Haringey Mental Health Trust
    • Ms Seher Kayikci – Senior Health Improvement Specialist, LB Barnet

     

    Dr Lake reported that the National Suicide Prevention Plan appeared to have shown some improvements and a clearer picture had emerged on the most useful actions needed locally and regionally. Significant developments had been made as part of the London-wide Suicide Prevention Framework, including the development of the Thrive London information-sharing portal for partners to exchange information where possible suicide was suspected. Targeted help was available for individuals affected by suicide particularly given that such individuals were known to also be at increased risk of suicide.

     

    Dr Lake presented Barnet’s Action Plan which included work on self-harm and ideation, and a review of safety planning for discharge after an episode of self-harm or a suicide attempt. There was also support for those bereaved or affected by suicide and a review of the data would be undertaken to try to identify any hotspots in the Borough. A working group met annually and has six-month review meetings and workshops on particular topics.

     

    Professor Marzano reported that Middlesex University was involved in several projects which make up a piece of work commissioned by the Samaritans and funded by the Rail Industry. Professor Marzano also worked with the media on its portrayal of suicide to try to avoid any unhelpful messaging. She was also keen to apply international work locally such as recommendations by the International Association of Suicide Prevention.

     

    Ms Kayikci reported that as part of the Public Health Team in Barnet, her role is to contribute to the annual Suicide Prevention Report, review data and work with partners to make sure that actions set out are achieved.

     

    Ms Thompson noted that she works directly with patients in collaboration with the CCG in Barnet and has operational responsibility for both inpatient and crisis patients. Her role involves ensuring safe discharge as well as producing support packages for affected families. She noted that a Serious Incident Review is undertaken for every suicide attempt, checking that the service had done all it needed to do including a review within 72 hours.

     

    A Member asked about the risks in relation to SEND adults. Ms Thompson responded that a care coordinator was responsible for coordinating referrals and this depended on individual needs. Dr Lake added that some work had begun with the Lead Commissioner for Learning Disabilities on suicide with a report scheduled to be available around Autumn 2019.

     

    A Member enquired about how referrals could be made. For example, the Samaritans were not able to make direct referrals. Ms Thompson noted that the highest percentage  ...  view the full minutes text for item 11.

12.

Urgent Care Developments and Cricklewood Walk In Service pdf icon PDF 307 KB

    Additional documents:

    Minutes:

    The Chairman invited the following to the table:

     

    ·         Sarah D’Souza - Director of Commissioning, Barnet CCG

    ·         Jenny Goodridge - Director of Quality and Clinical Services, Barnet CCG

    ·         Beverley Wilding, Deputy Director, Urgent and Emergency Care, Barnet CCG

     

    Ms D’Souza presented her report, together with a map and slides which are also part of the pre-consultation engagement.

     

    She explained that the Cricklewood Health Centre comprises two contracts: one is an Alternative Personal Medical Service (APMS) and the other is a Walk In Service. Both contracts are coming to end in March 2020. The APMS contract is currently out to consultation and is managed through NHS England. Every five years, there is a standard process to either recommission as a GP Practice or to disperse the service. Many factors are considered such as capacity and demographics. The consultation ends on 19 July 2019. The Walk In Service decision making will take place after the decision regarding the GP practice is made.

     

    The CCG’s intention is to do some early engagement on wider national changes around urgent care. The consultation on the Walk In Service is scheduled to start on 29 July for 12 weeks, finishing on 18 October. A final decision is due to be made in December.  Any concerns of the HOSC would be taken into consideration by the CCG as part of the public consultation.

     

    It was pointed out that there was a description in the paper of the changing environment around urgent care and key facts on Cricklewood. Cricklewood Walk In Service is on the south west corner of the Borough close to both Brent and Camden.

    Only 24% of the total number of patients using the Centre are registered with Barnet GPs whereas 58% are registered with Brent GPs, and the remaining 18% come from other boroughs. She also noted that the sort of care provided in the Walk In Centres was more limited than in other Walk In Centres as there are no diagnostics and the Centre can only provide episodic care in that it cannot refer to Secondary Care, provide prevention or access patient records.

     

    Ms D’Souza noted that the CCG needs to consider the development of Primary Care Networks (PCNs) and the NHS Long Term Plan. Most of central Government additional funding would centre around PCNs. The funding would include additional community paramedics and pharmacists to support Primary Care and patients better. Care and Health Integrated Networks (CHINs) are already working well in Barnet. She added that the national picture involved changes to Urgent Treatment Centres including the renaming of Walk In and Urgent Care Centres. The national plan was for these services to become part of Community and Primary Care Services, with a focus on integration into local Primary Care networks. In addition, there had been heavy investment in additional Primary Care appointments with an extra 48,000 evening and weekend appointments being provided across ten hubs sites. There had been a 21% reduction in the number of people using the Cricklewood Walk In Service  ...  view the full minutes text for item 12.

13.

Barnet Hospital - Meals for Patients pdf icon PDF 1 MB

    Additional documents:

    Minutes:

    The Chairman invited to the table:

     

    ·         Annabel Eady - Contract Director, Medirest

     

    Ms Eady explained that she was the Contract Director for Barnet Hospital (BH) Chase Farm Hospital (CFH) and Barnet, Enfield and Haringey Mental Health Trust (BEHMHT), managing food, domestics and portering.

     

    Ms Eady presented a sample of ‘Steamplicity’ packaged food ready for microwaving with a valve to help maintain nutrients. The meals were prepared centrally in collaboration with dieticians. She had already sent a variety of menus to be included in the agenda but gave some more to the Committee at the meeting. She reported that at CFH meals could be ordered at two hours’ notice. She noted that BH has protected meal times. There is a choice of 29 hot meals, sandwiches and soups. Chilled food was delivered every other day and she said wastage is under 2%. She commented that as many of the ingredients as possible are locally sourced with around 60% being UK grown.

     

    A Member was most impressed that there was also a choice of six vegan meals on the menu.

     

    A Member reported that at CFH the coffee shop which had replaced the Staff/Visitor Restaurant was not ideal, with limited choice and poor signage. Ms Eady responded that at CFH hot food had not generated sufficient income. The limited amount of space in the shop was a serious problem and work was ongoing to find a solution.  She informed the Committee that the Coffee Shop was run by Costa.

     

    The Chairman reported that at BH she had found the food at the Staff/Visitor Restaurant to be correctly labelled and it looked appetising, with free water available. She also mentioned that three meals on the menu were healthy eating options below 500 calories. She thanked Ms Eady for attending the meeting and giving such an informative presentation.

     

    RESOLVED that the Committee noted the verbal report.

     

     

14.

Health Overview and Scrutiny Forward Work Programme pdf icon PDF 199 KB

    Minutes:

    It was agreed that the following items would be added to the 28 October agenda:

     

    ·         Full update would be provided on the Ravenscroft Medical Practice

     

    ·         Update would be provided on GP services at FMH

     

    ·         Update and APMS/GP Practice in Cricklewood

     

    It was agreed that the following items would be added to 12 December meeting:

     

    • An update on the Cricklewood Walk in Centre consultation

     

    • Half year updates on the three Quality Accounts: Royal Free Hospital NHS Foundation Trust, North London Hospice and Central London Community Healthcare NHS Trust.

     

    RESOLVED that the Committee noted the Forward Work Programme.

     

15.

Any Other Items that the Chairman Decides are Urgent

    Minutes:

    • Briefing note on Proposals to relocate Ravenscroft Medical Centre to Finchley Memorial

     

    The Chairman invited the following to the table:

     

    • Sarah D’Souza – Director of Commissioning, Barnet CCG
    • Jenny Goodridge – Director of Quality and Clinical Services, Barnet CCG

    ·         Beverley Wilding, Deputy Director, Urgent and Emergency Care, Barnet CCG

    • Councillor Anne Clarke - Childs Hill Ward
    • Councillor Peter Zinkin – Childs Hill Ward

     

    The Chairman introduced the Briefing Note (attached) which she had only received from Barnet CCG that afternoon and had immediately forwarded to the Committee. Hard copies were also provided at the meeting for the Committee as well as the two Childs Hill Ward Councillors. The Chairman invited questions and/or comments for the CCG from the Committee and the two Childs Hill Councillors but there were none.

     

    The Chairman suggested that as the decision regarding Ravenscroft Medical Centre was due to be made by the North Central London Primary Care Committee in Common on 22 August 2019, the item was put on the 28 October HOSC Agenda.

     

    RESOLVED that the Committee noted the Briefing Paper.