Agenda item

The Chairman advised the Committee that she had invited Mr. Snee to provide the Committee with a verbal update on matters of interest relating to the CCG.  Mr. Snee provided the update as follows:

East Barnet Health Centre: Mr. Snee noted that the issue of a number of services moving out of the health centre had already been considered by the Committee and advised that the CCG were very disappointed that the services had not been repatriated.  Mr. Snee reported that after considerable discussion and, despite the issue between the landlord and Central London Community Healthcare, there was in principle now a way forward. He also advised that once the issues had been resolved, the services will be repatriated. 

A Member commented that NHS Property Services were the landlord of East Barnet Health Centre and questioned if the GPs had been charged rent for the entire building.  Mr. Snee advised the Committee that he was unable to comment on direct commercial factors, but noted that there has been a change in national policy to move to market funding.

The Chairman sought clarity as to whether progress was being made in respect of the repatriation of services.  Mr. Snee advised that the issue appeared to be moving forwards.

The Chairman suggested that the Governance Officer contact CLCH to ask for an update from their point of view on the repatriation of services and that it be circulated to Committee Members. 

Primary care related support for Care Homes: Mr. Snee informed the Committee that there were 2900 plus beds available for care across Barnet.  The Committee noted that primary care support for care homes also benefitted from an integrated Quality in Care team, which was funded by the Better Care Fund.  Mr. Snee highlighted the importance of best practice in primary care in care homes and noted the use of prevention tools and integration between multidisciplinary teams.  The Committee noted that the CCG had put in place the first phase of providing an enhanced support service to care homes.  Mr. Snee informed the Committee that the CCG also had a rolling programme of training in clinical care, including dementia and end of life care, available to all staff.  The Committee noted that Barnet is in the upper quartile of people dying where they choose to. 

Mr. Snee informed the Committee that Workforce Training and Development was a key deliverable in the Barnet Integrated Care Home Strategy (2015) and that a training needs analysis was carried out in Quarter 1 in collaboration with London Borough of Barnet. This resulted in key training being identified for delivery. The areas identified were: Dementia Awareness, End of Life Care (including Advanced Care Planning) and Communication Skills. The training programme will be delivered to all staff in the Care Sector in Barnet in order to improve their competence in care delivery.

Mr. Snee also commented on the Significant Seven (S7), a training tool which has been implemented in Barnet to support staff in the early identification of deterioration in the patient. The Committee noted that Barnet CCG, through collaborative working with the Local Authority Integrated Quality Team in Care Homes, is piloting the tool in ten Care Homes.  The Committee noted anecdotal evidence suggesting that positive feedback has been received from the homes already trained in improving staff confidence and competence.

The Vice Chairman noted that the North Central London Joint Health Overview and Scrutiny Committee (JHOSC) had received an item on primary care in care homes at their meeting on 30 September 2016. 

The Chairman expressed her delight that the “Significant Seven” was being implemented in Barnet.  The Chairman referred to Care Homes Enhanced Support Service (CHESS), which is an integrated care model intended to deliver timely care to older people in care homes, reduce avoidable hospital admissions, reduce the need for unplanned care and  improve the quality of care for the patients.  TheCHESS is made up of a multi-disciplinary team which consists of a geriatrician, pharmacists, nurses, a physiotherapist and a GP as the accountable clinician.  Mr. Snee commented on the functionality of the CHESS team, with every patient having the right to access a GP. 

The Chairman commented that there is a longer life expectancy in Barnet than in, for example, Islington and, as a consequence, there is a higher incidence of Dementia and Alzheimer’s in Barnet.

A Member questioned if people were tending to stay in care homes for longer or shorter amounts of time.  The Chairman advised that theoretically, the stay is on average only three years because people now tend to go into care homes when they are significantly older.  Mr. Griffin advised the Committee that nationally the average length of a care home stay is decreasing.

Finchley Memorial Hospital: Mr. Snee informed the Committee that the Audiology service at Finchley Memorial Hospital was now confirmed to open on 10 October 2016, as opposed to the planned date of 1 October 2016, due to an issue with the audiology booth.

Mr. Snee advised the Committee that the mobile breast screening unit will remain at Finchley Memorial Hospital until the indoor breast screening unit is in situ.  The Committee noted that there was a need to reconfigure the Walk in Centre at Finchley Memorial Hospital in order to accommodate the permanent, indoor breast screening unit and so the overall plans are more complex than the CCG expected.  Mr. Snee advised that the CCG had mobilised their own Project Manager and that the unit would be in place as soon as possible. The Committee were informed that this was a top priority for the commissioning strategy this year. 

The Committee noted that the CCG were continuing to pursue with local GPs as to how primary care could be brought into Finchley Memorial Hospital.  The Committee noted that this was a difficult issue due in part to complexities surrounding payment refunding routes.  Mr. Snee noted that the CCG had made a concerted effort to look at further options for primary care on site, such as via satellite or hub.

The Chairman requested that the CCG provide an update on the Older Persons’ Assessment Unit (OPAU) Mr. Snee advised the Committee that the OPAU had been paused but not cancelled as it had been felt that the way it was originally intended to be configured was too stand-alone and that the design should take into account the frailty pathway.  The Committee were informed that the pause would allow commissioners to consider what more could be done for the population from a frailty point of view. 

The Chairman expressed her disappointment that the breast screening facility was still being delivered through the mobile unit and that the empty ward on site was still not in use and was costing a considerable amount every month.  Mr. Snee commented that he had taken the time to visit the building and understood the disappointment.  Mr. Snee further said that the focus this year would be to deliver on things in the building that provide health and social care for the population. 

A Member advised that she had been informed that the blood testing unit at the Finchley Memorial Site might be closed.  Mr. Snee advised that he was not aware of this but would look into the matter and respond to the Committee.

Mr. Griffin informed the Committee that Barnet was the best performing CCG in terms of Cancer survival rate but noted that the CCG would not become complacent and would seek to improve the rate further.

RESOLVED that:

1.    The Committee noted the report

2.    The Committee requested that the Governance Service contact CLCH to ask for an update from their point of view on the repatriation of services to East Barnet Health Centre and that, once received, it be circulated to Committee Members. 

3.    The Committee requested that the CCG provide clarification as to the future of the blood testing unit at Finchley Memorial Hospital.