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Agenda and minutes

Contact: Peter Moore  020 7527 3252

Items
No. Item

153.

Introductions

Minutes:

The Chair introduced Members and officers to the meeting

154.

Apologies for Absence

Minutes:

Councillors Rakhia Ismail and  Tim Nicholls

155.

Declaration of Substitute Members

Minutes:

Councillor Jean Roger-Kaseki stated that he was substituting for Councillor Nicholls

156.

Declarations of Interest

If you have a Disclosable Pecuniary Interest* in an item of business:

§  if it is not yet on the council’s register, you must declare both the existence and details of it at the start of the meeting or when it becomes apparent;

§  you may choose to declare a Disclosable Pecuniary Interest that is already in the register in the interests of openness and transparency. 

In both the above cases, you must leave the room without participating in discussion of the item.

If you have a personal interest in an item of business and you intend to speak or vote on the item you must declare both the existence and details of it at the start of the meeting or when it becomes apparent but you may participate in the discussion and vote on the item.

 

*(a)Employment, etc - Any employment, office, trade, profession or vocation carried on for profit or gain.

 (b)Sponsorship - Any payment or other financial benefit in respect of your expenses in carrying out

  duties as a member, or of your election; including from a trade union.

 (c)Contracts - Any current contract for goods, services or works, between you or your partner (or a body

 in which one of you has a beneficial interest) and the council.

 (d)Land - Any beneficial interest in land which is within the council’s area.

 (e)Licences- Any licence to occupy land in the council’s area for a month or longer.

 (f)Corporate tenancies - Any tenancy between the council and a body in which you or your partner have

  a beneficial interest.

 (g)Securities - Any beneficial interest in securities of a body which has a place of business or land in the council’s area, if the total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body or of any one class of its issued share capital. 

 

This applies to all members present at the meeting.

 

Minutes:

None

157.

Confirmation of minutes of the previous meeting pdf icon PDF 165 KB

Minutes:

RESOLVED:

 

That the minutes of the meeting of the Committee held on 19 October 2015 be confirmed as a correct record of the proceedings and that the Chair be authorised to sign them

158.

Order of business

Minutes:

The Chair stated that the order of business was as proposed in the agenda

159.

Chair's Report

Minutes:

The Chair stated that the update on the Margaret Pyke centre would be discussed as requested at the last meeting.

 

The Chair also referred to a discussion that had taken place at the JOHSC on the intervention by the Whittington Hospital in relation to the lower urinary tract service and that following discussions it appeared that there appeared to be a possible resolution to the difficulties. There would be a deputation to the next meeting of the JOHSC on this issue however it is hoped that agreement would be reached.

160.

Public Questions

Minutes:

The Chair outlined the procedure for Public questions and the filming and recording of Public meetings

161.

Update Margaret Pyke Centre pdf icon PDF 418 KB

Minutes:

The Chair stated that the Committee had requested an update on this matter at the last meeting and a report had been circulated.

 

Mark Maguire, Service Director, Sexual Health and HIV and Sarah Marriott, Divisional Medical Director of CNWL and Jonathan O’Sullivan Public Health were present for discussion of this item.

 

During discussion the following main points were made –

·         Members were informed that no final decision had been made on the future of the buildings, however CNWL’s sexual health services collectively have a significant funding gap this year and next. The trust’s funding gap is expected to be about £5.8m in total over this period

·         CNWL is looking at ways to maintain its services whilst addressing the current and expected funding pressure. Buildings are under review since re-provision of services onto fewer sites would significantly reduce the estate costs and be a good way of closing the funding gap

·         The Trust has not reached a final recommendation but is looking at options to move from the current 3 major sexual health service sites across Camden and Islington. The Margaret Pyke Centre is the smallest and most expensive building per patient seen and the Trust’s assessment is that the building would not be able be in a position to absorb either of the other sexual health services. Another option considered is to retain all three sites, but transfer some of the services to other locations

·         Commissioners have been and will continue to work with the Trust to develop and understand options for savings and their impact

·         In response to a statement that the Trust will consider an options appraisal on estates at its Board meeting in January 2016 and once a recommendation is made, it will need engagement with stakeholders, the Committee expressed the view that there should be expanded stakeholder engagement and this should be reported back to the Committee at its January meeting

·         It was stated that the budget reductions could result in approximately 60 staff losing their posts out of 240/250 posts

·         All the services operating from all 3 sites were rated outstanding and the CNWL priority is to retain services with fewer staff and patient satisfaction at all of the sites is high

·         Options to reduce costs were being looked at including remote screening and the introduction of new technology and there is an extensive consultation process that will take place with GP’s, Commissioners and Councils to buy into this process

·         The integrated sexual health tariff had initially been developed, but not implemented, by the NHS in London, but progress had been halted at the point when sexual health services would be transferred to Councils.

·         The London Association of Directors of Public Health re-activated the integrated tariff programme in 2014 and the analysis has indicated that overall there is potential for significant savings across London commissioners, assuming activity levels remained unchanged following introduction of a new tariff. This would result in SRH services generally seeing an increase in commissioner income and a reduction in commissioner income  ...  view the full minutes text for item 161.

162.

Health and Wellbeing Board update

Minutes:

Councillor Janet Burgess, Executive Member Health and Wellbeing Committee was present and verbally outlined the recent developments at the Health and Wellbeing Committee.

 

During consideration of the report the following main points were made –

·         Continued Better Care funding had been agreed although the actual level of funding is not yet known

·         It was reported Dr.Gillian Greenhough was leaving the borough as she was retiring and this would be a great loss to the borough

·         The Whittington hospital were consulting patients on the estate strategy

·         The Council would be able to increase the Council Tax by 2% in order to fund social care initiatives

 

The Chair thanked Councillor Burgess for her update

163.

Value Based Commissioning pdf icon PDF 87 KB

Minutes:

Rebecca Kingsnorth, Islington CCG, and David Egerton GP and Clinical Lead for Value Based Commissioning were present for discussion of this item and presented the report.

 

During consideration of the report the following main points were made –

·         Value based commissioning means changing how healthcare is organised, measured and reimbursed in order to improve the value of services. In a value based commissioning service, services delivered by a number of providers are organised around patients with similar sets of needs, to ensure that these needs are met in the most cost effective manner

·         Health and care organisations are being asked to work together, across boundaries, for patients with similar needs and as commissioners contracts will describe the outcomes that are expected to be achieved. A proportion of the payment will be linked to the outcomes that are achieved collectively by the range of providers involved in providing care for that group of patients

·         In response to a question it was stated that a lot of work had been carried out to look at measurements of outcomes and these will be developed over time

·         It was anticipated that this would be put in place for the next financial year and measurements would be developed and defined over the next 5 year period

·         The Chair stated that the Friends and Families test is a good way in his view to encourage patients to respond and the Committee concurred with this view

 

RESOLVED:

That the report be noted together with the Committee’s comments above

164.

Healthwatch Work Programme pdf icon PDF 150 KB

Minutes:

Emma Whitby, Islington Healthwatch, was present and outlined the report. Bob Dowd, co-opted Member of the Committee was also present, together with Phil Watson Islington Healthwatch.

 

During consideration of the report the following main points were made –

·         Healthwatch  were developing a model for effective engagement  of children and young people and also had done work on how to inform residents on how to make a complaint about services offered at local GP practices and had disseminated a leaflet on making complaints about health services to local libraries, community centres, voluntary organisations and health services

·         There was however difficulties faced in ensuring that all the actions proposed were implemented by partners

·         The Committee welcomed the work of Healthwatch and that there were a large number of initiatives for a small organisation. It was stated that there are a team of volunteers who assist in the work of Healthwatch

·         Healthwatch had been commissioned by the CCG to carry out some work ín relation to ophthalmology provision

 

RESOLVED:

 

That the report be noted

165.

Executive Member Health and Wellbeing Presentation pdf icon PDF 519 KB

Minutes:

Councillor Janet Burgess, Executive Member Health and Wellbeing was present for discussion of this item and made a presentation to the Committee, copy interleaved.

 

During consideration of the report the following main points were made –

 

·         Life expectancy has increased for both men and women, however life expectancy for men in Islington remains lower than England and is the 4th. lowest amongst all London Boroughs

·         Infant mortality has fallen by 68% since 2003-2005 and has the 8th. lowest infant mortality of all local authorities in Islington

·         Children’s oral health has improved but there is still work to be done

·         The Committee expressed concern that child obesity levels were still too high and there had been a significant increase in the number of children referred and assessed for autism

·         There had been a 46% reduction in early deaths from heart disease over the past 10 years. This is a faster reduction rate than both London and England, however the rates remain higher than the national and London averages

·         There are significantly worse admissions to hospital as a result of alcohol and the rates have increased in Islington over the last 5 years

·         An estimated 15% of 5-16 year olds experience mental health conditions, which is higher than England, despite higher levels of investment than London or England. Addressing prevention and earlier intervention is key to improving mental health

·         Historically under-represented groups, such as men, people living in deprived communities and people from Black Caribbean groups are now well represented, amongst service users of ICope (Camden and Islington psychological services)

·         Challenges for the coming year include increasing the number of smokers who successfully quit, addressing the high levels of alcohol related admissions, improving the physical health of those with mental health problems, increasing the number of people with LTC’s who are in employment, tackling social isolation in vulnerable groups, such as older people, those with mental health and learning difficulties, and parental mental health in the early years and building resilience is being addressed

·         In 2014/15 Islington offered 3820 residents a social care service and the proportion of service users receiving a service to address a physical disability of frailty increases dramatically amongst the over 65’s, however it is the largest primary category for all service users aged over 40

·         Islington has the highest diagnosis rate for dementia in London and the 5th. highest in England

·         The numbers of adults with learning disabilities who require services is expected to increase as people transition from Children’s Services

·         The Adult Social Care Plan 2015/19 outlines how the Council will support the Council to deliver the Corporate Plan towards a Fairer Islington

·         During the period 2011-2015 the Council has had to close a net budget gap of £150m and adult social care has contributed £31m to the £150m during this period

·         The department has made savings of £6.8m in 2014/15 and has plans in place to facilitate the delivery of £10.5m savings in 2015/16. The estimated savings target is  ...  view the full minutes text for item 165.

166.

Scrutiny Review - Health Implications of Damp Properties pdf icon PDF 633 KB

Minutes:

Sinead Burke, Housing and Adult Social Services was present for consideration of this item.

 

During consideration of the report the following main points were made –

·         The Andover Estate pilot works concentrated on some of the ground floor units to Todds Walk, which are considered to be the worst affected flat units, being those with condensation and dampness within the ground floor units to the four storey blocks which have individual garages. The pilot works were completed in December 2014

·         The pilot phase is now complete and following on from the initial works it is recognised that the pilot did not go far enough and there has been a re-assessment and re-evaluation of the areas of risk and processes, design and products, with a view to achieving the best solutions for the benefit of any future works. There have also been issues identified in relation to existing heating and cold water supply systems, which are now proposed to be renewed

·         The Council has a delivery plan to address the issues starting with the External and communal cyclical repair works, which will pick up on the considerable areas of external repairs, defects and improvements necessary to the fabric of the building

·         In addition, the proposed decent home bathrooms, and kitchens that were missed last time will be incorporated with the proposed dampness and condensation remedy works and these are proposed to be completed together within each flat at the same time

·         Further to this there is co-operative work with the new build team and the various initial feasibility options are being considered and the impact and consequences of how this team will fit in with the above proposed measures

·         External and internal surveys have now been undertaken to the whole building envelope to address various defects/weaknesses/faults and the design of the proposed condensation/dampness works to take into account all possible potential areas of cold bridging for the various types of properties, together with LBI Building Control and the leading trade suppliers/manufacturers

·         Whilst there is now a noticeable change to the insulation levels within all  properties, where works were carried out on the pilot, there are still various measures required that are necessary to be undertaken to improve building performance and living conditions. Internally to improve the thermal performance of the flat units changes have been made to the insulation materials and the insulation material will be fixed direct to backing surfaces without the use of batons, which will save time and cost

·         The insulation will now be fitted for the garage side to the rear wall of the bathroom, bedroom and the kitchen. Some enforcement may be required where access to the garages is not forthcoming. All the exposed external living room, bedroom and hallway wall surfaces will now be insulated, as opposed to the partial wall works carried out in the pilot and will also include insulation to windows and front entrance/garden door reveals

·         Externally insulation will now be fitted to the sloping living room roof void from the outside,  ...  view the full minutes text for item 166.

167.

Work programme Health and Care Scrutny Committee pdf icon PDF 75 KB

Minutes:

RESOLVED:

That, subject to the amendment of the 111/Out of Hours specification/consultation report being moved from the November meeting to the January meeting, and a further update on the Margaret Pyke Centre, the work programme be noted