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Agenda and minutes

Contact: Peter Moore  020 7527 3252

Items
No. Item

1.

Election of Chair

Minutes:

In the absence of the Chair and Vice Chair it was proposed by Councillor Hyde and seconded by Councillor Khurana and –

 

RESOLVED:

That Councillor Klute be elected as Chair of the Committee for the remainder of the meeting

2.

Introductions

Minutes:

The Chair introduced Members and officers to the meeting

3.

Apologies for Absence

Minutes:

Councillors Gantly (Chair), Turan, Woodbyrne and Jana Witt – Healthwatch and Councillor Chowdhury for lateness

4.

Declaration of Substitute Members

Minutes:

None

5.

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

6.

Order of business

Minutes:

The Chair stated that the order of business would be as per the agenda

7.

Confirmation of minutes of the previous meeting pdf icon PDF 99 KB

Minutes:

RESOLVED:

That, subject on page 5 bullet point7 to the deletion of the words - ‘for social prescribing’ and the insertion of the words ‘patient activation service’ - the minutes of the meeting of the Committee held on 11 October 2018 be confirmed and the Chair be authorised to sign them

8.

Chair's Report

The Chair will update the Committee on recent events.

Minutes:

None

9.

Public Questions

For members of the public to ask questions relating to any subject on the meeting agenda under Procedure Rule 70.5. Alternatively, the Chair may opt to accept questions from the public during the discussion on each agenda item.

Minutes:

The Chair outlined the fire evacuation procedures and the procedures for questions and filming of meetings

10.

Health and Wellbeing Board Update

Minutes:

None

11.

Alcohol and Drug Abuse -Update pdf icon PDF 66 KB

Additional documents:

Minutes:

Emma Stubbs, Senior Commissioning Manager, Public Health, was present at the meeting and made a presentation to the Committee. (Copy interleaved) Service user and Peter Kane and Dr.Liz McGrath were also present representing Camden and Islington NHS Trust, the service provider.

 

During the presentation the following main points were made –

 

·         New estimates of the number of crack and/or opiate users (OCU’s) and alcohol in Local Authorities were published in 2017. These prevalence estimates give an indication of the number of people in a local area that are in need of specialist treatment, and the rate of unmet needs gives the proportion of those not currently in treatment

·         Cohort and estimated number – OCU’s 2168, Islington Unmet need 55.5% and national unmet need 51.7%. Opiate cohort and estimated number 1749, Islington unmet need 45%, and national unmet need 43%. Crack cohort and estimated number 1642, Islington unmet need 58%, national unmet need 62%. Alcohol cohort and estimated number 3674, Islington unmet need 76%, and national unmet need 78%

·         The Home Office estimated that in 2010/11 that the cost of illicit drug use in the UK is £10.7 billion per year. This figure includes 8% health service use, 10% enforcement, 28% deaths linked to eight illicit substances, and 54% drug related crime

·         Research has shown that for every £1 invested in drug treatment there is £2.50 benefit to society and of those people engaged in treatment in 2015/16 if they had not been in treatment it would have cost the NHS an additional £1billion

·         It is estimated that structured treatment prevented crimes in 2010/11, with an estimated saving to society worth £1billion in today’s prices, and further money was saved from former drug users sustaining their recovery

·         Impacts of substance abuse – Family history of addiction, socio-economic deprivation, homelessness, unemployment, poor working conditions and job insecurity, mental are more likely to use illegal drugs, poor mental health is linked to drug misuse and vice versa, and there are strong links between health inequalities and drug use, but the picture is complex

·         Better Lives update – the Better Lives new adult Islington drug and alcohol service started on 1 April 2018

·         Camden and Islington NHS Foundation Trust are the lead provider working in partnership with WDP and Blenheim

·         There were significant logistical challenges in the first 6 months of operation, and Camden and Islington have invested significant amounts of money into refurbishing buildings, in order to give service users, their families and staff comfortable and welcoming environments in which to transform their lives

·         As buildings have been refurbished, the services usually provided from these sites have had to be relocated elsewhere. This has caused some anxiety to service users, but through regular meetings, and by involving service users in planning, service users are now more aware of the reasons for the changes and are more comfortable with the plans

·         All eligible staff have been transferred over to the new providers, and the remaining key vacant posts, such as the Borough Service Manager,  ...  view the full minutes text for item 11.

12.

Annual Safeguarding Report pdf icon PDF 160 KB

Additional documents:

Minutes:

Elaine Oxley, Housing and Adult Social Services, was present at the meeting, together with James Reilly, Independent Chair of the Adults Safeguarding Board.

 

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

 

·         The Board is composed of a diverse group of partner providers in the health, care, justice, housing, voluntary and emergency services, all of whom engage with adults in need

·         Work has taken place with the Board’s sub groups to progress the well-being and safety of the adults at risk whom they serve. It had been particularly pleasing to work with the new service user group to explore the issue of social isolation and how to tackle it as it compounds the safeguarding risks confronting vulnerable adults

·         A successful event was held with voluntary sector and provider commissioned services to launch a safeguarding policy toolkit to strengthen their governance arrangements

·         Four training events were held to highlight issues regarding domestic violence, as this issue has gained national prominence over the past year. A more dynamic relationship has been forged with Pentonville Prison to better understand and support the safeguarding issues and efforts in the Prison

·         Having substantially completed the actions relating to the past 3 year strategy, concluding in March 2018, the Board completed a very successful consultation with Islington residents and professionals to inform its new 3 year strategy, which it agreed for the period April 2018 to March 2021

·         Through on-going training and more general awareness raising people are being encouraged to raise their safeguarding concerns, and indeed the number of referrals remains high, and is increasing. Health and Care Commissioners continually regularly monitor the safeguarding practices of the range of care providers they contract with. Where incidents of concern are raised they are investigated and follow up actions monitored

·         New legislation on social care for older people is in the pipeline, and is expected later in 2018

·         Key achievements included, together with the Board’s service user and carer sub-group, a well-attended social isolation and safeguarding event. The service user and sub-group continues to explore the relationship between the social isolation and safeguarding risks

·         It was noted that the Safeguarding Board met 4 times per year, and acts as an assurance and improvement Board, rather than a performance Board

·         There is good engagement with service users and last year consideration was given to social isolation and financial exploitation

·         Reference was made to paragraph 3.7 of the report, and that the Board’s sub-group considered two new referrals as to whether they met the criteria for a Safeguarding Adults Review under section 44 of the Care Act 2014. One of these cases did not meet the threshold and the other was progressed to conclusion

·         Members noted that where the Council was responsible for Adult Social Care it could have influence on the care provided and there were more concerns where self-funded care is purchased, particularly where mental frailty is concerned

·         The Board worked closely with Healthwatch, who reported concerns and it was also stated that  ...  view the full minutes text for item 12.

13.

Scrutiny Topic - GP Surgeries - Witness evidence - Verbal

Minutes:

Rebecca Kingsnorth and Imogen Bloor, Islington CCG, was present at the meeting and were accompanied by Michael Clowes and Dr.John McGrath, representatives of the Islington GP Federation.

 

During consideration of evidence the following main points were made –

 

·         Each of the 32 GP practices are facing challenges of growing demand, a struggling workforce, evolving care needs and ageing premises

·         The 32 GP practices are small businesses under contract to the NHS, but with significant variances – these include staff loyalty, resilience, efficiency, modernity, continuity, capability, scale, quality, patients, ambition, ethos, culture and care

·         Islington GP Federation is a private limited company owned by all Islington GP’s and was formed in January 2017

·         The Islington GP Federation operates exclusively under NHS contracts, and related contracts such as Health Education England

·         The Islington GP Federation will employ approx. 200 staff this month

·         Islington GP Federation was set up to ensure Islington registered patients have free and equitable service, access to good, safe, value for money primary care, and to maintain financial viability of the federation, in order to achieve its primary goal

·         Islington GP Federation builds GP scale capability and culture, enables GP resilience in Islington, and delivers new models of care

·         At borough level there is integrated access e.g.i Hubs, GP retention schemes, variability reduction e.g. diabetes, finance, IG,QI, analytics resource and access to all patient records for direct care

·         There are locality CHINS – locality-based preventative MDT’s, multi-agency partnerships, technology-driven risk stratification, health and care social prescribing, and strong governance and leadership

·         All initiatives are founded on a bottom up design, QI methodologies, and good enough technology

·         GP networks and neighbourhoods – there are 8 Network ambassadors, 8 practice based pharmacists, shared estate and workforce, 8 GP mentors, 8 MOT chronic groups, and patient and public participation

·         GP practices require IG support, back office support, technology and tools, practice rescue and turnaround, clinical and administrative training, and GP retention initiatives

·         Islington GP Federation presents a unified voice, promotes trust, a willingness to try, dependability, support and hope

·         The Islington GP Federation was the NHS70 Parliamentary Award winner for Healthier Communities for showing a really proactive approach to assessing the health needs of the area they serve, including some of the hardest to reach communities, and working together with partners to put in place targeted programmes, which make a real difference to peoples’ health and well-being

·         It was noted that there is a national shortage of flu vaccine and that the Islington GP Federation had made a successful bid for Home Based vaccinations, and this will enable Whittington Health and District Nurses to do other checks, such as blood pressure checks at the same time

·         It was noted that the Islington GP Federation felt that Islington is well placed to meet future challenges, and the iHUB and walk in centre offers improved the service to residents

·         It was noted that the Federation was a limited company but funded through contracts, the principal ones being ENT, Gynaecology, and i HUBS

·         The GP  ...  view the full minutes text for item 13.

14.

Work Programme 2018/19 pdf icon PDF 49 KB

Minutes:

RESOLVED:

That the report be noted