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Agenda and minutes

Contact: Peter Moore  020 7527 3252

Items
No. Item

44.

Introductions

Minutes:

The Chair introduced Members and officers to the meeting

45.

Apologies for Absence

Minutes:

Councillors Woodbyrne, Khurana and Hyde. Councillor Burgess, Executive Member Health and Social Care also submitted her apologies

46.

Declaration of Substitute Members

Minutes:

None

47.

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:

The Chair declared that she was an employee of NHS Digital

48.

Order of business

Minutes:

The Chair stated that business would be as per agenda order

49.

Confirmation of minutes of the previous meeting pdf icon PDF 117 KB

Minutes:

RESOLVED:

That the minutes of the meeting of the Committee held on 28 January 2019 be confirmed as a correct record of the proceedings and the Chair be authorised to sign them

50.

Chair's Report

The Chair will update the Committee on recent events.

Minutes:

The Chair stated that a meeting would be held at the Town Hall on 11 March to discuss cuts to the NHS and all were welcome to attend

51.

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 procedure for Public questions, filming at meetings and fire evacuation procedures

52.

Health and Wellbeing Board Update

Minutes:

Councillor Burgess provided a written update to the Committee, copy interleaved

 

The following main points were noted –

 

·         The agenda for the next meeting of the Board was notified to Members

·         A meeting of the Haringey and Islington Health and Wellbeing Boards Joint Sub Committee met on 6 March, and discussion took place on the NHS 10 year plan and there was a general discussion, but no conclusions were reached

·         Presentations also took place about progress in developing Locality Based Care in Haringey

 

RESOLVED:

That the report be noted

53.

Moorfields NHS Trust Performance update pdf icon PDF 160 KB

Minutes:

Ian Tombleson, Director of Quality and Strategy, Tracy Luckett, Director of Nursing and Allied Health Professions, and Johanna Moss, Director of Strategy and Business Development, Moorfields NHS Trust were present, and made a presentation to the Committee, copy interleaved.

 

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

 

·         Around 2350 people work at Moorfields, and it ranks first in staff satisfaction with the quality of work and care delivered. It also ranks first for staff motivation at work, and staff satisfaction with resourcing and support

·         The overall CQC inspection is good – January 2017

·         The 5 year quality strategy started in November 2017, and year 1 delivery examples include check in kiosks to reduce waiting times in clinics, governance framework and customer care training for administrative teams

·         Compliance with national targets – A&E 73022 patients seen this year, and achieving around 98%/99% patients seen within 4 hours

·         Cancer meeting national targets, and six week diagnostic targets met 100%

·         Infection control – year on year no cases of MRSA or c difficile

·         Quality Patient Experience Cancer – Moorfields did particularly well 90% or above. Patients are given a clinical nurse specialist to support them through treatment. Areas for improvement include practical advice about the side effects of treatment, giving information to assist family and carers and all the information to assist them at home, and patients being given a care plan

·         In the Friends and Family test the overall patient experience continues to be good

·         Financial update – finances are currently on target to deliver a surplus of £6.7m, and the use of resources rating remains 1 (the best)

·         Outlook for 2019/20 – Expectations continue to be challenging for 2019/20

·         It was noted that Oriel is the proposal to build a new facility at the site of St.Pancras Hospital in Camden, subject to consultation. If approved, all services from Moorfields on City Road, and UCL Institute of Opthalmology, located on Bath Street in Islington, will be relocated

·         The relocation will provide an opportunity to build a new purpose built centre for world class research, education and excellent care

·         Drivers for change include – more patients will need treatment in future, new techniques and technology to diagnose and treat conditions, blocks in the system, patient feedback, getting it right first time, and potential benefits from the new location

·         As part of the relocation services at St. Pancras Hospital for Camden and Islington, Mental Health patients would move to the Whittington Hospital site, plus there would be investment in community hubs

·         Up to 2 acres of St.Pancras site could be sold to Moorfields Eye Hospital for development of new eye care, and a research and education facility with UCL Institute of Opthalmology, and Moorfields Eye Charity. Moorfields would potentially fund the move from the release of the City Road site

·         St.Pancras Transformation Programme is not reliant on Oriel, however Oriel is reliant on the St.Pancras Transformation programme

·         Evidence has shown that 80% of those surveyed are supportive of the  ...  view the full minutes text for item 53.

54.

Scrutiny Review - GP Surgeries - Witness evidence pdf icon PDF 859 KB

Additional documents:

Minutes:

Katherine Gerrans, Primary Care workforce, and Rebecca Kingsnorth, Assistant Director, Primary Care, Islington CCG were present at the meeting and made a presentation to the Committee, a copy of which is interleaved.

 

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

 

·         A new five - year framework was announced in January 2019 between NHS England and the General Practitioners Committee, England, and will introduce increased workforce, creating networks, and see reconfiguration of services

·         The changes will provide much needed support, and resources, for general practice, expanding the workforce, reducing workload, increasing funding, retaining GP and partnership autonomy, and ensuring GP’s have a leadership role at the centre of primary care

·         Practices will form Primary Care Networks through a new Directed Enhanced Service, and Networks can facilitate shared decision making between practices for their total network populations, typically 30-50000), around funding and workforce distribution, and augmented service provision. Networks will need to be geographically contiguous

·         Practices will sign a network agreement that outlines what decisions the network has made about how they will work together, which practice will deliver what for specific packages of care, how funding will be allocated between practices, and how new workforce will be shared, including who will employ them

·         Practices will be expected to work together in networks to provide extended opening hours, currently provided on an individual practice basis

·         In full from 2020/21 the DES specification will require networks to outline how they will provide specific support for those in care homes, and undertake medication reviews

·         From 2020/21 the delivery of personalised care will commence, early cancer diagnosis will be supported, diagnosis and anticipatory care, and how data will be shared within the network will take place

·         From 2021/22 onwards, additional requirements will be added to Cardiovascular disease, prevention and inequalities, although these details are still to be negotiated. These areas will be linked to the expanded workforce employed by the network

·         In relation to Primary Care networks, additional workforce will be introduced and partially funded through the Network. The number will build up over 5 years

·         NHS England will fund 70% of each professional, including on costs. Networks will need to fund the additional 30% themselves. The exception is social prescribers, which NHS England will fund 100%, including on costs

·         The Network will decide how the additional workforce is employed

·         The workforce and network will be led by a Clinical Director, chosen from within the GP’s of each network. The Clinical Director will be funded, an average of a day a week for a network of 40000 patients, including on costs, from new funding provided by NHS England

·         In 2019, there will be 1x clinical pharmacist and 1x social prescriber, in 2020 first contact physiotherapist and physician associates, in 2021 all of the these will increase and community paramedics will be introduced, in 2022/23 all of the above workforce will be increased, and by 2024 a typical network will receive 5 clinical pharmacists, equivalent of one per practice, three social  ...  view the full minutes text for item 54.

55.

Annual Health Public Report pdf icon PDF 171 KB

Additional documents:

Minutes:

Julie Billett, Director of Public Health and Agama Keegan, Public Health were present for discussion of this item.

 

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

 

·         Healthy ageing, as defined by the World Health Organisation, is the process of developing and maintaining the functional ability that enables wellbeing in older age, in terms of quality of life, to be independent and safe in their environment, have health and care provided closer to home, and to be supported to remain connected to their community when they want to be

·         In 2017 there were an estimated 20786 older adults living in Islington, and 9% of the population is aged 65 years and over, and 1% is over 85 years or older

·         The sharpest projected population increase is expected in the very old, i.e.persons over 85 years and above, and within, the older adult population in terms of their experience of healthy ageing, and many people live long, healthy and independent lives, and many have significant needs that impact on their quality of life

·         Examples of inequalities in physical health and dementia include – deprivation, gender, ethnicity

·         In terms of quality of life -  this is subjective but social isolation and loneliness impact on health and wellbeing and have an adverse impact. Fuel poverty is also an aspect of financial insecurity, and can significantly impact health and wellbeing. It is estimated that around 8% of Islington households with residents aged 60 or over are fuel poor, and this is expected to increase

·         There are significant inequalities in quality of life amongst older residents in Islington

·         Quality of life – everyone has a role in enhancing community connectedness. Small acts of neighbourliness and connecting with others builds a more cohesive, connected community. Services commissioned and delivered by the Council, include maximising social value through the supply chain to promote and support quality of life in older age can contribute to this

·         The social prescribing model, and service, presents a key opportunity and a means for linking people into VCS, and community assets and into services to tackle isolation and loneliness, and other key deteminants. There is also a need to take a holistic approach to wellbeing, and quality of life, in older age

·         Environmental and social determinants of healthy ageing – the proportion of older residents who live in social housing is particularly high in Islington, and this presents an opportunity to support many residents to remain independent and well in later life. The quality of public places and spaces is important for everyone, and different things make a particular difference to older people. Accessibility to safe, comfortable, affordable and safe public transport is a key enabler, encouraging older people to access services, maintain active lives, and take part in leisure and social activities 

·         Environmental and social determinants of healthy ageing - key recommendations include, as the Council are social landlords that they should develop the relationships with older tenants, adopt a healthy streets approach, and incorporate aspects of  ...  view the full minutes text for item 55.

56.

Scrutiny Review - Adult Social Carers /Green Paper Social Care - Revised SID pdf icon PDF 43 KB

Minutes:

RESOLVED:

That the revised Scrutiny Initiation Document be approved