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Agenda and draft minutes

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Items
No. Item

153.

Introductions

Minutes:

The Chair introduced Members and officers to the virtual meeting and outlined the procedures for the meeting

154.

Apologies for Absence

Minutes:

Councillors Calouri and Klute

155.

Declaration of Substitute Members

Minutes:

None

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.

Minutes of the previous meeting pdf icon PDF 97 KB

Minutes:

RESOLVED:

That the minutes of the meeting of the Committee held on 10 March 2020 be confirmed and the Chair be authorised to sign them

 

158.

Chair's Report

Minutes:

The Chair stated that this was the first meeting of the Committee to be held since the start of the COVID 19 pandemic, and that she would wish to place on record her thanks to NHS/Public Health/other partners, and Council staff, who had worked so hard and tirelessly to maintain services and deal with residents during the pandemic

159.

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

160.

Health and Wellbeing Board Update pdf icon PDF 62 KB

Minutes:

Councillor Janet Burgess, Executive Member Health and Social Care was present for discussion of this item, and outlined her written report

 

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

 

·         It was noted that the information provided was contained in future reports and that any issues arising could be dealt with is subsequent reports, in view of the length of the agenda that evening

·         Councillor Burgess stated that L.B.Islington had fared better than many other places during the pandemic, with a relatively low number of deaths, and that this was in part due to the efforts of staff and partners, who had worked extremely hard in difficult circumstances

161.

Moorfields Performance Report - Presentation pdf icon PDF 769 KB

Minutes:

Ian Tombleson and Tracy Luckett, Moorfields Hospital were present, and made a presentation to the Committee, copy interleaved

 

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

 

·       Moorfields employs around 2350 staff, and ranks first in terms of staff satisfaction with the quality and care they are able to deliver. 95% of staff feel that they would recommend Moorfields as a place to receiver treatment, and 78% as a place to work

·       Progress is being made on the Quality Account, and A&E achieved 98.5% within 4 hours as against 95% target. Referral to treatment is an 18 week pathway achieving over 94% against 92% target. Cancer is meeting all three of its targets, and there have been no year on year cases of MRSA of C dificile. There are low rates of other infections

·       Patient’s experience – top performer nationally in Friends and Family test, and CQC emergency care survey 2018. Overall good performance compared to other Trusts. CQC Children and Young People’s Inpatient and daycase survey 2018 had excellent results, and also good performance on NHS Cancer survey with patient rating of 8.3 out of ten. Patient participation activities – strategy launched in 2018, creating a genuine culture of participation in all services and activities

·       Finance – Challenging year – overall deficit of £0.6m compared to £8.5 million surplus in 2018/19 and outlook challenging due to COVID 19

·       It was noted that the last CQC inspection had rated the Trust overall as good, however it was outstanding in a number of areas, and the Trust were working extremely hard to achieve outstanding at the next inspection next year

·       In response to a question as to complications with cataract surgery, it was noted that this is an extremely low number of cases, and usually where there are other complications with patients

·       In response to a question concerning the number of serious incidents, it was stated that these cases were extremely low, and usually a breach of process, rather than outcome

 

 

The Chair thanked Ian Tombleson and Tracey Luckett for attending

162.

Scrutiny Review - Carers Adult Carers - Consideration of Review pdf icon PDF 316 KB

Additional documents:

Minutes:

Members considered whether to expand the review to include recent developments in relation to COVID 19. The Committee also considered a submission from UNISON, which had been circulated in conjunction with this item. Andrew Berry UNISON outlined the submission, which was responded to by Councillor Burgess, Executive Member Health and Social Care

 

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

 

·         Members were of the view that in view of the recent COVID 19 pandemic, the scrutiny review should be extended in order to consider the effect that dealing with the pandemic has had on carers in Islington

·         UNISON stated that there was a need to address a number of issues in relation to the Government’s introduction of the Infection Control Fund for care homes and Domiciliary Care. It was noted that there had been confusion concerning the nature and allocation of funds initially, and referred to the e mail exchange between the EM Health and Social Care and the Leader

·         In response to a statement, the EM Health and Social Care stated that there were regular meetings between Trade Unions and the Council, and that these would continue and that there were also are also regular meetings with care  providers

·         It was stated that UNISON had concerns about care staff going into work, and possibly spreading infection when they were unwell, given that some providers were not fully funding sick pay. The EM Health and Social Care stated that to her knowledge care providers were now providing for a top up to SSP if staff were self-isolating, and there had been funding provided for care homes and staff for additional PPE. In relation to agency staff the Council were working with providers to limit the use of such staff, especially across more than one site, however there is a need for agency staff to be used in some instances, in order to ensure services are maintained

·         Members welcomed the UNISON submission, and stated that this could be considered as part of the Scrutiny Review going forward. Members expressed the view that the Scrutiny Review should be extended for a period, in order to consider additional information on COVID 19, including deaths of residents in care homes, and sheltered accommodation, availability of PPE, pay, including sick pay for carers/domiciliary staff, and the impact of COVID 19 on BAME staff and residents

·         Members noted that deaths in care homes had increased due to the Government decision early in the pandemic to decant elderly people from hospitals back into home cares. In addition, there had been a lack of testing in care homes initially although this was now improving

 

RESOLVED:

 

(a)  That the UNISON submission be noted, and considered as part of the Scrutiny Review.  UNISON to be invited to attend future meetings of the Committee where the Scrutiny Review is discussed

(b)  That the Scrutiny Review on Adult Paid Carers be extended for a short period to consider evidence from the UNISON submission, together with additional information in  ...  view the full minutes text for item 162.

163.

COVID Update pdf icon PDF 753 KB

Additional documents:

Minutes:

Councillor Janet Burgess, Executive Member Health and Social Care was present for discussion of this item, together with Julie Billett, Director Public Health, Mahnaz Shaukhat, Public Health, and Katherine Willmette, Adult Social Care. Presentations were made to the Committee, copies interleaved

 

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

 

·         As of 1 July there had been a cumulative total of 542 laboratory tested confirmed cases in Islington. The number of cases has been declining since mid-April. Islington has had the lowest rate of cumulative COVID cases in London, and the availability of testing has increased, however many suspected cases would not have been tested early on. There were 2 new cases reported  between 20-26 June

·         COVID deaths in Islington – Between 14 March and 19 June there have been a total of 150 COVID related deaths in Islington and an estimated 179 excess deaths. There were 2 deaths reported in Islington between 13 and 19 June. There are no statistically significant differences between COVID mortality rates between men and women in Islington, and there are no clear trends across deprivation areas. In Islington, although the mortality rate is higher in men than women, 154 per 100000 compared to 113 it is not a statistically significant difference

·         As of 31 May 2020, Islington’s age standardised mortality rate due to COVID was higher than the England average, 131 deaths per 100000 population, compared to 82, but similar to the London average 138. Mortality rates in non-COVID and COVID deaths follow a similar pattern across the local deprivation quintiles

·         COVID related deaths peaked in Islington during the week 4 April to 10 April at 42 deaths but has been falling steadily since. 150 deaths in Islington were COVID related, and the majority of all COVID deaths took place in a hospital – 66%. Just over a third of all deaths took place in care homes, and 54% of all hospital deaths of Islington residents related to COVID

·         Disparity of risks and outcomes in COVID – Men are disproportionately affected and the risk of death increases with age. In the NCL region those born in Africa were more likely to die of COVID, 66%, than those born in UK and Europe 51%

·         In terms of Adult Social Care a silver command was established, critical work areas identified, services supported and close working arrangements with other LBI services and partners to ensure support for critical areas

·         4 critical service delivery areas – hospital discharge, in house provision, contracting and brokerage, safeguarding residents. Hospital discharges were managed, priority groups emerged as the crisis developed, partnerships and collaboration were critical, and extensive support to commissioned services required to support care homes and domiciliary care providers

·         Staff in non-critical areas were redeployed

·         PPE – 672K items purchased at a cost of £200k, support to access mutual aid, daily provided briefings and dedicated website, and co-ordination and testing of staff. A number of other measures such as support to recruit staff, parking permits, key  ...  view the full minutes text for item 163.

164.

Performance Report pdf icon PDF 215 KB

Minutes:

Councillor Janet Burgess, Executive Member Health and Social Care, and Julie Billett, Director of Public Health were present for discussion of this item

 

During consideration the following main points were made –

·       COVID has resulted in a number of services either pausing or changing delivery approach since mid-March

·       Key achievements at Q4 – 55% smokers using Stop Smoking Services, (target 50%), Access to Psychological Therapies 51% (target 50%), and 124 new permanent admissions to residential and nursing care, resulting in  reduced visits to GP’s

·       Key challenges – increase number of drug users who complete treatment, increase number discharged from hospital, and reducing delayed transfer patients to social care. In terms of the percentage of alcohol users who successfully complete the treatment plan, this target was met and there was a 10% improvement from Q1. Services are reporting increases in demand for treatment, particularly from opiate and alcohol users

·       The number of Long Acting Reversible Contraception prescriptions made in local integrated sexual health services has exceeded the annual target by 235, but has been affected by COVID 19

·       The percentage of service users receiving care in the community through the use of direct payments, although below the target of 30% is in line with end of year performance

·       It was noted that nationally over 1m people had stopped smoking during lockdown

·       Members congratulated officers/Executive Member/Partners on the fact that there had been no delayed transfers of care during the pandemic to date

·       It was noted that the number of residents receiving direct payments needed to be increased following the pandemic

·       In response to a question as to dealing with mental health, and self-neglect post lockdown, it was stated that discussions were taking place in the next week on this issue, and details would be sent to Members of the Committee

 

RESOLVED:

 

That the report be noted, and that details of the proposals as to how to deal with self-neglect and mental health problems following lockdown be circulated to Members when available

 

The Chair thanked Councillor Burgess and Julie Billett for attending

165.

Draft Work Programme 2020/21 pdf icon PDF 50 KB

Minutes:

RESOLVED:

That, subject to the addition of further evidence in relation to the Adult Paid Carers Scrutiny review and this review being extended to October/November, the draft work programme be approved