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Agenda and minutes

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Items
No. Item

14.

Introductions

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Minutes:

The Chair welcomed everyone to the meeting and members and officers introduced themselves.

15.

Apologies for Absence

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Minutes:

There were no apologies for absence.

16.

Declaration of Substitute Members

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Minutes:

There were no substitute members at the meeting.

17.

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.

 

 

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Minutes:

No declarations of interest were reported at the meeting.

18.

Minutes of the previous meeting pdf icon PDF 330 KB

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Minutes:

Councillor Russell asked whether the Committee would be looking in-depth at sexual health as this was considered at the previous meeting. This was not agreed.  

 

RESOLVED:

That the minutes of the previous meeting held on 7th July 2022 be agreed as a correct record and the Chair be authorised to sign them.

 

19.

Chair's Report

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Minutes:

The Chair explained that the order of items had been amended to allow external partners to address the Committee first.

20.

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.

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Minutes:

The Chair advised that any questions from the public would be considered as part of each agenda item.

21.

External Attendees (if any)

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Minutes:

No requests.

22.

Camden and Islington Mental Health Trust Performance Update pdf icon PDF 2 MB

To include a verbal update on the use of Electroconvulsive Therapy, as requested at the previous meeting.

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Minutes:

The Committee received a performance update from the Camden and Islington Mental Health Trust. Mr Mafu, Managing Director Islington Division informed the Committee that there had been a divisional restructure that was helping to better support their community mental health transformation programme and the delivery of their priorities. It was highlighted that priorities included keeping people safe and providing a focus on ensuring care and treatment worked for the people who received it.

 

It was also explained that the Clinical Strategy within Camden and Islington (C&I) was focused on an integrated, community mental health service and improving patient flow and experience. The Committee were informed that during the trusts last Care Quality Commission (CQC) inspection, which took place in 2019, they were rated good overall.  They had been working to ensure the rating was sustained and to improve the areas CQC had recommended needed improvement.

 

It was highlighted that an area of focus in C&I was community mental health transformation. Here Central, North and South teams had been launched, in primary care, that would be multiagency and multidisciplinary, with a focus on prevention. New roles within the teams included population health nurses with a focus on physical health. As part of the transformation, they would also be looking to expand their interventions and to ensure greater collaboration within North Central London (NCL). There was work around eating and personality disorders being carried out at the NCL level. They were facing some challenges around recruitment; estates and there would be more work around stakeholder engagement.

 

A partnership between C&I and Barnet, Enfield and Haringey (BEH) were working together to reduce health inequalities, improve patient outcomes and create a sustainable workforce. Nine priorities had been identified including community mental health transformation, improving the crisis offer and having a single bed management plan for NCL.

 

The St Pancras Transformation Programme was progressing within C&I. Some services at St Pancras were being moved temporarily in order to complete the work within the trust. The Islington hub would be at Lowther Road. This included the community teams. Inpatient services would be at the Highgate Campus.

 

It was highlighted that Islington had the third highest prevalence of serious mental illness and the fifth highest prevalence of common mental health disorders. The trust would continue to remain agile and would adapt its strategy to meet any challenges, including those following Covid-19. Recruitment was a key challenge, and they would continue to ensure there was the right workforce within services. In August 2022 there was a cyber-attack that was managed nationally. Staff worked hard to ensure risks and the impact on services were minimised. There were some minor disruptions but no significant impact on patient care. Work was also underway to address inequalities and all services were assessed to prevent discrimination.

 

The appendix to the report included the services of the trust and a more detailed performance report.

 

Following a request by the Committee, Mr Mafu gave an update on the trusts use of  ...  view the full minutes text for item 22.

23.

London Ambulance Service Performance Update

Additional documents:

Minutes:

Mr Allen Brown, Camden and Islington Group Manager, London Ambulance Service (LAS) gave a presentation to the Committee. It was highlighted that the purpose of the LAS was to provide outstanding care for all their patients; be a first-class employer; provide the best value to taxpayers and to work with partners to optimise healthcare and emergency service provision. LAS were the only London wide healthcare provider and were one of the busiest ambulance services in the world with approximately ten thousand employees and volunteers serving a population of 8.99 million people. During the current year the service had received 2.2 million 999 calls and 2.2 million 111 calls, seeing a million patients, with an average response time of six minutes and fifty seconds. On busier days the service received a 999 call every six seconds and a 111 call every three seconds. They had recruited over one thousand new staff members and ranked number one amongst NHS employers for apprenticeships.

 

The LAS faced several challenges including high demand for the service. This required closer partnership working on more community pathways; the introduction of a new patient flow system to ensure patients were taken to the nearest hospital that could provide the quickest care and a clinical hub, where clinicians could give telephone assessments.

 

There had been improvements made to benefit staff and patients including a new purpose-built control room and two education centres; new technology including a simulation room; revamped logistics and supply units and a new computer aided dispatch system. Their key priorities were the health and wellbeing of teams including improving the work culture and staff morale; the launch of a recruitment drive; work to reduce violence and aggression towards staff and investment into green, lower emission and electric vehicles.

 

On their performance, it was highlighted that they were on target for responding to category one serious emergencies and category three calls. Category two was a challenge with a target of eighteen minutes and a response time of approximately twenty minutes to over an hour. It was explained that it was a challenging time for the whole NHS and they were working with partners to help manage their flow; were offering financial incentives for staff to cover shifts, had looked at a range of alternative care pathways and aimed to put out twenty – thirty additional ambulances a day.

 

Councillor Russell asked whether the summer heat resulted in an increase in ambulance callouts and whether they were looking at this being a long-term risk caused by the changing climate and, whether paramedics could be using e-bikes. It was explained that the heat caused spikes in demand and the weather would dictate whether extra ambulances were put out. They were looking at e-bikes however there were some complications. They would provide the committee with a written response on this.

 

Councillor Jeapes asked what caused delays at hospitals and whether there was a problem caused by patients waiting to be admitted; whether the service was impacted by Islington becoming a  ...  view the full minutes text for item 23.

24.

Scrutiny Review of Adult Social Care Transformation - Approval of Scrutiny Initiation Document and Initial Presentation pdf icon PDF 170 KB

Additional documents:

Minutes:

John Everson, Director of Adult Social Care informed the Committee that the scrutiny initiation document set out the programme for a detailed look at work in social care. The objective of the review was to put adult social care in context and to provide an overview following a number of changes to legislation, particularly in regard to the Health and Social Care Act 2022. The Committee would be given the opportunity to understand those changes and the resulting impact, including changes to services within the council and with wider partners.

 

The Committee would be informed of the way people accessed and went through services and it would be put into the Islington context using demographics. There was an emphasis on early help and prevention that should come through in the programme. The transformation and developments being put in place in services and with partners to address issues would then be considered. The vision for adult social care included ensuring strong, inclusive, connected communities where regardless of background people had fair and equal access to adult social care and the support to enable them, where possible, to live healthy, fulfilling and independent lives.

 

This meeting was to look at signing off the scrutiny initiation document. Meeting two would consider the adult social care context, vision and an overview of the integrated front door and urgent response service. Meeting three would look at the improved reablement service. Meeting four would be a summary.

 

Councillor Zammit asked whether personas could be used to clearly demonstrate the steps a person might go through once they have accessed a service. This was agreed. The Chair asked whether they would be meeting with vulnerable residents and whether this could be facilitated in the community. It was explained that the committee would meet service users for an informal discussion, in an appropriate setting.

 

RESOLVED:

To agree the Scrutiny Initiation Document.

 

25.

Health and Wellbeing Board Update

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Minutes:

The Cabinet Member for Health and Social Care explained there were no updates and the next meeting would be held in November.

26.

Covid-19 Update if required

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Minutes:

Jonathan O’Sullivan, Director for Public Health explained that Covid-19 infections had increased over the summer, had reduced but were starting to increase again. The majority of cases were the same type of OMICRON that had already been circulating in the community, so there was some immunity in the population.

 

Covid Vaccinations had been offered to older adults, health and social care workers, those with health conditions that made them vulnerable and those who lived with them. It was hoped that, subject to the national timetable, the vaccine would be rolled out to healthy adults over the age of fifty.

 

There had been an increase in Covid-19 infections in hospital admissions, following a low across central London in mid-September. There were currently 210-215 patients with Covid-19, with 25-30% of those admissions being due to Covid. No issues had been identified at care homes due to prevention measures still being in place to protect residents.

 

It was expected that there could be an autumn or winter surge in covid cases. New sub-variants were emerging, so it was important to get vaccinated. Flu had also begun to circulate in the community. This was early compared to most years and the type of flu was likely to be more infectious and more serious, so the flu vaccination was also strongly advised.

 

 

27.

Quarter 4 Performance Report - Public Health pdf icon PDF 588 KB

Additional documents:

Minutes:

Jonathan O’Sullivan, Director of Public Health explained to the committee that public health indicators came in nationally, therefore they were considering the last quarter of the financial year, January to March 2022. It was highlighted that services and the community were still affected by an OMICRON wave during December-January.

 

It was highlighted that primary vaccinations measured at 1yr was up compared to during Covid 19 however it was still below the level for heard immunity; an additional polio vaccination was being offered as a precaution following traces of the virus being discovered in the wastewater supplies; the measles, mumps and rubella (MMR) follow up vaccination had returned to pre-covid levels but was below the heard immunity level; it was proposed that the metrics on access to child health clinics be retired; long acting reversable contraception had been impacted by covid and they were seeing improvements due to prioritising it; there was a 66% success rate regarding stop smoking and there were improvements to the drug service indicators but there were still improvements to be made.

 

Councillor Turan explained there had been an increase in the number of people presenting with drug and alcohol problems. This was the impact of poverty, austerity and the cost-of-living crisis however services were doing a good job trying to help people at their most vulnerable. 

 

Councillor Clarke highlighted the good work being done to help pregnant women stop smoking and asked for clarification around the statistics. It was explained that they were looking closely at the whole pathway, from preconception to delivery.  Every pregnant woman should have a conversation and an offer of support and advice about stopping smoking. The statistics showed that those who engaged with the service were successful however the challenge was to encourage more people to take up the offer of support.

 

28.

Work Programme 2022/23 pdf icon PDF 151 KB

Additional documents:

Minutes:

There were no comments or amendments to the work programme.

 

Councillor Russell asked whether the Council would be involved in Great Mental Health Day being organised by the Mayor of London for the 28th January and, whether a report by Age UK that looked at access to public toilets had been considered. Councillor Turan explained they had been looking at developing a plan to invest in toilet facilities and to work with businesses regarding access to toilets. They would look into participating in Great Mental Health Day. Councillor Craig raised the issue of changing facilities for older children. Councillor Turan said they were working with changing places toilets. The Chair requested an update on the aforementioned and this was agreed.