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The Chair welcomed Councillor Helal Uddin who had
recently been appointed to the Panel and thanked retiring member
Councillor Asad for his contribution to
the Panel’s work.
She also welcomed guests from health service
bodies, Dr Somen Banerjee and Jane Milligan of NHS East London and
the City; Bill Williams, Manager and Dr Ruma Bose, Consultant Psychologist from Child and
Adolescent Mental Health Services (CAMHS) and Kay
Riley, Chief Nurse, Barts and The
London NHS Trust, Sarah Mussenden,
Director of Finance, Barts and The
London NHS Trust and Mark Mann, Head of External Communications,
Barts and The London NHS Trust,
who had been invited to present reports to the Panel.
At the Chair’s request, all in
attendance introduced themselves.
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1. |
APOLOGIES FOR ABSENCE
To receive any apologies for
absence.
Minutes:
No apologies for absence were received.
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2. |
DECLARATIONS OF INTEREST PDF 48 KB
To note any declarations of
interest made by Members, including those restricting Members from
voting on the questions detailed in Section 106 of the Local
Government Finance Act, 1992. See
attached note from the Chief Executive.
Minutes:
No declarations of personal or prejudicial
interest were made.
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3. |
UNRESTRICTED MINUTES PDF 77 KB
To confirm as a correct record
of the proceedings the unrestricted minutes of the ordinary meeting
of Health Scrutiny Panel held on 26th July
2011.
Minutes:
The Chair MOVED and
It was agreed that the minutes of the meeting
of the Panel held on 26 July 2011 be agreed as a correct record and
signed by the Chair.
In regard to minute 4.2 resolution 1, Members
enquired whether monthly detailed performance report made to
Barts and the London NHS Trust had been
provided to the Senior Strategy, Performance and Support
Officer. The Panel was informed that
the report had yet to be supplied but this would be followed up by
the officer.
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4. |
REPORTS FOR CONSIDERATION
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4.1 |
Joint Strategic Needs Assessment – Presentation by Public Health PDF 47 KB
Additional documents:
Minutes:
Dr Banerjee, assisted by
Jane Milligan, gave a presentation summarising the key findings at
sections 4 and 5 of the JNSA report in the categories of
population, social determinants of health, and health and wellbeing
throughout the course of someone’s life
Dr Banerjee highlighted
the following matters:
- The needs identified had not changed since the last JSNA,
however, given the Government’s drive for economies to be
made, there would be less money available to meet these
needs.
- The Community Plan was the route through which needs would be
addressed and it was therefore necessary that this be reviewed
regularly to ensure that provision remained reactive to the
demography of the area.
- Resources were being channelled through locality based
strategies therefore it was important to take advantage of these
opportunities offered by these.
- There were lower local levels of cognitive development in Tower
Hamlets compared to the national average. Noting Marmot’s
conclusions on the effects of child poverty on development Dr
Banerjee highlighted that prioritising
early years was critical for future health and
well-being.
- Marmot’s recommendation to extend the role of schools in
supporting families.
Dr Banerjee summarised
that there was progress to be made in terms of embedding healthy
lifestyles and around targeting.
In response to questions from the Panel, the
following information was provided:
- The Council could help strengthen partnership working by
promoting working between agencies involved in children's health
and well-being, children’s social care and
schools. The Children and Families
Partnership
was a partnership whose role was to consider matters
relating to children and worked closely with different service
elements. Schools and children centres
were a focal point in developing the Children’s Health and
Well-Being strategy.
- Improving the Health and Well-Being strategy was key to improving outcomes as each component of the
partnership could only do so much on its own. Improvements could also be achieved by better
engagement of suppliers.
- Patterns of hazardous drinking did not correlate with
circumstances of social deprivation.
- The data presented at page 31 of the report which outlined the
proportion of total budget spent on adult social care was more than
one-year-old. Areas of underinvestment
had been addressed since these data had been published. In addition
members were asked to note that there was higher than average spend on home care services and that this
service was still provided free to residents of the borough
presently.
- GPs had annually refreshed finance packages they were able to
use to promote health strategies for healthy lifestyle choice
advice to clients.
- Observed rates of dementia under-diagnosis were the result of a
combination of late presentation and under diagnosis. Therefore services were looking to campaigns to
get people to seek help early and in this respect more work could
be done at primary care level.
- “Carers” were not well defined in society and
therefore much more care took place in the community than was
formally recognised.
- Pharmacies had under-used resources.
This was not well explored in the JSNA but was a useful area that
could ...
view the full minutes text for item 4.1
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4.2 |
Child and Adolescent Mental Health Services PDF 39 KB
Additional documents:
Minutes:
Bill Williams General Manager and Dr Ruma Bose, Consultant Psychiatrist, Child and
Adolescent Mental Health Services (CAMHS) presented the report circulated agenda item 4.2
which provided a summary of how the issues of demographics,
partnership working, demand and capacity, the referral system and
accountability in governance is related to CAHMS.
In response to questions from the Panel, the
following information was provided:
- Adult mental health services supported those over 18 years
whilst CAHMS dealt with referrals up to age 18. The transition
between youth and adults provision might not be seamless as a gap
could occur where referrals were made around age 17.
- Public engagement in performance monitoring was achieved through
regular user forums. There had been consultation on the structural
changes recently implemented and the service operated a robust
complaints mechanism. It was the
General Manager’s view therefore that strong attention was
given to feedback.
- A client consultation would be undertaken where referrals to
CAHMS were made by teachers. An
educational psychologist would also be involved prior to a CAHMS
referral.
- Carer support work, in the main, was family based. Parents were directed to support groups to enable
direct contact and support to be given to families. In addition there was access to bilingual
co-workers.
- Most concerns for the CAHMS service arising from necessary cuts
in funding were that efficiencies had already been made and had
been achieved without staff losses.
However should more efficiencies be required, this might result in
a reduction in clinicians and therefore reduced capacity. Should
this occur, it would then be necessary to apply tighter thresholds
to the service that will be delivered.
RESOLVED
That the report to be noted.
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4.3 |
Proposed merger of Barts and the London, Newham and Whipps Cross PDF 45 KB
Additional documents:
Minutes:
A
presentation was given by Kay Riley, Chief Nurse, Barts and The London NHS Trust, Sarah Mussenden, Director of Finance, Barts and The London NHS Trust and Mark Mann, Head
of External Communications, Barts and
The London NHS Trust to update the Panel on what had happened in
the last few months in relation to the proposed merger of
Barts and The London, Newham and
Whipps Cross Hospitals and provide an
overview of the planning process. The
merger team highlighted the key areas emerging through the
development of the full business case, the key challenges and risks
and the journey ahead.
In response to questions from the Panel, the
following information was provided:
- The main motivators for the change to provision were, patient
benefits, financial challenge, service transformation that could be
achieved for East London and a financial position that would enable
Whipps Cross and Newham hospitals to
determine their own future.
- The executive team believed in the proposals and the clinical
groups were looking at strategies therefore they did not feel that
it had been oversold.
- Most of the best performing health organisations were foundation
trusts and these models had achieved throughout the England and
Wales.
- The hospitals’ continued accessibility was not in question
as at present the only changes proposed were in the structure of
the Trust. Additionally the business
case for the merger had been built on the basis of no change to
services.
- The first stakeholder event had dealt with general matters
following which stakeholders had raised a number of
issues. The forthcoming stakeholder
event was intended to be more specific and would answer concerns
that had been raised at the first event.
- It was not intended that there should be increased back-office
costs. There would be costs around
integrating IT; these had been factored in and would be
transitional. Additionally to save back
office costs, the new Trust Board was looking at linking existing
IT systems rather than purchasing a new one. Following this it was anticipated that there would
be savings in back office functions through economies of
scale.
- A Panel Member was concerned that transport links across the
three sites would be insufficient and asked the Trust Board to
engage with Transport for London to explore how integrated
transport links could be achieved. Kay
Riley, Chief Nurse, Barts and The
London NHS Trust acknowledged that transport links were issues for
staff as well as patients
The Chair agreed to write a letter to Transport for
London raising this matter.
Action:
Councillor Rachel Saunders
- A draft engagement strategy had been developed utilising all
opportunities to engage. The Trust
Representatives agreed to work with the THINks to ensure that engagement was appropriately
targeted.
- Regarding possible changes to doctors working arrangements to
enable 24/7 cover, joint rosters were already in operation and that
this would be further worked on to incorporate out of hours
cover. It was noted that the financial
advantage of avoiding costs of bringing up the levels of
Whipps Cross and ...
view the full minutes text for item 4.3
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5. |
ANY OTHER BUSINESS WHICH THE CHAIR CONSIDERS TO BE URGENT
Minutes:
The Chair discussed forthcoming business and
requested that the Panel’s meeting in January include the
following items:
- Budget proposals
- Feedback on Health and Well-Being Board - challenge
session
- Budget strategy - how health is delivered going
forward
- Councillor event with the merger team - challenge
session
- a high-level strategy on commissioning sexual health
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