Agenda and minutes
Venue: Room C1, 1st Floor, Town Hall, Mulberry Place, 5 Clove Crescent, London, E14 2BG
Contact: Alan Ingram, Democratic Services Tel: 020 7364 0842, E-mail: alan.ingram@towerhamlets.gov.uk
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APOLOGIES FOR ABSENCE To receive any apologies for absence. Minutes: Apologies for absence were submitted on behalf of Dr Amjad Rahi, Co-opted Member.
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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: There were no declarations of Disclosable Pecuniary Interest.
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UNRESTRICTED MINUTES PDF 82 KB To confirm as a correct record of the proceedings the unrestricted minutes of the ordinary meeting of Health Scrutiny Panel held on 11 June 2013.
Minutes: RESOLVED
That the unrestricted minutes of the meeting of the Panel held on 11 June 2013 be agreed as a correct record of the proceedings.
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REPORTS FOR CONSIDERATION Minutes: Following introductions of those present, the Chair indicated that agenda item 4.3 would be considered as next business after item 4.1. However, these minutes reflect the original agenda order, for ease of reference.
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Barts Health NHS Trust - Update on Financial Turnaround PDF 106 KB Minutes: Michael Pantlin introduced the presentation, as included in the previously circulated agenda, and commented that Barts Health NHS Trust faced financial challenges in order to achieve £78m savings by 31 March 2014. This had been further compounded by the merger of trusts over the past year. The Board of Barts recognised that there had been a slow start to the year, meaning that there was a current £24m year to date deficit but it was expected that the balance would be delivered by the due date.
He stressed that there had been no change in the Trust’s health care mission to change and improve lives in East London and Barts Turnaround was being developed as a whole organisation effort to accelerate the development and delivery of safe cost improvements, never losing focus on quality. The Turnaround encompassed 10 main principles, with patient safety being paramount, and care improvement plans to achieve £55.7m savings, designed from the bottom up, with rigorous quality assessment and peer review mechanisms.
Proper bill coding was very important, as the Trust was now paid on the basis of services delivered, rather than a block payment.
The CQC report on Whipps Cross hospital had been disappointing, with three warning notices having been issued, and action plans were in place to address the areas of concern, which related to infection control in the maternity unit; safety and suitability of equipment in the maternity unit; staff appraisals and supervision in the elderly care service. The Chief Hospital Inspector would review the action plans in November 2013.
The Turnaround also aimed at reducing the length of patients’ stay in hospital, which reduced costs and improved the patient experience. A further initiative, #becausewecare, was a call for all staff to commit to improving compassionate care and be welcoming to patients.
The Chair then invited questions from those present and the Barts representatives made responses that: · Care improvement plans were supported by clinical leads, who worked with CIP teams on a sometimes cross-services and cross-sites basis. · They were confident of achieving the required savings by March 2014 and each proposal was rated on how competent the organisation was in safety and deliverability. All proposals were subject to very rigorous assessment and there were some 1700 such schemes in progress. · It was anticipated that the Chief Hospital Inspector’s report on Whipps Cross would be received by Christmas 2013, following which an action plan would be developed. · Over the past year, clinically-led schemes relating to procurement had achieved substantial recurrent savings. Savings would also be achieved by getting people home from hospital as soon as possible, as long as this was a safe and effective course of action. · It was not considered that there was any way to negotiate a reduction in the national tariff efficiency requirement of £50m, as this was set on a national basis. · With regard to possible departmental/site closures, there would be a transformation in how health care was delivered. For instance, stroke care and cardiac ... view the full minutes text for item 4.1 |
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Mental Health Needs Assessment and Strategy Update (TO FOLLOW) PDF 50 KB Additional documents:
Minutes: Deborah Cohen introduced the presentation and Draft mental Health Strategy that had been previously circulated with the supplemental agenda, adding that an updated Strategy document had been tabled at the meeting. The Strategy was being supported by the Health and Wellbeing Board.
Ms Cohen added that it was intended that service users could take control of their own lives and recovery, with a service approach that looked at the whole person. The document also summarised development work that had been undertaken and summarised how the strategy had been organised.
Due to the fact that the Borough had many young people, whose numbers would increase over the next 10 years, it was important to target the mental health of children and young people as a huge number of adults suffering from mental illness had manifested symptoms before the age of 18.
Despite having achieved a national award for dementia services, other older people’s ailments such as depression would not be neglected.
In response to questions from the Panel, Ms Cohen indicated that: · There were very low referral levels from the Bengali community to dementia services. However, this had been addressed through the Alzheimer’s Society and a Sylheti-sepaking dementia café in the East London Mosque. · Elderly people were also affected by overcrowding. Many people did not seek help due to a perceived stigma and discrimination regarding mental health problems, which caused embarrassment. · The next step in the strategy was to produce an action plan and it was hoped to work with other partners using the Council’s influence. · It was important to include schools in the process, as their effect on the mental health of young people was significant and this might be addressed by bringing them into the work of the Health and Wellbeing Board. · The new community teams could be monitored by patient satisfaction surveys and interviews as part of the assessment process. Most dementia care would continue in specialised services and the teams would be looking mainly to address and support depression services. · Small voluntary organisations that wished to be included in the commissioning process but did not have the resources to do so could be helped by using consortium arrangements – as long as a lead organisation had appropriate rigour, this would not need to pass down to all groups included.
The Chair stated that the Draft Strategy seemed to cover all of the main issues and was well though-out and comprehensive. The Panel would continue to do what they could to scrutinise this work.
Ms Cohen asked that Members email her with any other comments they may wish to make. |
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Minutes: John Wardell introduced the presentation as contained in the previously circulated agenda, which comprised an overview of work currently being undertaken to achieve integrated care. He added that the over-arching aim was to allow individual service users to live independently and take more control of their own health care. An added advantage would be the reduction in duplication of systems. He made further comments that:
Paul Larrissey put forward his section of the presentation, stating that weekly meetings were held involving the Council, Barts Health NHS Trust and mental health services, to develop a strategy over the next 3 – 5 years and there was much to achieve. He also indicated that: · The Community Health Service had core services working with similar or same patient groups, including Adult Community Nursing; Community Virtual Ward; CReST short term intervention; Specialist Nurses; Palliative Care Centre; Referral Hub (a single point of access for services). · Phase 1 of the process was moving towards the provision of eight integrated care teams across Tower Hamlets, based on the eight GP networks. It was intended that they would manage all aspects of health for the local population and would include a rapid response element. People would be supported at home to reduce hospital admissions. · A new governance framework was being developed around the teams and the aim was for them to be up and running by the end of 2013. · The current Phase 1 proposal was more like a co-ordinated care approach, with more integration occurring over years two and three. The CHS out-of-hours service was also being co-located with that of the Council.
Mr Wardell added that application was being made to the Department of Health to participate in a pilot programme which might bring in extra IT and contractual support. Interviews in this connection were to be held on 6 September.
In response to questions from the Panel, Mr Larrissey and Mr Wardell stated that: · Some IT solutions were hoped to go live this Autumn and it was intended to move towards more mobile working, whereby real time access to patients’ records could be achieved during home visits. Work was needed to ensure systems compatibility and how to record data. At present there was no common ... view the full minutes text for item 4.3 |
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ANY OTHER BUSINESS WHICH THE CHAIR CONSIDERS TO BE URGENT Minutes: 5.1 Tower Hamlets Health and Wellbeing Board
The Chair expressed concern that there was not yet a properly constituted Health and Wellbeing Board for the Borough, despite the requirement for a statutory board to have been established as from 1 April 2013. This put Government funding in jeopardy and must be addressed. She intended to write to Deborah Cohen to get full details of the situation.
The Chair added that she had previously raised the matter with Mayor Rahman, who had not responded, as he would have to initiate the process of establishing a formal board. She had spoken on the matter with Chief Officers and had also brought up the issue at Cabinet and was now asking Officers to seek advice on how arrangements for the board might be implemented if the Mayor would not proceed.
The Chair felt that the Panel should be provided with Health and Wellbeing Board agendas and asked that the Mayor and Cabinet Lead Member be invited to attend the next meeting of the Panel to discuss the matter, if it remains unresolved by that time
Action by: Deborah Cohen, Service Head Commissioning & Strategy |