To receive any apologies for absence.

An apology for absence was received from Councillor Dr Emma Jones. An apology for absence was also received from David Burbridge.

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.

No declarations of personal or prejudicial interest were made.

To confirm as a correct record of the proceedings the unrestricted minutes of the ordinary meeting of Health Scrutiny Panel held on 24^th January 2012.

The Chair MOVED and

It was agreed that the minutes of the meeting of the Panel held on 24^th January 2012 be agreed as a correct record and signed by the Chair.

Matters arising

Page 4 – second paragraph: with regards to matters arising, Councillor Lesley Pavitt asked if there had been any further developments on press coverage about orthopaedic surgeon resignations and if the vacant positions had been filled. Robert Driver, Strategy Policy and Performance Officer, said he would follow this up and report back to the Panel.

Page 5 – fourth bullet point: with regards to the work of the Health and Wellbeing Board in developing a strategy, Councillor Lesley Pavitt wished to know what the Council’s plan was to link into the strategy. Mr Driver promised to look into it and report back to the Panel.

Members also requested feedback to respondents with regards to the Health Event at Burdett. Furthermore, they asked that an update letter be sent to the Barts NHS Trust about GUM clinics.

To receive a verbal update from the Barts Health NHS Trust on the ongoing merger and Quality Accounts for 2011-12.

Steve Ryan, Medical Director and ?? from the Barts Health NHS Trust introduced the report.

Mr ?? gave a brief introduction on the ongoing merger and outlined the following points for the Panel:

• Two appointments are to be made to the Exectutive team and are in the process of making appontments to the full structures in the Corporate functions and Service Groups being created across the system;
• Currently managing new Trust through three units of management;
• Have started new and encouraging dialogue with ELK and new commissioning groups emerging in the East London area.

Mr Ryan tabled a Powerpoint presentation and highlighted the following points:

Looking back

• Can report significant progress in improving quality and safety; although trajectory set had not been achieved, infection rates were reducing;
• The Trust is second in the country for low mortality rate and it strived to maintain this record;
• Have implemented recent changes to ensure safer medical cover at night and the Executive agreed to resource an additional five neo-natal members of staff due to safety concerns raised;
• In-patient survey – made progress in 8 areas, but there was still room for improvement;
• Community Services and Neo-intensive out-patients show satisfaction levels were rising;
• Accommodation breaches no longer occured as a result of the new buld at the Royal London hospital;
• Nutrition – matrix report to Board every month who in turn refularly monitor the figures;
• Rated by the Department of Health as “perfoming”;
• Cardiac, Stroke and Chest units show excellent results.

Going forward

• The aim was to keep patients better informed about their care and treatment, not just during their hospital admission, but before and post admission;
• Staff very keen to get timely feedback on their issues and concerns – currently have good reporting lines, however, the Trust need to ensure that staff are kept informed about action to be taken by the Trust;
• One of the tangible objectives that the Trust hoped to achieve was the cessation of smoking – a new Assistant Medical Director was to be appointed and his remit would be Public Health;
• Aim was to be capable of delivering compassionate care.

Mr ?? made the following additional comments:

There were three base line issues to note –

1.                  feedback to staff;

2.                  service improvements;

3.                  administration of patient scheduling.

Following questions raised by Members, the following points emerged:

• The Chair questioned how a big organisation like the Barts NHS Trust managed to stay responsive to the people of Tower Hamlets, ongoing concern. Mr ?? stated that the Trust’s objective was to deliver a health care system which delivered a consistent standard, the “Barts Standard” across the board. There was a need to tailor services according to local conditions
• Population health – further room for improving or contributing;
• Community health services – three areas of focus for 2012/13:

1.   The frail elderly-care;

2.   Care of the dying;

3.   Children Services and how these integrate into a seamless local experience.

• GUM services – there was still uncertainty as  ...  view the full minutes text for item 4.1

To receive a verbal update from the Tower Hamlets Involvement Network (THINk)

Deborah Cohen ??

How engaged was the Barts NHS Trust with the workings of the Health and Wellbeing Board Engagement Sub-Group? Concern that there needs to be more integration across the board. In response, Mr ?? stated they first needed clarity around partnership working and delivery mechanisms to achieve the stated objectives.

Mr Ryan added that the Trust needed to revisit frail, elderly care as this was a drain on resources. It also made sense to provide support to people living in their own homes and communities. The Trust is keen to have a proper debate on the issue with a view to making it happen.

Following questions from ?? partners and Members, the following points were outlined:

Diane Barham, THINk Director expressed some concern about the outbreak of the new MRSA bug and five “never events” at the Royal London in the last six months. In response, Mr Ryan explained that the “never events” which included dental work such as tooth extractions, were unfortunate but the Trust intended to eradicate these.

Members made some observations and the following points were made:

• One Member fed back some positive feedback from the community about the Accident Unit which was described as having a very peaceful environment. However, at the other end of the spectrum, one resident had complained about very poor standard of care that had been received at the Royal London hospital. It therefore appeared that there was still a lot of work to be done on a basic level. Officers from the Trust agreed that there was still room for improvement;
• Mr ?? clarified that more than 95% of patients were seen in less than 4 hours. The Royal London currently had the best response times in A & E in London. Mr Ryan further added that co-creation and joint working was imperative. Currently planning to design the role of Public Health so it had an impact the workforce [making staff ambassadors for health] and impact on patients.

Anna ?? expressed some concern about appointments and follow-up times in General Practice as approximately 20% of patients “get lost in the system” and fail to receive follow up appointments for instance. The risks associated witht this where patients suffer from serious ailments should not be overlooked. Also had concerns about the numbers of community staff and the lack of a joined up approach at hospital level, particularly when one patient needs to see different Consultants from different specialisms in the same hospital. Ms also commented that advocacy and interpretation services had been affected due to cuts and these services were badly needed for patients. Mr ?? stated that a consistent, swift and holistic approach to patient care was always preferred.

Mr Ryan further pointed out that the extra beds removed were superfluous to requirements and therefore represented a saving on resources.

Dianne Barham ?? tabled a “Health Community” document and introduced the report. She explained how THINk tried to engage with a healthy community and outlined the following points:

• The aim was to motivate and incentivise residents to have a better and healthier community, and ensure that local people were commissioning local services;
• Need to identify community needs and aspirations
• Aiming for two health watchers from each network, a total of 16 across the borough;
• Wish to build on knowledge that had already been acquired and information gathered during this process would be added to the repository of information – attention will be focused where there was a lack of knowledge.

The Chair thanked the officer for the presentation and requested that members feed their comments back to Robert Driver which would form part of the formal feedback. She referred to the tabled document “Consultation and service user engagement by Adult Health and Wellbeing” and summarised the salient points as follows:

• There were clear points at which service users can make an impact on the decision-making process with regards to social care;
• Would need to speak directly with service user groups at some point in the future;
• Welcomed the idea of developing a pool of health watchers;
• The role of the Health Scrutiny Panel was crucial in complementing the work of the Health and Wellbeing Board [HWB];
• Members’ enquiries – this was another useful way of ensuring the views of local residents are fed back to the Adult Social Care team

Anna ?? added that it would be helpful to have an inclusive approach. It was also important for the strategy to have a sustainability element to it. she however had some apprehension however about how much power the HWB had.

The Chair also voiced her concerns about her input on the HWB. As Chair of the Health Scrutiny Panel [HSP], her attendance is required at the HWB, though she had not been made to feel very welcome. The Panel therefore sought some clarification on the relation between the HWP and the HSP.

The report was noted.