Appointment of Chair

The Clerk opened the meeting and asked for nominations for a Chair for the meeting.  The Clerk explained that the Chair’s appointment would last for the duration of the meeting and not for the remaining meetings in the 2017/18 municipal year.  It was noted that the Overview and Scrutiny Committee would appoint a permanent Chair at its next meeting on 20 July 2017.

Councillor Jones moved that Councillor Clare Harrisson be appointed Chair of the Health Scrutiny Sub-Committee.  The motion was seconded by Councillor Chesterton. 

There being no further nominations, it was resolved that Councillor Clare Harrisson be appointed Chair of the Health Scrutiny Sub-Committee.

Appointment of Vice-Chair

The Chair asked for nominations for a Vice-Chair of the Health Scrutiny Sub-Committee for this meeting and the remaining meetings in the 2017/18 municipal year. 

Councillor Jones moved that Councillor Dave Chesterton be appointed Vice-Chair of the Health Scrutiny Sub-Committee.  The motion was seconded by the Chair. 

There being no further nominations, it was resolved that Councillor Dave Chesterton be appointed Vice-Chair of the Health Scrutiny Sub-Committee.

Appointment of Inner North East London Joint Health and Scrutiny Committee (INEL JHOSC) Members

The Chair asked for nominations for 3 Member representatives (2 Labour and 1 Independent Group) for the remaining meetings of INEL JHOSC, for the 2017/18 municipal year.

Councillor Jones moved that Councillor Clare Harrisson be appointed as a Member representative on the INEL JHOSC.  The motion was seconded by Councillor Chesterton.

It was resolved that Councillor Clare Harrisson be appointed as a Member representative on INEL JHOSC.

The Chair moved that Councillor Sharia Khatun be appointed as a Member representative on the INEL JHOSC.  The motion was seconded by Councillor Jones.

It was resolved that Councillor Sharia Khatun be appointed as a Member representative for INEL JHOSC.

The Chair moved that Councillor Muhammad Ansar Mustaquim be appointed as a Member representative on the INEL JHOSC.  The motion was seconded by Councillor Chesterton.

It was resolved that Councillor Muhammad Ansar Mustaquim be appointed as a Member representative for INEL JHOSC.

Apologies for absence were received from:

(i)         Councillor Shiria Khatun, for whom Councillor Denise Jones was substitute Member; and

(ii)        Councillor Abdul Asad.

There were no declarations of interest.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Panel held on 14 March 2017.

The minutes were agreed and there were no matters arising.

The Committee agreed to note the Health Scrutiny Sub-Committees terms of reference, quorum, membership and dates of future meetings as set out in appendices 1, 2 and 3 of the report.  The Committee also noted that the Health Scrutiny Sub-Committee, scheduled for 9 October 2017 had been rearranged and that the date was to be confirmed. 

Jackie Sullivan, Director at Royal London Hospital at Barts Health, together with Sarah Jenson – Chief Information Officer at Barts Health, provided a presentation on the cyber attack which took place on 12 May 2017 at the NHS Trust.   The presentation covered the following points:

·         That the virus was initially discovered in the x-ray machine, followed by more calls received indicating that PCs were also defective.

·         Newham was the first site, within Barts Health, to be affected.

·         A decision was made to shut down all technology to protect neighbouring providers and NHS systems.

·         Work undertaken to segregate networks and to schedule engineer visits.

·         Service areas within Barts Health were prioritised, for example, restoring the stroke and heart centres were first priority.

·         The difficulty presented by the high level of media scrutiny and presence. 

·         Systems were largely restored by 24 May 2017.  Since that date significant work was undertaken on recovery plans.

·         The fact that the cyber attack was treated as a London-wide major incident, as when trauma centres were closed, increased pressure was put on other trauma centres.

·         There were 120 in-patient cancellations, which all would be re-booked and seen before the end of July 2017.

·         The fact that imaging was an area of concern as, since the attack, waiting times had increased from 6 weeks to 12 weeks.

·         That the NHS Trust was vulnerable to the cyber attack due to a Microsoft Windows vulnerability as all medical equipment ran on a Windows operating system. 

Members then asked questions on points of detail.

The Chair asked what arrangements had been put in place to provide protection from such attacks in the future.  Ms Jenson said that there was no guarantee that such an incident would not occur again, nor that the anti-virus protection would release a security to prevent future similar incidents.  She also stated that it was unknown whether the NHS Trust would recover more quickly from such incidents in the future.  She added that relevant staff were looking into how the Trust could recover more quickly in the future.  Ms Sullivan referred to the many positives, including the innovative workarounds that allowed staff to provide a service, such as burning discs in order to view images and the improved performance of many staff members – as there were no computers, staff had to verbally communicate with each other.  She added that the Trust had learnt from the experience and referred to the Trust’s absolute commitment to patient care.  She referred to a Harm Review which was being undertaken to ensure that the incident had not indirectly caused harm to any patients.

Councillor Chesterton asked whether there were significant financial costs as a result of the attack.  Ms Jenson confirmed that the exact costs were still being calculated.  She added that the Trust had needed specialist helps with some areas, which was expensive.  Councillor Chesterton asked that when the calculations were complete that they were fed back to the Committee as it was important to know the financial consequences  ...  view the full minutes text for item 7.

The Chair introduced the paper which provided a report and recommendations of the Health Scrutiny Sub-Committee’s review of the LBTH Reablement Service.  She said that she could see the value of the service to the Council and pointed out that there were areas for improvement, including:

·         Patients’ discharge and relationship with the hospital

·         Communications and scrutiny

·         Wider partners

Mr Burbidge expressed concerns that the Older People’s Reference Group were not aware of the reablement service and were not able to provide observations on the service.  He also sought reassurance that if the Better Care Fund was taken away that funding would still be available for the reablement service.

Paul Swindells, Reablement Team Manager, stated that one of the main themes in the recommendations was how they engage with service users.  He pointed out that, as an adult social care service, they hadn’t engaged with users as effectively as they should have.  He added that they were now considering how to acquire meaningful feedback. 

Mr Swindells explained that other main themes in the recommendations referred to the need to engage more with partners, including partners not associated with health and how to spread the word about the reablement service.  He said that feedback indicated that people viewed reablement in a negative way and that there were misunderstandings about the service’s purpose.

Ms Sullivan acknowledged that discharge practices could be improved and stated that patient reviews were regularly undertaken.  She said that conversations were happening with the Director of Nursing in relation to when it is appropriate to discharge a patient and said that at present, they were trying to discharge before noon. 

Councillor Chesterton referred to blister medical packs and the fact that it was difficult to assign responsibility to put them together.  He suggested the possibility of volunteers at the hospital making up blister packs.  Ms Sullivan responded that she would look into the issue but took the view that it was unlikely that pharmacists would be comfortable with volunteers dealing with medication. 

Tim Oliver, a representative from Healthwatch Tower Hamlets, asked about the possibility of, after being discharged discharge, the patient’s prescription being sent straight to the pharmacy as this might free up some time for the hospital.  Mr Hall and Ms Sullivan agreed to take the suggestion away for further discussion.

Denise Radley, Corporate Director, Health, Adults & Community said that the work completed around ‘Ageing Well’ which could be used going forward.  She explained the funding for the reablement service was not a typical arrangement.  She added that the core service was adult social care and that needed to be considered as things prpgressed.

The Health Scrutiny Sub-Committee agreed to note the report and recommendations. 

The Chair introduced the report which provided an overview of the key issues raised at previous Health Scrutiny Sub-Committee meetings, the response of services to meeting the identified challenges and the recommendations put forward by the committee for consideration. 

Mr Burbidge referred to a consultation on CIL funding which had a bearing on health centres and GP centres.  He stated that, in his view, the consultation failed to make clear what suggestions they were looking for from the public.  He suggested that the committee look at the consultation and whether it was fit for purpose. 

Mr Burbidge also referred to sthe fact that a Health and Wellbeing Centre was recommended to be located in the new civic centre.  Ms Radley confirmed that it was likely that the centre would be funded through section 106 finances and confirmed that it was an opportunity to reflect the Council’s health and wellbeing priorities.

Councillor Chesterton expressed concerns that the independent mental health service in the Accident and Emergency department had its funding cut.  He described it as a good service that was doing very well.  Ms Radley confirmed that she was not aware that the funding had been cut and provided assurances that she would investigate further. 

The Chair referred to street triage and the fact that many using the service had wider mental health implications.  Mr Hall explained that many actions were for the CCG, but they were not in charge of them.  He added that the CCG were reviewing services that operated outside of Primary Care.

The Health Scrutiny Sub-Committee noted the report and recommendations. 

The Chair stated that the following changes were proposed to the work programme:

·         To move the mini-scrutiny session on new migrants and homelessness and to have the issue of safeguarding considered at a stand-alone session to enable the issues to be given due time and consideration. 

·         To have a scrutiny session on loneliness and wellbeing – possibly in the autumn.

Councillor Chesterton asked who might be involved in the scrutiny session and the Chair responded that people who had newly arrived in the country as well as organisations that work directly within the cohort the committee would be discussing were good examples.

Mr Burbidge confirmed that there was a crisis around homelessness on Commercial Street and that shelters were being provided.  He suggested it would be appropriate for the committee to follow up on the work they had Healthwatch had done.  The Chair asked if the report on the work completed could be circulated to the Committee. 

Mr Burbidge also referred to a report entitled ‘How is my Voice Heard?’ which detailed how organisations liaise with homelessness people and how they respond to public voice.[AJ1] 

The Chair then suggested:

·         an update paper on the maternity unit be reported to the next Health and Scrutiny Sub-Committee in October 2017.

·         That the Health Scrutiny Sub-Committee and the Housing Scrutiny Sub-Committee undertake joint work on the Grenfell tower block fire. 

There was no urgent business.