Members are reminded to consider the categories of interest in the Code of Conduct for Members to determine whether they have an interest in any agenda item and any action they should take. For further details, please see the attached note from the Monitoring Officer.

Members are reminded to declare the nature of the interest and the agenda item it relates to. Please note that ultimately it’s the Members’ responsibility to declare any interests and to update their register of interest form as required by the Code.

If in doubt as to the nature of your interest, you are advised to seek advice prior to the meeting by contacting the Monitoring Officer or Democratic Services

There were no declarations of disclosable pecuniary interest, however, Assan Ali disclosed that his wife works for Adult Social Care.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Panel held on 17 October 2023.

The minutes of the Sub-committee meeting held on 12 October 2023 were approved and signed by the Chair as a correct record of proceedings.

Chair’s Update

The Chair;

-       Noted that a written response from ICB has now been received regarding a 30% reduction of NEL ICB budget and the implications for Tower Hamlets. Full details can be found in the action log.

-       Reminded members that physical attendance to meetings is expected and that confirmation should be made to the Chair and clerk in writing when meeting invitations are received.

Angela Wong, Divisional Director, for Allied Health Diagnostics, BARTS Health NHS Trust and Nabeel Hussain, Programme Director Community Diagnostics Centre, BARTS Health NHS Trust, updated the sub-committee on the current diagnostic service levels in borough, including referrals, accessibility, affordability, quality of healthcare, outreach strategy and local partnerships. 

The sub-committee were informed that the service was heavily impacted by the pandemic and waiting times were high. Collaboration with both Royal London and Newham Hospitals has facilitated clearing the backlog and Mile End will in turn assist Homerton University Hospital. £1.5 million has been invested into Cancer Diagnostics Centres (CDC) until 2025. MRI performance was initially at 32% and CT at approximately 41%. This has now risen to around 95% for MRI and 99% for CT services.

Nabeel Husain then explained that between April and October this year, the CDC has delivered more than 700 MRI’s and CT scans, over 6,000 X-rays and more than 5,000 ultra sounds. This equates to 25,000 new patients seen over a seven month period. A new Thames Ward renovation to house MRI, CT and Ultra sound equipment is ongoing, scheduled to open next year.

Patient feedback has been pivotal in ensuring a calm environment whilst scans are undertaken. The introduction of  access to patients being offered same day multiple diagnostics and flexible appointments and weekend availability has added to the positive feedback received.

Further to  questions from the sub-committee, Angela Wong and Nabeel Hussain;

·       Explained that the service is available seven days a week from 8am to 8pm, to enable patients to visit after working hours. GP discussions are ongoing to ensure the services are promoted to residents, including the multi diagnostics service.

·       Clarified that the programme initially saw around 32% of patients having MRI scans in six weeks, this has now risen to 99%. CT scans or MRI’s can now be given in two weeks or even sooner.

·       Conceded that patients were concerned with the lack of wi-fi availability. This is now being rectified by re-routes in the majority of areas throughout the site. More seating and better décor has now been provided to enhance the settings.

·       Noted that an admin ‘daily huddle’ takes place to take video calls to assess if patients are willing to come in at short notice to fill cancelled appointments by others.

·       Confirmed that recruitment plans for the CDC service are in progress to assist in appointments and support patients accessing the service.

RESOLVED that;

1.    The presentation be noted.

The Sub-committee heard from two residents from the same family with learning difficulties. They both gave lived experiences of poor service received from healthcare professionals. They stated that Autism is a spectrum disorder that impairs cognition, and reasonable adjustments are not made when trying to access services. Some healthcare professionals and reception staff do not slow down speech, clarify points nor allow time for residents to comprehend information or answer questions. There are times when staff become impatient and raise their voice. This will exacerbate symptoms and cause unnecessary anxiety for the resident, as appointments can no longer be made online.

Real, Tower Hamlets' largest Disabled People's Organisation, assisted in changing GP's to resolve issues. However, further complications arose when trying to obtain wheelchair access for their mother, which took 9 months to resolve. Access to the GP was not provided and messages were not initially returned. When the GP did call, they were rude and  unprofessional, leaving the patient feeling frightened. Hospital staff can also be unsympathetic in writing down appointment times and explaining processes clearly. Assistance was provided from a temporary support worker, although this took three months to resolve.

Members were also informed that waiting lists for counselling appointments are high, which leads to further anxiety. Healthcare professionals were reminded that disabilities are not always visible and consideration should be made for patients to choose GP’s. Allowances should be made to hold double appointments in person, and reception staff should also be trained to show more empathy towards patients as they are front line staff.

The Chair thanked the residents for their feedback and introduced Jo-Ann Sheldon, Head of Primary Care Commissiong and Dr Roberto Tamsanguan, Clinical Director, Primary Care to give an overview on health service improvement plans for disabled residents.

Primary Care Presentation

Ms Sheldon updated the sub-committee on the Care Quality Commission's (CQC) nine GP requirements to receive a satisfactory rating. Practices are inspected  every five years and details of the Disability Discrimination Act 1995, which mandates all practices to make reasonable adjustments to provide access for disabled residents were outlined. New buildings all conform to the Act and there are plans to refurbish older sites. All practices can apply for a London Improvement grant, although funding is limited.

Members were informed of the systems in place to address patients' needs, particularly the portal which provides information for North East London (NEL) practices to best support patients, medical information systems and reasonable adjustment flags. The Universal Care Plans (UCP) are also available, to ensure residents with learning disabilities receive full support in order to navigate the process, and a clinical lead is also on hand to give further advice.

All borough practices have a digitally excluded patient policy, reviewed annually and letters with leaflets are sent to residents over the age of 14. These are co-produced with young people, informing them how to access care services. Details include a culturally appropriate tool kit and a QR code to easily access information.

Ms Sheldon then  ...  view the full minutes text for item 3.2

Councillor Gulam Kibria Choudhury, Cabinet Member for Health, Wellbeing and Social Care, introduced Ben Gladstone, Interim Deputy Director for Aging Well, who gave an overview of the proposal and the Adult Social Care (ASC) strategy, designed to support residents to stay in their own homes, or provide specialist housing with care facilities if required.

Mr Gladstone informed the sub-committee that the borough population is predicted to increase in the next 10 years. Current figures show 15% in 2033 rising to around 54% by 2033,  which is over the national average, adding more pressure to ASC services. The Social Care Institute of Excellence has recommended an increase in the current capacity of 214 flats with 240 housing with care facilities. Due to a lack of housing provision, high land prices and space in the borough, approximately half the residents requiring residential care or care home must be relocated outside the borough, often times against their wishes.

Details of current provision includes around 2000 people supported with home care, 9 supported living facilities for residents with learning disabilities,14 mental health facilities,six older adult focused care homes and two nursing homes.

Findings from the strategy include a need for more nursing care home beds for patients with complex needs and more supported living provision for those with learning disabilities or mental health concerns. Members were told that an expression of interest will be made for the ‘Accelerated Reform Fund’ from the Department of Health and Social Care next month. This is to grow the ‘Shared Lives’ scheme to support adults with learning disabilities by matching them with an approved carer.

Details of the housing, tenure and types of support were given, and Members were informed that extra care housing is the preferred method rather than residential care, as residents are tenants with housing rights as opposed to occupancy agreements.

The proposed units will have a dementia and disability-friendly scheme and will provide culturally specific homes, such as the Somali Gardens scheme, which is cantered on ethnic minority. The proposal  also includes more structured partnerships with housing providers to ensure the housing needs for the next 10 years are addressed. Currently, six of the borough's care homes are privately owned, which makes it difficult to control the quality and cost.

Mr Gladstone noted that an annual delivery plan will run alongside the strategy, a delivery group has been formed to focus on feasible locations for specialist housing development,  and discussions with NEL commissioning to share intelligence are ongoing. The strategy will request Cabinet implement the annual delivery plan in conjunction with the capital projects priorities.

Further to  questions from the sub-committee, Ben Gladstone;

·       Clarified that the aim is to support residents who have complex care needs within the proposed care facilities, so they do not have to move into a nursing home. This will increase the range of options for older people in the borough and decrease the rate of residents having to move out of Tower Hamlets.

RESOLVED that;

1.    The presentation  ...  view the full minutes text for item 3.3

The Chair reminded members of the site visit scheduled for 15th  January 2024 to Independent East, at the PDC in Bethnal Green. Members were urged to confirm attendance upon invitation.

Members were also informed of an upcoming scrutiny review on improving disabled residents access to leisure and exercise. The Chair advised that officers would send out invites as part of the policy development workstream and encouraged participation.