Venue: Committee Room 1, 1st Floor, Town Hall, Mulberry Place, 5 Clove Crescent, London, E14 2BG
Contact: Antonella Burgio, Democratic Services
Items
No. |
Item |
1. |
DECLARATIONS OF DISCLOSABLE PECUNIARY INTERESTS PDF 71 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 Monitoring
Officer.
Minutes:
No declarations of interest were made.
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2. |
MINUTES OF THE PREVIOUS MEETING(S) PDF 118 KB
Minutes:
The
minutes of the meeting held on 15 July 2014 were
presented.
RESOLVED
That the minutes of the meeting
held on 15 July 2014 be approved as a correct record of proceedings
without amendment.
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3. |
TO CONSIDER THE START TIME OF FUTURE HEALTH SCRUTINY PANELS DURING THE MUNICIPAL YEAR
Minutes:
The Chair invited members to consider whether
they wished the start time of meetings for the remainder of the
municipal year to be changed to 6.30pm or continue at 7.00pm.
RESOLVED
That the starting time of Health Scrutiny
Panel meetings for the remainder of the municipal year remains at
7.00pm
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4. |
REPORTS FOR CONSIDERATION
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4.1 |
Community Health Services (CHS) review (verbal update)
To receive an update from CCG
Minutes:
The Panel received a verbal report from Dr Sam
Everington Chair of Tower Hamlets CCG
on the review of Community Health Services (CHS). He informed the Panel that the current CHS
contract will expire in September 2015 and the CCG has decided that
it will reset in train the CHS as a result of the need for savings,
concerns about the variability of delivery, service integration and
encourage development of partnerships across services and that
personal care delegations contracts will cross the pathway to
eliminate competition that occurs between acute and primary
care.
In response to Members’ questions, the
following information was provided:
- The scheme was closed to enable
healthcare and services to be to be aligned with the integrated
care vision/ This would provide a
flexible approach and better working together in order to deliver
appropriate care to patients at each stage of their
indisposition.
- The contract at Barts had been extended to March 2016
- The revised CHS would deliver its
services at no extra cost and the new model would be different to
previous ones. Barts presently provided much support to CHS and
would take on wider responsibility for the patient journey.
- Better communication and
interconnectivity would provide a solution to previous issues
concerning patients that were discharged from hospital but did not
have assistance at home through data sharing, discharge planning
and 7-day working to provide necessary support.
RESOLVED
That the report be
noted.
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4.2 |
Transforming Services, Changing Lives PDF 135 KB
To receive a report and presentation from
TSCL.
Additional documents:
Minutes:
The Panel received a presentation from Neil
Kennet-Brown, Programme Director, Transformational Change NEL
Commissioning Support Unit on the Transforming Services, Changing
Lives programme and Dr Sam Everington,
provided supplementary information to the report at agenda item
4.2.
The Panel was informed that:
- The programme’s scope was
broad involving Acute Trusts, Community Mental Health Trust, East
London Tri-borough and neighbouring CCGs and local authorities.
- The purpose was to meet future
demand with the aim of achieving great health and health outcomes
for East London. A work programme had
been created and had begun to identify work that was required to be
done.
- Further reports would be made as the
programme progressed.
- The population increase anticipated
in the forthcoming 20 years has highlighted financial and staffing
pressures therefore it would be necessary to consider how
healthcare could be delivered, ensure consistency of services and
design new kinds of services such as virtual access services.
- Access to new kinds of service would
enable more effective outpatients’ style service delivery,
encourage patients to take control and work in partnership to
deliver their own healthcare.
- The programme would also include
work to improve patients’ end of life experience including
burial considerations relevant to their cultures.
- Technological improvements in
medical procedures would also be encompassed.
It was agreed that a visit to the new
Barts Cardiac unit be arranged for
Panel Members.
In response to Members’ questions, the
following information was provided:
- New roles anticipated under this
programme were; care coordinators, and
expanded roles for healthcare assistants, nurse practitioners and
physicians associates. These would
alleviate current pressures experienced by district nurses,
paramedics and traditional health workers.
- In general, life expectancy in the
borough was low and the pathological age was high. Statistical data on mortality would be provided
post-meeting.
- Some work had been done around
integrated care at end of life aimed at addressing issues that
arise at end of life situations such as advice after the death of a
person, certificates etc..
- There were now more midwife led
services in the borough which increased the likelihood of
one-to-one care and better continuity of care.
- To promote the benefits of the new
style services in the context of changing funding arrangements, it
was intended that the vision would be promoted from a patient
perspective and clinicians fully engaged in the change process to
ensure that a patient focus would be retained. The change pathway would be demonstrated in clear
logical journey ensuring that there was clinical input.
- The future healthcare funding gap
was a driver for change. Providers were aware of this as the
structure was commissioning led and therefore it was necessary to
achieve shared solutions.
- Privatisation might have diverse
impacts and some types could reduce competition such as that
currently experienced by small GP practices while other such
arrangements might prove unaffordable.
RESOLVED
That the report be noted.
Action by:
Tahir Alam, Senior Scrutiny Strategy and Policy
Officer
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4.3 |
Modernising In-patient Assessment Services for Older Adults with a Functional Mental Health Problem in Tower Hamlets, City of London & Hackney PDF 978 KB
To receive a report from East London NHS
Foundation Trust.
Minutes:
Representatives from East London NHS
Foundation Trust gave a presentation on a programme to modernise
in-patient assessment services for older adults with a functional
health problem in the localities of the Trust.
The representatives informed the Panel
that:
- An options appraisal had been
conducted and Members were asked to consider the proposal before
them.
- The proposal concerned centralising
the service as part of broader modernisation programme.
- Usage of the in-patient service had
declined and therefore the Trust wished to consolidate to a single
site to provide better service for in-patients, community patients
and better efficiency.
- In recent years, longer life
expectancy had led to more complex care needs and the Trust had
established a range of provisions to meet chronic health conditions
experienced by older adults with a function mental health
condition.
- There had been consultation with
Hackney Council’s health scrutiny body and CCG. The Panel was asked to consider whether there were
any other appropriate bodies the Trust should consult with and an
undertaking given that any advised would be consulted.
- After consultation a proposal would
be placed before the relevant Health and Wellbeing Boards.
In response to Members’ questions, the
following information was provided:
- The proposal to reduce in-patient
provision was due to a downward trend in service usage. Due to active planning, streamlining processes and
provision of integrated care, further decrease was also
expected. However this would be
reviewed if demand were to change.
- The average in-patient stay was 60
days and was in the mid-range for this type of care.
- While some people leaving in-patient
care went into sheltered care and a very small number into 24-hour
care, most were expected to be discharged home.
- Wards at the in-patient unit were
mixed but there was gender separation
- The service was not aimed at those
with dementia as old age psychiatry segregated mental health
services from those with dementia
- The service was not aimed at those
in end of life situations
- The new provision was for Tower
Hamlets and City and Hackney.
- There had been fewer issues around
transport than expected and it was found that the most affected
group were spouses.
- Clinicians felt that this proposal
would use resources more effectively and savings could be directed
towards community care.
- The consultation would be undertaken
with a focus out towards the community rather than an expectation
that consultees would be required to
approach the Trust.
- There had not been wide engagement
with GPs but those who had expressed a view have not caused
concern.
Having considered the information and
responses given by representatives of East London NHS Foundation
Trust, the Panel supported the proposal in principle as a basis for
the consultation to be taken forward.
RESOLVED
That the proposal to
modernise in-patient assessment services for
older adults with a functional mental health problem in Tower
Hamlets, City of London & Hackney be agreed in principle and following the consultation receive a report on
the outcome of the consultation.
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4.4 |
Work Plan
To be tabled at the meeting.
Minutes:
The draft work plan was tabled for
approval. The Panel considered the
items proposed and requested that:
- The aims of each challenge session
be clearly outlined to enable appropriate discussion and questions
at these sessions
- A briefing will be circulated to
Panel Members by the Strategy, Performance and Policy Officer prior
to each challenge session
- That the timings of the sessions be
added to the work plan
RESOLVED
That the Health Scrutiny Work Plan be
approved.
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4.5 |
Review Working Group
To consider a topic for
review and appoint members to the review working group.
Minutes:
The Strategy, Performance and Policy Officer
informed the Panel that a Review of the Self-management Programmes
for Patients with Long-term Conditions (with a focus on measuring
the impact on health outcomes rather than cost reduction) had been
selected from the review topics included in the work
plan. The Chair asked Members to
consider if they wished to be involved advising that the working
group should be politically balanced.
It was agreed that the working group comprise
5 members and the following agreed to participate:
Councillors Asma
Begum and David Edgar, Dr Sharmin
Shajahan.
The remaining two positions would be occupied
by a Conservative Member and Tower Hamlets First Member
respectively.
RESOLVED
That:
- A review working group comprising
five Members of Health Scrutiny Panel be established to Review the
Self-management Programmes for Patients with Long-term Conditions
(with a focus on measuring the impact on health outcomes rather
than cost reduction)
- That Councilllors Asma Begum
and David Edgar, and Dr Sharmin
Shajahan be appointed to the working
group and the remaining two positions be occupied by a Conservative
Member and Tower Hamlets First Member respectively.
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5. |
ANY OTHER BUSINESS WHICH THE CHAIR CONSIDERS TO BE URGENT
Minutes:
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