There were no declarations of pecuniary interests.

To confirm as a correct record the minutes of the Health Scrutiny Sub Committee on 12 February 2019.

RESOLVED:

1.       The minutes of the meeting held on 12 February 2019 were approved as an accurate record and signed by the Chair.

REPORT TO FOLLOW: General Exception – the Chair has decided to allow this item to be heard at the 30 April 2019 meeting of the Health Scrutiny Sub Committee. The report is late due to a delay in internal clearance procedures at the Tower Hamlets CCG.

Summary: Report of Jenny Cooke Deputy Director for Primary and Urgent Care. Tower Hamlets has a number GP practices that operated under APMS (Alternative Medical Provider Services) contracts. These contracts are time-limited (up to 10 years) and require re-procurement at the end of the contract term.   In some cases, the APMS re-procurement is directly linked to practice reconfiguration under the estates strategy. The APMS re-procurement process may impact continuity of services and a change to the clinical team delivering services.

The Committee will be asked to note the report and review the proposals for the procurement of APMS contracts in the borough.

The Chair changed the order of business from what was published on the agenda. The Suicide Prevention Action Plan item was presented first, followed by the Alternative Medical Provider Service Report and then the Update on the Diabetes Scrutiny Review. The minutes will follow the order presented on the agenda.

The Committee received the report of Jenny Cook (Deputy Director Urgent and Primary Care THCCG) on the Alternative Medical Provider Contracts Strategy.  

In response to Member questions officers provided the following:

·         The procurement would be mindful of the boroughs changing demographics, population increase, areas of deprivation and areas of affluence and will look at how bidders would tackle the needs of differing populations.

·         Market engagement found that there was no correlation between opening times and patient satisfaction. The procurement would not focus on extending opening hours because there was already a national contract on evening and weekend appointments in place.

·         The changes and potential impacts will be communicated to patients via letter. Short term disruptions to services were expected.

·         Market research had found the tender was attractive to both national and local bidders.

·         Online triage was expected to be a service feature.

·         The Patient Participation Group at Whitechapel were heavily involved in the design of the new building and a patient representative had been included in the architects project meetings so officers were confident that patient input regarding access had been taken into account.

The Chair thanked Jenny Cooke for her report.

RESOLVED:

1.    The Committee noted the proposals for the procurement of APMS contracts in the borough.

Update from Somen Banerjee, Director of Public Health, on the Tower Hamlets Suicide Prevention Strategy Action Plan.

The Committee received an update on the Suicide Prevention Action Plan from Nicola Donnelly (Programme Manager) and Chris Lovitt (Associate Director of Public Health).

Member questions followed by officer response:

In terms of peoples experience at A&E and improving environment can you give an example such as waiting times or how good the teams were in picking up issues and the follow through?  Hope Wall is a good example. A&E is busy and may not be the best environment in a crisis but the CCG is doing a number of interventions to prevent escalation to A&E. the Raid service is also good. A&E have placed measures to improve experience for example a triage service. The crisis line is 24 hours and linked to this there will also be a visitation team not just a phone line which will provide a more responsive intervention around crisis.

Do we have a map of where suicides are likely to happen? A map of suicides does not exist due to data protection issues; suicides can take place inside a person’s home for example. When there is a location where multiple suicides have occurred this is referred to as a ‘frequently used location’. Although not location specific, Public Health England have created a map which demonstrates the areas of the country were suicide is more prevalent. Local areas should have intelligence and action plans for any frequent locations in their area. 

The Thrive London programme will soon provide information following a suspected suicide in Tower Hamlet which may include location. Thrive London have commissioned a provider to join up information and share the datasets with local areas across London. Tower Bridge and Mile End station are known as ’frequently used locations’ in Tower Hamlets. Public Health will work with TFL to discuss what else could be done to prevent suicide, such as working with CCTV and Signage.

Starting conversations can be an important means of preventing suicide, an example of this is the Samaritans suicide prevention campaign on rail ‘small talks saves lives’. It is easier to establish data sharing agreement on a London wide level rather than local. East London Foundation Trust have a project with DLR staff which has involved the upskilling of staff to talk to people with mental health issues. A Real time data sharing platform is something that Thrive London will launch this spring, and following this, we should have access to data following a suicide at a local level. One prevention approach is to restrict access to high buildings which can be the means of suicide.

What proportion of people who attempt to suicide have been in touch with a council service or a health service/GP? Are opportunities being missed or are people disengaged from services? It is expected that the new data sharing platform, will share information on any previous contact with mental health services. Nationally we know that only 27% of people who died by suicide between 2005 and 2015 had been in  ...  view the full minutes text for item 4.

This will be a verbal update from Jack Kerr, Strategy and Policy Manager – Health Adults and Community.

The Committee received an update from Jack Kerr (Strategy and Policy Manager Health Adults Community) on the Committee’s scrutiny challenge on diabetes.  

A challenge session on diabetes took place on 21 March 2019.

To summarise the session had found that:

·         There had been an improvement in diabetic health in the borough compared to a decade ago.

·         Approximately 2.5-3.5 thousand people are diagnosed with type 2 diabetes in the borough. 

·         Data suggests Tower Hamlets has the highest hospital admission rate due to diabetes.

Some recommendations from the challenge session included:

·         Follow up on pre-diabetes and gestational diabetes. A check-up a year later was recommended.

·         Continued engagement with the Bangladeshi community and advice on the linkages between diabetes and obesity.

·         A review on leisure provision including more women only sessions.

RESOLVED:

1.    To note the summary and provide further comments to Jack Kerr – Strategy & Policy Manager.

As this was the last meeting of the municipal year, the Chair thanked fellow Members and Officers for their contributions and support to the Health Scrutiny Sub-Committee. He said it had been a pleasure to act as Chair of the Committee for the year.