COUNCILLOR TIM ARCHER (CHAIR) IN THE CHAIR

To receive any apologies for absence.

Apologies for absence were submitted on behalf of Councillors Rania Khan, Shelina Aktar, Abdul Asad, for whom Councillors Lesley Pavitt and Anna Lynch were deputising.

Apologies were also received from Dr Amjad Rahi and Myra Garett, Co-opted Member.

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.

Councillor Anna Lynch declared a general personal interest in the agenda on the basis that she was an employee of the Barts and the London NHS Trust.

Councillor Lesley Pavitt declared a general personal interest in the agenda on the basis that she was a member of THINk.

To confirm as a correct record of the proceedings the unrestricted minutes of the ordinary meeting of Health Scrutiny Panel held on 27^th July 2010.

That the minutes of the meeting of the Panel held on 27^th July 2010 be agreed as a correct record.

Matters Arising:

(Item 5.1) NHS White Paper. The Chair reported that the Panel’s response to the paper, taking into account the views expressed at the recent Challenge Session, had since been prepared on behalf of the Panel and been submitted to the consultation.

(Item 6.1) Improving Physical Access. The Chair had since received a response from Officers clarifying the Council’s powers/duties in relation to this matter and would be sending this to Mr Brian Harvey (Trust Member of the East London NHS Foundation Trust). 

In relation to meeting support, it was Agreed

(a)               that fruit be provided instead of biscuits;

(b)               that where possible reports be printed doubled sided to save paper and that blank pages in the agenda be removed.

It was noted that the regeneration of the Ocean Estate could result in changes to the shape of GP services on the estate. The purpose of this presentation was to establish the current position in respect of these plans and how the Panel may influence this process.

The Chair welcomed to the meeting Ms Bethan George (NHS Tower Hamlets) who was present to give a verbal update on these plans.

Ms George reported that, as part of the Ocean Regeneration Project, it was planned that the local GP practice be moved to the new Hartford Street Building with a timeline of late March 2011 for completion. It was planned that the new re - provided facility would also comprise a pharmacy and dental facilities.

It was also noted that Officers had sought feedback from patients and had carried out surveys to identify what they would like to see included in the new practice. Officers were currently assessing the feedback and were happy to share this with Members. Ward Members had been invited to the meeting and to input into the consultation.

A Member expressed disappointment over the absence of a written report for this item and expressed concern over the adequacy of the consultation methods, (over reliance on online consultation, lack of other means)

In reply to further questions from the Panel, Ms George reported the following points: 

• The plans solely involved the re - provision of the GP practice with the two new facilities. There were no plans to install any other additional facilities.
• That the needs assessment identified a need for a new pharmacy in the area.
• That there would be no disruptions in services during the move. There would be a seamless transfer.
• Outlined the Staffing plans.
• Referred to separate plans to provide a Café on the other side of the building.
• Referred to the plans to remarket the service to increase public trust. 

It was also noted that Officers were willing to meet separately with Members outside the meeting, if they so wish, to discus the plans and feedback their comment/any issues. 

It was Agreed that a further update report be submitted to the next meeting and the report from the outcome of the consultation be sent to the Health Scrutiny Panel.

Ms Caroline Alexander (Director of Quality, NHS Tower Hamlets) and Ms Judith Bottriell (Barts & London NHS Trust) presented the report covering the key complaints issued at the three local health trusts.

Members considered  a summary of complaints received during 09/10, the top issues, action to benchmark data,  changes made as a result of the report,  the ombudsman cases, (indicating few had been upheld, that the full report was on line) and overall themes in complaints.

In response to the presentation, Members expressed dissatisfaction at the complaints process. It was considered that the complaints process was very long, complex and needed to be made more user friendly and accessible to all groups.

In relation to Bangladeshi service users, consideration also was given to the low number of complaints from this group. The Panel discussed the reasons for their apparent reluctance to make a complaint, and that steps be taken to ensure they found the complaints system accessible. Members considered that a further breakdown of the numbers would be helpful to cast light on this problem.

Ms Dianne Barham (THINk Director) also questioned whether the Hospital Board’s Membership should include a Patient representative to facilitate patient engagement.

It was also considered that the complaints procedure should be clearly publicised (in GPs surgeries etc.)

In response to the presentation, Ms Alexander and Ms Bottriell reported that:

• It was acknowledged that the quality assurance/complaints team attempted to deal with complaints informally first. 
• Steps were being taking to ensure Bangladeshi people could access the complaints system. The team were looking at possible barriers to use, engaging and holding training sessions with them to improve experience.
• Explained in detail the complaints and investigation process.

• The website included complaints information. There was also a dedicated complaints e-mail.
• Recent improvements – Service now provided a much more personalised complaints service. They were also in the process of collecting/analysing customer feedback regarding complaints.
• Outlined the plans to scrutinise the whole process to identify and address the key cause of complaints.
• Complainants could approach the complaints service first, they did not need to go to their own GPs.
• Clarified the differences between the data in the Ombudsman Report and the report in the agenda (Due to the fact that they related to different stages of the compliant process).

The Chair thanked the representatives for their informative presentation and noted that by bringing all the trusts complaints together in this format was particularly useful for the Panel to understand patients concerns about health services in the borough.  

Resolved:

That the information set out in the presentation be noted.

Alan Steward (Deputy Director, Delivery Directorate, NHS Tower Hamlets) presented the update report which provided a summary of progress of developing the NHS Tower Hamlets contribution towards the East London and City Alliance Commissioning Strategy (ELCC). It also updates on the impact of current initiatives to close the financial gaps. 

Mr Steward reported that the review of current initiatives indicated that, with resign they were closing the gap. However, a substantial financial gap remained. Further work was therefore proposed to bridge the gaps.

Consideration was given to options for bridging the gap with minimum impact. It was planned that Mr Steward’s team would carryout out a review of non mandatory services with a view to identifying savings. The team would then draw up a list of possible savings in this area and would consult extensively on the proposals.

It was Agreed that, when drafted, this list of potential savings (in non mandatory services) be presented to the Panel for consultation.

Consideration was also given to other options for achieving savings, around unnecessary use of A&E – need for more preventive work around this, reducing repetition in services. The Panel also stressed the importance of reasonable waiting times and the need to protect this. 

Resolved:

(1)       That the proposals in the report be noted; and

(2)       That, when drafted, the proposed savings list be submitted to the Panel for consultation.

Ms Dianne Barham (THINk Director) presented the Think Patient and User Comments Report and recommendations. (Tabled at the meeting.) The Panel were invited to consider the comments collated between from October 2009 to July 2010, and how they may wish to help address these issues.

The Panel considered the feedback regarding the following issues and steps for improvement:

• General Practice – length of appointments, quality of services from GPs.  
• Royal London Hospital – staff attitudes, patient expectations – need to better communicate expected standards so patients could press for this, state of the buildings, accounts of poor patient experiences.
• Mental Health.
• Older People.
• Social Services.

Ms Barham invited the Panel to read the comments in detail in the tabled report. 

The Panel felt that this was very valuable piece of work and that the report should go to the services provides so that they were aware of the issues.

It was therefore Agreed that Ms Barham should be invited to the next meeting of the Panel with a report on how services providers had responded to the issues. If necessary the Panel may wish to invite them into a meeting to discuss issues of concern.

Resolved:

(1)       That the user comments report and recommendations be noted; and

(2)       That a further report be submitted to next meeting of the Panel detailing service providers responses.

Dr Somen Banerjee (Co – Director, Public Health Tower Hamlets and LBTH) presented the update on the Joint Strategic needs assessment (JSNA), summarising the 2009/10 findings and recommendations.

The Panel were invited to consider and comment on the content of the JSNA and approach for 2010/11.

In response, the Panel felt that the problems around overcrowding in the Borough – lack of adequate housing should be investigated and be included in the plan. The Panel also considered that the problems around older people feeling isolated - the need for a voluntary cost effective befriending service should also be explored.

The Panel expressed a desire to be involved in the process, and it was Agreed that details of future events be circulated to Members. 

It was also intended that a fuller report on the assessment would be brought to a future meeting of the Panel next year.

Resolved:

(1)       That the contents and approach towards the JSNA for 2010/11 be noted and that the Panel’s suggestions be included in the assessment; and

(2)       That it be noted that a further report will be submitted to the Panel at a future meeting.

The Panel considered their draft work programme.

In considered this, the Panel considered the need for extra meetings of the Committee next year given the amount of work in their programme. Consideration was also given to the possibility of holding a Saturday morning session, and the merits of having a consistency in Membership across municipal years to harness skills and experience.  

Resolved:

(1)       That the draft work programme items and schedule attached at Appendix 1 and 2 attached to the report be noted; and

(2)       That the work programme be reviewed every quarter

(a)       NEL JOSC

The Chair confirmed the details of the next meeting of the JOSC to be held at 9:30pm at the Town Hall, London Borough of Newham. The agenda could be found on the Council’s website. All Members were welcomed to attend this meeting.

Resolved

That Councillor Lesley Pavitt agreed to attend on behalf of Tower Hamlets Health Scrutiny Panel.

(b)       Polysystems Challenge Session Report.

The Chair reported that this was a really good session and that the draft report and recommendations would be sent to all stakeholders for comments  before it was considered by the Overview and Scrutiny Committee

The Chair reported that this would be the last meeting Katie Macdonald would be attending. The Panel thanked Katie for all her hard work in supporting these meetings and wished her all the best for the future.