Agenda and draft minutes
Venue: Hackney Town Hall, Mare Street, E8 1EA
Contact: Email: tracey.anderson@hackney.gov.uk 0208 356 3312
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MINUTES OF A MEETING OF THE INNER NORTH EAST LONDON JOINT OVERVIEW AND SCRUTINY COMMITTEE FOR HEALTH FRIDAY, 15TH JULY, 2011
Councillors Present: Councillor Luke Akehurst in the Chair Councillor Denise Jones, Wendy Mead, Councillor Ann Munn, Councillor Benzion Papier, Councillor Lesley Pavitt, Councillor Rachael Saunders and Councillor Winston Vaughan
Apologies: Councillor Ted Sparrowhawk
Officers in Attendance: Also in Attendance: Sarah Barr (Senior Strategy, Policy and Performance Officer), Jeremy Gardner (Head of Communications), Caroline Gilmartin (Deputy Director of Primary Care and Adult Community Nursing), Neal Hounsell (Strategy and Performance Director), Michael McGhee (Director of Older People Services), Dr Lucy Moore (Integration Director), Gerald O'Mahony (Clinical Director and Lead Consultant Older People Services), Don Neame (Communications Director), Thomas Pharaoh (Senior Project Officer), Dr Steve Ryan (Medical Director), John Wilkins (Deputy Chief Executive and Director of Performance and Business Development) and 3 members of the public
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APPOINTMENT OF CHAIR AND VICE CHAIR Minutes: 1.1 The appointment of the Chair and Vice Chair will be postponed for two reasons: a) Some Members present were interim appointments and permanent Members will not be confirmed until the following month b) Some members were confirmed just before this meeting so the Committee was requested to allow Members more time to consider and prepare their nomination for positions of Chair and Vice Chair. 1.2 In the absence of an appointed Chair it was agreed the hosting Borough (London Borough of Hackney) Chair of Health Scrutiny (Cllr Luke Akehurst) would chair the meeting. |
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APOLOGIES FOR ABSENCE AND ANNOUNCEMENT OF SUBSTITUTE MEMBER Minutes: 2.1 Apologies for absence from Councillors: Ted Sparrowhawk from London Borough of Newham and Denise Jones from London Borough of Tower Hamlets |
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DECLARATIONS OF INTEREST Any Member of the Committee or any other Member present in the meeting room, having any personal or prejudicial interest in any item before the meeting is reminded to make the appropriate oral declaration at the start of proceedings. At meetings where the public are allowed to be in attendance and with permission speak, any Member with a prejudicial interest may also make representations, answer questions or give evidence but must then withdraw from the meeting room before the matter is discussed and before any vote is taken.
Minutes: 3.1 Cllr Luke Akehurst from London Borough of Hackney declared he was a member of the Homerton Hospital NHS Foundation Trust. |
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LONDON CANCER SERVICES - IMPLEMENTATION PDF 111 KB A presentation from London Health Programmes about the implementation of the cancer model of care that focuses on earlier diagnoses, improving inpatient care and reducing inequalities in access to services, along with an update on the development of integrated cancer systems across London.
Minutes: 4.1 Presentation by Thomas Pharaoh from London Health Programmes about the London Cancer Implementation Programme. 4.1.1 The proposals for changing services were proposed by commissioning support services for London. In 2010 a review of cancer services was conducted which engaged 45 clinicians. 4.1.2 The case for change was published in December 2009, the model of care proposals were developed in August 2010 followed by a 3-month engagement process. It was reported over 85 per cent of survey respondents were supportive. 4.1.3 The three work areas were early diagnosis; common cancers and general care; rarer cancers and specialist care. 4.1.4 The compelling case for change was influenced by factors such as: • Late diagnosis resulting in poor survival rates • Variations in quality of care. (It was reported there are areas of excellence in London but inequalities in access and outcomes exist). 4.1.5 The vision is for treatment and care to be standardised, whereby Specialist surgery is centralised and common treatments localised where possible. 4.1.6 Seeing comprehensive pathways commissioned and organisational boundaries not a barrier. It was explained a patient can get lost in the system through organisation transition during their care. 4.1.7 The national patient experience survey revealed the patient’s perception of the quality of cancer service care was worse than actual performance. 4.1.8 The key themes for the model of care are: • Improve early diagnosis • Providers to work together in a small number of integrated systems delivering standardised pathways • Extended local provision of common cancer services to improve cancer rates across London. 4.1.9 In relation to early diagnosis this is an area where the UK performs poorly in comparison to Europe and the USA. It is suggested if the number of people through the door was improved survival rates would increase. 4.1.10 Working groups consisted of GPs, Public Health Consultants, Diagnostic Experts and patient representatives to identify the most effective evidence based interventions to improve early diagnosis. 4.1.11 LHP view the new proposed Health and Wellbeing boards as a vehicle to support this process locally, recognising local population issues whilst engaging with key players and promoting positive messages. 4.1.12 LHP advised they were working closely with the cancer community to develop a specification against which proposed systems could develop their plans. Hospitals were being asked to demonstrate how they could work together to improve patient experience and provide seamless cancer care. Proposals were submitted on 30th June 2011 demonstrating how they would address clinical outcomes and improve patient experience. 4.1.13 Organisations have been requested to develop service plans with a view for implementation around April 2012. 4.1.14 The proposed systems for London were: • London Cancer (NE and NC London) • ‘The Crescent’ (SE, SW, NW London). 4.1.15 It is anticipated LHP will be in a position to announce local implications autumn 2011. 4.1.16 The Committee was informed providers and commissioners will be required to work differently together and commission services in a more effective way. There will be a closer alignment between pathway ... view the full minutes text for item 4. |
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BARTS AND EAST LONDON HEALTHCARE MERGER PROJECT PDF 1 MB Presentation by Integration Director of Barts and East London healthcare merger project and Medical Director of Barts and the London Trust about the proposed merger of Barts and The London NHS Trust, Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust.
Minutes: 5.1 Presentation by Dr Lucy Moore, Integration Director of the Barts and East London Healthcare Merger Project and Dr Steve Ryan, Medical Director of the Barts and the London Trust about the proposed merger of three acute trust in North East London. The main points of the presentation were: 5.1.1 The hospitals being proposed in this merger are: • Newham and Whipps Cross general hospital: local hospitals providing A&E, urgent and community care, outpatients, maternity, women’s and children’s services and planned surgery • Barts and The London NHS Trust (BLT) which currently operates three hospitals: The Royal London: providing all the services available at Newham and Whipps Cross plus a major trauma centre, an acute stroke centre providing immediate care for people who have suffered a stroke, and more specialist care/complex surgery for adults and children Barts: near St Paul’s provides specialist cancer, urology and cardiac (heart) care as well as sexual health services and a minor injuries unit In 2016 the heart attack unit at The London Chest in Bethnal Green will move to Barts. 5.1.2 It was noted there was a huge amount of expertise and knowledge to be shared among the trusts and segments of exemplar services. For example • Newham trust have a nationally adopted End of Life care model • Whipps Cross trust have low rates for MRSA amongst the lowest in the country and; • Barts and the London trust have the country’s most advanced major trauma centre. 5.1.3 One of the major contributing factors to the decision for the merger is to improve the life expectancy and tackle the challenging health needs of the population. North East London has some of the most deprived, unhealthiest communities and big health inequalities (17 years difference in life expectancy). 5.1.4 Another key factor is the challenging financial climate currently facing the NHS. Members were informed health care was getting more expensive and it was important for the NHS to find ways to make services more sustainable in the long term, whilst creating the ability to invest in services such as maternity due to increasing birth rates in East London. 5.1.5 It was highlighted all three trusts individually cannot achieve foundation trust status as required in the pending Health and Social Care Bill. All three trusts face would have significant difficulty in being able to meet the financial requirements of foundation trust status. This would leave them subject to the following options: • To merge with another trust, • Be taken over, • Have their future decided by the Secretary of State for Health. 5.1.6 It was recognised that there are areas that need to be improved such as: • Patient experience could be much better • Some services are excellent but far too many needed to improve. 5.1.7 The nature of healthcare is changing. New understanding of best practice means we need to take a fresh look at our services e.g. ensuring senior doctors are on site for more ... view the full minutes text for item 5. |
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INNER NORTH EAST LONDON MENTAL HEALTH INPATIENT SERVICES PDF 433 KB Presentation by Associate Director (Performance, contracting and Procurement), Older Adults Mental Health Commissioning lead, and Head of Communications from NHS East London and the City about the proposal to make changes to the in-patient mental health care services in Inner North East London.
Additional documents: Minutes: 6.1 Presentation by Gerald O’Mahony, Clinical Director and Lead Consultant Older Peoples Services, from East London NHS Foundation Trust, Caroline Gilmartin, Associate Director (Performance, contracting and Procurement) and Jeremy Gardner, Head of Communications from NHS East London and the City. The main points of the presentation were: 6.1.1 Dementia is deemed as a terminal illness that will end your life. 2/3rd of inpatient cases related to dementia. The Commission noted individuals were presenting late thus requiring hospital stay. 6.1.2 In keeping with national guidance and principles the vision is to develop a range of early identification, assessment and support services. At present 70% of people with dementia live at home and the trust wants to bring services to the community. • Invest in a broader range of community services and offer intensive homebased support as an alternative to hospital/institutional care admission • Offer choice in treatment and care options to users and carers • Embed a re-enablement approach to treatment and care throughout the service. 6.1.3 A review of the bed base spend revealed a disproportionate amount of spend across the three locations. 6.1.4 This led to two options under consideration: • The first was to stay as it is. • The second was to re-configure dementia assessment wards to enable more investment and flexible services that would be person centred and in the community. Under the reconfiguration proposals the trust would change from operating three small units in three different boroughs to one large unit in a central location accessible by all the local authorities. 6.1.5 Out of scope of these proposals will be other adult in-patient and residential services, including continuing care wards and respite care these will continue to be borough based for each local authority. 6.1.6 It’s proposed the reconfiguration of the centralised unit will enable pooling of skills which will develop the service. 6.1.7 Previously older people mental health services were not a priority and service performance became poor. A national strategy and refocus over the last two years resulted in investment in dementia services in East London. 6.1.8 It was explained how demand for the service had changed in Hackney from approximately 40 case referrals per year to 10 a week. The new Memory clinic in Newham alone was seeing approximately 500 referrals a year. 6.1.9 There has been investment over the past two years in dementia services for City and Hackney, Newham and Tower Hamlets. 6.1.10 Among the clinical benefits noted in the presentation from implementing the proposals the key highlights were: • A sliming down of in-patient ward services • Increased community services. There would be a nurse led service operating in the community. Greater emphasis would be placed on the building of partnership working following the centralisation of the unit. 6.1.11 It was highlighted the cost of running a ward was the same irrespective of the number of occupants i.e. the operating costs for a ward with 7 occupants was similar to one with 20 ... view the full minutes text for item 6. |
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INEL JOSC TERMS OF REFERENCE AND PROCEDURE RULES PDF 73 KB A discussion about the draft terms of reference and procedure rules, for a standing joint committee for Inner North East London. Additional documents: Minutes: 7.1 Cllr Vaughan from London Borough of Newham requested for Members agreement of the draft Terms of Reference (TOR) and Procedure Rules for the INEL JOSC could be postponed until the next meeting. He advised the Legal Officer in Newham Council had raised some concerns regarding the TOR and procedure rules and this was not present to their Full Council meeting for agreement. He suggested the Overview and Scrutiny Officer supporting the INEL JOSC liaised with the Overview and Scrutiny Team in Newham for the full details and amendments to present for sign off. 7.2 The Members agreed to postpone. ACTION Overview and Scrutiny Officer to contact Newham Overview and Scrutiny Team to get requested amendments for TOR and Procedure rules to present for the next meeting of the INEL JHOSC.
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ANY OTHER ORAL OR WRITTEN ITEMS WHICH THE CHAIR CONSIDERS URGENT Minutes: URGENT ITEM / ORDER OF BUSINESS 8.1 Cllr Vaughan suggested the venues to host the INEL JOSC meetings were rotated and he offered Newham to start for the next meeting. 8.2 Member agreed. ACTION Overview and Scrutiny Officer to rotate INEL JOSC meeting around the Boroughs.
Duration of the meeting: 4.00 - 6.15 pm
Signed
…………………………………………………………………………….. Chair of Committee Contact: Tracey Anderson 020 8356 3312 tracey.anderson@hackney.gov.uk
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