Agenda and minutes

Details of the arrangements in case of fire or other events that might require the meeting room or building’s evacuation will be announced.

The Chairman reminded everyone present of the action to be taken in an emergency.

Members are invited to declare any interests in any of the items on the agendas at this point of the meeting. Members may still declare an interest in an item at any time prior to the consideration of the matter.

There were no declarations of interest.

To approve as a correct record the minutes of the meeting held on 7 December 2011 (attached) and authorise the Chairman to sign them.

The minutes of the meeting held on 7 December 2011 were agreed as a correct record and signed by the Chairman.

To receive a presentation on the work of the Heartstart Havering organisation.

The officer from Heartstart Havering explained that the organisation had been set up in 1992 by the British Heart Foundation to spread knowledge of Cardiac Pulmonary Resuscitation techniques in the general population. Free courses of approximately 2.5 hours in length were offered by the organisation covering essential information regarding how to save a person’s life. Heartstart Havering ran its first course in 2002 and had run a total of 247 courses, training 3,360 people since 2003. A further 25 adults and 55 children had been trained so far in 2012.

The organisation had no budget for publicity and a bid for funding from the Community Chest had been unsuccessful. Course dates had however been set to the end of 2012 and an on-line booking system had been set up. A text information system was also on trial.

Heartstart Havering was keen to ensure that defibrillators got to people as quickly as possible. The AED defibrillator read the level of electrical activity in a person’s heart and gave an electric shock to the heart if necessary. The use of the defibrillator was demonstrated to the Committee who felt that it was easy to use with clear, audible instructions. AEDs were already available on all platforms at Romford station as well as in shopping centres and libraries. The aim was now to try and put AEDs on streets in residential areas.

Each AED unit cost £1,000-£1,500 and would be maintenance free for 5-7 years. Several pilot areas to have an AED located had been identified in Havering in order that several hundred houses could be within as little as a three minute walk of an AED machine. Outdoor cabinets for the AED machines were available at a cost of £400 - £1,000. As a measure against vandalism, the cabinets included a photograph of each person that opened the cabinet, which could also be e-mailed to the Police if necessary. Emergency 999 calls could also be made from the cabinet. Heartstart Havering wished for the Committee’s support for future applications for funding for the scheme.

Members felt the scheme was a good idea but remained concerned about the risk of vandalism of the equipment. Perhaps the machines could be sited inside tower blocks or at petrol stations and supermarkets where there was less risk of vandalism etc. The AED machines self-checked on a daily and weekly basis but it was also envisaged that local people would do weekly checks of the equipment. It was accepted the spraying of graffiti on the equipment could probably not be prevented.

The representatives from BHRUT and NHS ONEL supported the AED idea. The borough director from NHS ONEL felt the locating of the machines in residential areas could be given a trial and the strategy reassessed if necessary.

The Committee agreed that, while not controlling any funding itself, it was otherwise happy to support the Heartstart Havering project. This would include written support of the plans if required. 

Update on issues affecting Barking, Havering and Redbridge University Hospitals’ NHS trust (BHRUT) from Neill Moloney, Director of Planning and Performance, BHRUT.

The Director of Planning and Performance at BHRUT explained that additional beds were being put in at King George Hospital to cater for in the region of seven births per day. A small amount of maternity activity had also been shifted to Essex (20-30 births per month). The Essex arrangements had been due to continue until April but this had now been relaxed due to capacity issues in Essex. Planned caesarean section deliveries would continue to take place at Homerton Hospital until the end of March at which point this arrangement would cease as the cap on numbers of deliveries at Queen’s would be lifted from 1 April. It was accepted by the Trust that transferring caesarean sections to the Homerton was not ideal but it was felt that it was now acceptable to bring these deliveries (approximately 3-5 per week) back to Queen’s. The Care Quality Commission was also supportive of this change starting from 1 April.

The capital funding of approximately £1.5 million for expansion of the maternity facilities at Queen’s had now been agreed. It was anticipated that works would be completed by November 2012 and this would be followed by works to expand the Special Care Baby Unit. The start date for the transfer of maternity services from King George to Queen’s had not yet been agreed. Capacity issues at Whipps Cross and Newham hospitals would also be considered as part of the Health for North East London programme. Members were anxious that maternity and other services at King George were not reduced until the new facilities were in place.

There were a range of options to accommodate the extra demand for A&E services at Queen’s including converting the current renal or sexual health units. The BHRUT officer would update the Committee further on these plans in due course.

Tenders had been released for the operating of the Barking Birthing Centre and the formal contract would be awarded shortly. More detailed work on this would also be needed.

Figures for staff assaults at BHRUT were as follows:

Calendar year 2011 – 149 incidents of verbal abuse and 113 of physical abuse.

April 2010 – March 2011 – 175 verbal abuse and 144 physical abuse.

April 2011 – December 2011 – 114 verbal and 80 physical

The Committee agreed unanimously that such amounts of abuse of staff were unacceptable and officers agreed to ascertain if figures for the proportion of assaults relating to drink or drug abuse could be provided. It was also noted that funding had been received for the installation of mobile A&E tents in Ilford and Romford town centres in order to deal with alcohol-related incidents.

£5-7 million funding was available for reablement and other local schemes to reduce readmission to hospital.

The incidence in the recent LINK report concerning a lack of ECG and blood pressure apparatus had been investigated by the Director of Nursing but such equipment was not considered necessary in low risk births (one third of the  ...  view the full minutes text for item 22.

Presentation on structure and future plans of Havering Clinical Commissioning Group (provisional item).

The borough director explained that the Clinical Commissioning Group (CCG) was headed by a board of seven experienced clinicians, each leading on a particular area. The CCG would have to deal with a number of issues specific to Havering including a growing population and pockets of deprivation. Other challenges included issues regarding Queen’s Hospital, introducing improvements to primary care and the rising demand for health services.

The CCG was already planning clinical improvements including the introduction of seven outpatient clinics in community settings and undertaking peer reviews of how individual practices were performing. Corporate successes included the merger of the previous two Havering CCGs into one organisation and a draft constitution being developed. The CCG board would operate as a shadow CCG from 1 April with delegated authority from NHS ONEL for the community budget. Overall responsibility for the budget would however remain with NHS ONEL for another year.

As regards engaging with partners, the CCG had undertaken a lot of work with patients, Councillors and the Local Involvement Network. Work was also in progress with the Health and Wellbeing Board. The borough director accepted that there was a very challenging year ahead but was confident that the CCG would rise to the challenge.

Members were anxious to ensure that patients would not see any reductions in services but the borough director emphasised the CCG would have patients at its centre with the implications for patients of any changes being considered at the CCG board. The overall NHS budget had been uplifted by 2% but outpatient clinics located in the community as planned by the CCG would also be cheaper to operate than those in acute settings.

All GP surgeries would be required to have patient participation groups of which there were currently 12 in total. Lesley Buckland, NHS ONEL vice-chairman, was leading on patient engagement for the CCG.

A representative of Havering LINk was concerned about any possible loss of contact between patient and doctor as a result of these changes. The borough director responded that the GPs involved were funded to employ locums whilst they were engaged in CCG work. It was a matter for each practice to manage continuity of care. Two of the members of the CCG board were semi-retired and hence did less clinical work in any case. It was emphasised that overall GP consulting hours were not expected to reduce as a result of the CCG being set up.

The salaries paid to GPs were confidential but funding to set up the CCG equated to £2 per head of resident population and so totalled approximately £500,000. This was also expected to cover the costs of clinical backfill and engagement work. The budget was expected to be underspent at the end of the year.

The borough director was certain that the CCG would lead to an improvement on the existing healthcare system as the performance management framework introduced would address quality and financial issues.

The Committee was concerned that there were no female doctors on  ...  view the full minutes text for item 23.