Agenda and minutes

The Chairman gave details of action to be taken in the case of fire or other event requiring evacuation of the meeting room.

Apologies were received from Councillor Wendy Brice-Thompson and from Councillor Linda Trew (Councillor Sandra Binion substituting).

Councillor Paul McGeary was also present.

NHS officer present:

Sir Peter Dixon, Chairman, Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT)

Neill Moloney, BHRUT

Jacqui Van Rossum, North East London Community Services (NELCS)

Fiona Weir, North East London NHS Foundation Trust (NELFT)

Dr. Gurdev Saini, Havering Clinical Commissioning Group (CCG)

Alan Steward, Havering CCG

Also present:

Cliff Reynolds, Vice-Chair, Havering Local Involvement Network (LINk)

Joan Smith, Coordinator, Havering LINk

Anne-Marie Dean, Chair, Healthwatch Havering

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

There were no disclosures of interest.

To receive the minutes of the meetings held on 24 January 2013 (joint meeting) and 7 February 2013 (attached) and agree as a correct record.

The minutes of the meetings held on 24 January 2013 (joint meeting) and 7 February 2013 were agreed as a correct record and signed by the Chairman.

The Chairman had participated in the recent meeting of the Joint Health Overview and Scrutiny Committee which had considered in detail the implications of the changes to maternity services across the sector including the closure of the maternity department at King George Hospital.

Members had recently visited the breast screening unit at Victoria Hospital and had been very impressed by the screening programmes that were available there. A meeting would be arranged with the CCG shortly to discuss issues around the condition of the estate at the Victoria Hospital.

The Chairman had met with a representative of the CCG and discussed the overall progress of the Clinical Commissioning Group. It had been disappointing that Members had not been included in the recent CCG public event and the CCH chief operating officer apologised for this oversight although Council officers had been present at the event.

The Committee had also recently made a return visit to Queen’s Hospital to view the JONAH discharge system. Detailed discussions had been held with the ward manager and Members were pleased that the system was improving.

The Chairman remained concerned at proposals for changes to service for urological cancer that would involve Havering residents travelling into central London for this type of surgery. Travel and parking issues were large concerns although a Member added that all cancer patients were automatically entitled to a disabled Blue Badge. It was noted that the numbers of Havering residents affected by this change of hospital were quite low and that options for improving patient transport under consideration. The final decision on changes to urological cancer services would rest with the NHS Commissioning Board.

Havering LINk had recently visited Sunrise Ward at Queen’s Hospital and noted a much improved atmosphere. The ward was very clean and water jugs were now less full which was better for elderly people. All sensory signs were also now displayed where needed on the ward.

The Committee would also arrange a new date for a return visit to view South Hornchurch Health Centre.

The Chairman also welcomed Anne-Marie Dean, the Chairman of the new Healthwatch Havering organisation.

To receive a presentation from Sir Peter Dixon, Chairman, BHRUT.

The BHRUT Chairman agreed that the recent Care Quality Commission (CQC) inspection of Queen’s Hospital A&E had confirmed that the way in which patients were dealt with was not good enough and not as safe as it should be. The demands on A&E at the Trust were growing and both internal flows and length of patient stay at Queen’s needed considerable improvement. Dialogue was in progress with the CQC in order to agree how the situation could be improved.

The Chairman felt that the condition of A&E at Queen’s on a Monday morning was often in an unacceptably dirty state and this had been mainly caused by people who did not need to attend A&E in the first place.

The Trust wished to recruit well qualified permanent staff and the Chairman wanted to make it clear that BHRUT had a future and could offer a good career to the right people. It was accepted that there were too many locums in A&E and the Chairman wished to change this. Discussions were also in progress with the UCL partners organisation in order to recruit new staff to the Trust.

The maternity department at King George Hospital had now closed and there was not believed to be a major issue concerning the recently publicised final birth to take place at King George. The restriction of number of births at maternity had, in the Trust Chairman’s view, led to an improvement in the maternity service.

It was accepted that BHRUT had been losing money for the last 10 years and become something of a scapegoat. The Chairman wished to restore  pride to the organisation and highlight the areas in which the Trust provided good services such as maternity, stroke and cancer (where the Trust saw 10% of all London cancer patients). Members agreed that the Trust offered good services in these areas.

The Trust Chairman also felt that too much use had been made in the past of management consultants etc and that the Trust should do more of this work itself. There was no date for the closure of A&E at King George Hospital which the Trust Chairman felt could be some years away. This would not take place until an improvement had been recorded in the A&E at Queen’s including the completion of additional capacity. The two hospital services would move over time towards providing different services at each location. This would however take place in a safe and measured way.

The Chairman thanked the Trust Chairman for his presentation which it was felt gave confidence in the Trust’s future direction. It was confirmed that BHRUT was now working more closely with primary care and the Trust Chairman was pleased that some GP surgeries were planned to open at weekends.

Safety statistics such as Dr. Foster were reasonable overall for the Trust and it was confirmed that the Trust did monitor these regularly. It was also confirmed that plans were progressing to significantly increase  ...  view the full minutes text for item 58.

To receive an update on outstanding issues from senior NELCS officers.

The NELCS community treatment team had now been extended across Havering. This team, in partnership with BHRUT, aimed to reduce A&E attendance and unnecessary hospital admissions. The team had a community hub as well as a presence at Queen’s A&E. There had been low initial take up of referrals in Havering but there was now more engagement taking place with Havering CCG. There were also now more referrals to the team from nursing homes as well as self-referrals. More detailed analysis of referrals could be provided to the Committee. 

With effect from 15 March, the Community Treatment Team was also accepting referrals from patients requiring an IV drip. This could be carried out in the community rather than in an acute hospital. The service would also be available 7 days per week from the end of March from 8 am to 8 pm. Members were pleased with this progress and that the service was working together with BHRUT.

NELFT was still looking at options for premises to deliver services in Havering that were currently provided outside the borough. Negotiations were in progress to purchase a site in London Road, Romford and an alternative site was also being investigated. The London Road site would offer car parking. Proposals were also being drawn up for a new model of day hospital where more rehabilitation could take place in people’s home. An update could be given on this at a future meeting of the Committee. It was clarified that the required refurbishment of the London Road site would take approximately nine months from the signing of any lease.

The NELCS officer accepted that transport links to Grays Court were very poor but added that NELFT did have a contract with the London Ambulance Service for patient transport. All patients who had cancelled appointments at Grays Court had been assessed. Many patients had in fact received their treatment either at home or in other facilities such as Harold Wood polyclinic. The number of ‘Did Not Attends’ at Grays Court was now reducing.

Foxglove ward at King George Hospital was now fully operational. Patients were now able to access the main gym area and options were also being investigated to create a better day area for patients. An activity programme was also available for patients which included their having walks outside of the ward. The NELCS officer agreed to investigate reports from Havering LINk that patients were not able to access the gym area situated immediately below Foxglove ward.

The Committee NOTED the presentation and thanked the NELCS officer for her input to the meeting.

To receive a presentation on the current consultation on plans to redevelop the St. George’s Hospital site, Hornchurch.

The representatives of Havering CCG explained that the overall plan for the St. George’s site was to develop it as part of an integrated care strategy for the population of Havering. This would include more proactive services offering better information, access and support to Havering patients.

It was felt that St. George’s was no longer fit for purpose and the site had been gradually decommissioned over the last ten years prior to being closed on health and safety grounds in October 2012. It was not possible to simply refurbish the current buildings.   

The CCG was therefore consulting on building a centre of excellence for older people on the site. This would be a brand new building offering community services, diagnostics and an enhanced GP surgery. It was hoped that social care and voluntary services would also be available on the site. The current consultation on the proposals was due to finish on 12 May.

It was possible that 15-30 intermediate care beds would be located on the St. George’s site but further work needed to be done on this. These beds would cater for patients with multiple conditions. The Committee felt it was important that these facilities were developed in order to take over from Grays Court in Dagenham and that the new services on the St. George’s site were fit for purpose. Officers agreed but added that enhanced community services may mean there will be less demand for rehabilitation beds such as these. The priority was the standard of care, regardless of how many actual beds were needed.

The consultation documents had been sent to stakeholders and were also available on-line. Two consultation events had also been held in local libraries. Members were concerned however that there had been very little promotion of the consultation either in local GP surgeries or at Queen’s Hospital and officers agreed to consider promoting the consultation in these locations.

A LINk representative felt that the consultation did not have enough detail on the options but the CCG officers explained that they wished to gather information on what people felt were the issues at this stage prior to developing a more detailed plan. Further consultation would be held once a more detailed plan was available. A minor injuries unit or urgent care centre was being considered as part of the enhanced GP surgery and it was hoped this would progress to a 24:7 service over time.

Comments received by the consultation so far had included that the historic nature of the site be preserved and having a polyclinic-style facility at St. George’s in order ease the pressure on Queen’s Hospital. Concerns had also been raised about the amount of housing on the site. Officers were happy to give an update to the Committee after the end of the consultation period.

Whilst noting that a second, more detailed consultation document was available, Members remained concerned that there was a lack of detail about the St. George’s plans. Officers emphasised that more detailed proposals would be  ...  view the full minutes text for item 60.

To note that Havering Local Involvement Network (LINk) will cease operations on 31 March 2013 and that Healthwatch Havering will commence formal operation on 1 April 2013.

The Chairman thanked Havering LINk for the work carried out by its highly professional volunteers. The Chairman felt that, unlike in many boroughs, the Committee had worked very well with the LINk and it was felt that for example the LINk’s enter and view visits had been very effective.

The Vice-Chair of Havering Link agreed that the LINk’s relationship with overview and scrutiny had been very productive and better than in many other areas. Thanks were recorded to the Committee Chairman for her support and also to the LINk coordinator for her work throughout the LINk’s period of operation. A legacy document had been produced by the LINk which would aid the transition to Healthwatch. He felt that the LINk had made a difference and that Healthwatch would also be successful.

It was felt that the series of topic group meetings looking at patient discharge had been very helpful and that the LINk had made progress in for example getting hospitals to make more use of the butterfly signs indicating patients with sensory difficulties.

The Committee recorded its thanks to Havering LINk for its work and noted that Healthwatch Havering would commence operations on 1 April 2013.