Agenda and minutes

The Chairman gave details of arrangements in case of fire or other event that may require evacuation of the meeting room or building.

Apologies were received from Councillor June Alexander, Councillor Ray Morgon substituting.

There were no disclosures of interest.

The Sub-Committee asked to note recent membership changes.

The Sub-Committee noted changes to its membership that had been made following the Annual Council meeting.

To agree as a correct record the minutes of the meeting held on 10 March 2016 and of the joint meeting with the children and learning overview and scrutiny sub-committee held on 20 April 2016 and to authorise the Chairman to sign them (attached).

The minutes of the meeting of the Sub-Committee held on 10 March 2016 and of the joint meeting with the Children & Learning Overview and Scrutiny Sub-Committee held on 20 April 2016 were agreed as a correct record and signed by the Chairman.  

To receive a presentation from Alan Steward, Chief Operating Officer, Havering Clinical Commissioning Group (CCG).

Due to the absence through illness of a representative from Havering Clinical Commissioning Group (CCG) this item was deferred to the next meeting of the Sub-Committee.

Update from Alan Steward.

In the absence of a representative from Havering CCG, it was agreed that the Clerk to the Sub-Committee should seek to obtain a written update on this issue and circulate this to Members.

Update from Alan Steward.

In the absence of a representative from Havering CCG, it was agreed that the Clerk to the Sub-Committee should seek to obtain a written update on this issue and circulate this to Members.

Report attached.

The Interim Director of Public of Public Health explained that Havering had met its target for HIV testing and had made progress on the numbers of schools achieving the Healthy Schools award. It was noted that this was due to become a traded service and that schools would be asked to pay £595 p.a. for healthy schools support.

The percentage of women smoking at the time of delivery had fallen and this was expected to reduce further as the population of Havering became more diverse.

It was accepted that the target for the number of eligible patients offered a NHS Healthcheck was not being met. This service was commissioned from Havering GPs and was a mandated service that the Council was required to commission. The Director explained however that this was similar to performance in other geographical areas and there was no evidence that healthchecks improved a person’s overall health.

Healthchecks were required to be provided every 5 years to patients aged 40-74, unless they were already on a GP’s disease register. Healthchecks included tests of Body Mass Index, blood pressure and cholesterol. Patients would be written to when their healthcheck was due although some GPs undertook this if a patient visited the surgery for other reasons.

It was emphasised that it was mandatory for the Council to commission the Healthcheck service but it was uncertain what sanctions would be taken against the Council if this was not done. Audits were undertaken to ensure healthchecks were carried out and GPs were required to enter data from healthchecks on a computer system before they could be paid for this work. Public Health England expected healthchecks to be carried out but there remained a lot of contradictory evidence as to their effectiveness.

Information was held on which GPs did not do healthchecks and publicising this was one possibility. Another option could be to work via the Accountable Care Organisation to make the carrying out of healthchecks more appealing to local GPs. It was also possible that more demand for healthchecks could be created through for example, an article in Living in Havering but it was important to avoid duplication and overspending of the healthcheck budget which was around £200,000.

The Director added that no savings were predicated on the impact of healthchecks as they were not felt to keep people out of hospital. The Director felt there was no evidence that the healthcheck programme was delivering on its purpose and that the resources committed could be used in a different way.  

The Sub-Committee NOTED the position.

To be tabled.

The Director explained that targets for participation in the national child measurement programme were being met and that the programme measured children in reception and year 6 in order to build up a database of information on childhood obesity. HIV testing targets were also continuing to be met.

The current provider was not meeting the target for the successful completion of drug treatments and the commissioner (the Council) and the provider were currently working on an action plan to address this.

The target for new birth visits by health visitors was being met by this service provider – NELFT.

The indicators chosen by the Council were some of only a few quantitative indicators in the public health service plan and the Sub-Committee could scrutinise quarterly performance against the service plan if it wished. It was AGREED that the annual report of the Joint Strategic Needs Assessment, as presented to the Health and Wellbeing Board, should be brought to the next meeting of the Sub-Committee.

Ian Buckmaster, Director, Healthwatch Havering, will present the organisation’s annual report (attached).

A director of Healthwatch Havering explained that Healthwatch was a statutory body established by the Health and Social Care Act 2012 in succession to earlier organisations such as Community Health Councils. Patient and Public Involvement Forums and Local Involvement Networks. A Healthwatch organisation had been established for every London borough and county and there was also a national Healthwatch England organisation.

Healthwatch represented the interests of patients and service users and had the unique statutory power of being able to undertake enter and view visits to health and social care premises.

There was a small team of part-time, paid Healthwatch staff but much of the organisation’s work was undertaken by volunteers who included several former Health Service employees. In addition to involvement with several of the Overview and Scrutiny Sub-Committees, Healthwatch was a full member of the Health and Wellbeing Board and also sat on the CCG’s Primary Care Commissioning Committee which allocated contracts to GPs. Healthwatch was also represented on the local Urgent Care Board. Healthwatch worked closely with the Care Quality Commission, NELFT, BHRUT and other Healthwatches in the local area.

All reports on enter and view visits undertaken were published on the Healthwatch website. The programme of visits had recently been extended to include GP practices and a report on this would be brought to a future meeting of the Sub-Committee. A total of 26 enter and view visits had taken place in the year under review and this included to Whipps Cross Hospital (which was used by some Havering patients) and St Francis Hospice.

Other Healthwatch activities included the introduction of ‘Tell us what you think’ cards that allowed people to comment, positive or negatively, on health and social care services and working with the local Positive Parents group for the parents of children with learning disabilities in order to improve links for this group with the Council, NELFT and the CCG. A joint review on delays to treatment at BHRUT had been established by Healthwatch and the Sub-Committee and this was believed to be the first such joint review in the country.

Survey work by Healthwatch had investigated why people went to A & E and showed low awareness among patients of alternative facilities such as community treatment teams and urgent care centres. Other Healthwatch research showed that most people preferred to speak to a person face to face regarding a medical issue rather than use a website or app.

The Healthwatch work programme for 2016/17 would include mental health, acute services, facilities for people with learning disabilities and domiciliary care. Healthwatch was funded principally via a grant of approximately £117,000 from the Council.

A representative of NELFT commended Healthwatch for the level of enter and view visits it undertook. The director felt that the organisation needed more volunteers in order to carry out its various workstreams. It was clarified that Healthwatch had only a very limited remit for children’s services.

The Sub-Committee NOTED the annual report of Healthwatch Havering.

It was AGREED that Councillors White, Patel and Alexander should be the Sub-Committee’s representatives on the Outer North East London Joint Health Overview and Scrutiny Committee.

It was also AGREED that Councillor White would be the Sub-Committee’s representative on any pan-London health scrutiny work that may be required.

Attached for discussion and approval by the Sub-Committee.

It was AGREED that updates on developments at meetings of topic groups, the Outer North East London Joint Committee etc, should be given at meetings of the Sub-Committee.

It was AGREED that an update on the stroke services reconfiguration process should be given at a future meeting of the Sub-Committee.

It was felt that scrutiny of the Accountable Care Organisation and Sustainability and Transformation Plan could be most effectively conducted at the Joint Committee level although updates could also be fed back to the Sub-Committee.

The Clerk to the Sub-Committee would circulate a revised version of the workplan to Members for information.  

To consider any other items of which the Chairman is of the opinion, by means of special circumstances which shall be specified in the minutes, that the item shall be considered as a matter of urgency.

There was no urgent business raised.