Agenda and draft minutes

Joint Health Overview & Scrutiny Committee
Thursday, 26th July, 2018 4.00 pm

Venue: Council Chamber - Town Hall. View directions

Contact: Anthony Clements  Email: anthony.clements@oneSource.co.uk 01708 433065

Items
No. Item

1.

CHAIRMAN'S ANNOUNCEMENTS

The Chairman will announce details of the arrangements in case of fire or other events that might require the meeting room or building’s evacuation.

Minutes:

The Chairman have details of the arrangements in case of fire or other events that might require the evacuation of the meeting room or building.

2.

APOLOGIES FOR ABSENCE AND ANNOUNCEMENT OF SUBSTITUTE MEMBERS (if any) - receive.

Apologies have been received from Councillors Beverley Brewer (Redbridge) Chris Pond (Essex) and Emily Rodwell (Barking & Dagenham).

Minutes:

Apologies were received from Councillors Eileen Keller and Emily Rodwell, Barking and Dagenham, Beverley Brewer, Redbridge (Muhammed Javed substituting) and Chris Pond, Essex.

3.

DISCLOSURE OF INTERESTS

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 point prior to the consideration of the matter.

Minutes:

There were no declarations of interest.

4.

MINUTES OF PREVIOUS MEETING pdf icon PDF 138 KB

To agree as a correct record the minutes of the meeting held on 13 February 2018 (attached) and to authorise the Chairman to sign them.

Minutes:

The minutes of the meeting of the Committee held on 13 February 2018 were agreed as a correct record and signed by the Chairman.

5.

BHR CCGs - COMMUNITY URGENT CARE SERVICES CONSULTATION pdf icon PDF 68 KB

Report and details of consultation attached.

Additional documents:

Minutes:

With the agreement of the Chairman, a member of the public briefly addressed the Committee. The member of the public wished to raise what she considered the poor state of local health services, particularly in the Ilford South area. This area had the worst GP ratio of the three boroughs with, the member of the public contended, local residents waiting up to 11 weeks for a GP appointment.

 

It was felt that the urgent care consultation ignored this very serious situation. and that the local CCGs did not know what was happening in the locality. Loxford polyclinic was not functioning as a walk-in centre and a lot of diagnostic equipment had been removed from the site.

 

In the view of the member of the public, there was not a GP hub at Loxford Polyclinic and appointments there could not be booked via NHS 111. Appointments could only be booed at the site and poor signage meant people did not know about the clinics available. It was felt that it should be noted that the Loxford area was the most deprived in Redbridge with many people for whom English was a second language and for whom it was therefore difficult to telephone for an appointment.

 

The member of the public felt that Loxford Polyclinic should be made an Urgent Treatment Centre in order to reduce the numbers of people attending A & E at King George Hospital.

 

Officers representing the Commissioning Support Unit confirmed that the public consultation period would close at 5 pm on 21 August 2018. Urgent care – care needed the same day for illness, cuts or minor injuries, was mainly delivered by GPs though also by community pharmacists. It was felt that there was a case for change in rationalising the way in which urgent care was delivered, particularly in the evenings or at weekends.

 

GP access hubs currently delivered urgent care at evenings and weekends via a separate telephone number from NHS 111. One third of these patients could be given advice by phone rather than needing to see a GP face to face and this was the same for walk-in centres. There were currently seven local GP hubs covering Barking & Dagenham, Havering and Redbridge and four walk-in centres.

 

It was felt that the best person to see for urgent care was a GP although officers accepted that it could be challenging to access GP services. GP services themselves were not being consulted upon. Officers felt that change was needed for a variety of reasons including public confusion over where best to go for treatment, national guidance on the need to improve facilities and the need to upgrade urgent care centres to urgent treatment centres, allowing x-rays, blood tests, diagnostics etc.

 

Officers felt that the NHS 111 service had improved over recent years the new service provider starting on 1 August would increase to 50% the proportion of callers able to speak to a clinician. It was proposed that both options would allow a single phone number  ...  view the full minutes text for item 5.

6.

NEW NHS 111 CONTRACT pdf icon PDF 66 KB

Report attached.

Additional documents:

Minutes:

The Committee was advised that the new NHS 111 service would go live on 1 August 2018. The service, which had been procured jointly by the North East London CCGs, would be provided by London Ambulance Service. Competent health advice would be provided by phone or on line and callers could still be booked to see a clinician if necessary. Translators and Typetalk facilities for deaf callers would also be available.

 

Pathways has been developed to refer people back to their GP if necessary and a clinical assessment service would be based within NHS 111, comprising multi-disciplinary staff. It was planned that, shortly after the launch date, NHS 111 clinicians would have access to a patient’s health care records (with a patient’s consent). This would facilitate a quick transfer to a mental health assessment, should this be required.

 

The new system would allow consistency of approach through a single contact number. The service would be monitored closely with a patient participation group also being established. National metrics on e.g. rates of abandoned calls would be collected as would local metrics. Any instances of misdiagnosis would be monitored and investigated but it was felt that overall outcomes should improve under the new service.

 

A monthly Clinical Governance Group covered the whole of London and allowed learning to be shared and patient experience surveys would be undertaken.

 

The representative of Healthwatch Havering felt that views of NHS 111 differed across the local boroughs with, for example, lower use of the service being seen in Havering, where more people tended to present themselves at Queen’s Hospital A&E. There was therefore a need to persuade more people in Havering to use NHS 111 and this did not seem to have been addressed thus far. Officers accepted that A&E departments should advise people to call 111 where appropriate and the service would shortly be advertised in A&E.

 

Health advisors at NHS 111 undertook a six week training course and had their calls audited before being allowed to go live on the system. There had not been any instances at NHS 111 of missed cases of e.g. sepsis. Advisers were supported and calls could be referred on to the Clinical Assessment Service as required. It was possible that skype calls could be introduced to the service in the medium term. The clinical decision software used by the service would also be more sophisticated in the future.

 

Staff would be transferred from the current service provider under the TUPE regulations and it was noted that the London Ambulance Service already provided the NHS 111 service in South West London. The service call centre would be based in Barking. There would be a ratio of 1 clinician to four call handlers and this would include other clinicians such as pharmacists. This was considered an adequate level of cover and the processes for establishing them could be shared with the Committee.

 

It was agreed that an update on the performance of the NHS 111 service should  ...  view the full minutes text for item 6.

7.

PROPOSED AMENDMENTS TO JOINT COMMITTEE'S TERMS OF REFERENCE pdf icon PDF 68 KB

Report attached.

Additional documents:

Minutes:

A report of the clerk invited the Joint Committee to agree some minor changes to the Committee’s Terms of Reference which sought to encompass how the Joint Committee and the relevant boroughs worked in practice and also reflect recent changes to NHS structures.

 

The recommendation of the report – that the changes to the Committee’s of Reference as shown in the report appendix be agreed) was agreed unanimously with one further amendment that clause 6 of the Terms of Reference be amended to start as follows:

 

If a member is unable to attend a particular meeting, he or she may arrange for any appropriate Member of the borough Council to attend as substitute, provided that a Member having executive responsibilities may not act as a substitute.

8.

JOINT COMMITTEE'S WORK PLAN 2018-19 pdf icon PDF 79 KB

Report attached.

Minutes:

The initial work plan for the Joint Committee was agreed as shown in the report to the Committee. Additional items for inclusion on the work plan included proposed changes to cancer services in the locality.

9.

SCHEDULE OF FUTURE MEETINGS

The Joint Committee is asked to discuss and agree the schedule of future meetings for the 2018-19 municipal year. This is provisionally as follows:

 

Tuesday 2 October 2018, 4 pm, Barking & Dagenham

Tuesday 15 January 2019, 4 pm, Waltham Forest

Tuesday 9 April 2019, 4 pm, Redbridge

Minutes:

The schedule of meetings for the remainder of the 2018/19 municipal year was agreed as follows:

 

Tuesday 2 October 2018, 4 pm, Barking & Dagenham

Tuesday 15 January 2019, 4 pm, Waltham Forest

Tuesday 9 April 2019, 4 pm, Redbridge