Agenda and minutes

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.

The Chairman gave details of arrangements in case of fire or other emergency requiring the evacuation of the meeting room.

Apologies for absence were received from:

Councillor Abdus Salam, Barking & Dagenham

Councillor High Cleaver, Redbridge

Councillor Khevyn Limbajee, Waltham Forest

Also present were:

Councillor Paul McGeary, London Borough of Havering

Emma Lexton, Vice-Chair, Havering LINk

Joan Smith, Coordinator, Havering LINk

Sue Boon.NELFT

Bob Edwards, NELFT

John Vile, NELFT

Nick Hulme, BHRUT

Scrutiny officers present:

Anthony Clements, Havering (minutes)

Glen Oldfield, Barking & Dagenham

Corrina Young, Waltham Forest

There were three members of the public present.

Members are invited to disclose any pecuniary interest in any of the items on

the agenda at this point of the meeting.

Members may still disclose any pecuniary interest in an item at any time prior

to the consideration of the matter.

There were no disclosures of interest.

To approve as a correct record the minutes of the meeting held on 10 April 2012 (attached) and authorise the Chairman to sign them.

It was noted that Councillor Maravala from Redbridge had not in fact been present at this meeting. Subject to this correction, the minutes were agreed as a correct record and signed by the Chairman.

Under matters arising, a Member asked for details of how patient experience could be measured, as mentioned by the Medical Director of NHS ONEL at the previous meeting. It was agreed that the Clerk to the Committee would contact the health officer concerned and ask for further details on this point.

To receive an update from senior BHRUT officers on key issues facing the Trust.

The Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) officer explained that the Care Quality Commission had recently acknowledged improvements in maternity services at the Trust and had removed the remaining restrictions placed on the service. He felt that the maternity unit at King George would most likely close in mid-2013 but final decisions on timescales had not yet been taken.

A midwife-led unit would be based at King George with more special care and neo-natal beds installed at Queen’s. Work was also under way with commissioners to ensure more capacity at other hospitals once the maternity unit at King George was closed. It was confirmed that the cap on maternity cases from other areas being seen at BHRUT had now been lifted. There was no longer any daily limit on numbers of births at BHRUT but an annual cap of 8,000 births per annum was still in place.

Monthly reports of maternity activity would continue to be presented at the BHRUT Board. It was emphasised that it would not be safe for there to be in excess of 8,000 births per year carried out at BHRUT and that deliveries would have to be carried out elsewhere once this limit was reached. The issue of women’s choice had been considered as part of the Health for North East London (H4NEL) consultation but officers were happy to have further discussions around this.

The vacancy rate at BHRUT maternity was now only 2-3% which was considered negligible. The Trust would provide information on where midwives were recruited from as well as retention figures for maternity staff.

It was accepted that BHRUT continued to face a considerable challenge in meeting the four hour target for A&E treatment. Discharge issues were also being considered in order to reduce the average length of stay in hospital. Work on this was under way with community services, social care and other stakeholders. A reduction in length of stay would be required if Queen’s was to accommodate the larger A&E department needed in light of the Health for North East London reconfiguration.

Members were sceptical that A&E at Queen’s could cope with any further increase in demand, even if other parts of the hospital offered good care. The BHRUT officer responded that he was taking the lead on the outline business case for the extension of A&E. These works would include more resuscitation bays, six more beds in Majors and improvements to the general flow of patients in A&E. The department would be both expanded and redesigned. The BHRUT officer agreed to bring the plans for A&E back to the Committee once they had been considered by the Trust Board in August 2012. He was also happy to take the plans to the individual borough Health Overview and Scrutiny Committees.

It was emphasised that the A&E at King George would not be closed until it had been confirmed that Queen’s A&E could cope with the larger number of patients.  ...  view the full minutes text for item 5.

Discussion on proposed changes to acute care services at NELFT.

NELFT officers explained that the introduction of home treatment teams had led to fewer in-patient beds being needed for local mental health services. NELFT had a fairly long average length of stay (20-25 days) but someone did have to be quite ill to be admitted. Mascalls Park acute hospital had been shut in recent years and a new but smaller in-patient unit opened at Sunflowers Court, Goodmayes Hospital. Younger adult in-patients were treated at Naseberry Court in Waltham Forest.

Naseberry Court had a total of 41 beds for patients of 16 years and over. The unit was 16 years old but had what was now an outdated design. The Committee was welcome to visit Naseberry Court if it wished. Staff observation was often difficult in the unit and there were sometimes problems with people absconding. Naseberry Court was also at least 25 minutes drive from Goodmayes Hospital which could make it difficult if support was needed from the other unit.

The NELFT officers emphasised that most mental health services were now provided in the community. The total number of hospital beds across the NELFT area was now less than 300, a far lower figure than previously. The NELFT home treatment team also worked on wards in order to assist discharge etc. If Naseberry Court was to be closed, NELFT aimed to commission a home treatment team for older people as well as support people with dementia. The overall effect of the proposed reorganisation would be to reduce total numbers of NELFT adult male beds from 80 to 75 and adult female beds from 58 to 40. Beds in Sunflowers Court at Goodmayes Hospital would rise by 20 male and 5 female beds.

Naseberry Court now only rarely reached 100% occupancy. Its closure would allow NELFT to create additional home treatment teams and increase staffing levels on acute wards. It was emphasised that the closure of Naseberry Court was for clinical reasons and had been driven by clinicians. The closure would also produce a financial saving which would assist NELFT to make its required efficiency savings.

There would be a three month public consultation starting shortly. This would be led by NHS North East London and the City although NELFT would be partners. This would be followed by a one month staff consultation period. Subject to the results of the consultation, it was possible that Naseberry Court would be closed in February 2013 although this was not definite.

It was felt that locating the inpatient service at Goodmayes would allow more equality of access across the local boroughs. An equalities impact assessment had been carried out on the change and the longer travel distances were being considered by the NELFT carers’ reference group.

NELFT was now providing both community and mental health services and this would allow services to be integrated more closely. For example smoking cessation and weight management services could be offered, where appropriate, to mental health service users. It was agreed that the dates for  ...  view the full minutes text for item 6.

Report attached.

As the representative from Whipps Cross University Hospital NHS Trust had been unable to attend the meeting, it was AGREED that this item would be taken at the Committee’s October meeting.

It was also AGREED that an update from BHRUT should be taken as a standing item at future meetings and that the Care Quality Commission should be invited to give an update on its views on BHRUT’s performance, either directly at a future meeting or in writing.

Members remained concerned about transport links to and between local hospitals and asked that the borough engagement officer for Transport for London arrange for colleagues to brief the Committee on hospital transport issues at the next meeting.

Subject to the comments shown above, the Committee AGREED its outline work programme as shown in the agenda papers.

Provisional dates as shown below, for agreement by the Committee. Start times and host Councils also to be agreed.

Tuesday 9 October

Tuesday 8 January (2013)

Tuesday 9 April

It was AGREED that, subject to accommodation being available, the Committee’s remaining meetings of the municipal year would be held in Barking & Dagenham, then Redbridge, then Waltham Forest.

Following a discussion, the Committee also AGREED to keep meeting start times unchanged at 3.30 pm.

To consider any other item in respect 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 at the meeting as a matter of urgency.

A representative of Havering Local Involvement Network (LINk) explained that the organisation had recently published its annual report and gave a brief summary of the work the LINk had been doing.

The Chairman congratulated the LINk on its work and on how it had successfully worked together with scrutiny in Havering.