Agenda and minutes
Venue: Boardroom - Brent Civic Centre, Engineers Way, Wembley, HA9 0FJ. View directions
Contact: Toby Howes, Senior Democratic Services Officer 020 8937 1307, Email: toby.howes@brent.gov.uk
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Declarations of personal and prejudicial interests Members are invited to declare at this stage of the meeting, any relevant financial or other interest in the items on this agenda. Minutes: Councillor Ketan Sheth declared an interest as a member of the Council of Governors for the Central and North West London NHS Foundation Trust, however he did not view this as a prejudicial interest and remained present to consider all items on the agenda. |
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Minutes of the previous meeting held on 28 January 2014 PDF 114 KB The minutes are attached. Minutes: RESOLVED:-
that the minutes of the previous meeting held on 28 January 2014 be approved as an accurate record of the meeting. |
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Matters arising (if any) Minutes: None. |
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Mental Health Services in Brent PDF 57 KB The report provides an overview of the mental health services provided in Brent for people with severe mental health issues. The report is divided into two parts:
· Community Mental Health Services · Acute Mental Health Services at Park Royal: including details of wards, structure, patient data and information on discharge/transfer delays. Additional documents:
Minutes: The Chair invited a service user to describe her experience of mental health services in Brent. The service user began by informing the committee that she had extensive experience of the treatment provided by the mental health service in the borough. In her view she felt that over a period of time the service had deteriorated, particularly in terms of patient access and had become more bureaucratic with monitoring undertaken on a points based system. Whilst her condition was now improving as she steadily undertook a process of reintegration, she felt that her cause had not been helped by what she saw as a rolling back of services. A number of community services had been withdrawn and there was a lack of transitory services for patients. The service user had made a request for a community psychiatric nurse, however this had been turned down and she had been offered a social worker instead, however they lacked the medical knowledge to be able to help. The service user felt that the service focused too much on crisis intervention rather than crisis prevention and patients were taking too long to be seen. The cost reductions in mental health services were also impacting, which she suggested was a reason why she had been told she was not unwell enough to be provided with treatment, whilst she also felt that patients were discouraged from being admitted to hospital. Her own personal experience of staff in the mental health service was positive, however she felt that they were frustrated by continuous cost cutting.
The Chair thanked the service user for their contribution and asked that they liaise with mental health services to discuss their case.
Robyn Doran (Chief Operating Officer, Central and North West London NHS Foundation Trust ) welcomed discussion with the service user and their input into helping redesign the service. Robyn Doran then presented the report that had been jointly produced by Brent Clinical Commissioning Group (CCG), the council and the Central and North West London (CNWL) NHS Foundation Trust. The report mainly focused on adults, however members heard that a report on children’s mental health services could be provided at a future meeting. Members heard that around 25% of people will have mental health problems at some stage during their lives. In most cases, they would be cared for by their GP and carer and possibly a representative from the voluntary and community sector. Up to around 2,500 people may be using mental health services in Brent at any one time. Robyn Doran drew the committee’s attention to the number of patients recorded with depression and the number of new diagnosis of depression in 2012/13 in the borough. Funding in the borough was middling compared to the other London boroughs. However, there was a need to redesign the service to address issues such as waiting times, urgent care and how to ensure people who received treatment remained well. There also needed to be steps taken to improving access to psychological therapy ... view the full minutes text for item 4. |
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Task Group Report on Tackling Violence against Women and Girls in Brent PDF 91 KB Members of the Health Partnership Overview and Scrutiny Committee (HPOVS) on a number of occasions, expressed an interest in forming a task group to tackle violence against women and girls in Brent; focusing on Female Genital Mutilation (FGM), Honour Based Violence (HBV) and Forced Marriages (FM).
The task group was agreed by HPOVS in March 2013 and has used this time to conduct an in-depth review into harmful practices. The task group report is attached as appendix A. Additional documents:
Minutes: The Chair invited Councillor John, chair of the task group for tackling violence against women and girls in Brent, to present the report to committee.
Councillor John advised that the task group started its work in 2013 to look at issues such as female genital mutilation (FGM), honour based violence and forced marriages. Members heard that such inequalities existed across the World and these were cited in the report. The United Nations had identified FGM as being a global epidemic and the practice was widespread. FGM represented a violation of both children and women, however there had not been many measures to address the problem until recent publicity. It was estimated that there were around 14 million forced marriages each year Worldwide and this was also happening in the UK, as had been reported by the Evening Standard newspaper recently. As a result, the Government was setting up initiatives to address this issue.
Councillor John emphasised the need for the Children’s Safeguarding Board, the Health and Wellbeing Board, the Safer Brent Partnership and the Assistant Chief Executive’s Service to work together to prevent such practices from being carried out in the borough and of the need for each of these organisations to ensure proper data sharing between each of them and this was captured in the task group’s second recommendation. Councillor John referred to two examples of women who had been subject to forced marriages and had managed to escape to the UK where they now felt safe. She then advised the committee that it was the council’s duty as a corporate parent to safeguard babies, children and young women from harm. GP practices and schools should also play their role and every effort should made to eliminate these practices in the borough. Councillor John thanked all other members of the task group and Kisi Smith-Charlemagne (Scrutiny Officer, Assistant Chief Executive’s Service) for their participation in the task group and in producing the report. Councillor John then referred to the twelve recommendations in the task group report and asked for the committee to agree them.
During discussion, it was enquired what steps would be taken to move the recommendations forward and how would Brent CCG facilitate recommendation twelve.
In reply, Councillor John advised that following approval from the committee, the recommendations would then be presented to the Executive on 24 March. She added that recommendation two would be facilitated by the Assistant Chief Executive’s Service. Cathy Tyson (Head of Policy and Scrutiny, Assistant Chief Executive’s Service) added that it was important that a coordinated approach was taken and the Policy Team was in the process of outlining responsibilities and to monitor and coordinate action. Updates would also be provided to the committee and the Corporate Management Team. Jo Ohlson (Chief Operating Officer, Brent CCG) confirmed that Brent CCG would be commissioning services in respect of recommendation twelve and was keen to support the initiatives.
The Chair thanked the task group for their work and report and felt that the information ... view the full minutes text for item 5. |
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Future of Central Middlesex Hospital and Willesden Centre for Health PDF 63 KB The reports are attached. Additional documents:
Minutes: The Chair referred to the fact that this item had been deferred from the previous meeting as members had wanted more information, particularly in relation to Brent Mental Health Services moving to Central Middlesex Hospital (CMH).
Rob Larkman (Chief Officer, Brent Clinical Commissioning Group) presented the report that provided an update on the future of Central Middlesex Hospital (CMH) and Willesden Centre for Health (WCH). He explained that CMH was currently underused and so consideration was being given as to how to utilise the site more, including providing additional services. CMH was also being considered in the context of Shaping a Healthier Future (SaHF) and Rob Larkman drew members’ attention to the report summarising the programme to date. Rob Larkman then referred to the report outlining the three options that had been considered for CMH and advised that option two, considering a long list of all potential additional services that could be safely and practically provided at the site, had been the one pursued. As a result of the exercise undertaken, it had been determined that following additional services would be provided at CMH:
· Hub Plus for Brent · Elective Orthopaedic Centre · Re-locate Brent’s Mental Health Services from Park Royal Centre for Mental Health to CMH · Regional genetics service relocated
The SaHF programme also had implications for WCH which had historically been underused and Brent CCG was due to consider the two preferred options at a meeting of the Governing Body in March.
During members’ discussion, it was felt that there was a lack of information regarding proposals for the Park Royal Centre (PRC) and details of services presently provided there were sought. In respect of mental health services, it was asked where this would be located and how would the remaining wards be accommodated. The percentage of resources set aside to undertake the reconfiguration of mental health services was requested. A member asked whether free parking spaces would be available at CMH as they currently were at PRC. Another member commented that there had been a wide range of views expressed at the public engagement meeting on 19 February and if the CMH was to be fully utilised, will it be fit for purpose to be able to do so. Details of the costs of moving services to CMH and the total number of bed spaces were sought. It was commented that there seemed to be a lack of space around the beds in CMH in comparison to Northwick Park Hospital (NPH). Information was also sought in respect of a memory clinic, treatment teams and a home treatment team.
A member felt that following visits to CMH, PRC and NPH, that NPH had significantly more space than the other sites and appeared to be more suitable to accommodate some services that CMH would provide. There was also an apparent lack of outside space at CMH and it was suggested that a lot more work would be needed before CMH could accommodate such services. It was queried where the ... view the full minutes text for item 6. |
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Redesign and Investment in Diabetes Services in Brent PDF 54 KB Members will remember that, at the last committee meeting in January, it received a report that outlined the range of diabetes services provided in Brent. The committee requested that a follow up report be provided to this meeting with more details on the planned changes to the way diabetes services are delivered that were mentioned in the original report. In response to the committee’s request, this report outlines the rationale for changes in services. The redesigned services will focus on providing integrated care in a community setting in line with national and local guidance and priorities.
A subsidiary report is also attached, which provides an update on the Diabetes Task Group recommendations which were reported to, and approved by, the committee in February 2013. Additional documents:
Minutes: Dr Ajit Shah (Clinical Director, Brent CCG) introduced the report that provided an update of the redesign and investment of diabetes services in Brent and the case for change. Members noted that the recorded prevalence of diabetes in Brent according to GP records was 8.1%, higher than both the London and the national rate. However, Diabetes UK reported a higher prevalence in the borough, at 10.5% which included an estimate of undiagnosed cases and was the highest in the UK compared to a national rate of 7.4%. In terms of other complications arising from diabetes, however, Brent generally performed better than the national average. Dr Ajit Shah then drew members’ attention to the various schemes as set out in the report to address the comparatively high diabetes rates in the borough, such as the diabetes insulin local enhanced services (LES) and Brent CCG’s response to the recommendations made by the committee’s task group on diabetes.
During members’ discussion, reasons were sought as to why Newham had significantly more diabetic specialist nurses than Brent. Clarification was sought with regard to the £1.030m figure quoted as the new total cost of diabetes pathway costing and also an explanation of footnotes ‘c’ and ‘d’ on page 243 of the report. Another member enquired how many times would a diabetic patient be expected to attend a clinic and what treatment would they receive. The total number of patients who were taking insulin injections was asked and it was also queried why the total cost per patient for diabetes treatment had risen. A member also commented that they felt that secondary services appeared insufficient.
In reply to the issues raised, Dr Ajit Shah explained that about 15% of his practice’s patients had diabetes and most only required his support and that of the practice’s nurse. Members were informed that on average diabetic patients would visit a clinic between three to four times a year, although if the condition was particularly acute it could be more like 15 to 20 times a year. Typically a diabetic patient would be given a blood pressure check, have their feet measured and there would be a review of their medication and a discussion about their diet and the level of control they had over their condition. A change in medication would be undertaken if deemed appropriate. It was not known precisely how many patients in Brent were taking insulin injections. With regard to footnotes ‘c’ and ‘d’ in the report, Dr Ajit Shah explained that these were used as a way of identifying more patients to receive the appropriate treatment, although kidney disease in Brent was lower than the national average.
Isha Coombes (Assistant Director, Brent CCG) advised that the diabetic specialist nurses in LB Newham also carried out paediatric work, whilst in Brent patients could access the DESMOND scheme.
Dr Ethie Kong explained that the diabetic specialist nurses provided support resources for practices and would not necessarily have a direct, hands on role. She added that the administering ... view the full minutes text for item 7. |
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18 Weeks Referral To Treatment Incident and Urology Serious Incident PDF 56 KB The reports are attached. Additional documents: Minutes: Tina Benson (Deputy Chief Executive, North West London Hospitals NHS Trust) presented the item and advised that the final report on the incidents was awaited. Tina Benson confirmed that no significant harm had been identified to individual patients, however an elevated risk existed for all patients who had waited too long. Members heard that all deaths amongst patients waiting longer than 18 weeks had been reviewed and four of these deaths were under clinical review. The committee noted that the Trust had reduced its overall waiting list size and the number of patients waiting over 18 weeks and that overall progress was slightly ahead of schedule.
A member sought clarification as to when the final report would be published. Another member expressed their approval of the Trust’s progress since the incidents, however she was surprised that there were problems in recruiting theatre nurses at Northwick Park Hospital, particularly as new surgery theatres had been built there.
In reply, Tina Benson advised that the final report was being produced by an independent organisation and although a final publication date could not be confirmed at this stage, it was anticipated that it would be ready for a Trust Board meeting in April. She also advised that theatre nurses were hard to recruit as it was not a popular option amongst nurses, however it was possible that there may be interest from Philippines trained nurses and this was being pursued. |
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Health Partnerships Overview and Scrutiny Committee work programme 2013/2014 PDF 42 KB The work programme is attached. Minutes: The work programme for 2013/14 was noted by the committee. |
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Date of next meeting The next meeting of the Health Partnerships Overview and Scrutiny Committee will be confirmed at the Annual Council meeting on 4 June 2014. Minutes: It was noted that the next meeting of the Health Partnerships Overview and Scrutiny Committee would be confirmed at the Annual Council meeting on 4 June 2014. |
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Any other urgent business Notice of items to be raised under this heading must be given in writing to the Democratic Services Manager or his representative before the meeting in accordance with Standing Order 64. Minutes: None. |