Agenda and minutes

Community and Wellbeing Scrutiny Committee
Wednesday 28 February 2018 7.00 pm

Venue: Boardrooms 3-5 - Brent Civic Centre, Engineers Way, Wembley, HA9 0FJ. View directions

Contact: Nikolay Manov, Governance Officer 

Items
No. Item

1.

Apologies for absence and clarification of alternate members

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 64.

Minutes:

The following apologies for absence were received:

·                     Councillor Colwill

·                     Councillor Hector

·                     Councillor Jones

·                     Helen Askwith (Co-opted Member)

·                     IramYaqub (Co-opted Member)

·                     Simon Goulden (Co-opted Member)

·                     Lesley Gouldbourne (Observer)

·                     Jean Roberts (Observer)

 

2.

Declarations of interests

Members are invited to declare at this stage of the meeting, any relevant disclosable pecuniary, personal or prejudicial interests in the items on this agenda.

Minutes:

Councillor Ketan Sheth declared that he was a lead governor at Central and North West London (CNWL) National Health Service (NHS) Foundation Trust. 

 

3.

Deputations (if any)

To hear any deputations received from members of the public in accordance with Standing Order 67.

Minutes:

There were no deputations received.

 

4.

Minutes of the previous meeting pdf icon PDF 130 KB

To approve the minutes of the previous meeting as a correct record.

 

Minutes:

RESOLVED that the minutes of the previous meeting, held on 31 January 2018, be approved as an accurate record.

 

5.

Matters arising (if any)

Minutes:

None.

6.

Tuberculosis: Prevalence in Brent (verbal update)

Minutes:

OrderDr Melanie Smith (the Council’s Director of Public Health) delivered a presentation on the prevalence of Tuberculosis (TB) in Brent. She highlighted that despite the fact that Brent’s rates of TB infection per 100, 000 people were declining, they remained above the average for England and the rates used by the World Health Organisation (WHO) to identify areas of high prevalence. In relation to available data, Dr Smith noted that figures post-2014 were partially available, but there were not any aggregates. In terms of absolute numbers, there were approximately 200 cases registered a year in Brent. There had been a slight reduction in rates in recent years which could be due to improved detection rates, changes in healthcare and the requirement for nationals of certain countries to undergo an X-ray prior to applying for a visa. Referring to a slide showing TB cases by ethnicity, Dr Smith pointed out that the disease was most prevalent among the people of Indian origin. She reminded Members that as Brent was one of the most diverse boroughs in London, many residents came from or had spent long periods of time in countries experiencing high rates of TB.

 

The Committee heard that there were a number of cases of latent TB infection in Brent, which meant that people could live with the disease without experiencing any symptoms (such as cough) and without spreading it to others. While it was difficult to predict how many people infected with latent TB would develop the condition,  deprivation, homelessness, drunkenness and alcohol abuse were listed as some of the factors that could increase the risk of re-activation. Showing a slide illustrating the demography of those at most risk of developing TB, Dr Smith pointed out that there was a strong correlation between ethnicity and deprivation, with people of Black, Asian and Minority Ethnic (BAME) being most affected. Members of the Committee challenged the relationship between deprivation and travelling abroad, which led to Dr Smith explaining that this was due to the fact that people might have lived in a high-risk area before moving to the UK and it was not necessary associated with travelling after they had settled in Brent.

 

Dr Ajit Shah (Co-Clinical Director at Brent Clinical Commissioning Group (CCG)) explained that a special screening service had been run since May 2016 by Public Health in collaboration with Brent CCG and Harrow CCG. It was part of a national programme and it focused on patients aged 16 to 35 who had arrived in the UK in the past five years and had lived in a high-risk country. Using a screening questionnaire and blood tests for latent TB, the programme identified patients who were at risk of developing TB and who had not been tested or treated. Over 1,000 individuals had been tested as part of the programme in the period April 2017 – February 2018 and 193 results were positive, with treatment offered to those infected. Dr Shah noted that Brent and Harrow had high rates of  ...  view the full minutes text for item 6.

7.

Order of Business

Minutes:

RESOLVED that the order of business be amended to as set out below.

8.

Life Chances of Adults with a Learning Disability in Brent pdf icon PDF 215 KB

The report addresses how the local authority and its partners are helping to improve outcomes across social care, health, education and employment for adults with learning disabilities living in the Borough.

Additional documents:

Minutes:

Councillor Krupesh Hirani (Lead Member for Community Wellbeing) introduced the report which examined how the Local Authority and its partners were helping to improve outcomes for adults with learning disabilities living in Brent across social care, health, education and employment. The New Accommodation for Independent Living (NAIL) project had been successful, with a wide range of units (with capacity ranging from 6 to over 90) provided. However, despite the plans to expand the NAIL provision, there had been a number of challenges as it had been difficult for families to adjust to the changes made as their properties had been converted. Councillor Hirani concluded his presentation by saying that the Transforming Care Partnership and the Brent Learning Disability Forum were examining how the way services worked together could be improved.

 

Members asked questions that related to the life chances of adults with learning disabilities and enquired if these were better in Brent than in other boroughs. In response, Councillor Hirani said that housing and employment were the only areas in which specific targets had been defined. As people’s life expectancy increased, this put additional pressure on services which had to adapt to meet the rising needs of residents. Transport had been an area of uncertainty - there were barriers associated with the cost of travel for carers and although a number of options were available, it had not always been clear what they were entitled to. In relation to Brent’s provision, Duncan Ambrose (Assistant Director at National Health Service (NHS) Brent CCG) noted that the Borough had performed well in relation to annual health checks with 90% of residents registered with a General Practice (GP) surgery receiving a health check, which exceeded the national target of 64%. Furthermore, health passports had been introduced to summarise patients’ needs and options to migrate these to an electronic format were explored. Reasonable adaptations to services had been made – a Blue Light Tool Protocol had been developed to support individuals who had been considered to be at risk of inpatient admission to ensure that there were arrangements in place to provide urgent interventions to support them to stay in the community. Members heard that Brent was progressing the work around the Green Light Tool Kit to audit and improve mental health services so that they were effective in supporting people with learning disabilities, including autism (for further details, please see paragraphs 10.11 and 10.12 of the report on page 18 to the Agenda pack).  

 

Helen Woodland (the Council’s Operational Director for Social Care) said that not everyone who had a learning disability would be diagnosed with one as some residents could be able to use mainstream services without needing additional support. She pointed out that the number of people with learning disabilities was increasing and their needs were becoming more complex. She directed Members’ attention to section 7 of the report (page 14 of the Agenda pack) which contained information about a survey the Adult Social Care Directorate had undertaken in relation to  ...  view the full minutes text for item 8.

9.

Childhood Obesity pdf icon PDF 181 KB

The report describes the pattern of childhood obesity in Brent and action being taken to address the high levels.

 

Minutes:

Councillor Krupesh Hirani (Lead Member for Community Wellbeing) presented the report which described the pattern of childhood obesity in Brent and outlined the actions that had been taken to address the issue. The prevalence of childhood obesity in Brent was among the highest in the country and there was a clear link between deprivation and obesity (Graph 5 on page 82 of the Agenda pack). A number of actions, such as restriction of the opening of new fast food restaurants within 400 metres of a secondary school or a further education establishment, the Slash Sugar campaign, and the Healthy Early Years (HEY) Award, had been taken to address the problem. In addition, Public Health and Physical Education (PE) teachers had held a successful conference (‘The Power of an Active School) at Wembley Stadium in January 2018 where talks had been delivered to children about what they could do to be more active and improve their diet. Councillor Hirani reminded Members that despite the Soft Drinks Industry Levy (commonly known as ‘the Sugar Tax’) coming into force in April 2018 and the traffic light labels becoming mandatory for food outlets, promoting a balanced diet remained challenging as some businesses continued to organise ‘buy one, get one free’ promotions on unhealthy foods.

 

In relation to the timeframe for results to become noticeable, Councillor Hirani pointed out that the outcomes of the activities currently undertaken would not become visible in the next five to ten years.  He suggested that a similar approach as the one taken towards smoking should be adopted where the government had intervened to change people’s behaviour and he acknowledged that the introduction of the Soft Drinks Industry Levy would be a step in the right direction. When asked about the other underlying causes of childhood obesity, Councillor Hirani said that factors such as housing, employment and education had an impact on people’s health and their risk of becoming obese. This led to a discussion on the reasons why the obesity rate among people of Black, Asian and Minority Ethnic (BAME) origin was higher compared to other groups of the population. It was noted that apart from deprivation, culture played an important role as in some communities having overweight children meant that they were well fed which indicated that there were barriers that had to be overcome. Therefore, it might be necessary to target specific campaigns at these communities, run events with them and train key people within them to promote healthy lifestyle messages – for example, a stall would be set up as part of the Central Middlesex Hospital Community Hub and tailored messages had been delivered to residents at Diwali. Dr Melanie Smith (the Council’s Director of Public Health) added that the campaigns had to engage all family members because if both parents were obese, this could lead to an increased risk for their children.

 

Duncan Ambrose (Assistant Director at National Health Service (NHS) Brent CCG) expressed support for this approach and gave an example of promoting cardiovascular  ...  view the full minutes text for item 9.

10.

Home Care Overview and Scrutiny Task Group pdf icon PDF 83 KB

The report updates Members of the Committee about the final report produced by the Task Group to review the new home care commissioning arrangements.

Additional documents:

Minutes:

Councillor Sheth introduced the report of the Task and Finish Group on Home Care which had been set up in September 2017 to review the policy around the commissioning of home care in the Borough. He expressed his gratitude to the officers who had supported the Group, its Members and the Lead Member for Community Wellbeing. Councillor Sheth reminded the Committee that the recommendations to Brent Council’s Cabinet were on page 106 of the Agenda pack.

 

RESOLVED:

(i)    The contents of the Overview and Scrutiny Home Care Task Group Report, be noted;

 

(ii)  The following recommendations to Brent Council’s Cabinet be approved:

o   The London Living Wage is introduced incrementally as part of new commissioning model so that home care workers working for providers commissioned by Brent Council are paid the London Living Wage rate by 2021.

o   A minimum standard of training is incorporated in the new commissioning model which gives staff in Brent sufficient development opportunities to encourage home care as a career within the social care sector.

o   A home care partnership forum should be set up as part of a new commissioning model to discuss issues of strategic importance to stakeholders involved in domiciliary care services in Brent.

 

(iii)The fact that adopting the recommendations listed in (ii) would enable Brent to sign up to the Homecare Charter be noted.

 

11.

Community and Wellbeing Scrutiny Committee Work Programme 2017-18 Update pdf icon PDF 83 KB

The report updates Members on the Committee’s Work Programme for 2017/18 an captures scrutiny activity which has taken place outside of its meetings.

Additional documents:

Minutes:

RESOLVED:

(i)    The contents of the Update on the Committee’s Work Programme 2017-18 report, be noted; and

 

(ii)  The ‘Response received’ column in the Tracker of Scrutiny Recommendations 2017-18 be updated.

 

 

12.

Any other urgent business

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 60.

Minutes:

None.