Agenda and minutes

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

Contact: Bryony Gibbs, Governance Officer  Email: bryony.gibbs@brent.gov.uk

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:

Apologies for absence were received as follows:

 

·         Councillor Afzal (Councillor Gill attending as substitute)

·         Councillor Shahzad

·         Mr Frederick (Co-opted Member)

·         Reverend Helen Askwith (Co-opted Member)

·         Mrs Jean Roberts (Appointed Observer)

2.

Declarations of interests

Members are invited to declare at this stage of the meeting, the nature and existence of any relevant disclosable pecuniary or personal interests in the items on this agenda and to specify the item(s) to which they relate.

Minutes:

Personal Interests were declared as follows:

·         Councillor Gill - employed as a Psychiatrist by Central and North West London NHS Foundation Trust.

·         Councillor Sheth – Lead Governor, Central and North West London NHS Foundation Trust

·         Councillor Ethapemi – spouse employed by the NHS.

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 90 KB

To approve the minutes of the previous meetings held on 17 April 2019 and 9 May 2019 as a correct record.

 

Additional documents:

Minutes:

RESOLVED: that the minutes of the previous meeting held on 17 April 2019 and 9 May 2019 be approved as an accurate record of the meeting.

5.

Matters arising (if any)

Minutes:

There were no matters arising.

 

6.

Substance Misuse Service pdf icon PDF 143 KB

This report provides an account of substance misuse services in Brent. It covers the Integrated Treatment, Recovery, Wellbeing and Substance Misuse service model and the commissioning arrangements by Brent Council Public Health. The performance of the provider, Westminster Drugs Project (WDP) with Central North West London (CNWL) NHS Foundation Trust as the clinical partner, is described. The work of B3, the service user council for Brent entirely run for and by local residents who have been directly affected by problematic drug and alcohol misuse, is described.

Minutes:

Councillor Hirani (Lead Member for Public Health, Culture and Leisure) introduced the report on the Substance Misuse Service from the Director of Public Health. The report provided details of: the Integrated Treatment, Recovery, Wellbeing and Substance Misuse service model; commissioning arrangements; provider performance; and, the work of B3, the service user council for Brent run by and for local residents directly affected by problematic drug and alcohol misuse. Councillor Hirani advised that the responsibility for Public Health had been transferred to local government following the Health and Care Act 2012.  Despite year on year reductions to the public health grant, Brent’s Substance Misuse service was considered to be an example of best practice, particularly in relation to the inclusion of peer support.

 

Andy Brown (Head of Substance Misuse) provided a brief overview of the key themes of the report, advising that data provided via the National Drug Treatment Monitoring System (NDTMS) estimated that there were: 2,310 opiate and/or crack users; 1,752 opiate users; 1,331 crack users; and 3,169 problem alcohol users in Brent. This data suggested that approximately only a third of active drug users and a fifth of problematic alcohol users were engaged with treatment services in Brent - this was broadly in line with national figures.

 

Discussing ‘The New Beginnings service’, Andy Brown advised that this new service model had been developed in conjunction with B3, responded to areas of local new or under met need, and rebalanced the divide between clinical services and non-clinical support such as outreach, criminal justice services and recovery support. The new service model had been fully mobilised by 1 April 2018. With the change in service provider there had been a transfer of staff, clients and case files from across five organisations into a single performance management and reporting system led by the new provider, Westminster Drugs Project (WDP). As was expected the transfer led to a temporary drop in performance, in part due to data cleansing through the bringing together of records from different organisations, but this was improving and remained higher than the national averages across a number of areas.

 

Radha Allen (Project Co-ordinator) and Amina Gariba (B3 Volunteer), then delivered a short presentation to the committee on the work of B3, which as previously highlighted, was an entirely peer-led service, designed and run by service users, and funded directly by Brent Council. B3 provided peer-led support and opportunities for service users and volunteers to develop new skills and qualifications.  B3 also operated an out-of-hours’ weekend drop-in service for people struggling with substance misuse issues. Moving forward, B3 had recently established an outreach programme to help sign-post individuals not engaging with treatment services.

 

The Chair thanked the Lead Member, officers and representatives of B3 for the introduction and invited questions from the committee.

 

In the subsequent discussion, the committee queried how the council was assured that the key objectives of the substance misuse service were being met. Members queried the strategy for engaging hard to reach cohorts and questioned what  ...  view the full minutes text for item 6.

7.

Childhood Obesity: Members' Scrutiny Task Group pdf icon PDF 101 KB

To enable members of the Community and Wellbeing Scrutiny Committee to set up a members’ scrutiny task group to review childhood obesity in Brent.

Additional documents:

Minutes:

Councillor Thakkar introduced the report proposing that the committee establish a task group on childhood obesity as per the terms of reference and membership detailed in the scoping paper attached as Appendix A to the report. The committee was reminded that levels of childhood obesity in Brent were some of the worst in the country. It was intended that the task group would focus on four key areas: the NHS, local government and public services; external environment; and, home and parental engagement. With regard to membership, it was highlighted that a member of the Brent Youth Parliament would join the task group as a co-opted member.

 

The Chair thanked Councillor Thakkar for her introduction to the report. The committee subsequently RESOLVED:

 

       i)          To agree the details of the scoping paper attached as Appendix A to the report from the Assistant Chief Executive.

 

     ii)          To establish a task group as per the terms of reference and membership detailed in the scoping paper attached as Appendix A to the report from the Assistant Chief Executive.

8.

Central Middlesex Hospital - Urgent Care Centre Changes in Operating Hours pdf icon PDF 3 MB

Thispaper from NHS Brent CCG looks at the urgentcare provisionin Central Middlesex Hospital (CMH) and report on the findings on its utilisation, impact on equality, health inequalities and overall quality of CMH UCC.  Included inthiscase for change report are the alternative options that Brent CCG has taken into consideration to ensure the access toservices are providing best use of public money and better use of resources. The paper shows current usage of the urgentcare centre (UCC) as well as thepublic and stakeholder engagement plans.

 

Additional documents:

Minutes:

The Chair welcomed colleagues from Brent Clinical Commissioning Group (CCG) to the meeting and noted that two members of the committee had conducted a site visit to the Urgent Care Centre at Central Middlesex Hospital to aid scrutiny of the proposals contained in the published report.

 

At the invitation of the Chair, Rashesh Mehta (Assistant Director, Integrated Urgent Care, CCG) introduced the report from the Brent CCG setting out a case for changing the operating hours of the Urgent Care Centre (UCC) at Central Middlesex Hospital (CMH). The committee was reminded that all CCGs had a statutory responsibility to ensure that the services they commissioned provided good value for money, were efficient and met local need. With regard to the UCC at CMH, it was explained that there were very few patients presenting between midnight and 8am. Irrespective of usage however, the provider of the UCC was required to have a full complement of staff. It was therefore considered an inefficient use of resources to deliver UCC services overnight at CMH. Brent CCG had considered three different options for the opening hours of the UCC: closing the UCC 8pm to 8am; closing between 10pm and 8am; and, closing between midnight and 8am. The latter had been selected as the preferred option. The CCG had carried out a series of engagement activities on the proposals with the public and other stakeholders, including the Brent Equality Engagement and Self-care (BEES) committee, Healthwatch, CVS Brent, members of the Carers Board and ran a bespoke workshop to include voluntary sector organisations and patients. Summaries of feedback received were provided in the report. The Governing Body of Brent CCG had subsequently considered the proposals on 25th June and approved them, subject to receiving confirmation of approval from the LNWHT A&E Delivery Board.

 

Sheik Auladin (Chief Operating Officer) advised that Brent CCG was required to make savings where value for money was not being achieved. The CCG had a deficit of £9million in the current year. It was clarified that all eight North West London CCGs were in deficit and recovery plans were in place at both a North West London level and local CCG level. It was simply not justifiable to continue to invest the level of resources at the CMH UCC site given the level of usage and the clear patient preference for sites which co-located UCCs and Accident and Emergency services.

 

The Chair thanked Brent CCG colleagues for the introduction to the report and subsequently invited questions from the committee.

 

Members questioned how the identified £450k per annum savings would be better directed in primary care. Clarification was sought regarding required staffing levels and the redistribution of the staffing resource. Members questioned comparative levels of use at the other UCC sites in Northwick Park and further queried whether anticipated population growth had been considered. The committee asked what consideration was given to the impact of additional travel of those redirected to alternative UCCs. Members questioned how out of  ...  view the full minutes text for item 8.

9.

Palliative and End of Life Care in Brent pdf icon PDF 537 KB

This report provides an update for the Overview and Scrutiny Committee on Community Palliative and End of Life Care (EOLC) services in Brent. The report describes demographic data and activity, the current range of local acute and community specialist palliative care services and the CCG’s strategy and commissioning intentions that address some of the challenges in the delivery of EOLC services in Brent

Minutes:

At the invitation of the Chair Rashesh Mehta (Brent CCG) introduced the report on Palliative and End of Life Care services in Brent. The report described End of Life (EOL) service provision in Brent and explained that a recent suspension of in-patient services at the Central London Community Healthcare Trust (CHCLT) Pembridge hospice provided an opportunity to review Brent’s EOL strategy. This review would encompass an evaluation of system capacity and demand for community specialist palliative care services, as well as consideration of whether the Pembridge hospice service was of sufficient quality, was clinically safe and provided good value for money.

 

Rashesh Mehta further explained that an independent review of the Pembridge hospice service as well as other local services had already been conducted by the commissioner of the service, Central London CCG. The resulting review report detailed a number of options, but recommended the procurement of one lead provider in the community for specialist palliative care services. The review also recommended that that the in-patient provision at Pembridge hospice could be reduced, given that all displaced patients had been accommodated by other hospice providers within existing capacity.

 

Sheik Auladin (Chief Operating Officer, Brent CCG) advised that since the suspension of services at Pembridge hospice, Brent CCG had been engaging with local providers about potential options moving forward. It was emphasised that currently, Brent CCG paid the full contract sum, despite the suspension of in-patient services at Pembridge hospice. There were three other providers of community specialist palliative care services for Brent patients in North West London, all of whom provided a high standard of service and value for money. If the Pembridge hospice service was permanently decommissioned, this would allow for re-investment in other providers. The committee was therefore asked to comment on potential options as identified in the report for the provision of EOL services in Brent to feed into the Brent CCG review and subsequent further engagement with residents and providers. As Brent CCG was moving towards a single North West London CCG structure and a new collaborative way of working between providers and commissioners, it was highlighted that due consideration needed to be given to the impact on providers across North West London of any proposed service changes in Brent.

 

The Chair thanked Rashesh Mehta and Sheik Auladin for the introduction to the item and invited questions from the committee.

 

The committee raised a number of queries regarding the circumstances leading to the suspension of in-patient services at Pembridge hospice and exploring alternative solutions to continuing these services at the site. Members sought assurance that the other three providers of hospice services for Brent patients had sufficient safeguards against similar circumstances. The committee questioned the robustness of conclusions drawn with respect to the capacity of the three remaining providers, seeking particular comment on ability to expand capacity with projected increases in demand. Clarification was sought regarding the option to pursue a tri-borough arrangement, rather than a Brent specific service and noting the intention to expand community  ...  view the full minutes text for item 9.

10.

Community and Wellbeing Scrutiny Committee Work Programme 2019/20 Update pdf icon PDF 94 KB

The report updates Members on the Committee’s Work Programme for 2019/20 and captures scrutiny activity which has taken place outside of its formal meetings.

Minutes:

RESOLVED that the contents of the Update on the Committee’s Work Programme 2019-2020 report, be noted.

 

11.

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.