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

Minutes:

Apologies for absence were received as follows:

 

·         Councillor Knight

·         Councillor Stephens (Councillor Kabir attending as substitute)

·         Teachers Union observers.

 

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 Ketan Sheth – Lead Governor, Central and North West London NHS Foundation Trust.

·         Councillor Ethapemi – Spouse employed by the NHS.

·         Councillor Shahzad  Spouse employed by the NHS.

·         Councillor Thakkar – Employed as Care Navigator (minute amended as agreed at the Community and Wellbeing Scrutiny Committee on 26 November 2019).

 

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 112 KB

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

 

Minutes:

RESOLVED:-

 

that the minutes of the previous meeting held on 9 July 2019 be approved as an accurate record of the meeting, subject to following amendments to the attendance list:

 

·         Rev Helen Askwith – delete Councillor.

·         Mr Alloysius Frederick – Name misspelt as Fredericks.

 

5.

Matters arising (if any)

Minutes:

There were no matters arising.

 

6.

Order of Business

Minutes:

RESOLVED: that the order of business be amended as recorded below:

 

·         Agenda item 7, Cricklewood Health Centre taken before Agenda item 6, Home Care Recommissioning

 

7.

Cricklewood Health Centre pdf icon PDF 365 KB

This papersets out the proposals fortheCricklewoodwalkin service,whichis commissionedby BarnetCCGundera standardNHScontract,Brent CCGare associateto thiscontractandworkclosely withBarnet CCGas theleadcommissioner.

 

Additional documents:

Minutes:

Dr Jahan Mahmoodi (Clinical Director, Brent CCG) introduced the report, setting out the context of the paper and explaining proposed changes. Dr Mahmoodi said that evidence suggested that far fewer patients were seeking walk-in access to primary care. He went on to highlight the stated benefits of a joined up approach being developed by Primary Care Networks where all clinicians seen by a patient have access to that patient’s notes digitally, therefore ensuring the best possible care for the patient. Rather than the patient potentially seeing a number of different clinicians when making multiple visits to the walk-in centre, it was preferable for the patient to be treated in a facility where their notes were available to whomever they saw or had been referred to, so that clinical decisions could be made with all the information to hand. The CCG aimed to provide a seamless service with efficiency, choice and accessibility being the presiding ambitions.

 

Dr Mahmoodi confirmed that the CCG was working towards consolidating services over the next few months and was influenced by the evidence of patients preferring alternative methods of accessing primary care such as online consultations. The lease on the Cricklewood premises was due for renewal next year and there were restrictions on the re-procurement process which would be taken into account.

 

Andrew Pike (Assistant Director of Communications and Engagement NHS North West London CCGs) spoke about the 14-week Consultation which started on 12 August 2019 engaging the walk-in patients and nearby GP practices. Documentation in respect of the Consultation was available in libraries and other public places and its aim was to explore thoroughly with walk-in users why they used the service and what factors needed to be taken into consideration. Stakeholders, including the Committee were strongly encouraged to participate. Dr Mahmoodi added that the consultation would illustrate how the CCG planned to seek the engagement of users and stakeholders in creating a joined up non- fragmented service.

 

The Chair thanked the CCG representatives for the introduction and invited questions from the committee.

 

In the subsequent discussion, the committee queried the validity of evidence that walk-in centres were dated and under-used and asked what risks there were for residents and how they would be mitigated. They asked what would happen to people who were not currently registered with a GP and how the closure of the walk-in centre would affect those patients needing an emergency provision. In relation to other available healthcare resources, they queried if there would be adequate and improved provision going forward with enough GPs available and ease of registration. Further questions were raised about the engagement with the current users of the walk-in service, how it was being promoted, how would elderly people and those with language barriers be included and if there was sufficient time before the proposed closure date to let patients know about the alternative provisions so that there would be no gap in service or health implications. It was also asked if feedback had been received as  ...  view the full minutes text for item 7.

8.

Home Care Recommissioning pdf icon PDF 145 KB

This report provides an overview of the homecare re-procurement, including an assessment of the different factors considered as part of this process. A version of this report has previously been taken to the Policy Co-ordination Group (PCG) for comment and direction, and the outcomes of that discussion are now reflected in this report.

 

The report further comments on how the proposed model will meet the objectives identified as part of the CWB Homecare Task Group report of February 2018 and will make the council fully compliant with the Unison Care Charter.

Additional documents:

Minutes:

Councillor Farah (Lead Member for Adult Social Care) introduced the report which sought the Committee’s input into the recommissioning the Homecare Contract. Councillor Farah said it was hoped to incorporate the London Living Wage and reduce the number of zero hour contracts while improving the Homecare Provider Network.

 

Andrew Davies (Head of Commissioning, Contracting and Market Management) explained the reasons behind the recommissioning and the current position following the closure of the West London Alliance Homecare Framework. He highlighted the current issues which focussed around the high number of providers and the Council’s ability to monitor the quality of delivery and the employment terms of the employees. The Committee’s attention was drawn to the paragraphs in the report (5.1 onwards) describing the new Homecare model and the intention to move away from geographical commissioning to a patch based system aligned to the 13 primary care networks. In addition, there would be larger patches where specialist services that didn’t fit into the 13 patches would be commissioned. The overall provider numbers would reduce to between 13 and 25 enabling closer monitoring and greater consistency of care workers.

 

The Chair thanked Councillor Farah and Andrew Davies for the introduction and invited questions from the committee.

 

In the subsequent discussion, the Committee queried how the new model would fit in with the Borough Plan and how it would work robustly to improve performance from the existing commissioning and went on to ask questions around how the new model would enable closer monitoring of providers, how eliminating zero hour contracts would meet the increasing demand for services and would there be enough care workers with relevant skills. Additional questions were raised concerning the diverse range of needs in the Borough and how the smaller number of providers would meet these and what level of research had been carried out with service users in the light of frequent complaints and the needs of vulnerable people.

 

Further questions from the Committee covered the issue of workforce training, risk assessment, the idea of a holistic approach where carers linked their clients with other services, the option and benefits of bringing services in-house and the potential of partnerships and outsourcing.

 

Councillor Farah explained that the issues of the London Living Wage and zero hour contracts closely affected the residents of Brent, particularly women, and therefore a minimum of 16 hour contracts would be offered. He said the new system would be an improvement on the current model as the Council would have more control, ensuring contracts fell in line with Borough priorities. Andrew Davies responded to the Committee’s questions advising that growing demand for services and a greater complexity of user needs was envisaged year on year in the future and working with a smaller number of providers would enable better scrutiny of service quality and allow the monitoring staff to build closer relationships with the providers.

 

Andrew agreed that individual worker contract hours was a complicated issue and some workers liked the flexibility, but it was preferable  ...  view the full minutes text for item 8.

9.

Community and Wellbeing Scrutiny Committee Work Programme 2019/20 Update pdf icon PDF 80 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.

Additional documents:

Minutes:

RESOLVED that the contents of the Update on the Committee’s Work Programme 2019-20 report, be noted.

 

10.

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.

 

Councillor Kabir, in referring to the Work plan item - Early Intervention to Reduce Youth Crime, requested it be noted that the Safeguarding Report and Knife Crime Task Group Report should be considered when those discussions take place.