Agenda and minutes

Venue: Conference Hall - Brent Civic Centre, Engineers Way, Wembley, HA9 0FJ

Contact: Hannah O'Brien, Governance Officer  Email: hannah.o'brien@brent.gov.uk

Items
No. Item

1.

Apologies for absence and clarification of alternate members

Minutes:

Apologies for absence were received as follows:

 

  • Councillor Shahzad
  • Councillor Hector (Councillor Kabir attending as substitute)
  • Observers John Roche and Jenny Cooper
  • Dr Melanie Smith, Director of Public Health

 

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/ Vice Chair at Central and North West London NHS Foundation Trust and CNWL NHS Trust
  • Councillor Ethapemi – 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.

North West London NHS Financial Recovery Plan pdf icon PDF 501 KB

To receive and consider a report from Brent Clinical Commissioning Group (CCG) providing an update on the financial position of the North West London (NWL) Collaboration of CCGs and the financial recovery programmes in place.

 

Minutes:

The Chair advised that he had received a number of request to speak on the Financial Recovery Plan, which he advised he had allowed and would consider, before proceeding to hear from the presenting Officers.

 

He then invited each speaker to address the Committee in turn.

 

Councillor Daly (Local Subdury Ward Councillor) reminded Members of the Committee that Brent was one of the poorest Boroughs in London and felt that the report did not reassure the local community. Councillor Daly was of the opinion that the financial recovery plan aimed to avoid patient referrals to hospital by creating fear in GPs, and felt that this was due to lack of funding in the NHS. Referring to the planned changes to prescriptions, concern was expressed that many patients were not taking their required medication due to lack of affordability. Councillor Daly expressed concern that those who were seriously ill at A&E, such as those with pneumonia, would not be given a hospital bed under the planned changes.

 

Councillor Nerva (Local Queens Park Ward Councillor) thanked the Committee for convening the meeting. It was felt by Councillor Nerva that there was a lack of local accountability in the plan and there was fear of a double cut to Continuing Healthcare (CHC). It was questioned whether patient choice would remain following the planned changes, and the presenting Officers were asked whether these changes would be proposed should the health service be in balance. Councillor Nerva felt that detailed scrutiny of the proposals by the Committee was necessary.

 

The Chair advised that he had allowed Councillor Colacicco (Local Mapesbury Ward Councillor) 2 minutes to read out a statement on behalf of Dawn Butler MP (Brent Central). The statement objected to the proposed financial recovery plan, specifically in relation to the planned closure of the 24-hour Urgent Care Centre at Central Middlesex Hospital. Dawn Butler MP was of the opinion that the cuts to health services were falling disproportionately on the constituents in the south of the Brent Borough, particularly Harlesden and Stonebridge areas, which were pointed out to be ranked top in Brent according to the Index of Multiple Deprivation. The statement referred to both the 2014 closure of the A&E service, which was on the proviso that a 24-hour Urgent Care Centre would be available, and the planned closure for the Urgent Care Centre as part of the financial recovery plan. Dawn Butler MP argued in the statement that the decision to close the Urgent Care Centre removed 24-hour NHS services from the constituency, and conveyed that those constituents without access to a vehicle would be required to travel for over an hour to the nearest available hospital. The statement referred to concern regarding the lack of public consultation on the decision to close the Centre. Dawn Butler MP believed that the falling attendance figures referred to in the report were a product of design, and asked the Clinical Commissioning Group (CCG) to invest in the Central Middlesex hospital to create  ...  view the full minutes text for item 4.

5.

North West London Commissioning Reform Case for Change pdf icon PDF 565 KB

To receive a report from Brent Clinical Commissioning Group (CCG) updating on progress with the commissioning reform in the North West London Collaboration of CCGs and the decision of Brent CCG to move to a single CCG in 2021 in light of the need to focus on financial recovery along with a move to a single operating structure across North West London.

 

Minutes:

Mark Easton (Accountability Officer, North West London Clinical Commissioning Group - CCGs) introduced the report, updating the board on the progress with the commissioning reform in the North West London Collaboration of CCGs and the decision of Brent CCG to move to a single CCG in 2021 in light of the need to focus on financial recovery along with a move to a single operating structure across North West London. Mark Easton explained that there was an engagement process that took place in order to make a decision on when to go ahead with the merge, and the outcome of those discussions, agreed by all 8 CCG governing bodies, was that the merge would take place in April 2021. Next, there would be conversations regarding a constitution and there would be an Equality Impact Assessment for the proposal, which were felt to be sufficient arrangements for public assurance and scrutiny.

 

The Chair thanked Mark Easton for introducing the report and invited questions from the Committee. The Committee asked for reassurances about patient safety. Mark Easton agreed that safety was paramount and was to be looked at carefully. It was stated that a risk log would be kept and there would be conscious monitoring to ensure the change in governance and management did not impact patient safety.

 

The Committee queried whether the deficit would be higher once the merge occurred. Mark Easton answered that they were still awaiting an answer from NHS London regarding the way in which the deficit would need to be treated.

 

Regarding the additional roles reimbursement, the Committee wanted assurance that the CCG were confident they could recruit more staff. Fana Hussain (Assistant Director for Primary Care, Brent CCG) responded that they were taking a phased approach to recruitment. It was confirmed that there was already a full complement of pharmacists, and that specific organisations were working with the CCG to recruit staff, such as University graduates. It was felt that there would be sufficient paramedic trainees to recruit in year 3 of the plan. With regard to responsibility for staffing in Healthcare Services, Mark Easton informed the Committee that all existing staff would transfer to the single CCG. The Committee were informed that cost reduction would be focussed on back office services rather than patient facing services.

 

Engagement from the community was also a priority for the Committee, with questions regarding the level of turnout for the 130 engagement events referred to in section 3 of the report. Mark Easton confirmed that some of the events had very good engagement while others were more intimate, but felt confident that they had reached all interested parties. Ian Niven (Healthwatch, Brent) summarised some of the responses from the Brent patient participation group; most respondents were concerned about point of care rather than governance, some were concerned about the population of North West London, lack of Primary Care Networks and there was also a feeling of concern regarding the delivery of savings. Ian Niven suggested that the patient  ...  view the full minutes text for item 5.

6.

Any other urgent business

Minutes:

None.