Agenda and minutes

Members are invited to declare at this stage of the meeting, any relevant financial or other interest in the items on this agenda.

There were none.

RESOLVED:-

that the minutes of the previous meetings held on the 9 December 2009 and 7 January 2010 be approved as accurate records.

Item 10 - Health Select Committee Work Programme – visit to St Luke’s Hospice

It was noted that Andrew Davies (Policy and Performance Officer) was waiting to hear back from St Luke’s Hospice regarding possible dates for a visit.  Andrew Davies stated that he would follow this up.

None.

This report updates the Health Select Committee on the progress made in implementing the recommendations from the Access to Health Sites Task Group.

The Chair introduced the report which updated the committee on the progress made in implementing the recommendations from the Access to Health Task Group.  It was noted that appendix 1 of the report set out the task group’s recommendations, the original response from the organisations affected by the recommendations and an update on their implementation. It was also noted that NHS Brent had not provided an update in appendix 1, but would be providing a verbal update during this item.  The committee expressed their disappointment that Transport for London (TfL) had not sent a representative to this committee meeting as it was felt that their contribution would have been extremely valuable.

It was agreed that the committee would look at each recommendation in turn and would take note of any updates which were not covered in appendix 1. 

Strengthening working relationships:

• Recommendation 1 - Jo Ohlson (Director of Primary Care Commissioning, NHS Brent) stated that some links with TfL and Brent Transport Services had been made, but that NHS Brent could do more to strengthen these links.  She added that as part of the paediatrics polysystem planning, NHS Brent had taken travel into account much more than it would have been in the past.  It was noted by the committee that it seemed that NHS Brent were not engaging with Brent Transportation Unit. A suggestion was made by Jim Lawman (Senior Public Transport Officer, Brent Council) that quarterly meetings be held between Brent Transportation Unit and NHS Brent.  In response, Jo Ohlson agreed to the quarterly meetings. It was noted that the committee endorsed the setting up of these quarterly meetings.
• Recommendation 2 - It was noted by Jo Ohlson that there was nothing further to update, except that she would also be involving public health as appropriate.
• Recommendation 3 - It was noted that the Public Transport Liaison Meetings had been taking place with TfL and that whilst it was positive that these had been taking place, a concern was raised that TfL had become disengaged from other local meetings such as the Northwick Park Public Transport Liaison Group meetings.  Now that TfL had decided to only attend borough liaison meetings, it was noted that the Public Transport Liaisons meetings were an important forum for NHS Brent to engage with TfL.

Healthcare for London:

• Recommendation 4 – Jo Ohlson informed the committee that as part of NHS Brent’s primary care strategy, NHS Brent examined a map around travel. She added that NHS Brent would consider travel as it develops the plans for the 3 polyclinic sites, including how those potentially using services in Edgware Hospital would be affected.
• Recommendation 5 - Jo Ohlson informed the committee that NHS Brent had contacted the Sustainable Transport Officer for WestTrans to ask them to develop the travel plan for the GP led health centre in Wembley, but that it had not yet been completed.
• Recommendation 6 – Jo Ohlson explained that they had not yet started to  ...  view the full minutes text for item 5.

The Health Select Committee has asked for an update on the consultation taking place on paediatric services provided by North West London NHS Hospitals Trust. Members will recall that at the special meeting of the Health Select Committee held on the 7^th January 2010, Members made a number of recommendations relating to the public consultation. Following that meeting Councillor Chris Leaman wrote to NHS Brent and North West London NHS Hospitals setting out those recommendations (see appendix 1).

David Cheeseman, Director of Strategy at North West London NHS Hospitals, has responded to the letter (see appendix 2). As the committee asked for an update on the progress of the consultation, it has been agreed with the chair that this will be done verbally at the meeting. This is so the latest position with regards to this work can be reported on the day of the meeting.

Fiona Wise (Chief Executive, North West London NHS Hospitals Trust) provided the committee with an update on the consultation which was taking place on paediatric services in Brent and Harrow.  She explained that all of the committee’s recommendations, which were made at the Health Select Committee meeting held on the 7 January 2010, had been carried out, as set out in the letter from David Cheesman (Director of Strategy, North West London NHS Hospitals Trust). She added that they were hoping to publish the separate communication, on the future of Central Middlesex Hospital as an important provider of health services, the following week. She also confirmed that the third public meeting, which was referred to in the letter, would take place at Central Middlesex Hospital on the 11^th March and that a meeting specifically related to sickle cell disease had been set up for 25^th March. 

Fiona Wise stated that the Trust had a robust consultation plan.  She added that as well as the public meetings, they had consulted with a number of community and voluntary sector groups, including the Brent Youth Parliament and the area forums.  She added that she was able to email the consultation programme to anyone who would like to view it. She also informed the committee that a challenge session had been held at Northwick Park Hospital last week and that it had included representatives from Harrow as well as Brent.

In the discussion which followed, the committee noted that they were pleased that the committee’s recommendations had been carried out.  In response to a query regarding the attendance at the first public meeting held in Brent on the 11^th February, Fiona Wise explained that around 20 people had attended the meeting and that some of these were staff. She added that a lot of the focus was on sickle cell patients.  She explained that the Trust was working towards gaining a better understanding of the proportion of sickle cell patients who would be using the service.  The Chair noted that the Health Select Committee’s formal response to the consultation would be developed and presented to the Health Select Committee at the meeting on the 24^th March 2010.

RESOLVED:-

that the update on the public consultation on paediatric services be noted.

This report, as requested by the Health Select Committee in December 2009, provides information on the MEND Childhood Obesity Programme and the progress which has been made in reducing childhood obesity.

Melanie O’Brien (Strategic Joint Commissioning Manager) introduced the report which provided the committee with information on the MEND (Mind, Exercise, Nutrition, Do it!) programme and the progress which had been made in reducing childhood obesity.  She began by providing the committee with some background information on childhood obesity.  She explained that childhood obesity was a growing threat to Children’s health, both physically and mentally, and that it had a significant impact on life expectancy. She added that childhood obesity was also a huge drain on the current and future resources of the National Health Service and Local Government.   

Melanie O’Brien informed the committee that levels of childhood obesity were measured and recorded as part of the annual National Child Measurement Programme (NCMP). She noted that Brent had higher levels of childhood obesity than both the London and national averages and that the total number of overweight and obese children in Reception year had increased from 22.3% to 24.1%.  More positively, she added that there were early signs of a stabilisation of rates in year 6 pupils.

Melanie O’Brien explained to the committee what the MEND programme was and how it worked.  She stated that it was an intensive programme which included participants taking part in 20 sessions over a 10 week period.  She informed the committee that they had completed 9 programmes so far and were half way through the 10^th and 11^th programme. She added that they were contracted to do 18 programmes in total and that each programme had 12 children taking part, even though a small number had dropped out.  Melanie O’Brien stated that the outcomes of the programme had been very positive and that the programme had achieved some very encouraging results.   She then highlighted some of the successes of the programme, which included the fact that the Brent had proven to be a London leader in delivering the programme. She also stated that Brent had developed a regional London MEND group, which met on a regular basis to share good practice.   Melanie O’Brien then set out the challenges, including the fact that the programme only had the capacity to reach a small percentage of the overweight and obese children in the borough.  She concluded by highlighting the recommendations she made in the report, which were needed to ensure the successful reduction of childhood obesity. 

In response to a query regarding the long-term analysis of the outcomes of the MEND programme, Melanie O’Brien explained that whilst it was early days, she was planning to complete a six month and a year follow up on those who had gone through the programme.  She added that this information would be provided to the committee once available. It was noted that at a previous meeting concerns were raised regarding the LAA target.  In response, Melanie explained that the committee would have seen the report following the summer holidays, when one rather than two MEND programmes had been running, which meant that a smaller number of children had  ...  view the full minutes text for item 7.

The Health Select Committee has asked to be kept informed on the work that NHS Brent is doing to improve access to GP services in the borough. NHS Brent has provided a report on this, which includes the results of the 1st and 2nd quarter GP access survey results for 2009/10. As of this year, satisfaction with GP access will be surveyed quarterly rather than annually.

Jo Ohlson (Director of Primary Care Commissioning, NHS Brent) introduced the report which provided the committee with an update on the work being carried out to improve access to GP services in the borough and the results of the 1^st and 2^nd quarter GP access survey results for 2009/2010.   It was noted that as of this year, NHS Brent had been asked by the committee to provide quarterly rather than annual updates.  Jo Ohlson began by explaining that whilst NHS Brent remained concerned and disappointed with the results for the 1^st and 2^nd quarter of 2009/2010, which were below both the national and London average, GP access continued to be a top priority for NHS Brent and featured in NHS Brent’s Annual Plan and 5 year plan. Jo Ohlson drew the committee’s attention to the 2009/2010 quarter results as shown in the report and explained that whilst the survey uptake had improved compared to the 2008/2009 results, the satisfaction scores, excluding the ‘ease of seeing a Practice Nurse’, had gone down compared to 2008/2009.  She stated that she hoped that the effects of more recent work in improving access, such as extended hours, would have a positive impact on the quarter 3 and 4 2009/2010 results.

Jo Ohlson made the committee aware of the 6 main components that NHS Brent were focusing on in order to improve the overall satisfaction with access across Brent, as highlighted on the graph on page 1 of the report.   She stated that one of the ways which NHS Brent had responded to the 2008/09 results, was by holding an ‘Improving Access discursive event’ on the 20 January 2010. This event, she explained, provided the GPs and practice staff, from across NHS Brent, with the opportunity to discuss the issue of improving access and the approach that their practices would like to take to improve access. She explained that the event had left NHS Brent looking to improve access for patients by implementing support modules for practices. She added that NHS Brent’s ‘Improving Access Steering Group’ was currently assessing the responses to the event. 

Jo Ohlson drew the committee’s attention to the list of proposed modules, shown on page 2 of the report, which if approved would be delivered to NHS Brent practices as part of an Improving Access Programme of Work.  She explained that one of the modules being proposed was to aid practices in carrying out demand and capacity surveys.  Demand and capacity surveys, she explained, enabled practices to gain an understanding as to when their services were in most demand, so that provision could be tailored to meet these demands.   Jo Ohlson concluded by setting out some of the next steps which NHS Brent would be taking to improve patient access, which included visiting practices to create and agree practices’ plans, delivering the modules, if approved, and providing support to identified practices.  She added that she hoped that they would start to see an improvement in results within  ...  view the full minutes text for item 8.

The Health Select Committee has asked NHS Brent to provide a quarterly update on the performance of the smoking cessation service. The update is attached at appendix 1.

The Chair introduced Susan Hearn as the newly appointed Stop Smoking Manager for NHS Brent, who was present at the meeting to update the committee on the performance of the smoking cessation service.  It was noted that NHS Brent had been asked by the committee to provide quarterly updates on its performance in this area.  Susan Hearn began the update by reminding the committee that smoking was one of the most significant contributing factors to life expectancy, health inequalities and ill health and that therefore reducing smoking was a key priority for NHS Brent. She stated that a Health Profile report for Brent, in 2009, had reported that there had been 247 deaths in Brent through smoking. She also noted that in Brent the smoking rate varied greatly according to areas in Brent.  Susan Hearn informed the committee that Brent had signed up to a new national strategy which aimed to cut the number of smokers from 21% to 10% of the population by 2020.  She added that she was going to ask NHS Brent’s Communications Department to do a press release that would inform the public about this new piece of information.

With regards to meeting the 2009/2010 annual 4 week quit target, Sarah Hearn informed the committee that as of 22 January 2010, 2135 registrations had taken place.  This she explained represented 50% of the planned registrations to date which would be required to reach the quit target of 2022, based on a 40% conversion rate from set to quit to actual quit.  She added that they may see an increase in registrations over the next couple of months, as this was the time of year when it was most likely that people would attempt to quit smoking.

Sarah Hearn drew the committee’s attention to some of the measures which had been put in place to improve performance and increase the number of registrations. This included infrastructure development through the setting up of a new web based information system, which would allow it to be easier for providers to view how they were performing month by month.  This, she noted, was currently being piloted in 5 pharmacists. She explained that whilst there had been a few start up problems with the new system, she believed that they would be able to resolve these problems.   She informed the committee that the core stop smoking team had been built up through the recruitment of new staff, including the stop smoking manager and a service administrator. Furthermore, she noted that interviews for a stop smoking specialist were scheduled to take place shortly.  Another measure, she explained, had been to promote capacity building within the service by increasing the number of commissioned providers.  She stated that Metroline at Willesden/Cricklewood had taken up Level 2 training in January 2010 and Mcvities in Harlesden had recruited workplace advisors to be trained in February 2010.  Brent Council’s Occupational Health Service had also been engaged.   She added that the stop smoking team had also been  ...  view the full minutes text for item 9.

The Health Select Committee had asked for an update on GP services in Kingsbury following discussions on the Stag Lane Clinic. NHS Brent has provided a brief statement setting out the latest position with Stag Lane (see appendix 1).

Jo Ohlson (Director of Primary Care Commissioning, NHS Brent) introduced the position statement on Stag Lane Clinic by Mark Easton (Chief Executive, NHS Brent), dated 2 February 2010.  She noted that a large crack had appeared, last summer, on one side of the building.  An underground survey, she added, had revealed that there was underground movement.  Once this had been discovered, she noted that NHS Brent had three options. One option would have been to close Stag Lane Clinic.  However, this was not an option that NHS Brent pursued.  The other two options, she stated, were to either isolate part of the Clinic so that practices could run or to put up a portakabin.  In November 2009, Jo Ohlson explained that NHS Brent were hoping to isolate part of Stage Lane Clinic to house the GP practice whilst building work was carried out to make it safe.   However, she noted, that after a further assessment of the building, it had been decided to commission a new portakabin on the current clinic parking area to accommodate the practice.   Jo Ohlson explained that they could not have guaranteed that additional underground movement would not have occurred had the building be retained.   She noted that the setting up of potakabins would give certainty to patients for at least two years.  She stated that a timetable would be published shortly.

At present, Jo Ohlson explained that a number of community services, which were on the side of the building affected by the work, had been moved to alternative sites as stated in the position statement.   However, she noted that she had been informed by Dr Shah that the Family Planning Service was still operating at Stag Lane Clinic. Looking to the long term, Jo Ohlson explained that they were in discussions with practices to find out how many could be moved to Robert Courts.  Due to the fact that there was zero growth in the budget, she noted that it would need a number of practices coming together into one building so that the new building was revenue neutral.  She explained that NHS Brent were in discussion with the council, following the council’s plans to rebuild Hay Lane and Grove Park, regarding a joint development.  However, it was stated that this may not be possible. She noted that a land swap could be another possibility.  

In the discussion which followed, a concern was raised regarding the amount of progress which had been made since November 2009. In response to a query, Jo Ohlson noted that a 16 week provisional timetable would be published shortly.   When asked why the joint development might not be possible, Jo Ohlson explained that the council’s plans for the rebuild were so far advanced that it might not be able to accommodate them. Councillor Dunwell raised a concern that the council’s housing programmes could suffer as a result of NHS Brent not having the growth in their budget to provide an infrastructure for health services.   In response to a  ...  view the full minutes text for item 10.

This report sets out a list of items for inclusion in the Health Select Committee work programme in 2009/10.

Andrew Davies (Policy and Performance Officer) updated members on the committee’s work programme for 2009/10 and explained that the work programme would be updated to include the committee’s response to the consultation on paediatric services at the next meeting. In response to a query regarding access to health care for people with learning disabilities, Andrew Davies explained that there would be time on the agenda to take this item at the next meeting if the report was available.

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.

None.

The next meeting of the Health Select Committee is scheduled for Wednesday 24March 2010.

It was noted that the next meeting of the Health Select Committee was scheduled for Wednesday 24 March 2010.