Agenda and minutes

None declared.

The minutes are attached.

RESOLVED:-

that the minutes of the previous meeting held on 29 November 2011 be approved as an accurate record of the meeting.

None.

The report is attached.  Presentation slides have also been circulated to Members.

Andrew Davies (Performance and Policy Officer, Strategy, Partnerships and Improvement) introduced the item and confirmed that following on the meeting in November 2011, the chairs and vice chairs of Brent, Ealing and Harrow health scrutiny committees had met with representatives from Ealing Hospital Trust and North West London Hospitals NHS Trust on 24 January 2012 to discuss concerns raised in a letter sent to both trusts at the previous meeting.  Andrew Davies referred to the main issues to emerge from the second meeting as outlined in the report and advised that the Chair of this committee was seeking to send a further letter to the trusts outlining the committee’s views on the merger.

The Chair then invited Simon Crawford (SRO, Organisational Futures Project) to make some opening remarks.  Simon Crawford advised that following the presentation of the outline business case to Members in November 2011, the final business case was due to be put to both trust boards in March 2012.

Members then discussed the item.  Councillor Daly sought clarification regarding the amount that the 15% back office savings would represent and she also commented that there was real concern amongst GPs about the proposed merger.  She suggested that the relationship between the NHS and the public was deteriorating and that management should pay more heed to the concerns of both residents and front line NHS staff.  Councillor Hunter enquired how the increase in community services would be resourced and commented that the viability of service changes needed to be considered.  Councillor Colwill commented that residents wanted both hospitals in Brent to remain open after the merger and he sought assurances that this would be the case.  He also asked what views the GPs had on the proposed merger.

The Chair sought assurances that there were sufficient funds to provide the transition of service provision to the community and stressed the importance of not compromising on providing a service to those who most needed it. 

Mansukh Raichura (Chair, Brent LINk) was invited to address the committee.  He confirmed that Brent LINk had already submitted a response to the proposals and stated that there was significant opposition to health reforms in general and concern about the impact on patients.  He emphasised the need for a joined-up approach in undertaking these changes.

In reply to the issues raised, Simon Crawford advised that the outline business case submitted included plans by the commissioners to reduce acute services, with a third of its budget being re-invested in an integrated community and acute services.  Members heard that the final business case needed to demonstrate the viability of the merger and that no major service changes were planned on any of the sites.  The commissioners were to put together a plan to specify what services each site would provide and an earlier report had included four possible case scenarios which were to be consulted upon.  Simon Crawford acknowledged that the changes presented a challenge, however a collaborative approach would be taken to provide more healthcare  ...  view the full minutes text for item 4.

The report is attached and includes a presentation that will be given to Members.

Rob Larkman introduced the report and explained that the North West London NHS budget of £3.5bn was under pressure and changes to service provision were required.  Although schemes such as the Short Term Assessment, Rehabilitation and Reablement Service (STARRS) had improved the transition of patients between acute hospital services and community service, more changes were still needed, whilst hospitals in North West London also needed to perform better in a number of areas.  Members noted that health services needed to be localised where possible, centralised where necessary and integrated across health, social care and local authorities where it improved patient care.  Members then noted the timetable for the consultation and that a Joint Health Overview and Scrutiny Committee would be set up to provide external scrutiny.

Dr Mark Spencer added that a pre-cursor to these changes had started two years ago and it was intended to provide a series of quality changes to health provision.

Councillor Daly sought further details with regard to the legislative implications of the changes and commented that when the original Government legislation was approved, it was not envisaged that there would be such wholesale changes to health provision.  She asked that if external consultation was undertaken, to what extent did it take place and she felt that it was important that the individual health overview and scrutiny committees of each borough concerned retained their scrutiny role to oversee the changes.  Concern was expressed that hospital care needed by older persons and diabetics was to be reduced and details were sought as to how the 24% reduction in cost of care for these groups as outlined in the integrated care pilot could be achieved. Councillor Daly requested that the peer review paper for the pilot scheme, the community strategy and costings of the project be supplied and she asked how many hospitals and beds were due to close.

Councillor Hunter also expressed concern that the Joint Health Overview and Scrutiny Committee would be the sole delegated scrutiny body and that there would not be a role for the individual health and overview scrutiny committees.  She stated that it was important to scrutinise on both a local and North West London wide level and she asked whether this arrangement was certain or remained a proposal.  Councillor Colwill sought assurance that proper safeguarding measures were in place.

The Chair referred to paragraph 4.5 in the supplementary report and sought further information with regard to the role of the individual health overview and scrutiny committees.  She commented that most individual health and overview scrutiny committees would wish to provide input regarding proposals within their own borough and asked what the next steps were with regard to the creation of the Joint Health and Overview Scrutiny Committee.  The Chair queried why the Health and Wellbeing Board was not formally involved in the scrutiny process even though the council was to have more public health responsibilities.  Information on the membership of the hospital working groups was also sought.

Dr Mark Spencer  ...  view the full minutes text for item 5.

A presentation will be given to the committee on the Joint Strategic Needs Assessment (JSNA) and Members will be given the opportunity to comment on its contents.  The JSNA is available on the council’s website at:-

http://www.brent.gov.uk/localdemocracy.nsf/JSNA/LBB-425?OpenDocument&pp=200088

Andrew Davies presented this item and explained that some emerging themes had been raised during the presentation at the last committee meeting.  The Joint Strategic Needs Assessment (JSNA) was being consulted upon until 23 March and feedback could be provided through the council’s website. The JSNA was looking at what health arrangements were working well, what ones could improve and what measures could be undertaken in tackling inequalities.  Focus was also being given on the major causes of mortality.  Andrew Davies welcomed any suggestions to add topics which it felt were missing from JSNA.  A meeting with Brent LINk would also take place during the consultation period.

Mansukh Raichura commented that it was important that Brent LINk had sufficient time to advise people that a meeting was taking place and discussions would take place with Andrew Davies in respect of this.

The Chair felt that it may be beneficial to consult pharmacists who played an important role in the community.  The committee agreed to a suggestion from the Chair that it would be useful for Members to undertake a separate session on the JSNA to help inform them and to suggest any particular areas of interest to them.

This report sets out the findings and recommendations of the Khat Task Group that are being presented to the Health Partnerships Overview and Scrutiny Committee for endorsement.

Councillor Hunter, the Chair of the khat task group, introduced the item and explained that the group had heard a wide cross-section of views concerning khat and also had read a number of Government reports on the matter.  The task group had made nine recommendations as set out in the report that it had considered both practical and useful to pursue and these would also be put to the Executive for formal approval.  Councillor Hunter commented that khat use was often associated with Somalians who were unemployed, particularly with those who arrived in the UK earlier and who may have English language difficulties that limited their employability.  The task group was not advising on a khat ban and it was noted that this was not within the scope of the committee and this would be a matter for the Government to consider.  Furthermore, a Government report published in 2005 had concluded that there was not sufficient evidence to ban khat.  Councillor Hunter acknowledged that there were some within the Somalian community in Brent who had hoped that khat could be banned, whilst others had felt that criminalising khat use would worsen matters.  The committee heard that the London Borough of Hillingdon had undertaken a similar study on khat last year and had concluded that banning khat was not a solution to concerns raised.

The Chair then invited Abukar Awale, who had participated in task group activities, to address the committee.  Abukar Awale introduced himself as a community engagement officer and as an ex khat addict.  Abukar Awale asserted that khat was responsible for damaging communities and that the majority of those attending meetings organised by the task group supported the banning of khat.  Whilst it was acknowledged that there were some moderate khat users, Members heard that there were around 520 young males in West London who suffered from mental health issues as a result of khat use.  Abukar Awale also cited The Netherlands as an example of a country that had outlawed khat, even though it was well-known for its tolerance to drugs.  He asked that the voices of those wanting khat to be banned be heard and that felt that it was within the councillors’ scope to support this.

The Chair invited Dr Muna Ismail, who had carried out a scientific study on khat, to address the committee.  Dr Muna Ismail explained that she had carried out a PhD in khat use and was continuing research on this at post-doctorate level.  She drew Members’ attention to a document she had produced that was circulated at the meeting and advised that at present there was no conclusive evidence with regard to the question of khat being damaging to human health and there was a clear need for further scientific research to be undertaken.  Members noted that there was not much evidence at present that there a high percentage of chronic habitual khat users.  Dr Muna Ismail explained that she had undertaken a comparison of  ...  view the full minutes text for item 7.

This report requests the Health Partnerships Overview and Scrutiny Committee to consider the attached scope for ‘Tackling Diabetes in Brent’ and agree for a task group to be set up.

Andrew Davies advised Members that a diabetes task group had been suggested as a result of emerging findings from the JSNA.  Agreement of the scope of the task group was sought and Members should indicate if they also wanted to be involved in the task group.  The committee agreed the scope of the task group and both the Chair and Councillor Colwill confirmed that they would be members of the task group.  Andrew Davies advised that he would be contacting the main opposition political group regarding what member they would like to put forward to be on the task group.

RESOLVED:-

(i)        that a tackling diabetes in Brent task group be created;

(ii)       that Councillors Kabir and Colwill be members of the task group, and a third member from the main opposition political group is to be confirmed.

Members will receive a verbal update on this  item.

Ethie Kong introduced this item and advised that the Clinical Commissioning Group (CCG) comprised of five localities (consortiums) and was working on developing primary care in Brent.  Out of hospital services and prevention and promotion initiatives, such as immunisations and breast screening, was also being considered.

The Chair asked whether patients’ representative group, such as the Kingsbury one which she recently attended, were not presently resourced and she enquired if the CCG could assist on this matter.  She also suggested that the CCG could report back to each patients’ representatives group.  Councillor Hunter concurred with this suggestion and felt that meetings on this level could be piloted.

In reply, Ethie Kong advised that each consortium has its own patients forum and resources came from the locality concerned.  There was a small budget to support this and she advised that patients had the right to insist that this was provided.  Ethie Kong also suggested that a Brent wide residents group could be created to discuss common issues.  The CCG had also identified care for diabetic patients as a priority in Brent and Ethie Kong suggested they would be happy to contribute to the work of the diabetes in Brent task group.

Members will receive a verbal update on this item.

Andrew Davies advised that the Shadow Health and Wellbeing Board was taking a leading role with regard to the JSNA which would help inform the Health and Wellbeing strategy.  A number of major health sector issues were being considered, including the out of hospital care strategy and some of the Board’s work overlapped with this committee.

Councillor Hunter sought clarification on whether there was any decision in respect of opposition political group representation on the board.  In reply, Phil Newby (Director of Partnerships, Strategy and Improvement) advised that consideration of the Board’s composition was still being discussed and was subject to what shape the health service would take.  There remained uncertainty on a number of major issues and the composition of the Board would not be confirmed until these had been resolved.  Andrew Davies advised that the Health and Social Care Bill seemed to suggest that proportional representation could be provided, however it also referred to there being no requirement to provide this as was presently the case.

The work programme is attached.

Andrew Davies advised that discussions with the Chair and Vice Chair of the committee would take place as to what items would appear on the agenda of the next meeting as there were a large number of topics that had been suggested.  Councillor Daly suggested that information on waiting lists, including initial referrals and planned surgery, should be a standing item on future agendas.  Councillor Hunter felt that a task group on female genital mutilation was needed and she requested that this should be added to the work programme.

The next scheduled meeting of the Health Partnerships Overview and Scrutiny Committee is scheduled to take place on Tuesday, 27 March 2012 at 7.00 pm.

It was noted that the next meeting of the Health Partnerships Overview and Scrutiny Committee was scheduled to take place on Tuesday, 27 March at 7.00pm.  The Chair confirmed that a  pre-meeting would start at 6.30 pm.

None.