Agenda and minutes

The minutes are attached.

RESOLVED:-

that the minutes of the previous meeting held on 9 October 2012 be approved as an accurate record of the meeting.

Brent Tobacco Control Service – progress report

Councillor Hunter advised that the Brent Pension Fund Sub-Committee had considered the recommendations of the Health Partnerships Overview and Scrutiny Committee and in light of these had decided that the Statement of Investment Principles be amended by incorporating into the Statement the current practice of not directly investing in tobacco companies.  However, Councillor Hunter advised that the final wording of the recommendation would be agreed at the next meeting of the Brent Pension Fund Sub-Committee.  She explained that Members of the Brent Pension Fund Sub-Committee had been advised that they did not have the powers to terminate current fund manager contracts, however it would have the ability to instruct fund managers accordingly for future contracts.  Councillor Hunter felt, however, that the council could go further and introduce a policy to not invest in tobacco companies either directly or indirectly and to invest ethically.  Members agreed to her suggestion that the committee await the final wording of the Brent Pension Fund Sub-Committee's decision on this matter before making any further recommendations to the Sub-Committee.

The Director of Strategy, Partnerships and Improvement will provide an update for Members on the Executive’s decision regarding the appointment of a Director of Public Health following the committee’s recommendations on this matter.

Phil Newby (Director of Strategy, Partnerships and Improvement) updated Members on this item and confirmed that the Executive had agreed to integrate public health services and to appoint a single Director of Public Heath for Brent.  Staff were being engaged during the consultation with regard to the integration and draft proposals had been circulated to them for further discussion.  The committee heard that the interim Chief Executive had appointed Paul Corrigan, a health consultant, to advise her in respect of the new arrangements and he had also worked with Brent clinical commissioning groups (CCGs). 

Councillor Harrison enquired whether the transfer of staff would lead to any redundancies.  Councillor Leaman enquired whether the post of Director of Public Health had been advertised and would there be an appointment by April 2013.  He also sought clarification as to whether the appointment would be made by the Senior Staff Appointments Sub-Committee.

In reply, Phil Newby advised that the proposals did not include redundancies for any permanent staff, although some fixed term contracts would be terminated.  He advised that the timing of the appointment of the Director of Public Health was yet to be determined and would be subject to clarification of the final integrated structure.

The Chair requested that an update on this item be provided at the next meeting and that any other information be provided to Members in the meantime should there be any significant developments.

The report included information on the NHS health check day being organised by NHS Brent and involve Brent MENCAP and details of how Brent MENCAP has been able to build on the initial project to train NHS staff members on working with people with learning disabilities.

Ann O’Neil (Brent MENCAP) introduced the report updating Members on the work of Brent MENCAP to help people with learning disabilities in using health services.  Ann O’Neil informed the committee that the NHS health check day had been well attended by a wide mix of professionals, carers and people with disabilities and feedback had been used to inform the Brent NHS Self Assessment Framework (SAF).  It had been identified that there had been issues in providing exact figures and this needed to be addressed in order to deliver the necessary services and appropriate safeguarding measures.  Ann O’Neil advised that it was hoped that funding for the Health Action Group would continue beyond March 2013.  The committee noted that a learning disability nurse had been in post for around a year and there were plans to appoint an acute liaison nurse, although more hospitals would need to be covered. Funding for a focus group for carers and people with learning disabilities had recently been secured and it was anticipated that it would meet on a monthly basis, whilst a patient focus group for people with learning disabilities had met twice at Central Middlesex Hospital to look at issues in all hospitals in Brent. 

Ann O’Neil advised that Brent MENCAP had provided a comprehensive response to the Joint Strategic Needs Assessment (JSNA) consultation, and whilst funding for training GPs and other health care staff in respect of people with learning disabilities had ceased, it was hoped it would re-commence once a business case had been developed. The Royal College for General Practitioners had developed an online training course and also hoped to provide training sessions.  Members heard that mystery shopper exercise at GP practices and Central Middlesex Hospital had found that whilst staff were helpful, there was very little information or help with regard to signage.

During discussion, Councillor Hunter enquired what steps were being taken to improve the amount of accurate data available.  With regard to signage, she felt there was much room for improvement and stated that this not only helped people with learning disabilities, but also those where English was not their first language and she enquired what action was being taken to address this.  Councillor Hunter also welcomed the pilot health passports scheme and she hoped that it would provide stimulus to make the scheme more widespread.  Councillor Leaman welcomed the report and suggested that in order to gain more real data, the Health and Wellbeing Board should consult with the voluntary sector and he enquired if there was any mechanism which provided voluntary sector organisations such as Brent MENCAP to provide feedback to the Health and Wellbeing Board.

The Chair enquired what the main issues raised by Brent MENCAP with regard to the JSNA consultation and she requested a copy of the document that was submitted.  She stated that members had concerns about health services provided for those with learning disabilities mainly due to lack of information and knowledge given to them. 

In reply to the issues  ...  view the full minutes text for item 5.

The report provides an update of recruitment of health visitors in Brent following an earlier report to the committee on 30 May 2012.

Jacinth Jeffers (Ealing Hospital NHS Trust) introduced the report that updated Members on the recruitment of health visitors in the borough.  She began by stating that the pan-London recruitment programme had accepted 250 new health visiting students by October 2012 specifically for health trusts across the capital.  However, the planned number of ‘return to practice students’ had fallen short of that forecast for London, with just one interviewed in October 2012.  As a result of this shortfall, a refocusing of efforts on recruiting more full time students was being undertaken.  Jacinth Jeffers drew Members’ attention to the table in the report dealing with recruitment of health visitors in Brent, which included two externally recruited health visitors and three internal staff that had trained in Brent and she emphasised the importance of retaining students trained in the borough.  Members heard that a new role, a peripatetic specialist community practice teacher (SCPT) had been introduced, of which there were five allocated places including three for student places.  Efforts to recruit health visitors internationally were also being considered and an update on this could be provided at a future meeting of the committee.

During discussion, Councillor Gladbaum enquired how long the health visitor training courses were and whether those who had declined offer of posts was due to pay differentials between different boroughs.  Councillor Hunter sought an explanation as to why return to practice student numbers were low in London and was the refresher course being re-structured accordingly for their needs, such as taking into account a possible lack of familiarity with some of the IT tools used.   She also asked if job sharing was available and why was there a shortage of health visitors in London and why did problems continue in respect of their recruitment.  Councillor Hector felt that issues with regard to lack of IT familiarity should be applicable nationally and felt that there needed to be further exploration as to the underlying reasons why there was lack of return to practice students. 

Councillor Harrison, in noting that Brent had a shortage of seven health visitors, sought confirmation that those leaving the service were asked for their reasons why and what measures were in place to try and attract more to the borough.  Councillor Leaman enquired what authority would be responsible for the overall strategy for recruiting health visitors when NHS London ceases to exist in 2013.

The Chair asked if discussions had commenced regarding arrangements when the council would take over recruitment of health visitors. 

In reply, Jacinth Jeffers confirmed that all health visitors were required to be registered nurses and that the health visitor course lasted a year. The main reasons given for declining health visitor posts in Brent were usually of a personal nature and it was confirmed that health visitors were paid the same rate across the country at national pay scale at Band 6 of the NHS Agenda for Change pay scale.  A London-wide evaluation was being undertaken as to the lack of return to  ...  view the full minutes text for item 6.

An update on the merger of Ealing Hospital NHS Trust and North West London Hospitals NHS Trust is attached.

David Cheesman (North West London Hospitals NHS Trust) introduced this item and reaffirmed that there was a sound clinical argument for the merger, however the full business case had been deferred as NHS London wanted further discussion on it, however it still supported the merger in principle.  The main reason for deferral of the full business case was that there was not yet sufficient financial assurance and the originally proposed merger date of 1 April 2013 would not now be achieved.  A new proposed date for the merger was yet to be identified whilst the trajectory of the move was still in the process of being set out.  David Cheesman emphasised that it was important that the full agreement of NHS London was achieved before it was replaced, as otherwise discussions would need to start afresh with the new organisation.  In the meantime, integration planning and developing opportunities for as much joint working as possible with clinical and support services between the two Trusts continued and shared IT and joint procurement functions were being considered. 

Turning in more detail to the financial aspects of the proposed merger, David Cheesman advised that the full business case had identified required savings of £73.2m over two years, with £30m identified for 2012/13 and £43.3m for 2013/14.  Members were informed that as of end of September, the Trusts had achieved £9.8m savings, slightly behind the £11m target to date, however it was still forecast that 2012/13 savings target would be achieved as most savings had been back ended for the second half of the year.  Pressures on the savings included having to use more agency staff for nursing posts and increased medical products due to rising demand in the number of patients.  David Cheesman added that the merger was essential in achieving recurrent savings.

Tina Benson (North West London Hospitals NHS Trust) then provided an update with regard to recruitment for the Accident and Emergency (A and E) unit at Central Middlesex Hospital (CMH).  She explained that five international candidates were to be interviewed for middle grade posts and another candidate at consultant level.  It was hoped that the A and E vacancies could be filled in time for winter when patient demand was always historically higher.  Tina Benson advised that a single recruitment agency was now being used which would bring more stability to the A and E unit.  Members noted that Northwick Park Hospital (NPH) was becoming busier as winter neared, particularly at weekends, whilst CMH continued to become less busy with an average of around 30 patients a day at its’ A and E unit.  Tina Benson advised that discussions were also taking place with NHS London and NHS Harrow with regard to handling patient numbers, particularly as there were physical capacity factors to consider in respect of NPH. 

During discussion, Councillor Hector enquired why recruiting agency staff was problematic and were there insufficient middle grade staff available to recruit from.  She also asked how the ambulance service was coping in  ...  view the full minutes text for item 7.

The purpose of this report is to set out how the council will implement the requirements of The Health and Social Care Act 2012 in relation to the creation of a local Healthwatch and Complaints Advocacy Service.  The act requires the council to establish local Healthwatch by April 2013.

Phil Newby presented the report that detailed the creation and role of a local Healthwatch that are required under the Health and Social Care Act 2012.  Under the Act, local authorities would be statutorily required to ensure that an effective and efficient local Healthwatch was operating in their area by April 2013.  Phil Newby explained that the local Healthwatch should act as a ‘consumer champion’ and would have a seat on the Health and Wellbeing Board, as well as ensuring the views and experiences of patients, carers and other service users are taken into account during the preparation of local needs assessments and strategies, such as the JSNA and authorisation of the CCGs.  The local Healthwatch would also offer an information service that would provide people with information about their choices and what to do when things go wrong.  Phil Newby advised that in contrast to Brent Local Involvement Network (LINk), the local Healthwatch will be a corporate body carrying out statutory functions and must be a social enterprise, which although not legally defined, the Department of Health’s current view was that it meant a ‘business with primarily social objectives whose surpluses are principally reinvested for at purpose in the business or in the community.’ 

Phil Newby advised that a two stage competitive procurement process was being undertaken in accordance with the council’s Standing Orders to award an organisation to operate the Healthwatch.  He drew Members’ attention to the procurement timetable which started with the invitation to tender on 27 November 2012 with contract starting on 1 April 2013.  A consultation had also been held on 23 October to obtain feedback from residents, members of community and voluntary groups and councillors on the role of the local Healthwatch and the overriding views were that it must have a local focus.  Phil Newby added that the local Healthwatch would be expected to interact with this committee.

Councillor Gladbaum commented that in the past, community health councils had operated and were effective and she asked whether the local Healthwatch would operate in a similar way.  Councillor Leaman asked if there was any more information on the structure of the local Healthwatch.  Councillor Hunter sought further clarification with regard to the mention in the report that local authorities were to take on responsibility for commissioning an NHS complaints advocacy from April 2013.

The Chair sought confirmation as to when decision to award the contract to operate the local Healthwatch would be made. 

In reply, Phil Newby commented that the structure of the local Healthwatch and how it would operate would be included in the contract specification as part of the tender criteria.  In respect of the local authority’s responsibility to commission an NHS complaints advocacy, he advised that would be part of a pan London scheme.

Mark Burgin (Policy and Performance Officer, Strategy, Partnerships and Improvement) advised that the decision to award the contract would take place in January 2013.

The Chair welcomed the report and asked that a  ...  view the full minutes text for item 8.

The reports, for information only, summarise the work of Brent Link 2011-12 and the community health survey it undertook in 2012.

The committee noted the Brent LINk’s report on their work in 2011/12 and the first part of the 2012/13.  The Chair advised that Brent LINk’s annual report had been received on 26 November 2012 and so it was agreed that this item be deferred to the next meeting.  Councillor Hunter added that a number of actions had been undertaken as a result of Brent LINk’s visit to the Willesden Centre for Health and Care.  Members noted that further visits to health facilities were being undertaken and details of these would be provided to the committee at a future meeting.

Members will receive a verbal update from the Lead Member for Adults and Health on the council’s commitment to sign up to the Time to Change pledge.

Councillor Hirani introduced this item and confirmed that the Time to Change pledge had been agreed unanimously at the Full Council meeting on 19 November 2012. The pledge gave public notice of the council’s commitment to addressing mental health discrimination and the council’s Human Resources department would be looking at a number of measures in respect of this issue.  Stress awareness training for staff was already available and the staff handbook provided information of indicators of stress and relevant links to the pledge would also be provided.  Internal policies were being considered and mental health issues were already included in the equalities policy, whilst a number of other policies, such as stress management and staff absence were also being reviewed and an online staff attendance management system was being set up.  Members noted that a staff Health and Wellbeing Group had been set up. Councillor Hirani advised that councillors could also individually sign the pledge and this would be the last act of the current Mayor of Brent.

During discussion, Councillor Harrison enquired what support measures were in place for staff whose workloads were increasing as a result of the efficiencies being undertaken as part of the One Council programme as this was a potential source for more stress.  The Chair suggested that stress management sessions could also be provided for councillors.

In reply, Alison Elliott (Director of Adult Social Care) advised that it was understood stress could increase as a result of efficiencies and so procedures had been reviewed accordingly.  A degree of stress could be beneficial in raising staff productivity, however excessive stress was counter-productive and managers were expected to manage stress within their department.  The absence management system would also help identify reasons for staff being absent. 

Councillor Hirani commented that stress management could be added to the Member Development Programme.

The work programme is attached.

Councillor Hunter advised that the scope of the female genital mutilation group had been widened to include rape and honour crimes.  The Chair added that it had been agreed that the task group would also include child marriages.  She informed Members that a report had been presented to the House of Lords on 27 November 2012 which had estimated that there had been around 10m child marriages worldwide in 2011, and although less were expected this year, it was still a major issue.  The Chair also advised that the role of community pharmacists in improving health and wellbeing would either go to the 29 January 2013 or 19 March 2013 meeting and was particularly relevant as pharmacists were playing an increasingly important role and dealing with a rising number of customers.

None.

The next scheduled meeting of the Health Partnerships Overview and Scrutiny Committee is scheduled for Tuesday, 29 January 2013 at 7.00 pm.

It was noted that the next meeting of the Health Partnerships Overview and Scrutiny Committee meeting was scheduled for Tuesday, 29 January 2013 at

7.00 pm.