Agenda and minutes

• Councillor Moeen, joining remotely
• Councillor Begum
• Co-opted member Mr Alloysius Frederick, joining remotely

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.

Personal interests were declared as follows:

• Councillor Sheth – Lead Governor of Central and North West London NHS Foundation Trust
• Councillor Matin – employed by NHSE, part of the National Programmes Team which includes Diagnostics
• Councillor Ethapemi – spouse employed by NHS
• Councillor Collymore –Member of Palliative Care End of Life Steering Group
• Councillor Rajan-Seelan – spouse employed by NHS
• Councillor Smith – employed at Royal Free Hospital as a Management Consultant for Transformation Partners Healthcare Consultants and previous experience as a Project Manager on the Capital Midwife Programme under NHSE, including a pan-London assessment where Northwick Park Hospital was assessed
• Councillor Fraser – employed with the NHS Transformation Team as a Lived Experience Practitioner

To hear any deputations received from members of the public in accordance with Standing Order 67.

There were no deputations received.

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

RESOLVED:-

that the minutes of the previous meeting held on 7 March 2023 be approved as an accurate record of the meeting.

There were no matters arising.

To provide an update on the progress made by partners on the implementation of the recommendations made by Baroness Casey following the UEFA Euro 2020 Final at Wembley Stadium.

Chris Whyte (Director of Environment and Leisure, Brent Council) introduced the report, which provided the Committee with a joint presentation explaining the continued response to the Casey Review of the Euro 2020 Final. He reminded the Committee that the Casey Review was a piece of work commissioned in the aftermath of the Euro 2020 Football Tournament Final, where there had been scenes of disorder, much of which were attributed to the consumption of alcohol and other compounding factors at that particular point in time. The review recommended a number of required actions and a fundamental response from all of the partners involved in the planning and preparation of large-scale events at Wembley Stadium.

In continuing the introduction, the Committee heard that, since the Final, the past two years had seen a programme of work to recover the situation, and new regulations had been introduced as well as ways of working, protocols, and the format around enforcement to ensure the type of events that occurred during the Final did not happen again. There were other recommendations around the security of the stadium building itself and arrangements for stewarding that had also been incorporated into the improvement actions undertaken by partners. Chris Whyte highlighted that the Council was only one of a number of partners undertaking this responsibility and there were colleagues present from the Football Association (FA) to present their overall response as well.

In relation to the work the Council had done, Chris Whyte explained that the Council had introduced controls around the sale and consumption of alcohol that contributed to the scenes of the Final. There were now licensing controls in place so that off-licences in the local area were not permitted to sell alcohol for casual street drinking, which was monitored. This was communicated clearly, not just on the day of the event itself but several days before events, through effective liaison and engagement with businesses. The secondary part of that was enforcement of street drinking on the day of the event, with teams of Council officers on the ground undertaking that enforcement with the Metropolitan Police so that individuals who were in the local area and very clearly consuming or in possession of alcohol were asked to hand it in and refrain from that behaviour. Those 2 strands of work had been very effective in harnessing those problems to the extent that there had been no repeat of the issues seen on the day of the Euro 2020 Final. This was also thanks to local businesses’ willingness to comply. Within the Council it was felt that those arrangements had transformed event days to create a much more family-friendly and welcoming environment with much less opportunity to create the disorder seen on the day of the Final.

As the Metropolitan Police were unable to be present at the meeting due to staffing a large-scale event at the time of the meeting, they had given Chris Whyte some information to share with the Committee on their behalf regarding their  ...  view the full minutes text for item 6.

For the Community and Wellbeing Scrutiny Committee to receive an update on the delivery against the London North West University Hospitals NHS Trust Maternity Improvement Plan, the Maternity Strategy, and on the Trust’s regulatory compliance.

Lisa Knight (Chief Nurse, LNWUHT) introduced the report, which updated the Committee on the progress of the Northwick Park Maternity Improvement Plan. She reminded the Committee that Northwick Park Maternity Services had been inspected by the Care Quality Commissioner (CQC) in March 2021 and graded as inadequate. As a result, London North West University Healthcare NHS Trust (LNWUHT) had attended the Scrutiny Committee in August 2021 to provide assurances and present the Maternity Improvement Plan. The CQC had then made a repeat visit in October 2021 where Northwick Park Maternity Services was upgraded from inadequate to requires improvement, which remained the rating at the time of the meeting as there had been no inspection since then. LNWUHT were very pleased with that rating as an outcome after just 6 months and the CQC had said that from a morale perspective and multi-disciplinary team perspective there had been a ‘sea change’ in the department. The link to that report was included in the agenda pack for the Committee meeting and described what further work was being done to improve, in particular in relation to staffing, training and equipment management.

Lisa Knight advised the Committee that there was now a national programme of inspections for all maternity services in the country which had been ongoing for approximately one year. Northwick Park was expecting another inspection fairly soon as business as usual but were not certain whether they were part of the national programme, having been inspected so close to the announcement. As such, preparations were taking place in order to be ready for inspections. As the service had not been inspected for a while, the report included outcomes from the peer assessments undertaken in August 2022 by 14 individuals against the Shrewsbury and Telford report. These assessments found that LNWUHT had maintained compliance on the majority of measures, which was a good outcome, benchmarked against other London areas. The assessment had found 2 areas of non-compliance. One was regarding consultant ward rounds and there had been compliance with that now since November 2022, and one was around workforce planning, particularly around staffing, and whilst that had improved it did remain a challenge. There was still around a 35% vacancy rate in the middle midwifery layer, but there was a solid pipeline of approximately 20 international midwives coming in to Northwick Park Hospital by December as part of the Capital Midwife Programme.

Northwick Park Hospital was on the National Maternity Programme, who were happy with the engagement from Northwick Park Hospital and were helping the Maternity Unit with clinical pathways, triage, governance processes, and preparing for inspection. The Maternity Services Improvement Plan had been moved to a Strategy, and a new National Maternity Improvement Plan had been published the previous week which Northwick Park Hospital was benchmarking against. It had been found that the themes in the Northwick Park Maternity Improvement Strategy aligned with those in the National Programme so there was confidence that LNWUHT was on the right track.

The Chair thanked  ...  view the full minutes text for item 7.

To provide the Community and Wellbeing Scrutiny Committee with an update on the development of new NHS Community Diagnostic Centres in Brent and North West London.

Pippa Nightingale (CEO, LNWUHT) introduced the report, which provided information on the new Community Diagnostics Centres (CDCs) in NWL. She felt CDCs were an exciting initiative which had received a significant amount of investment (£44m) to decrease waiting times for residents to have diagnostics tests. The report detailed the plan for CDCs and where each centre would go, which was based around deprivation and population need. The methodology for determining the location of CDCs had focused on ensuring patients would not have to travel for more than 45 minutes to a CDC. One important thing to note was that CDCs were an additional service and did not replace the diagnostics already done in hospitals. Instead, the CDCs allowed for an extra 300,000 members of the NWL population to have diagnostics tests in a much quicker way than they were having now. The majority of patients referred for a diagnostics test did not have an illness, so they could be relieved quicker, and those who did have an illness and needed treatment could get faster access to treatment. As a result, the patient pathway was improved as well as survival rates and there was better access to care.

The Chair then invited comments and questions from the Committee, with the following issues raised:

The Committee agreed that CDCs were an exciting initiative. They knew NWL was one of many areas across the country identified as an area of deprivation and who would be opening CDCs, so asked what learning had been taken from other areas that had already launched their CDCs. Pippa Nightingale advised the Committee that the detailed work that had been done regarding deprivation had also helped other pathways, such as the Elective Orthopaedic Centre, because that data had been collected in a granular way, not just by borough but locality as well. Learning had also been taken from other parts of the country ahead of NWL in the rollout of CDCs, particularly around how those areas decided where the sites would be placed, as well as their implementation and rollout. NWL were working in a detailed and connected way with the CDC NHSE team.

The Committee asked how this related to GP direct access. Pippa Nightingale felt that CDCs were a ‘game changer’ for GP direct access, as for many years GPs had been frustrated that they had not been able to access basic diagnostics. This gave NWL an opportunity to look at direct access models on a wider scope as well, which was being done by place-based partnerships. Tom Shakespeare (Integrated Care Partnership Director) added that the Integrated Care Partnership (ICP) would be working closely with the GP community as well as acute and NWL colleagues on the development and rollout of CDCs over the coming months.

Members of the Committee advised presenting officers they had heard from residents that they had waited a long time to have tests done and once tests had been done, they had waited a long time to hear the results of  ...  view the full minutes text for item 8.

To update the Community and Wellbeing Scrutiny Committee on the progress made against the recommendations from the GP Access Task Group over the past year.

Tom Shakespeare (Integrated Care Partnership Director) introduced the report, which was a one-year response to the scrutiny task group recommendations around primary care access, which the Integrated Care Partnership (ICP) had spent a lot of time and effort implementing. In introducing the item, he highlighted the significant increase in funding coming into primary care, with over £4m coming in and expected recurrently. There had been a significant improvement in the number of appointments available in primary care, including evenings and weekends. Through the Addition Role Reimbursement Scheme (ARRS) there had been a significant increase of additional staff in primary care of 170, and that continued to increase day by day, as well as training in individual practices. He felt that underpinning this was partnership working in a joint, collaborative approach with colleagues in primary care and Primary Care Network (PCN) clinical directors. There was a clear workplan with 5 priority areas that the ICP were working towards, including communications campaigns that gave residents a clear understanding of how to access services.

In continuing to introduce the report, Versha Varsani (Head of Primary Care, ICP) added that the ICP would be working with primary care colleagues and PCNs over the next year to ensure local access plans were done and that primary care was working towards additional access priorities.

The Chair thanked those present for their contributions and invited comments and questions from the Committee, with the following issues raised:

The Committee asked what work was being done to improve access specifically for elderly and vulnerable patients. Versha Varsani acknowledged that demand and capacity were very challenging areas, particularly as the population in Brent was continually growing. An area being worked on was supporting telephony services in GP practices, looking at a cloud-based, smart telephone service that could do call-back opportunities and which gave GP practices data regarding when the biggest demand in the surgery was, so that services could be wrapped around demand. Another approach was for those in ARRS roles to see patients as there were lots of skilled staff in GP surgeries that could see patients aside from doctors. A focus going forward was on both reactive and proactive models. The reactive model would support patients who wanted on the day demand and look how that could be done at scale, such as through the enhanced access hubs. The proactive care model would support more complex patients, including elderly and vulnerable patients. There were many different channels primary care were using to support the work.

The Committee were advised that there had been some technical challenges and the ICP were looking to address some of those challenges, as well as the lack of awareness around the additional out of hours appointments which had been released.

As no further issues were raised, the Committee RESOLVED:

i)              To note the contents of the report.

To provide the Community and Wellbeing Scrutiny Committee with the 2022-23 recommendations tracker.

RESOLVED that the contents of the Update on the Committee’s Work Programme 2022-23 report, be noted.

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or her representative before the meeting in accordance with Standing Order 60.

The Chair informed the Committee that this would be Carolyn Down’s (Chief Executive, Brent Council) final meeting at the Community and Wellbeing Scrutiny Committee. He thanked her for the support she had given over the years to the Committee and highlighted that some of the work done by the Committee over the past few years would not have been possible without her support.