Agenda and minutes

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 64.

The following apologies for absence were received:

·           Councillor Thakkar 

·           Simon Goulden (Co-opted Member)

Members are invited to declare at this stage of the meeting, any relevant disclosable pecuniary, personal or prejudicial interests in the items on this agenda.

The following personal interests were declared:

·           Councillor Ketan Sheth declared that he was a Lead Governor at Central and North West London National Health Service Trust and an ambassador for the All-Party Parliamentary Group for Diabetes.

·           Councillor Shahzad declared that his wife worked as a doctor at Northwick Park Hospital.

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 Committee meeting held on 28 November 2018 as a correct record.

RESOLVED that the minutes of the Committee meeting, held on 28 November 2018, be approved as an accurate record.

There were no matters arising.

It was RESOLVED that the order of business be amended as set out below.

This report provides an update for the Community and Wellbeing Scrutiny Committee on Winter Pressures – learnings from winter 2017/18 and sets out a system-wide approach on winter preparedness in Brent for 2018/19.

Rashesh Mehta (Assistant Director for Integrated Urgent Care and Long-Term Conditions, Brent Clinical Commissioning Group (CCG)) introduced the report which provided an update on learnings from winter 2017/18 and set out the plans of Brent CCG, London North West University Healthcare National Health Service (NHS) Trust (LNWUHT) and Brent Council for 2018/19 which had been based on a system-wide approach. The plans for winter 2018/19 had been coordinated by executives from Brent CCG, Brent Council, London Ambulance Service (LAS), NHS 111, Urgent Care Centres & Community Services and Accident and Emergency (A&E) Delivery Boards and had been scrutinised by NHS England (NHSE) and NHS Improvement (NHSI). Furthermore, the A&E Delivery Boards had focused on five key initiatives against the national winter requirements – reducing extended lengths of stay; development of an ambulatory emergency care service; minor patients breaches reduction; improving ambulance handovers; and implementing effective demand management schemes (for details please see paragraph 3.2 of the report (page 30 of the Agenda pack)).

James Walters (Deputy Chief Operating Officer, LNWUHT) added that winter planning for 2018/19 had started earlier than in previous years and assured Members that the Trust had been successful in supporting the Trust’s A&E Department to achieve performance targets – for instance, 90% of patients were seen within the target of four hours and ambulance handover times had been improved. However, since December 2018 various flu strains and cooler weather had led to an increased demand for services – for instance, over 750 patients had been treated and 130 ambulances had arrived at Northwick Park Hospital on Saturday 26 January 2019.  Mr Walters pointed out that a specific focus had been placed on timely discharge of patients as unnecessary delays could increase the risk of healthcare acquired infections. A special Older People’s Short Stay Unit had been launched at Northwick Park Hospital and there had been plans to extend the scope of the Home First Initiative across all discharge pathways and to additional hospital sites. Members heard that stakeholders had taken a collaborative approach towards the simplification of the discharge pathways from hospital to community, reducing the pathways from 17 to four (for details please see paragraph 6.7 of the report (pages 36-37 of the Agenda pack)). In response to the Chair’s request to outline any different practices at Imperial NHS Trust, Clare Hook (Director of Operational Performance, Imperial NHS Trust) said that these were similar to the ones at LNWUHT.

Members welcomed the report and enquired about the performance of A&E Departments at Northwick Park Hospital and St. Mary’s Hospital. Mr Walters said that the longest wait for a bed at Northwick Park Hospital had been eight hours, but the actual journey for patients could have been longer as they may have sought help from NHS 111 or their General Practitioner (GPs) prior to presenting themselves at the A&E Department. He reminded the Committee that the target to assess, treat and discharge patients at Northwick Park A&E Department was four hours.  ...  view the full minutes text for item 7.

The 2017/18 Complaints Annual Report was presented to Cabinet on 10 December 2018. This version of the paper focuses on complaints performance in the Community Wellbeing Department - Adult Social Care directorate and Culture service and complaints performance in the Children and Young People Department. 

Councillor McLennan (Deputy Leader, Brent Council) introduced the Complaints Annual Report 2017-18 and explained that the version presented to the Committee focused on complaints performance in the Community and Wellbeing Department (Adult Social Care directorate (ASC) and Culture Service) and the Children and Young People Department (CYP). It was noted that complaints concerning social care in Adult and Children services came under separate statutory complaint procedures and separate summary reports had been provided in Appendices A and B respectively (pages 47 and 57 respectively of the Agenda pack), with an overview report on complaints performance set out in Appendix C (page 69 of the Agenda pack). Councillor McLennan stressed that there had been an overall decrease in the number of complaints and challenges associated with response times had been addressed successfully. She commented that the Council’s performance had been affected by the reduction of funding available from central government which, in some cases, had led to reductions in staff numbers. However, the risk that this would lead to an increased number of complaints had not materialised as the Council had been focused on resolving issues early on. Irene Bremang (Head of Performance and Improvement, Brent Council) highlighted that overall performance in the Community and Wellbeing Department (CWB), CYP and the Culture Service had been strong with the number of complaints being low in comparison to the rest of the Local Authority.  Ms Bremang said that despite the noticeable improvement in the timeliness of CYP Statutory Stage 1 cases, the timeliness of Stage 2 complaints remained below target. However, it should be taken into account that the volume was low and most of these complaints were very complex so resolving them in a timely way could be challenging.

The Committee heard that the Complaints Service Team worked closely with the Council Management Team and Department Management Teams to provide them with regular feedback on performance and to implement lessons learned. Ms Bremang reminded Members that last year’s report contained eight specific recommendations to Cabinet which had informed the development of an Action Plan. The current paper set out measures that had been taken to implement these (for more details please see paragraph 3.6 of the report (pages 44-45 of the Agenda pack)).   

Members welcomed the report and commented on the fact that the number of complaints received by ASC in 2017/18 (97) had remained unchanged from the previous year. Phil Porter (Strategic Director of Community Wellbeing, Brent Council) explained that the figure had to be considered in context of an increased number of service users which indicated that performance had improved in real terms. He assured Members that all complaints had been carefully examined and responses had been issued on time in the majority of cases (95% of Stage 1 complains had been responded on time).

A specific question that was raised related to amount of money paid in compensation and mentioned in the report. Helen Woodland (Operational Director, Social Care, Brent Council) highlighted that £12,500 of the total £13,945 compensation  ...  view the full minutes text for item 8.

This report updates committee members with interim feedback from the members’ overview and scrutiny task group which was set up by the Community and Wellbeing Scrutiny Committee to review contextual safeguarding in Brent.

Councillor Orleen Hylton (Chair of the Members’ Overview and Scrutiny Task Group) presented the report which provided feedback on the work of the Members’ Overview and Scrutiny Task Group that had been set up to review contextual safeguarding and how it could be introduced more widely in Brent. She informed Members that the approach of contextual safeguarding had been developed in recent years by Dr Carlene Firmin at the University of Bedfordshire’s International Centre. The model asked practitioners working with adolescent children to recognise the limits of safeguarding approaches which just focused on risks within the family and to address the risks from ‘contexts’ outside of the family such as peer groups, schools and neighbourhoods in which an adolescent child lived.

Members heard that the Task Group was minded to develop recommendations in a number of areas, which were set out in the feedback report to the Committee. These included ensuring that in Brent’s approach to online safeguarding was a separate context; making sure that public information was provided to give residents better knowledge about safeguarding; reviewing children’s safety while using the bus network; and addressing the concern about adolescent children’s time during school holidays. The final report on the work of the Task Group would be presented to the Committee at the meeting on 18 March 2019 for agreement of recommendations, following which it would be scheduled to go to Cabinet.

Members welcomed the report and enquired why special attention should be paid to social media, e.g. it had been proposed to add a fifth context ‘online’ to Brent’s approach, and whether consideration had been given to other modes of transport. Councillor Hylton said that a significant proportion of parents were not aware of the content their children accessed online and could not explain to them the dangers of using social media and sharing too much personal information. Moreover, the Task Group supported the view that social media companies should take more responsibility for the way their platforms were used. As far as travel was concerned, the discussion had been focused on buses and the management of the bus system, e.g. travelling by Underground had not been suggested by the Task Group as an area of concern.

In response to a question about developing contextual safeguarding in Brent, Councillor Hylton explained that the thinking was already having an influence and the model was being put into practice in some areas. Various stakeholders were also committed to its principles. For example, schools had already been collaborating with bus companies to promote safer travel and they had organised IT classes for parents. The introduction of more Safe Spaces was being looked at and Brent Council’s Youth Offending Service had been working on identifying safe areas for adolescents who they worked with. Councillor Hylton said the Task Group would examine the budgets for children’s services and implementing contextual safeguarding at its next meeting and the findings would be included in its final report. Councillor Mili Patel (Lead Member for Children's Safeguarding, Early  ...  view the full minutes text for item 9.

The report updates Members on the Committee’s Work Programme for 2018/19 and captures scrutiny activity which has taken place outside of its formal meetings.

The Chair noted that the Community and Wellbeing Scrutiny Work Programme for the 2018/2019 Municipal Year had been set out in Appendix 1 (pages 91-99 of the Agenda pack).

RESOLVED that the contents of the Community and Wellbeing Scrutiny Work Programme 2018/2019 Update 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 his representative before the meeting in accordance with Standing Order 60.

None.