Agenda and minutes

Venue: Virtual

Contact: Hannah O'Brien, Governance Officer  Email: hannah.o'brien@brent.gov.uk

Items
No. Item

1.

Apologies for absence and clarification of alternate members

Minutes:

Apologies for absence were received as follows:

 

           Councillor Sangani, substituted by Councillor Long

2.

Declarations of interests

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.

Minutes:

Interests were declared as follows:

  • Councillor Ketan Sheth – Lead Governor, Central and North West London NHS Foundation Trust
  • Councillor Ethapemi – Spouse employed by the NHS
  • Councillor Shahzad – Spouse employed by the NHS
  • Mr Simon Goulden – Spouse Chair of governors of a Brent School

 

3.

Deputations (if any)

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

Minutes:

There were no deputations received.

 

4.

Minutes of the previous meeting pdf icon PDF 136 KB

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

 

Minutes:

RESOLVED:-

 

that the minutes of the previous meeting held on 21 July 2020 be approved as an accurate record of the meeting.

5.

Matters arising (if any)

Minutes:

There were no matters arising.

 

6.

BAME Communities and the Impact of Covid 19 in Brent pdf icon PDF 225 KB

This report considers the impact of COVID-19 on BAME Communities in Brent.

Minutes:

Councillor Neil Nerva (Cabinet Member for Public Health, Culture and Leisure, Brent Council) introduced the report which provided an overview of the underlying causes of the patterns of infection and mortality from Covid-19 among Brent’s Black and Minority Ethnic (BAME) communities. Councillor Nerva pointed to report paragraphs 6.8.1 onwards regarding community health meetings that had taken place the previous week with community leaders in Church End and Alpterton. There was a proposal to create Community Champions roles for outreach in those communities.

 

Dr Melanie Smith (Director of Public Health, Brent Council) noted when thinking about the disproportionate impact of Covid-19 on BAME communities it was important to think about the potential causes, such as occupational exposure, increased susceptibility to severe infection from underlying health conditions and access to appropriate healthcare, and Brent’s possible response to those regarding exposure to the virus. Dr Melanie Smith acknowledged the entrenched structural inequalities within society and expressed that there was a need to act in the immediate and longer term, with immediate actions aimed at reducing exposure to the virus, increasing resilience and ensuring access to healthcare.

 

The Chair thanked both for their introduction and invited questions from the Committee, with the following issues raised:

 

The Committee queried what actions would be taken forward as a result of the findings that BAME communities were disproportionately impacted by Covid-19. Dr Melanie Smith advised they would be acting to reduce the exposure of BAME communities to the virus. For example, Public Health England research had shown that national messaging was not culturally competent therefore Brent had developed local messaging and were part of the ‘keep London safe’ campaign which had produced materials more appropriate for a diverse London population. The Council wanted to work with the community and engage Community Champions to ensure messaging was reaching all communities effectively. Dr Melanie Smith expressed it was important the Council worked with the community to develop the action plan rather than presenting an action plan produced for them, as Public Health England qualitative research showed many BAME communities felt disempowered.

 

Further discussing the action plan, the Committee heard that the Council and health colleagues were reducing exposure by getting people tested and self-isolated. There was a hyper-local walk-in testing site in Harlesden which had adapted the national model to ensure it was accessible to local people, and increasingly those getting tested at that site were reflective of the ethnic diversity of the communities who lived there. It was also highlighted that BAME communities were more susceptible to severe levels of infection, some of which was associated with higher levels of diabetes, hypertension and cardiovascular disease in those communities. Dr Melanie Smith explained that there was evidence those conditions, if poorly controlled, contributed to worse outcomes. The Public Health department were working hard with Brent Clinical Commissioning Group (CCG) to ensure people with those long term conditions were contacted and helped to maximise the control of their condition in preparation for a second wave. Work on the flu vaccination  ...  view the full minutes text for item 6.

7.

Brent NHS and Covid 19 Response and Recovery pdf icon PDF 469 KB

This report provides an overview of the operational response by Brent’s local NHS to the COVID-19 pandemic and the recovery plans and operational recovery, including planning for a possible second wave.

Additional documents:

Minutes:

Sheik Auladin (Managing Director, Brent CCG) introduced the report which provided an overview of the operational response by Brent’s local NHS to the Covid-19 pandemic and the recovery plans and operational recovery, including planning for a possible second wave. He drew the Committee’s attention to key aspects of the report including mortality rate and data analysis, the immediate response, the Covid-19 recovery phase, lessons learnt, and financial implications, noting that many factors were complex and intersectional. He highlighted that at the beginning of the pandemic in March 2020 during the immediate response, NHS England had issued guidance for acute trusts to prepare to manage capacity and ensure facilities were there, therefore non-elective and non-urgent patients were discharged to create capacity in the system. At the same time in the CCG GPs were informed to start seeing patients by e-consultation, which he advised was easy to do as GPs had begun e-consultations pre-Covid. The recovery phase for GPs required them to offer face to face appointments and operate 100% capacity while following the guidelines. Work was being done to ensure the flu vaccination campaign was underway and well-established, with faith establishments supporting the message to get vaccinated. A Covid escalated care planning hot-hub was launched on 27 March 2020 to manage and see Covid-symptomatic patients and care and monitor them in the community instead of putting pressure on hospitals. The hub continued to operate at a low level and remained in place to escalate if needed. Sheik Auladin advised that learning had shown more efficient use of NHS resources when all partners and providers worked together, including the local authority, acute hospitals and all CCGs and providers. He added that there was now work underway at both a national and local level addressing health inequalities. A substream of work involved the CCG working with primary care networks and 10 GPs to tackle health inequality issues in Church End and Alperton, looking at a new model of work for a multi-disciplinary approach in relation to managing long-term conditions, including mental health, specialist nurses and GPs. The model was in its very early stages but there had been good response from all major providers. 

 

The Chair thanked Sheik Auladin for the introduction to the report and invited comments and questions from the Committee, with the following issues raised:

 

The Committee heard that Northwick Park was at the forefront during the early stages of the pandemic and was the second busiest A & E in London, so there were challenges regarding the number of places in critical care facilities. Northwick Park had been supported by the system, particularly Royal Brompton Hospital, with the transfer of patients to receive critical care. There was positive news coverage about the response to Covid, with community testing noted and innovative treatments and drug regimes used for Covid patients, such as CPAP oxygen use. Simon Crawford (Deputy Chief Executive, London and North West Hospitals Trust) advised the Committee that Central Middlesex Hospital, GPs and UTC were now running and had  ...  view the full minutes text for item 7.

8.

Single CCG for NW London and Development of the Integrated Care System pdf icon PDF 107 KB

This report sets out the plan to form a single CCG and the vision for establishing an Integrated Care System (ICS).

Additional documents:

Minutes:

Lesley Watts (Senior Responsible Officer, North West London Health and Care Partnership) introduced the report which set out the background and context of how the NHS were operating and seeking to operate as an Integrated Care System (ICS) and the rationale for merging the 8 North West London CCGs into one. The belief behind the merge was that the provider / commissioner split needed to come to an end. Lesley Watts expressed that the essence of the ICS meant that together they would use all the resources available to drive up the quality of care, drive out duplication and variation, address inequalities and learn from each other to get the best outcomes for patients and provide the vast bulk of care together. Direction had been increased in Boroughs with senior directors from community care, mental health and primary care who would work with the Local Authority as a result of discussions with Local Authority Chief Executives at joint meetings with Local Authority providers and Chief Executives.

 

Dr MC Patel (Chair, Brent CCG) added that as a member of the CCG and Board he had supported the principle of a single North West London CCG as it offered significant opportunities such as improved efficiency and the ability to address the severe problems of deprivation and inequality of access to healthcare. The merge meant they could start to address the shifting of resources with emphasis on particular areas to ensure everyone across North West London had an equitable offer and break down barriers that had traditionally existed. There was a desire to build on the good history of working with the Local Authority, local acute trusts and community services. Dr MC Patel advised that they should be looking at the population of North West London and its diversity particularly in terms of inequalities.

 

Sheik Auladin (Managing Director, Brent CCG) echoed this, stating that over the previous year health and the Local Authority had started working together more closely and collaboratively due to the pandemic, which had helped to galvanise all the work going forward from an ICS and system perspective. He informed the Committee that Brent CCG members had now voted in favour of the merge to a single North West London CCG.

 

The Chair thanked health colleagues for their introduction and invited members to ask questions, with the following issues raised:

 

In response to queries about the consultation process with the community and service users, Rory Hegarty (Director of Communications and Engagement, North West London CCGs) explained that the recent consultation had shared the Case for Change with each Borough’s Scrutiny Committees, Local Authority Chief Executives and Leaders, Cabinet leads for health, and was presented at Joint Health Scrutiny Committees, to the local Healthwatch organisations, community groups, all patient participation groups and campaigning organisations such as Brent Patient Voice and Save Our NHS. The case for change had also been published online for public comment, with a press release and social media activity. The legal consultation with the Local Authority had  ...  view the full minutes text for item 8.

9.

Any other urgent business

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.

Minutes:

None.