Agenda and minutes

• Councillor Aden
• Observer Jenny Cooper
• Councillor Tazi Smith apologised that she would be joining the meeting late.

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 Ketan Sheth – Lead Governor of Central and North West London NHS Foundation Trust
• Councillor Ethapemi – spouse employed by NHSE

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:-

The minutes of the meeting held on 5 February 2025 were approved as an accurate record of the meeting.

There were no matters arising.

The Chair advised that he had agreed to take an urgent item regarding additional beds that had been added at Northwick Park Hospital A&E Department in response to winter pressures as well as an update on the improved services in Northwick Park Maternity Services. As such, he advised that he would be taking item 10 – Any Other Urgent Business – first.

Notice of items to be raised under this heading must be given in writing to the Deputy Director Democratic Services or their representative before the meeting in accordance with Standing Order 60.

In accordance with Standing Order 60, the Chair agreed to take two urgent items relating to additional beds in Northwick Park A&E and Northwick Park Maternity Services. He welcomed Pippa Nightingale, CEO of London North West University Healthcare NHS Trust, to provide an update.

A&E Winter Pressures and Additional Beds

Pippa Nightingale began her remarks by reminding the Committee that NWL hospitals were still currently in the winter period, with an outbreak of a new strain of norovirus in the community which was being seen across all hospitals and impacting patients and staff. As a result, the Trust was reminding people not to socialise in public when they were symptomatic. The Committee heard A&E departments had experienced significant pressure this winter, with Northwick Park seing a 9% increase in attendance to A&E, which had not been the intention with the Out of Hospital Strategies in place. She advised that these strategies did not seem to have been delivered effectively and therefore an increase in attendance to emergency departments had put a strain on the Northwick Park Hospital. She advised, however, that the Trust was fortunate to have two A&E departments through Northwick Park Hospital and Ealing, so had the ability to move ambulances between the two, which was not always ideal for local populations but meant there was a footprint to move patients where one site was busy.

Pippa Nightingale then moved on to highlight some of the positives, which were that the Trust had ran all three Urgent Care Centres themselves for the first year, and those centres were operating daily at 99% and achieving the target of seeing, treating and discharging patients within 4 hours, which was highlighted to be very good performance. As a result of that positive performance, more patients could be seen and the Trust could move patients between A&E and Urgent Care Centre pathways in a much more streamlined way than previously when there had been third party organisations running those services. The Trust had also opened additional winter beds this year to deal with the extra demand being experienced. As an estimate, around 130 conveyances of patients by ambulance was seen by Northwick Park daily, but the Hospital usually only needed to admit between 40-45% of those patients, so colleagues felt there was work to be done to remind people when it was the right time to use an ambulance and how to use other parts of the health system. That communications work would be done through Primary Care next year.

The Committee were informed that the Trust was fortunate to have been funded to build an additional 32-bed acute ward, which had opened in April 2024 and had helped demand. Pippa Nightingale expressed that it was a very good facility and had been full from the first day of opening. In addition, the Trust had been fortunate to open some mental health compliance rooms in response to the high numbers of patients in NWL hospitals with  ...  view the full minutes text for item 7.

To provide an update from North Central London NHS on the Start Well Programme.

Anna Stewart (Service Development Director, CYP, CAMHS, Maternity and Neonates, NHS NCL ICB) introduced the report, which described the public consultation outcome on the proposed changes to North Central London’s (NCL) maternity, neonatal and children’s surgical services that took place between 11 December 2023 to 17 March 2024. She highlighted that the Start Well programme was a long-running change programme in NCL that had started with a case for change looking at maternity and neonatal services and some children’s surgical services, looking at best practice care models, options appraisals on how best to deliver that care, and then moving through to the public consultation. In introducing the report, she reminded members that she had attended the Committee the previous year to present the options that North Central London Integrated Care Board (NCL ICB) would be consulting on around the delivery of maternity and neonatal care in NCL (inclusive of the boroughs of Camden, Islington, Barnet, Enfield and Haringey). Following consideration of all possible options, two that were seen to be deliverable were then consulted on. The first option was to close the maternity and neonatal unit at the Royal Free Hospital in Hampstead, which was identified as NCL’s preferred option at consultation stage. The second option was to close maternity and neonatal services at Whitington Hospital in Highgate. In both of those options, maternity and neonatal services would be retained at Barnet Hospital, North Middlesex Hospital and UCLH. The second area of the consultation was around the closure of the standalone midwifery-led unit at the Edgware Hospital site in NCL used as a place to give birth, which was being considered given the decreasing number of people using that as a site to give birth with only 28 giving birth there in the last financial year. Although NCL was consulting on closing the birthing suite there, Anna Stewart advised that NCL would retain and enhance the antenatal and postnatal care at the site.

Anna Stewart then moved on to the consultation period, which lasted for 14 weeks. She advised the Committee that NCL had conducted widescale engagement to hear resident views on the proposals and worked closely with both the NWL ICB and NCL ICB teams, receiving guidance and support from the Director of Public Health for Brent. She advised members that NCL had seen very good engagement and wide feedback, with over 3,000 responses to the questionnaire, over 200 meetings which were formally minuted, and some very targeted engagement in areas where NCL particularly wanted to hear people’s views on. Those areas were Harlesden and Willesden for the option to close Royal Free Hospital, and Holloway and Finsbury Park for the option to close the Whitington Hospital. To do that, targeted mailing to 1/3 of the residents in those areas was done, alerting them to the consultation and inviting them to feed back, as well as some focus groups.

The outcome of the consultation, which had been published in November 2024, was then outlined. Anna Stewart highlighted that, overall,  ...  view the full minutes text for item 8.

To provide an overview on nicotine addiction and vaping in Brent, including both national and local contexts and available data.

The Chair opened the item by reminding members of the Committee that this particular item had been brought to the Committee by Brent Youth Parliament (BYP), and therefore he would be inviting them to contribute to the discussion. He then asked officers to introduce the report.

Dr Melanie Smith (Director of Public Health, Brent Council) introduced the report, which she advised covered nicotine addiction and vaping in Brent and touched on national policy and legislation as well as providing the local context. She advised members that it was important to recognise that, whilst smoking was the focus for the vast majority of national policy and effort, locally in Brent there were a variety of ways nicotine and tobacco was used, including shisha smoking and chewing tobacco, which the paper drew out. The report also spoke about the health risks, which for smoking were relatively well understood in the community, but for shisha smoking and chewing tobacco, despite the strong evidence base, were generally not well understood by communities. For vaping, research was in its early stages, and whilst it was clear there were some health impacts, the long-term impacts were not yet known. There was also a gap in knowledge specifically related to the long-term effects of vaping on young people, and research had now been commissioned to address that. She advised the Committee that the data in the report on levels of smoking came from 2 sources – the national survey, which she added was robust at a borough level but not granular enough to see ward level data or different groups, and data from WSIC (Whole Integrated Care System) which used local NHS data derived from GP surgeries, allowing public health to look at subgroups of people in the population, but which could not be taken as the whole truth due to the variance across GPs in terms of timeliness of recording and reporting data. The report then detailed the service response and what was planned moving forward, and the Council had been fortunate in bidding for additional funds for tackling nicotine addiction, some of which had been used to recruit a Smoking and Nicotine Addiction Team who would help people using nicotine to overcome that addiction.

Dr John Licorish (Public Health Consultant) added that there was upcoming legislation relating to smoking and smoking age coming through parliament, with the proposal that no-one born after 2009 would be allowed to smoke. Whilst that legislation was being brought through the parliamentary process, in the short term there was funding to increase the scope, attention and evidence base around smoking and vaping.

Councillor Neil Nerva (as Lead Cabinet Member for Adult Social Care, Public Health and Leisure) thanked Brent Youth Parliament for bringing the item in front of Scrutiny and looked forward to a discussion on how the work could be taken forward in Brent.

The Chair thanked presenters for their introduction and before inviting comments and questions from the Committee he asked Brent Youth Parliament to introduce their anti-vaping  ...  view the full minutes text for item 9.

To present the Scrutiny Recommendations Tracker to the Community and Wellbeing Scrutiny Committee.

The Committee noted the recommendations tracker and requested that deadlines for action completion were included in the table.

To provide an update on the changes to the Community and Wellbeing Scrutiny Committee Work Programme 2024-25.

The Committee noted the work programme.