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Agenda and minutes

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No. Item




Apologies for absence were received from Councillor Geoff Walker.  Councillor Caroline Erics was present as substitute.





Members are required to declare any pecuniary or non-pecuniary interest they or their spouse/partner may have in any matter that is to be considered at this meeting.  Interests are defined in the front cover of this agenda.


There were no declarations of interest.



To approve the minutes of the meeting held on 23 November 2016.


The minutes of the meeting held on Wednesday, 23 November 2016 was confirmed as a correct record and signed by the Chair.




Members of the public are welcome to participate in scrutiny meetings.  You may speak for three minutes on a topic related to the Committee’s work, and fifteen minutes in total is allowed for public speaking, at the discretion of the Chair.  If you would like to speak, please contact Democratic Services (details above) by 12 noon on the day before the meeting.




There were no requests to speak from members of the public.




Additional documents:


Dr Heather Noble and Zebina Ratansi were present from Whipps Cross Hospital to update the Committee on the next steps the hospital will undertake following the latest quality report into Whipps Cross Hospital published by the CQC in December 2016.

The Committee was reminded that on 17 March 2015 the Trust Development Authority announced that whole of Barts Health NHS Trust would be placed into Special Measures. This was following the publication of a CQC inspection report on Whipps Cross Hospital which rated the hospital overall as ‘inadequate’ and issued four Warning Notices plus specific compliance actions. The CQC re-inspected the hospital between 26 and 29 July 2016, and their quality report was published on 15th December. The CQC gave the hospital an overall rating of inadequate, and also rated it as inadequate for the categories of “responsive” and “well-led”, as well as “surgery” and “outpatients”. 

The Committee was informed that since March 2015, Whipps Cross had
embarked on an ambitious improvement plan, “Safe and Compassionate.”  Although the rating remained the same in December 2016, the report showed significant improvement at Whipps Cross. Attention was drawn to the differences between the two inspections: at the first inspection Whipps Cross was rated as in adequate in 19 areas and the 2016 inspection was rated inadequate  in six areas; the first inspection only had  five “goods” yet the recent inspection had 13 “goods”; and Whipps Cross had moved many of their “inadequates” to “requires improvements.” 

The Committee was also advised that the Maternity Services had done exceptionally well and children and young people services are now good.  A lot of work had taken place improving engagement.  Significant improvements had taken place in safety and effectiveness.  Dr Noble stated she was disappointed that the hospital did not achieve the  “requires improvement” rating overall but was very proud to report on the “goods” especially in urgent and emergency services where there were a couple of goods compared to a lot of red beforehand.

The “inadequate  rating for outpatients and diagnostic imaging was disappointing as improvements had been made but not enough by the time of the inspection.

The Committee was pleased to note that Whipps Cross is continuing to recruit permanent staff rather than agency staff and that they were able to keep staff with a turnover of 11% compared to national turnover of 15%.

The Committee’s attention was drawn to the twelve “must do” actions, particularly all the work around organisational culture,
patient flow and discharges and Governance and learning from incidents which were seen as critical.   

The Committee were given a brief update into the progress against 12 must do actions:


Ø  Patient flow and discharges: Not improved, but not deteriorated, seeing 8% more patients every month compared to last year

Ø  Infection control:  a lot of work done working with surgical team.  Some policies are across Barts Health 

Ø  VTE (venous thromboembolism) assessments: clinical champions for all specialities, getting better at communication

Ø  Organisational  ...  view the full minutes text for item 25.




Consideration was given to the report of Public Health.


Stella Bailey gave a detailed presentation of the report which is an in-depth look at the Borough’s work on treating and preventing substance misuse over the course of this year. This report was the last paper on the topic and is focussed on prevention.


Arising from the presentation, Members put a range of questions to Stella Bailey.  The responses are summarised below.


Measuring impact of prevention: Ms Bailey accepted that prevention is hard to monitor as you can ask school and college students whether they have tried drugs or alcohol at the age of 15 but you will not see the results until years later.  There are well established programmes where partnership work is key to understanding what is happening in schools.


Comparison with neighbouring boroughs:  Statistics on population levels estimated by Public Health England and Office of National Statistics are based on estimates of the population.  Hospital admissions for men under 40 are higher than neighbouring boroughs and is possibly linked to deprivation.


Criminal justice system: the Committee asked whether criminal justice was used as a deterrent for young people.  Members were told that the criminal justice system is used as a means of legislating to encourage prevention. Enforcement measures outlined in the report refer to the work done with adults rather than children.  When legislation is changed, as has been proposed with minimum unit pricing or making alcohol less available, it aims to change behaviours . Enforcement is also used as a deterrent for those supplying and using drugs.  However, it was noted that this method is not for everyone: for example especially with young people selling drugs as there are a number of ways a young person can be diverted away from the criminal justice system, for example by considering whether they have learning disabilities a previous trauma that it is more important to secure help for.


Talking therapies:  useful for a number of reasons and people respond in different ways.  Almost anything accessed earlier is better before behaviours become engrained. 

Different Communities: In terms of hidden harm amongst different communities, there is more that we can to do adequately address the issue.   Intelligence is being formulated by talking to frontline staff at treatment services.  Voluntary network and faith groups are key to help the service with wording and reduce stigma on treatments services.


BME Rehabilitation has a variable success rate for people that go in to rehabilitation especially if people stay for 12 weeks or more.  However, Public Health do realise that is not always acceptable for some community groups to be sent away for rehab because of differences with culture and it can be a barrier to seeking help. 


Serious case reviews:  The report only mentioned drugs however there are national statistics relating to alcohol involvement in serious cases and the committee asked for those figures to be sent to them. 

Prevention work in schools: Public Health is not  ...  view the full minutes text for item 26.