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Agenda and draft minutes

Venue: Council Chamber - Waltham Forest Town Hall. View directions

Contact: Perminder Purewal, Democratic Services Officer  020 8496 4537 | Email: perminder.purewal@walthamforest.gov.uk

Items
No. Item

1.

APOLOGIES FOR ABSENCE AND SUBSTITUTE MEMBERS

Minutes:

Apologies for absence were received from Shumon Ali-Rahman (co-optee) and Terry Huff (Waltham Forest CCG).

2.

DECLARATIONS OF INTEREST

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.

Minutes:

Councillor Richard Sweden declared a non-pecuniary interest in Agenda Item 7 (NELFT CQC Quality Report) as he is managed but not employed by NELFT.

 

Councillor Richard Sweden also declared a non-pecuniary interest in Agenda Item 8 (Mental Health Update) in his capacity as a Trustee of Leyton Orient Trust.

 

Notwithstanding his interests in these items Councillor Sweden was able to remain in the room and participate in the debates and vote.

3.

MINUTES OF PREVIOUS MEETING pdf icon PDF 86 KB

To approve the minutes of the meeting held on 25 January 2017

Minutes:

The minutes of the meeting held on 25 January 2017 were approved as a correct record and signed by the Chair.

4.

PUBLIC PARTICIPATION

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.

 

 

Minutes:

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

 

5.

NHS DISCHARGE POLICIES - BUDGET AND PERFORMANCE SCRUTINY COMMITTEE REFERENCE TO HEALTH SCRUTINY COMMITTEE pdf icon PDF 59 KB

Minutes:

The Committee considered a reference from the Budget and Performance Scrutiny Committee expressing its concern about NHS discharge policies and suggesting that the Health Scrutiny Committee might wish to ask for a detailed report given the impact of changes in NHS discharge policies on costs and service provision.

 

John Higgins (Head of Assessment and Care) informed the Committee that Adult Social Care was not aware of any hospital discharges being managed in the way described by Members at the Budget and Scrutiny Committee meeting. He advised that monitoring information around re-admissions was that there had been a significant reduction in re-admission rates over the past two years.

 

He commented that it would be helpful to have details of specific cases which could then be investigated if Members had specific concerns. Members took the opportunity to raise specific cases of poor hospital discharge cases known to them. The Head of Assessment and Care agreed to follow them up. These included examples of discharges being carried out late in the evening which was considered unacceptable.

 

The Head of Assessment and Care then outlined the current role of the Area Co-ordinators in the discharge process and pointed out that conversations were taking place about how the Co-ordinators might be deployed more effectively in promoting closer links with the health service.

 

Decision

 

The Committee agreed to receive a further report early in the New Municipal Year on current hospital discharge arrangements for patients. This item should be jointly presented by council officers alongside representatives from Barts Health NHS Trust and the North East London Foundation Trust.

Members asked that the report include case studies of both successful and unsuccessful discharges that have taken place, and refer to the practicalities of enacting a provision for hospitals to be fined when inappropriate discharge has occurred.

 

The Committee further asked that members of the Adult Social Care Scrutiny Committee be invited to attend the meeting when the report is presented.

 

6.

PROMOTING HEALTH AND WELLBEING THROUGH THE BOROUGH'S LEISURE CENTRES pdf icon PDF 66 KB

Minutes:

Joyce Guthrie (Head of Parks and Leisure) presented a report on how the Council uses its leisure centres to promote health and wellbeing for all residents.

 

The report set out details of the leisure opportunities being provided at each of the centres including the bespoke programmes for women, people with disabilities and over 60’s and drew attention to the significant increase in participation rates as a result of the investments that have been made including the new Waltham Forest Feel Good Centre which was opened in October 2016.

 

The report made clear that the promotion of health and wellbeing is paramount to the activity programmes on offer which are designed to ensure that something is available for everyone. Although no qualitative data was available on the positive health impact of leisure centres, Joyce Guthrie said that she would circulate information on the impact our parks have on residents’ health and wellbeing.

 

The Committee was pleased to note the healthy mix of leisure opportunities that are available in the borough many of which are provided free of charge or at reduced cost.

 

The Committee was also pleased to note the bids being made to Sports England to attract additional funding for leisure activities in the borough.

 

A matter of concern to the Committee was the availability of swimming facilities for the disabled members of the Dolphins Swimming Club at the Leytonstone Leisure Centre.  Currently there is only one slot for disability swimming at the Centre early on Tuesday mornings. The Committee considered this to be inappropriate and asked that discussions take place with the Club to identify whether more appropriate arrangements could be made either by revising the timetable for disability swimming at the Centre or possibly for the Club to share a session in the pool with another targeted group.

 

Decision

 

The Committee:

(a)  noted the report; and

(b)  looked forward to the outcome of discussions with the Dolphins Swimming Club about the provision of disability swimming for its members at the Leytonstone Leisure Centre.

 

7.

NELFT'S CQC QUALITY REPORT pdf icon PDF 52 KB

Additional documents:

Minutes:

The Committee received a summary of the Care Quality Commission’s Quality Report on its inspection of the North East London NHS Foundation Trust published in September 2016 based on its inspection visit on 4-8 April and its unannounced inspection on 14 April 2016.

 

Using its four point rating scale of outstanding; good; requires improvement; or inadequate, the Care Quality Commission (CQC) found that overall the Trust requires improvement.

 

The Quality Report also set out the following CQC’s ratings of the Trust’s services based on the five key indicators which is uses for its inspections:-

 

Are services safe? – requires improvement

Are services effective? – requires improvement

Are services caring? – good

Are services responsive? – requires improvement

Are services well-led? - requires improvement

 

The Committee noted the reasons set out in the Quality Report which led to the CQC’s inspection ratings and the actions which the CQC had identified the Trust both must or should take to improve its services.

 

The Committee also received NELFT’s Improvement Plan in response to the inspection findings. Sue Boon and Hilary Shanahan from the Trust attended the meeting and gave a comprehensive oral update on the steps being taken to implement the 137 recommendations in the Improvement Plan, including those specifically relating to Waltham Forest all of which had been actioned by the target date of 31 March 2017. The Trust’s representatives also drew attention to the preparations being made for the CQC’s re-inspection.

 

Following their presentation Members took the opportunity to ask a range of questions and received further information as summarised below:-

 

Serious Incidents and Complaints   

It was noted that the Action Plan for had been reviewed and that there were no issues for Waltham Forest. A more robust system has been introduced for learning from incidents across all teams and information reporting feedback sessions have been held.

 

Agency Staff 

Whilst recruitment of staff remained a challenging issue particularly within community health services there were more staff starters than leavers. The Trust is now better able to identify services where there are potential risks. The Trust is operating within an agency cap and looking to reduce agency spend.

 

There was concern that agency staff might be less able to access patients’ medical records when required to do so. It was noted that all staff receive training on the clinical records system and have full access to medical records. A ward based access system has been put in place to ensure this is not a problem.

 

Information Sharing

Whilst different recording systems are currently in place the Trust is able to share information with external agencies and an Information Highway Delivery Programme is being developed. The recommendations on information sharing in Waltham Forest across all disciplines and localities have been signed off.

 

Brookside Assessment Unit

The CQC report was particularly critical about the Brookside Unit. It was noted that the building had to be closed for refurbishment works to bring it up to the required standard and that following re-inspection in September the  ...  view the full minutes text for item 7.

8.

MENTAL HEALTH UPDATE pdf icon PDF 341 KB

Minutes:

Nuzhat Anjum (Associate Director Mental Health, Waltham Forest CCG) presented a report updating the Committee on the developments and achievements made in mental health commissioning in 2016 and outlining the priorities and strategic plans for 2017.

 

The report drew attention to Waltham Forest performance on the delivery of mental health services against the targets set out in the Five Year Forward Review.

 

Developments and Achievements in 2016

This part of the report covered the following mental health areas which had been prioritised in 2016:-

Improving Access to Psychological Therapies

Early Intervention in Psychosis

Developing a Lead Commissioning Arrangement

Child and Adolescent Mental Health Services

Mental Health Wellness Service

Crisis Care in Mental Health

Psychiatric Liaison Services at Whipps Cross Hospital

 

Nuzhat Anjum drew Members attention to the work which has been done in Waltham Forest to meet the standards and requirements set out in the Five Year Plan in each of these areas. It was noted that all the national and local targets had been met.

 

The Committee was particularly pleased to note the recent successful outcome of the CCG’s bid for additional funding for Psychiatric Liaison Services at Whipps Cross Hospital (£330,000) which will enable the service to be expanded to be ‘core 24’ compliant and will increase the skill capacity of the team to offer mental health liaison services to all age groups.

 

Mental Health Transformation Programme 2017

The Committee was pleased to note the plans for service improvements in 2017 and the expected outcomes as summarised below and looked forward to seeing the results:-

  • stronger pathways and transitions for patients
  • reduced length of stay within hospital, increased capacity within the services and decrease in demand of the highly specialist services
  • care provided holistically taking into account the Mental Physical and Social Health of patients. Once successful transformed we would also expect to achieve efficiencies across the services
  • improved level of functioning for Mental Health users
  • carers will feel more supported in their role
  • more people will live in stable accommodation
  • more timely assessment and support for mental health service users

 

The Committee:

(a)  thanked Nuzhat Anjum for her presentation and noted the report; and

(b)  asked the officers in consultation with the Waltham Forest CCG to re-visit the recommendations made the Committee last year following its consideration on the report on mental health services and to report back on the progress made.

 


9.

SUBSTANCE MISUSE pdf icon PDF 56 KB

Additional documents:

Minutes:

In June 2016 the Committee agreed to carry out a themed review into substance misuse and at three subsequent meetings looked at various issues around the Council’s work on substance misuse taking evidence from the Public Health Team and the Families Team. This was followed by a visit to Lifeline who provide alcohol and drug services and work with individuals, families and communities both to prevent and reduce harm and promote recovery.

 

James Holden (Policy and Public Affairs Officer) presented the report. The report set out the key issues arising from the evidence gathering sessions and put forward the following eight recommendations to support the work of the Council and its partners in treating substance misuse, building upon current practice.

 

Recommendation 1: The Council should work with Lifeline staff and service users to review the premises and determine what changes are needed to ensure that Lifeline is housed in up-to-date facilities that are welcoming for people actively seeking treatment.

Recommendation 2: The Council should continue to work with partners to ensure that the range of services offered by Lifeline is understood by healthcare professionals and the wider community.

Recommendation 3: The Council and Lifeline should consider how they can improve treatment readiness for GP and criminal justice referrals.

Recommendation 4: The Council should work with the STP board and other partners to secure investment in preventions that will reduce hospital admissions and burdens elsewhere.

Recommendation 5: The Council should continue to liaise with the MPS to ensure that performance in this area is monitored and continues to improve.

Recommendation 6: The Council should consider whether it is possible to utilise systematic screening explore the benefits of systematic screening techniques and what the potential benefits could be.

Recommendation 7: The Council should continually work to ensure that high quality prevention work is being delivered in all schools, including academies.

Recommendation 8: The Council should use its new VCSE provider, Community Waltham Forest, to explore with voluntary organisations what support they can and do provide to residents of all ages to prevent substance misuse.

Decision

The Committee:-

(a)  approved the report and its recommendations subject to a minor wording amendment to paragraph 5.2 referred to at the meeting;

(b)  delegated responsibility for finalising the report to the Strategic Director for Corporate Development in consultation with the Chair; and

(c)  expressed its concern about the current lack of enforcement action on cannabis use and asked that this be brought to the attention of Cabinet.