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Agenda and draft minutes

Venue: Committee Room 3 - Waltham Forest Town Hall. View directions

Contact: Perminder Purewal, Democratic Services Officer  020 8496 4537 | Email:

No. Item




Apologies for absence were received from Councillor Geoff Walker and Shumon Ali-Rahman (co-optee).


The following substitute member arrangement was in place:

Councillor John Moss for Councillor Geoff Walker.



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.


Councillor Richard Sweden declared a non-pecuniary interest in Agenda Item 8 (Communicating with Partners around the Needs of Vulnerable Adults) as he is managed but not employed by NELFT.


Notwithstanding his interest in this item Councillor Sweden was able to remain in the room and participate in the debate.



To approve the minutes of the meeting held on 25 April 2017.


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


Minute 6 –Promoting Health and Wellbeing Through the Borough’s Leisure Centres


James Holden was asked to enquire about the outcome of discussions with the Dolphins Swimming Club about the provision of disability swimming for its members at Leytonstone Leisure Centre.


Minute 8 – Mental Health Update


James Holden was asked to re-circulate to Members of the Committee the recommendations made following the Committee’s consideration of the report on mental health services and to provide feedback on the progress made.


Minute 9 – Substance Misuse


It was noted that the recommendations made by the Committee to support the work of the Council and its partners in treating substance misuse will be submitted to Cabinet at its meeting on 10 October 2017 and were likely to be adopted.



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.


Mary Burnett speaking on behalf of WF Save Our NHS addressed the Committee on her concerns about developments within the East London Health and Care Partnership (ELHCP) and more specifically its proposal to appoint one Accountable Officer for all 7 Clinical Commissioning Groups (CCG’s) within the North East London STP to replace five current posts as a condition to access transformation funding from NHS England.


She reminded the Committee of the Cabinet’s decision in January this year not to sign up to the North East London Sustainability and Transformation Plan (STP) because of the need to address a number of outstanding issues and drew attention to her concerns and those expressed by City and Hackney CCG and the Inner London Joint Health Overview and Scrutiny Committee (JHOSC) about the Single Accountable Officer proposal. Mary Burnett suggested there had been no public consultation on the proposal which she considered threatened the accountability of statutory organisations as well as the role of local authorities in health service planning and scrutiny. She was of the view that the NHS is pushing the changes through to enforce spending cuts given the challenges faced by the health and care system in north east London.


She asked the Committee to challenge the Single Accounting Officer proposal and to join with other local authorities to request full and proper public consultation.


Members of the committee had various concerns about the proposal and in response to questions received further information from Ian Tomkins and Henry Black from the East London Health and Care Partnership about the driver for the proposed change and the model it was proposed to adopt. In summary they made it clear that the Single Accounting Officer proposal was very much work in progress and that the focus was more on local service delivery and control and how to make best use of the available resources and avoid duplication.




The Committee agreed to ask Mary Burnett to provide a summary of her concerns about the current proposals to enable the Committee to determine what action it should take.




The Committee received a report on the on-going strike by Unite members employed as cleaners, porters, catering and security staff at Whipps Cross Hospital and all other hospitals managed by Barts Health Trust over the past several weeks because of a pay dispute with their employer, Serco.


The Committee was concerned at the affect the industrial action has had on patient care and safety at Whipps Cross Hospital but was informed that Serco has today made an offer which is to be discussed.


The Committee asked to be kept informed on the situation.



Presentation from Ian Tompkins(East London Health & Care Partnership) on the Partnership’s New Payment System.

Additional documents:



The Committee was invited to comment on a Consultation Paper published in July by the East London Health and Care Partnership entitled ‘Payment Development and the Drivers for Change’. The consultation paper set out a number of payment options that might be adopted as part of the Partnership’s new approach to managing health and care across East London in a more integrated way and to support system development.


In his presentation of the proposals and the timetable for change Henry Black emphasised out that the new payment system will not be introduced until robust testing has been carried out and would not be in place until 2019. He pointed out that current payment systems are fragmented and do not support collaborative working.


The consultation paper which Mr Black said was more of an engagement exercise to gather as much information as possible sought responses from a range of organisations as well as clinicians, other health and care professionals, front line staff, finance managers, local councils, patients and the public and posed 13 specific questions. The Chair suggested the Committee should concentrate on Questions 1 and 9 which dealt with priorities to support better outcomes for patients and the steps needed to secure practical engagement among ELHCP member organisations


The Chair was particularly interested to know how much the proposals were driven by savings and how much by achieving better outcomes. The ELH&CP representatives commented that the intention is to make best use of the available resources and to reform the current system and shift the balance to prevention and self-care. It was considered important to incentivise GPs to provide better sign-posting and avoid unnecessary referrals to A and E departments.


The Committee highlighted the fact that the new payment system should aim to encourage professionals to focus on prevention.


Councillor Sweden welcomed the assurance given that the new systems will be rigorously modelled before they go live.




The Committee thanked the ELH&CP representatives for their presentation and looked forward to receiving a progress report on the introduction of the new payment system in due course.





Arising from discussion at the last meeting the Committee received a report on the process of hospital discharges and how health and social care partners are working together to ensure that discharges are timely and effective. The report summarised the action plan recently agreed by partners to ensure that supported discharge for patients that have on-going voluntary, health or social needs are effectively undertaken to enable them to maximise their independence.


Nick Davies and Deborah Madden presented the report. They pointed out that most people, in the region of 90%, are discharged from hospital without the need for support from social care or health services. For those residents that do need support the Integrated Discharge Team (IDT) based at Whipps Cross Hospital, staffed by a nurses and social workers, works with patients to ensure 

that supported discharges take place successfully.


Members discussed the report and asked several questions.


Councillor Shameen Highfield raised the issue of transport home for patients on discharge. Deborah Madden advised that Barts Trust has recently taken back transport services in house including out-patients services and anticipated some improvement in transport arrangements.


Councillor Sheree Rackham enquired about the availability of nursing home placements for patients ready to be discharged. It was pointed out that this was a real challenge for the IDT because of the capacity challenge not only in Waltham Forest but throughout London for nursing home provision and there was no quick fix. Each case needed to be assessed on its merits.


The Committee was interested to know the A&E targets for the efficient operation of the hospital and particularly the target that Delayed Transfers of Care do not exceed 10 in any one day which it was reported is difficult to maintain.


The Committee was assured that the needs of patients are properly assessed before discharge arrangements are put in place and that lessons continue to be learnt from previous cases to mitigate any future problems.




The Committee noted the report which members found very interesting and helpful.






In response to concerns arising from knowledge of a case regarding the way in which a health partner recently communicated with a vulnerable adult, the Committee received a report from the North East London NHS Foundation Trust (NELFT) on the procedures in place for dealing with referrals to community and mental health services.  Sue Boon introduced the report. She described the action taken in response to a referral; drew attention to the way information from third parties is treated; gave examples of good practice in making referrals; and suggested ways in which communications might be improved.


She particularly emphasised the importance of third parties obtaining the consent of individuals where possible before making referrals and highlighted the issues of confidentiality that need to be addressed in communications with referrers including access to clinical records.


The Chair was particularly interested to learn that NELFT have a system in place for dealing with referrals by MPs and suggested the system should be extended to include enquiries from councillors. He also felt it would be useful if NELFT was able to produce some sign-posting information for councillors to ensure that enquiries they have are directed to the appropriate service. Councillor Rusling also suggested that it would be helpful if a workshop could be organised soon after the Local Council Elections in May next year for councillors to learn more about services for vulnerable adults and assist them in providing information and advice to their constituents.


Councillor Sheree Rackham was concerned that in her experience Members do not receive feedback following referrals made by them and asked that this be addressed.


Sue Boon agreed to give further consideration to the points made by members and to take appropriate action.




The Committee thanked Sue Boon for her report and presentation and looked forward to the further action to be taken in particular around ensuring that councillors are given appropriate guidance on how to engage with residents with mental health issues.




Additional documents:


Consideration was given to a report of Mark Bursnell, Policy and Public Affairs Officer.


The report reminded the Committee of its chosen topic for this year’s themed review – the provision of pre and post-natal care services for mothers in Waltham Forest – and set out data on the current demand for these services and the initiatives that have been introduced to raise awareness of the services available.


The Committee discussed the specific areas it wished to focus upon in conducting the review.


The key points identified for research were:


  • Promotion of the services provided by the Neighbourhood Midwives Service recently launched in the borough - to include a Members’ visit.
  • Provision of information and advice services to expectant mothers and pre-conception advice to include health promotion and dietary support.


  • Preparation of a Road Map of Services provided by different hospitals for expectant mothers to choose from when planning for births to include information on the different approaches and services offered.


  • Support for mothers with mental health issues.


  • Review of the services provided at children’s centres.




The Committee noted the report and asked the officers to progress the issues identified as part of the review.




WORK PROGRAMME 2017/18 pdf icon PDF 46 KB

Additional documents:


Provisional Work Programme 2017/18




The Committee approved its Provisional Work Programme for 2017/18 as set out in the report subject to the inclusion of the Annual Report of the Waltham forest Children’s Death Overview Panel on the agenda for its 22 November 2017 meeting rather than its meeting on 24 April 2018.


The Committee authorised the officers to make any necessary further adjustments to the Work Programme as a consequence of this decision.


Whipps Cross Hydrotherapy Pool


In discussing the Work Programme the Chair drew the Committee’s attention to Bart’s Trust proposals concerning the Whipps Cross Hydrotherapy Pool.


The Committee was concerned about the future of this service and asked James Holden to raise the raise the following questions with the Trust:



What benefits does hydrotherapy have for patients?


What is the current use of the hydrotherapy pool?


What are the alternative proposals for hydrotherapy treatments?


How many people use hydrotherapy for the treatment of ankylosing spondylitis and why is this condition not an NHS service?


What evidence is there that has led to the shift towards land based therapies?


How many staff are employed at the hydrotherapy pool and what will happen to them?


How many patients with learning disabilities have been stopped from using the hydrotherapy because of concerns about incontinence.