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Agenda and minutes

Venue: Committee Room 2 - Waltham Forest Town Hall. View directions

Contact: Democratic Services Officer  020 8496 4102 Email: democraticservices@walthamforest.gov.uk

Items
No. Item

15.

APOLOGIES FOR ABSENCE AND SUBSTITUTE MEMBERS

Minutes:

Apologies for lateness were received from Councillor Tony Bell.

16.

MINUTES OF PREVIOUS MEETING pdf icon PDF 356 KB

To approve the minutes of the meeting held on 30th October 2019.

Minutes:

The minutes of the meeting held on 30th October 2019 were agreed by the Committee and signed by the Chair.

17.

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:

None.

18.

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:

None.

19.

COMMITTEE ACTION TRACKER AND FORWARD PLAN pdf icon PDF 128 KB

Additional documents:

Minutes:

Consideration was given to the report of the Scrutiny Officer. Mr Spragg introduced the report.

 

Mr Spragg said that the next two Committee meetings had a large number of items. He would be speaking to officers to either merge items or request that they are brought to the Committee as briefings.

 

The Committee noted the report.

 

20.

WALTHAM FOREST INTEGRATED HEALTH AND CARE STRATEGY pdf icon PDF 539 KB

Additional documents:

Minutes:

Consideration was given to the report of the Corporate Director of Integrated Commissioning.

 

Mr Lobban said that the strategy had now been approved by the Clinical Commissioning Group (CCG), Whipps Cross Hospital Board, the North East London NHS Foundation Trust (NELFT) and the Council’s Health and Wellbeing Board. The strategy had been linked to the Whipps Cross redevelopment, as it needed to be viable with the new ways of care that the hospital would provide, and to the NHS Long Term Plan. Mr Lobban highlighted the models of care in the strategy which would see a better coordination of care.

 

The Committee asked about the five year time-frame for the implementation of the strategy. Mr Lobban said that changes needed to start immediately to ensure that they were ready for the completion of the Whipps Cross redevelopment. He added that there was also reliance on partners to contribute to the implementation to keep to the time-frame.

 

The Committee asked about general funding for the strategy. Mr Lobban noted that currently Waltham Forest spent most of its funding on acute care and spent less on community care. Mr Lobban said that there needed be an increase in the proportion spent on community care. Mr Lobban and Mr Sanghera were also involved with the Waltham Forest and East London (WEL) Board and had indicated that money would be made available in the future for transformation projects. Mr Lobban added that the strategy would also provide an incentive for more funding. The Committee asked why Public Health had been underfunded in Waltham Forest. Mr McDonnell said that there had been historic underfunding for the borough coupled with reductions in national funding.

 

The Committee asked about the Public Health aspects of the strategy. Mr McDonnell said that the strategy aimed to give a higher priority to prevention work and wider aspects such as housing and debt would be taken into consideration. Mr McDonnell said that healthy weight was part of the partnership approach, which would look at how environments are developed that encourage healthy eating. He added that one of the biggest initiatives in the borough that had an impact on Public Health had been the ‘Mini-Holland’ scheme, which had encouraged more residents to walk and cycle in the borough. Waltham Forest had also been the first borough to stop fast food businesses operating within 400 yards of schools. Mr McDonnell confirmed that fifty fast food restaurants had been denied premises near schools so far. He also mentioned the ‘Superzone’ around Mayville school in Leytonstone, which was a GLA-led initiative that sought to work closer with leisure facilities and projects to improve air quality. Officers were looking at setting up a second superzone at another school in the borough in 2020.

 

The Committee asked what changes patients might experience as a result of the strategy. Mr Lobban said that it would identify a named person who would help organise a patient’s needs. He gave the example of a patient who had  ...  view the full minutes text for item 20.

21.

CHILDREN AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) PERFORMANCE AND DEVELOPING TIER 2 SERVICES pdf icon PDF 298 KB

Minutes:

Consideration was given to the joint report of the CAMHS Transformation Manager of NELFT and the Associate Director of the WFCCG. Ms Anjum introduced the report and explained the context on the service to the Committee. She highlighted that CAMHS had received continued funding from the CCG which had improved the service and that Mr Bright, had been employed as a Transformation Manager to assist the development of the service.

The Committee asked if CAMHS was benchmarked with other authorities. Ms Anjum said that the service was benchmarked with all London CCGs and local authorities. The Committee was informed that originally there had not been enough staff to meet demand for the service, and this had impacted on performance in the past.

 

The Committee then asked how experience of the service had changed in the last twelve months. Mr Bright confirmed that there had been improvement, but it was part of a continuing program of changes, which had included the recruitment of high calibre staff. He added that staff had engaged with young people to share their experiences of the service. Ms Anjum said that feedback had generated different ideas, such as support for the siblings of children who access services and the avoidance of jargon in written communications.

 

The Committee asked about the process of providing services to schools. Mr Bright said that link workers were used to enhance partnerships and help clarify the work provided by NELFT and what was expected from schools. Mr McDonnell said that the service was offered to schools who sign up to the Mental Health Charter and training would also be provided to teachers. The Committee asked the Mental Health First Aid Course. Mr McDonnell said that had been aimed at school staff and was offered to schools and if there was a high-profile suicide, training would be offered to the community. Ms Anjum said that the Applied Suicide Intervention Skills Training (ASIST) programme was also offered.

 

Ms Anjum also highlighted the work with the Public Health team in developing KOOTH, digital support platform for mental health, which Mr McDonnell confirmed that around a thousand children had accessed some form of support through KOOTH. The Committee was informed that the platform provided advice for young people through moderated support forums and access to trained counsellors. Most young people who used KOOTH tended to use the service once or twice and if it was used regularly by a person, they would be directed to appropriate services. KOOTH was being used by half of the London Boroughs and officers at Waltham Forest was trying to use the platform innovatively to help inform young people of services available to them.

 

The Committee asked for more information on the work with the Violence Reduction Partnership (VRP) and how the partnership informed pathways about trauma. Mr Bright said that CAMHS was a part of the VRP and had started to develop a trauma-informed pathway which would identify where it may be a factor.

 

The Committee asked whether the  ...  view the full minutes text for item 21.

22.

MENTAL HEALTH INPATIENT SERVICES - NELFT pdf icon PDF 611 KB

Minutes:

Consideration was given to the report from the Associate Director of WFCCG.

Ms Anjum introduced the report highlighting the work that had taken place to reduce the numbers of out-of-borough placements following the increased demand for acute mental health services. She noted that a new twenty bed ward had been opened by NEFLT and an agreement was in place with East London NHS Foundation Trust (ELFT) to provide further bed space if there was a further surge in demand.

 

The Committee asked if there were any impacts from the recent closure of a mental health centre in Highams Park. Mr Bright said that the decision was made to move provisions to Goodmayes as it was safer and had better resources available.

 

The Committee agreed;

 

·         That services respond in writing on the following queries:

o   The extent to which ward closures have impacted on inpatient performance,

o   What impact will the new Mental Health Compact have and what it means for services,

o   How far out of borough are people placed, and what support is put in the place to allow family to visit,

o   To what extent was the spike in admissions was linked to referrals from the criminal justice system.

 

23.

THEMED REVIEW: PROVIDER RESILIENCE - CURRENT CONTRACTS DATA & COMMISSIONING PROCESS FOR CONTRACTS (INCLUDING DUE DILIGENCE AND CONTRACT MONITORING) pdf icon PDF 642 KB

Minutes:

Consideration was given to the report from the Continuing Healthcare General Manager (interim) NEL Commissioning Support Unit (CSU).Mr Smith introduced the report. He noted that Waltham Forest had largest patient population across the four CCGs that the NEL CSU supported, adding that this created risks in contract management and contracts were currently being reviewed.

 

Mr Smith said that a clear process had been set out for managing failure and noted that it was important to build relationships and support providers, rather than let them fail, as there was a risk of running out of healthcare providers. Providers at risk of failure would be monitored over quarterly meetings to identify trends and both the local authority and nursing homes in the borough would be informed of the outcomes of these meetings.

 

The Committee asked how the CSU worked with the Care Quality Commission (CQC) to monitor providers. Mr Smith said that the CSU had a different set of criteria for monitoring and looked at care delivery. The CSU collaborated with the CQC, but inspections took place in different timescales. Mr Smith added that a provider required to be inspected by the CQC before they were commissioned but this created a delay as many providers were not inspected within the first six months.

The Committee asked about the move from Thorpe Coombe. Mr Smith confirmed that the family engagement had been a key consideration and the move had been going well. The CCG’s Integrated Director had been working closely with the NHS and the local authority to try and ensure it was a seamless process.

 

The Committee noted the report.