Agenda and minutes

None.

The Chair will consider the admission of any late items of urgent busines. (Late items will be considered under the agenda item where they appear. New items will be dealt with at item 8 below).

None.

A Member with a personal interest in a matter who attends a meeting of the authority at which the matter is considered must disclose to the meeting the existence and nature of that interest at the commencement of that consideration, or when the interest becomes apparent.

A Member with a personal interest in a matter also has a prejudicial interest in that matter if the interest is one which a Member of the public, with knowledge of the relevant facts, would reasonably regard as so significant that it is likely to prejudice the Member’s judgement of the public interest.

None.

To approve the minutes of the meeting of 30 October (attached).

AGREED:

That the minutes of the meeting of 30 October be approved.

To consider progress with the review and future timetable.

It was noted that City University had been in contact and it was hoped that they would attend to next meeting on 18 December to provide independent expert input. 

Preliminary consideration of evidence by the Panel to date suggested that there was an issue with information gathering and sharing. In addition, interventions were not always proven to be effective and there were a lack of resources for support groups. The complexity of many of the issues being considered by the review was a challenge for the Panel. 

The Panel noted that the Alzheimer’s Association and Age Concern had not been able to attend the meeting and agreed that they would be invited to come along to the next meeting on 18 December instead.

It was agreed that future meetings of the Panel would begin at 18:00 hrs in order to assist in enabling Members to attend all of the meeting.

To receive evidence fromthe following groups and organisations on their perception of services that are provided to support vulnerable people with long term conditions:

·        Barnet, Enfield and Haringey Sickle Cell Support Group

·        The Alzheimer’s Association

The Panel received evidence from Samantha Greaves, Comfort Rainier and Vivienne Mensah from Barnet, Enfield and Haringey Sickle Cell Support Group.  Ms. Greaves reported that she had previously been admitted to hospital approximately every six weeks during the winter.  Many of these admissions had been by ambulance. She was frequently in pain.  There had been a great improvement in service when the North Middlesex hospital had introduced its outreach service where nurses went out to visit patients who were experiencing problems.  However, she no longer used the outreach service.  She had changed her diet and now did not use the drugs that were previously administered to her by the nurses.  She had done this because she did not like the side effects of them.  Since making these changes, she had not been admitted to hospital for 3 years. 

Sickle cell was a condition that caused the red blood cells to become misshapen.  The cells became clogged around the joints, preventing oxygen flow and causing pain and organ failure.  When people had crises, these were normally dealt with by administering painkillers and blood thinning drugs.  Blood transfusions could also be required.  The condition was hereditary.  Free blood screening was available.  The prevalence of the condition was become greater due to mixed race relationships.

Ms. Mensah reported that her 15 year old son had the condition.  Although a Haringey resident, she received her services from Hackney as she had built up relationships with health professionals through them.  Her son had to receive blood transfusions regularly which entailed her driving to the hospital regularly.  Hackney were now thinking along similar lines to health professionals in Haringey and looking at providing an outreach service. 

Ms. Greaves felt that the service could be improved further if there was a greater availability of nurses.  At present, patients were only able to have two visits in 24 hours and had to wait till a nurse was available.  The nurses were very busy and were not available overnight.  The nurses were often required to administer opiates to help control pain and these could only be given by appropriately qualified professionals.   She had previously needed large doses of opiates but had weaned herself as she did not like the side effects or the feeling of being constantly high.  She now used complimentary medicines and these had enabled her to stay out of hospital for three years. 

The support group had been set up in 1985 and was the first in the country.  It was a voluntary group and received no funding.  They were currently trying to register as a charity. They had over 800 members and helped to signpost services and increase awareness of sickle cell disease.  In particular, there was a need to increase awareness amongst health and social care professionals and especially the fact that cold weather could trigger it off.  They had good links with the medical team at the George Marsh Centre.  They were trying to get into schools to increase awareness amongst young people.  ...  view the full minutes text for item 22.

To receive evidence from Haringey Teaching Primary Care Trust on the Diabetes Education and Self Management for Ongoing and Newly Diagnosed programme and the Expert Patients Scheme. 

Marina Chrysou and Sue Tokley from Haringey TPCT gave a presentation about the Expert Patients scheme.  This was a generic course open to all people with long term conditions.  Referrals came from a wide range of sources including self referral, community matrons and other health professionals. The programme was piloted in 2004.  It was not aimed at any particular conditions nor was it specifically intended for very high intensity users.  The emphasis was on self management and the long term consequences of conditions.  It was led by volunteer lay people who had a long term condition themselves.  It aimed to address a range of issues including loss of confidence, stress management, relaxation and living with pain.  It promoted physical activity and a problem solving approach.  Its overall objectives were to help people become more self sufficient and overcome the symptom cycle.  The group structure provided a means of support for people as well as social benefits.  The sessions all took place in community settings. 

7 courses had been run last year, including one aimed at Turkish speaking people as part of the Race for Health programme.  There had also been a course aimed a people with communication impairments.  Referrals for the scheme were steadily increasing and good links the Mental Health Trust’s team of psychologists had been developed.   Mental health users constituted the largest group of those referred (1/3).  This was due partly to the fact that mental health professionals had a good understanding of the approach that was used.  Other conditions that participants had included chronic pain (25%), arthritis (21%), diabetes (17.5%), COPD and angina. 

Evaluation of the course had shown that patients had felt that they had benefited from an increased level of physical activity, social benefits and increased confidence. Three generic courses were planned this year plus another course for Turkish people and one for people with Aphasia.  In addition, a specific course was planned for people from the Greek and Greek Cypriot community with cardiac conditions who had a low take up rate of cardiac rehabilitation. 

The scheme was now in its fourth year of operation.  Last year, 80 patients took part in the scheme and 76% completed it.   Encouragement was given to people on the courses to continue meeting and twice yearly reunions were held.  No data was kept on whether people who had completed the course were more likely to comply with their medication.  Consideration was being given to franchising the programme to appropriate support groups so that they could run them themselves.  The intention was to increase the number of courses that were run next year. 

A bid for expansion had been put in for next year.  This was part of a four year plan and would mean that more courses could be run.  However, whether or not additional money was forthcoming was dependent on other priorities. 

Monitoring of take up was undertaken but there was a lack of information on how effective the courses were.  Consideration could be given to assessing the  ...  view the full minutes text for item 23.

None.

18 December at 6:30 p.m.

Tuesday 18 December at 6.00pm.