Agenda and draft minutes

Dr Luder, Dr Pandya, James Slater, Jinty Wilson.

The Chair will consider the admission of any late items of urgent business.  (Late items will be considered under the agenda item where they appear.  New items will be dealt with at Item 9 below).

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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 and if this interest affects their financial position or the financial positions of a person or body as described in paragraph 8 of the Code of Conduct and/or of it relates to the determining of any approval, consent, licence, permission or registration in relation to them or any person or body described in paragraph 8 of the Code of Conduct.

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Approved

To hear from Robert Edmonds, Director of Age Concern Haringey and Chair of the Haringey Association of Voluntary and Community Organisations on Stroke Prevention from a voluntary sector point of view.

There is a high incidence of stroke amongst older people.

There are three Age concern stroke clubs across Haringey, which have been running for approximately 15years, they were started with a donation by Tottenham Spurs Football Club.

The clubs are funded by the TPCT with a Haringey Council top up and run for forty weeks a year.

There is also additional support e.g. befriending, buddy schemes with new and long term stroke patients.  Members are also in contact with each other outside of the clubs.

A challenge for the clubs is that they have to cover everything within the 2hrs.  If transport is late then this is cut dramatically and therefore the clubs are not able to fulfil everything they had intended to with a person.

Big issues are:

1. Transport to activities including the stroke clubs – if your transport does not arrive then you simply can not attend.
2. Finding health trainers who are qualified and covering the cost of these.
3. People are not being signposted on appropriately.
4. People are not being navigated back into support when they need it.

The importance of access to information and advice was stressed.

It is very important for people to be ready to listen when discussing health needs.  Being diagnosed with a condition can come as a shock to people and they may therefore need time to adjust and accept what they are being told.

Important to ensure that stroke patients are not kept in a box – people need to remember that they need access to a wide range of services e.g. support in the home.

Stroke services right across the board can only work well if they are working together with other local agencies.

The Expert Patient Programme has had 180 people graduate through it.  These skills should be utilised for the community.  The programme should be about more than people just going through it – people should be encouraged and empowered to become involved in other aspects of work associated with the programme.

There needs to be a co-ordinated support and advocacy strategy for people with long term conditions and those newly diagnosed. 

Consideration for recommendation in final report.

Greater community involvement is needed.  Low level preventative work can be led by people in the community within existing health centres with support from professionals.

When the planning is taking place for the Neighbourhood health centres there needs to be engagement with this concept.

Consideration for recommendation in final report.

Points of discussion

Work around Expert Patient Programmes needs to link with other strategies that are taking place e.g. Experience Counts.  Should be about capacity building, building social capital.

Links made with LAA target around volunteering.

There is an overlap between the work that Different Strokes does and the work that Age Concern does.  The main difference is the age profiles of each group, noted that some people go to both groups.

The importance of caring for Carers is noted.

Discussion around the need for a multi-disciplinary forum for people involved  ...  view the full minutes text for item 30.

To hear from Dr Jaspar Holmes, Senior Researcher, Ricability on the ‘Getting Back Home’ booklet and to consider whether a similar publication would be beneficial to Haringey.

The company grew out of ‘Which’ in the 1960’s.

Primary focus is on information provision for older people and those with disabilities.

“Getting Back Home” booklet will be handed out to patients on stroke wards/units.  Tis booklet includes information on secondary prevention, there is a separate booklet being formulated for prevention under the same project.

The original “Getting Back Home” booklet was written in 2004.  This is being updated during this project.

Cost for writing and printing both documents is approx £25-30,000 which is being jointly funded in Islington.

Booklet contains a directory and is actionable – it’s not just about providing information.  It’s also about active management.

Booklet contains a tear off workbook section.

There will be a PDF version available.

The panel was shown a first draft of the prints for the prevention booklet which contained messages such as the effect of smoking and alcohol for strokes.  It also contained blunt messages regarding the effects of strokes e.g. on sexual ability.

A prevention leaflet like the one being done through Ricability for Islington would be useful for Haringey, to include shock factors and have an ethnic diversity element.

Consideration to be given for a recommendation

Noted that Haringey stroke patients in the Whittington Hospital would be given the Islington specific Getting Back Home booklet due to the location of the hospital.  This would mean all information and contacts in the booklet would not be specific to their area of residency.

Points of discussion

Beer mats, post cards, bill boards, buses – blunt message

Vascular checks could be tacked onto these.

TV in each surgery is currently being rolled out – this could be used to get messages out.  Discussion around production costs and use of local celebrities.  Could costs be cut by using a local college?  Could any money from the stroke grant be used for this?

Consideration  to be given for a recommendation.

Discussion around using cultural centres in the borough for vascular checks.  This would enable the TPCT to access people who do not go the GP surgeries.

The TPCT is currently investing in Health Trainers.

Discussion around exploring the possibilities of joint working on information with other boroughs as well as having some projects which are Haringey specific.  The need for some Haringey specific information was noted.

Consideration to be given for a recommendation.

To hear from the Teaching Primary Care Trust on their plans for the implementation of Vascular Checks and plans for a social marketing campaign for health.

Vascular Checks

The panel was given an overview of Vascular Checks which are due to begin to be rolled out in April ’09.

Vascular checks are being rolled out using a staged approach which is to be completed by 2010/2011.

Initial roll out will be in GP surgeries, community pharmacies and similar.

Vascular Checks are a screening programme and therefore people will be called in for an appointment in the same way that people are called in for cervical and breast screening programmes.

TPCT is working to ensure that the checks are systematic and structured with clear pathways and quality assurances in place.  This is a challenge for the programme on the whole.

There are also ethic considerations for example you have to have the systems in place to support a person once you have identified a risk or illness.  For example, weight management programmes – Active for Life, GP referral schemes.

Challenge – how do you get people that do not normally attend their GP surgeries to attend for a vascular check?  How do you then get people to follow up on the advice that is given to them?

Possibility of vascular checks being rolled out to further settings for example in day centres.

GPs and pharmacies will be incentivised to carry out Vascular Checks.

Points of discussion

Weight measurement is not in the DH guidance.  However the TPCT could modify their tool to include this.  Weight measurements are particularly relevant in Haringey due to the ethnic diversity in the borough and links with particular health problems.

A social marketing campaign could use people that have had a stroke/have a long term condition for an element of realism e.g. “I wish I had known….”.

Discussion around setting local success criteria/targets e.g. 5% increase in leisure facility use.

Consideration to 3 months free leisure membership?

Discussion around the capacity of other services e.g. if you sign post people to leisure facilities then they need to be available to them.  This includes physical capacity, cost and opening hours.

There needs to be a link between all services and vascular checks to ensure that the structure is there to support the checks as they are rolled out.

Consideration to be given for this to have a named person e.g. The Joint Director of Public Health and for a recommendation regarding capacity building.

Consideration of using the opening of neighbourhood centres/Hornsey as an opportunity to write to everyone in the catchment area inviting them in for a Vascular check.

Discussion around the possibility of piloting on a neighbourhood basis.

Discussion about using Haringey People to advertise and encourage people to have vascular checks.  This would be more beneficial later down the line, when the checks have been rolled out further.

Social Marketing

Social marketing is about understanding the local population and what levers might make them change their behaviour.

About marketing messages to people dependent upon their background and lifestyle.

Current campaigns include diabetes, Chlamydia, cervical screen etc.

A London wide Vascular Check  ...  view the full minutes text for item 32.

To discuss draft recommendations for the final report and next steps for the panel.

Overall approval of draft recommendations thus far.  Specific thoughts to be emailed.

More will be included.

Recommendations will then be circulated again for comment before inclusion in the final report.

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