Venue: Enfield Council Chamber, Civic Centre, Silver Street, Enfield EN1 3XQ
Contact: Dominic O'Brien, Principal Scrutiny Officer Email: email@example.com
FILMING AT MEETINGS
Please note this meeting may be filmed or recorded by the Council for live or subsequent broadcast via the Council’s internet site or by anyone attending the meeting using any communication method. Members of the public participating in the meeting (e.g. making deputations, asking questions, making oral protests) should be aware that they are likely to be filmed, recorded or reported on. By entering the ‘meeting room’, you are consenting to being filmed and to the possible use of those images and sound recordings.
The Chair of the meeting has the discretion to terminate or suspend filming or recording, if in his or her opinion continuation of the filming, recording or reporting would disrupt or prejudice the proceedings, infringe the rights of any individual, or may lead to the breach of a legal obligation by the Council.
The Chair referred Members present to agenda Item 1 as shown on the agenda in respect of filming at this meeting, and Members noted the information contained therein’.
APOLOGIES FOR ABSENCE
To receive any apologies for absence.
Apologies for absence were received from Cllr Larraine Revah (Camden), Cllr Kemi Atolagbe (Camden), Cllr Philip Cohen (Barnet), Cllr Rishikesh Chakraborty (Barnet) and Cllr Jilani Chowdhury (Islington).
The number of apologies given by Members meant that the Committee was not quorate. To be quorate there are two criteria:
a) For at least four Committee Members to be present. This condition was met.
b) For Members from at least four of the five NCL boroughs to be present. This condition was not met.
In the circumstances, the meeting continued as a briefing for the Members present. This meant that discussions on the agenda items could continue but any formal decisions made could not be ratified.
ELECTION OF CHAIR
To elect the Chair of the Committee for the 2023/24 municipal year.
As this was the first North Central London Joint Health Overview and Scrutiny Committee (NCL JHOSC) meeting of the 2023/24 municipal year, the election of the Chair was required.
The Members present indicated their preference for Cllr Pippa Connor to continue as Chair for 2023/24. It was not possible to ratify this decision as the meeting was inquorate and could only continue as a briefing. This decision would therefore be deferred to the next meeting.
The Members present determined that Cllr Pippa Connor should Chair the briefing.
ELECTION OF VICE-CHAIRS
To elect the Vice-Chair(s) of the Committee for the 2023/24 municipal year.
As this was the first JHOSC meeting of the 2023/24 municipal year, the election of the Vice-Chairs was required.
The Members present indicated their preference for Cllr Tricia Clarke and Cllr Larraine Revah to continue as Vice-Chairs for 2023/24. It was not possible to ratify this decision as the meeting was inquorate and could only continue as a briefing. This decision would therefore be deferred to the next meeting.
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 under item 14 below).
DECLARATIONS OF INTEREST
A member with a disclosable pecuniary interest or a prejudicial interest in a matter who attends a meeting of the authority at which the matter is considered:
(i) must disclose the interest at the start of the meeting or when the interest becomes apparent, and
(ii) may not participate in any discussion or vote on the matter and must withdraw from the meeting room.
A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Register of Members’ Interests or the subject of a pending notification must notify the Monitoring Officer of the interest within 28 days of the disclosure.
Disclosable pecuniary interests, personal interests and prejudicial interests are defined at Paragraphs 5-7 and Appendix A of the Members’ Code of Conduct
Cllr Pippa Connor declared an interest by virtue of her membership of the Royal College of Nursing.
Cllr Pippa Connor declared an interest by virtue of her sister working as a GP in Tottenham.
DEPUTATIONS / PETITIONS / PRESENTATIONS / QUESTIONS
To consider any requests received in accordance with Part 4, Section B, paragraph 29 of the Council’s constitution.
To note the Committee’s terms of reference.
The terms of reference for the NCL JHOSC were noted.
To confirm and sign the minutes of the North Central London Joint Health Overview and Scrutiny Committee meetings on 20th March 2023, 6th June 2023 and 7th June 2023as a correct record.
The minutes from the meetings held on 20th March 2023, 6th June 2023 and 7th June 2023 were discussed.
It was not possible to approve the three sets of minutes as the meeting was inquorate and could only continue as a briefing. This decision would therefore be deferred to the next meeting.
For the Committee to receive an overview of maternity and neonatal services in NCL including Ockenden Review assurance/compliance and the role of the Local Maternity Services Network.
The update on maternity and neonatal services was provided by Rachel Lissauer, Senior Responsible Officer, Chris Caldwell, Chief Nurse for NCL ICB and Executive Lead for Maternity & Neonatal services, David Connor, Group Director of Midwifery at the Royal Free NHS Trust and Co-Chair of the Local Maternity System, Sumayyah Bilal, Head of Maternity Services & Commissioning for NCL, Nicole Callender, Associate Director for Midwifery at NMUH, Barbara Kuypers, interim Divisional Director of Midwifery and Nursing at NMUH, Dhruv Rastogi, Divisional Clinical Director & Consultant Paediatrician at NMUH, and Isabelle Cornet, Director of Midwifery at Whittington Health NHS Trust.
Rachel Lissauer began by explaining that, while accountability for services remained with the NHS Trusts, the Local Maternity and Neonatal Service (LMNS) within the NCL ICB had a role in considering elements such as safety, using data and insights, ensuring a supportive infrastructure for services, using the voices of pregnant women to inform how maternity services were run and equality of outcome and access. The Service worked alongside the Start Well programme which was looking at structural issues in the Case for Change. The role of the LMNS had really changed over the past 3-4 years with stronger role and closer working with Head/Directors of Midwifery, including on staffing, recruitment, training and demand pressures.
David Connor said that the Care Quality Commission (CQC) had been revisiting Trusts across the sector as part of its national response to the Ockenden report. The CQC’s report on the Whittington NHS Trust had been published while the North Middlesex University Hospital (NMUH) and University College London Hospitals NHS Trust (UCLH) had been inspected and the reports were currently being awaited. An inspection of the Royal Free Trust was expected soon. Through the LMNS Board, the action plans from inspections were monitored with feedback and learning shared across the system.
Asked by Cllr Connor whether there were any particular areas of concern as part of this process, David Connor said that triage assessments were an area where improvements could be made and that this was a common issue nationally so best practice models were being looked at.
Sumayyah Bilal provided an overview of the Women’s CQC Survey, which was a national survey that covered all aspects of the maternity journey and was conducted annually. The responses received in NCL were not representative of the diversity of survey users and so further work was planned on reaching those community voices with a recently recruited independent senior advocate, as recommended by the Ockenden report. Area for improvement across NCL including monitoring of mental health in pre and post-natal periods, infant feeding support and the ability of partners to visit in hospital (where there had previously been some restrictions due to Covid).
Sumayyah Bilal also explained that all NCL Trusts were asked to provide assurances to the LMNS Board of how they were implementing the recommendations of the Ockenden report. Ockenden assurance visits were also carried out with all NCL Trusts in 2022 and the feedback was mostly ... view the full minutes text for item 10.
For the Committee to consider the development of a Cancer Prevention Plan for NCL.
Ali Malik, Managing Director, and Fanta Bojang, Programme Manager, at NHS North Central London Cancer Alliance, introduced the report on the North Central Prevention, Awareness and Screening strategy and action plan.
Ali Malik said that work had recently been carried out to examine the overarching cancer pathway and the core aims and objectives for the cancer system. At the heart of this was the early diagnosis programme, which supported the national target in the NHS Long Term Plan for 75% of people with cancer to be diagnosed at stage 1 or 2 by 2028.
Fanta Bojang explained that the strategy had initially been drafted in 2019/20 but had been delayed by the Covid-19 pandemic and redrafted in the context of the implementation of Integrated Care Boards, aligning with the cancer system aims and objectives, the Population Health and Integrated Care Strategy and the Core20PLUS5 framework on health inequalities. The focus on prevention, awareness and screening included supporting and encouraging people to present to primary care early and to take up their screening invites, a targeted lung health checks programme which was still at an early stage, and identifying people with a high risk of developing cancer through genetic testing. Prevention was part of the strategy but this was a shared priority across the health system. There was an action plan associated with the strategy and this was only a two-year plan as the future availability of resources beyond this was not known.
Ali Malik and Fanta Bojang then responded to questions from the Committee:
For the Committee to consider the detail of and rationale for changes in this area, the equality impact assessment, the approach to engagement and the travel analysis.
The presentation on the NCL Surgical Transformation Programme: Ophthalmology Surgical Hub Proposal was provided by Dilani Siriwardena, Deputy Medical Director at Moorfields Eye Hospital and NHS London Clinical Director for Ophthalmology, Jon Lear, Senior Operations Manager at Royal Free London NHS Foundation Trust, Marco Inzani, Deputy Director of Strategic Programmes for NCL ICB and lead for the Surgical Transformation Programme and Richard Dale, Executive Director of Performance and Transformation NCL ICB.
Marco Inzani explained that there were current more than a quarter of a million patients waiting for elective care in NCL. Ophthalmology was one of the higher volume specialities and the waiting lists had grown by 48% over the past seven years. There were also risks associated with waiting including health deterioration and increased complexity of care so this really affected people’s quality of life. It was not possible to keep up with demand in NCL despite initiatives including evening/weekend working, using capacity in the independent sector and Trusts offering mutual aid to each other.
Elective Orthopaedic Centres had previously been developed in NCL, at Chase Farm and at UCLH, and these had doubled the number of surgeries for hip and knees. The aim was therefore to replicate this in other specialities, beginning with ophthalmology. In developing the engagement work, the focus had been on what mattered to patients and a key finding was that patients were willing to travel further if this meant that they would be seen quicker and that the service was better.
Marco Inzani continued by explaining that the main proposals were to consolidate surgery from Whittington Health and Chase Farm Hospital to the Edgware Community Hospital and Royal Free Hospital. Outpatient appointments and tests would remain at all local hospitals so it was just the surgery that would move location, which would typically be only one or two appointments. Patients would still have a choice of three Trusts in NCL and it was expected that this would drive efficiency and productivity. There was expected to be an additional 3,000 procedures per year which could potentially help patients to be treated 10 weeks earlier. He explained that the downside was that some patients would have to travel further, estimated to be an additional 19 minutes by public transport on average. The maximum additional journey time (i.e. for someone who lived close to Chase Farm Hospital who needed to travel to the Edgware Community Hospital) would be 90 minutes but this would be for a very small proportion of patients. They would also continue to have the option of travelling to Potters Bar, which is closer but outside of the NCL border.
Dilani Siriwardena added that ophthalmology would ideally involve two theatres running in parallel with senior supervision for all patients and a reduced likelihood of late cancellations. This was already the type of service provided by Moorfields and St Anns, but for Royal Free staff they may have to travel between sites during the day which reduced the number of patients that they could treat. ... view the full minutes text for item 12.
To provide an outline of the Committee’s 2023-24 work programme.
The Committee then discussed the Work Programme for 2023/24. The September 2023 meeting had provisionally been scheduled to include items on Finance, Start Well and Diabetic Services. However, it was now necessary to include an update on the Ophthalmology Surgical Hub Proposal in the September 2023 agenda. It was agreed that the Diabetic Services item could instead by taken at the November 2023 meeting.
The November meeting now included the Diabetic Services item as well as items on the Estates Strategy, Workforce update and Winter Resilience. It was agreed that the Workforce item could instead by taken at the January 2024 meeting.
It was also agreed that a written update should be requested on the Camden Acute Day Unit issue, which had previously been discussed by the Committee, to be received ahead of the September 2023 meeting.
DATES OF FUTURE MEETINGS
To note the dates of future meetings:
· 11th September 2023 (10am) – Islington Town Hall
· 13th November 2023 (10am)
· 29th January 2024 (10am)
· 18th March 2024 (10am)
· 30th October 2023 (10am)
· 29th January 2024 (10am)
· 18th March 2024 (10am)