Agenda and draft minutes

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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’.

There were no apologies for absence.

It was noted that Cllr Sheila Peacock was attending the meeting online.

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 as noted below).

None.

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 Members’ Register of 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 interest 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.

Cllr Mary Mason declared an interest as a Trustee of the Bridge Renewal Trust.

Cllr Thayahlan Iyngkaran declared an interest as a consultant radiologist and a deputy medical director.

Helena Kania declared an interest as a co-Chair of the Joint Partnership Board.

To consider any requests received in accordance with Part 4, Section B, Paragraph 29 of the Council’s Constitution.

A deputation was received by the Panel on the subject of Osborne Grove Nursing Home. This was presented by Mary Langan, chair of the severe complex autism and learning disabilities reference group, Gordon Peters from the Haringey over 50s forum, Ann Gray from the older people’s reference group and the Haringey over 50s forum, Sharon Grant, chair of Healthwatch Haringey and a co-Chair of the Joint Partnership Board and Vida Black, chair of the Carers forum.

Gordon Peters set out the key points, stating that:

• A vision for Osborne Grove, as a home of health and well-being integrated into local community life, had been produced in 2017 with several Councillors and others in an early example of co-production. Details of this vision are available online at: https://osbornegrovenursinghome.commonplace.is/
• There had been an established co-production steering group that had worked together on the design and plans for over five years, with due consideration of scale, environmental impact, community interaction and neighbourhood integrity, as well as creating a multifunction facility appropriate to the needs of vulnerable people and a meeting place for local residents and visitors all on one site.
• The project would have provided at least 70 places for elderly people in need of nursing care and people with learning disabilities who would otherwise be placed outside of the borough. This would reduce the long-term financial burden to the Council of making placements elsewhere.
• The project design had been reduced in size to take into account resident and service need feedback and was ready to seek planning permission for building completion within two years when the project was paused in 2023. They were concerned that the project would not recommence for some time or could be deprioritised altogether.
• Communications from the Council had been reduced in 2023 compared with previous years and details such as cost-benefit studies and current working assumptions had not been shared with the co-production steering group.
• The deputation therefore had four requests:

o   That Osborne Grove be made a priority within the Council’s Medium Term Financial Strategy (MTFS)

o   The full cost-benefit analysis of the redesigned facility should be provided to stakeholders, including capital costs, revenue costs and the income potential of the facility compared to doing nothing.

o   The co-production steering group should be reconvened before the end of the 2023/24 cycle with an updated timetable for the implementation of the project.

o   The Council should issue a statement specifying that Osborne Grove remained a part of its strategy for health and social care in the Borough and recognised the importance of co-production with local partners.

Mary Langan then emphasised the commitments in the Haringey Labour manifesto for locally delivered care and to empower communities by working with them. She expressed disappointment that the members of the co-production group that had worked on this project for five years, as part of what had been a positive and productive relationship with the Council, were now at this meeting as petitioners. She felt that the recent handling of  ...  view the full minutes text for item 47.

To approve the minutes of the previous meeting.

The minutes of the previous meeting were approved as an accurate record.

RESOLVED – That the minutes of the meeting held on 12^th December 2023 be approved as an accurate record.

To receive a briefing on the Start Well programme and proposals to reorganise maternity and neonatal services in North Central London.

Anna Stewart, Programme Director for Start Well, introduced the report for this item and was joined by Clare Dollery, Medical Director at Whittington Health NHS Trust and Vicky Jones, Medical Director at North Middlesex University Hospital NHS Trust.

Anna Stewart provided an overview of the NCL (North Central London) Start Well programme, a long-term piece of change work to improve maternity and neonatal and children’s surgical services. A public consultation was in progress which included details of options to reduce the number of maternity and neonatal units in NCL from five to four:

• Option A would involve the closure of services on the Royal Free site in Hampstead but remain open at the Whittington Hospital site. This was the preferred option based on the modelled flows of patients and the expected number of staff that would need to be move to a new location.
• Option B would involve the closure of services on the Whittington Hospital site but remain open at the Royal Free site.
• In both cases, the services at UCLH, North Middlesex University Hospital (NMUH) and Barnet Hospital would remain in place.

The proposals were based on a case for improving services and meeting best practice standards against a backdrop of declining birth rates and increasing complexity of both women giving birth and babies who needed care. The changes were not about reducing funding and around £40m of capital investment had been earmarked for the remaining sites. The ICB strongly believed that, by having a smaller number of units, staffing resources could be better used to meet quality standards.

In addition, there were separate proposals for:

• The closure of the birthing suites at Edgware Birth Centre, due to declining use with only 34 births in the last financial year.
• The streamlining of pathways for paediatric surgical care with the consolidation of some surgical care at Great Ormond Street Hospital and day case surgery at UCLH.

The public consultation was due to run until 17^th March with several events having taken place in Haringey already. There had been an unprecedented amount of hard-to-reach groups as part of the integrated impact assessment and the data was being used as part of the improvement programme. The Start Well team were keen to hear from a wide range of voluntary and community sector voices and any recommendations from the Panel on local groups would be welcomed.

Anna Stewart, Clare Dollery and Vicky Jones then responded to questions from the Panel:

• Cllr Connor expressed concerns about the existing provision of services given the latest CQC ratings for maternity services at the Whittington Hospital, which was rated as ‘requires improvement’ and at the NMUH, which was rated as ‘inadequate’. Particular areas of concerns raised in the CQC report on the NMUH included staffing issues, a lack of detailed treatment records and failure to implement lessons learned from incidents.

-       Regarding the NMUH, Vicky Jones acknowledged that the CQC report highlighted failings that they were acting to rectify. The visit was in May  ...  view the full minutes text for item 49.

To provide an update on the provision of aids and adaptations following the recommendations made by the Panel in September 2022. Minutes from this meeting are available to view at: https://www.minutes.haringey.gov.uk/mgAi.aspx?ID=74001

A previous update was provided to the Panel in March 2023. Minutes from this meeting are available to view at: https://www.minutes.haringey.gov.uk/mgAi.aspx?ID=75471

Kerine Smith, Acting Head of Service, introduced the report for this item which provided an update on progress against the recommendations on communication issues and delays previously made by the Panel in September 2022:

• A key action was on initial assessments and ensuring that the family was fully involved. The occupational therapists were now providing more regular updates with a 4-6 week pathway review including details on their position on the waiting list. An additional occupational therapist (OT) and occupational therapist assistant (OTA) had been recruited. The OTs were working closely with those within the adaptation process and there was also an adaptation delivery manager overseeing the process and providing further support.
• Another recommendation was for the Council to offer advocates and this was now being done at the assessment stage with residents referred to Voiceability, Disability Action Haringey, POWhER and Connected Communities.
• On the recommendation that key decisions should be confirmed in writing, a series of communication actions carried out by the service was provided in the report including a summary of input to the resident following an assessment/review, support plans and a copy of the OT specification.
• On the recommendations that delays should be explained to residents and that details of a named contact should be provided to residents, everyone on the waiting list had been contacted in the past year and the additional recruitment had improved capacity for individual communications with residents.
• On the recommendation that suggestions made by residents/families should be recorded on the case file, the new case management system enabled this to be recorded using bespoke forms.
• A recommendation on recording and communicating delays and timescales to residents had been addressed through a new recording system for all adult social services.
• On the recommendation about widening provider choices for aids and adaptations, it was noted that standard equipment was provided through a contract involving a consortium of 20 local authorities. Further details about this were provided in the report.

Kerine Smith responded to questions from the Panel:

• Asked by Cllr Connor about further reducing the waiting list, Kerine Smith explained that the waiting list was for the OT assessment after which the recommendations were passed to the adaptation team which included the surveyors. In addition to the new recruitment, some of the OT assessments were being outsourced to speed this part of the process up.
• With reference to a specific case, Cllr Iyngkaran queried what happened where a Haringey resident was discharged out of the Borough because their current home was unsuitable. Beverley Tarka, Director of Adults, Health & Communities, said that it was not generally the policy of the Council to place people out of Borough but that she would be happy to look into the details of the specific case outside of the meeting. Cllr Lucia das Neves, Cabinet Member for Health Social Care & Wellbeing, highlighted the impact of the housing crisis and that the Council was consequently in a position of having to place some residents out of Borough  ...  view the full minutes text for item 50.

An opportunity to question the Cabinet Member for Health, Social Care & Well-being, Cllr Lucia das Neves, on developments within her portfolio.

Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Well-being, responded to questions from the Panel on issues related to her portfolio:

• Cllr Mason asked about the future of the Burgoyne Road project which she had understood had been due to replace two women’s refuges in Hornsey which were no longer fit for purpose. Cllr das Neves noted that Burgoyne Road was no longer in her portfolio as it now sat with Housing. She explained that the main difficulty with the project was that the funding required from the GLA was no longer forthcoming and agreed to provide a written response on refuge provision for women, which may require input from Cllr Williams as Cabinet Member for Housing Services. (ACTION)
• Cllr O’Donovan raised concerns that life expectancy in Haringey had gone down and was now amongst the worst in London and observed that factors may include Covid, poverty and air quality. Cllr das Neves agreed that this was worrying and added that ‘healthy life expectancy’ rates and the gap in rates between the west and east of the Borough were also causes for concern. She added that the impact of poverty on this was a large multi-faceted issue and advocated the development of a ‘Marmot’ approach nationally to tackle health inequalities. Will Maimaris, Director for Public Health, said that Covid deaths in Haringey had been relatively low compared to statistical neighbours. However, the broader picture in terms of life expectancy related to poverty and issues such as housing. The male life expectancy had gone down in particular. Further details were available in the Council’s annual public health reports which Will Maimaris would circulate for information. (ACTION) Cllr das Neves highlighted the impact of ‘long Covid’ on people’s health, particularly those with multiple health conditions.
• In response to a request from Cllr Iyngkaran for an update on Canning Crescent, Cllr das Neves reported that she had recently signed a decision to give the contract to an organisation to finish the project because the previous contractor had gone voluntarily bankrupt. However, the new organisation had also now gone voluntarily bankrupt so the project was back in the same situation and future options were being discussed. A lot of local authorities were seeing these issues with contractors at present due to economic circumstances.
• Asked by Cllr Iyngkaran about the uptake of the measles vaccine in Haringey, Will Maimaris explained that there was some concern about the increase in measles cases nationally and in London and acknowledged that vaccination rates were low in London and parts of Haringey. He had previously circulated a briefing on this to all Councillors which he would recirculate. (ACTION) This included information about communications campaigns and targeted work in areas with low take-up rates.
• Cllr das Neves reported that Haringey had the highest rate of flu vaccinations in schools in North Central London because of the partnership work with schools from the public health team.
• In response to a question from Cllr Connor  ...  view the full minutes text for item 51.

It was noted that a further evidence session for the Panel’s scrutiny review on hospital discharge would be taking place the following week.

Meeting dates for 2024/25 will be published shortly.

Meeting dates for 2024/25 will be published shortly.