Agenda and minutes

Adults & Health Scrutiny Panel
Tuesday, 30th July, 2024 6.30 pm

Venue: George Meehan House, 294 High Road, N22 8JZ

Contact: Dominic O'Brien, Principal Scrutiny Officer, Email: dominic.obrien@haringey.gov.uk 

Items
No. Item

1.

FILMING AT MEETINGS

Please note that 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. Although we ask members of the public recording, filming or reporting on the meeting not to include the public seating areas, members of the public attending the meeting should be aware that we cannot guarantee that they will not be filmed or recorded by others attending the meeting. 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 and using the public seating area, 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.

Minutes:

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’.

2.

Apologies for absence

Minutes:

There were no apologies for absence.

 

3.

Items of Urgent Business

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).

Minutes:

None.

4.

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 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.

Minutes:

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 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.

 

In relation to the item on Continuing Healthcare, Cllr Felicia Opoku declared an interest as she had been involved in the design of an electronic version of the tools referred to in the report.

 

5.

Deputations/Petitions/ Presentations/ Questions

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

Minutes:

None.

6.

Minutes pdf icon PDF 330 KB

To approve the minutes of the previous meeting.

Minutes:

Referring to the deputation on Osborne Grove Nursing Home at the previous meeting, Cllr Connor requested an update on the commitment to set up a meeting with the co-production group. Vicky Murphy confirmed that one meeting had already taken place with another one to be scheduled soon. The subject matter had been discussed at the Co-production Commissioning Board. She agreed to provide a more detailed update on this to the Panel. (ACTION)

 

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

 

RESOLVED – That the minutes of the meeting held on 22nd February 2024 be approved as an accurate record.

 

7.

Continuing Healthcare pdf icon PDF 299 KB

To follow.

Additional documents:

Minutes:

Anthony Rafferty, Director for Adult Community Services at Whittington Health, provided an overview of Continuing Healthcare (CHC), explaining that this was a package of ongoing care arranged and funded solely by the NHS where an individual had been assessed and found to have a primary health need as set out in the national framework. The CHC team worked alongside multi-disciplinary team (MDT) colleagues to screen and complete CHC checklists as all patients were entitled to be screened to ascertain if they required a CHC assessment. The CHC/MDT teams and hospitals identified patients who had a rapidly deteriorating condition and were approaching end of life so that they could be fast tracked for CHC assessment automatically.

Anthony Rafferty set out details of the main CHC assessments/tools including:

  • CHC Checklist: A screening tool used in a variety of settings to help practitioners identify individuals who may need a referral for a full assessment of eligibility for CHC. This could be used in a variety of settings and the checklist scoring had 11 domains with the threshold set deliberately low in order to screen people in rather than out. Information for this could be gathered from families and patient notes.
  • Decision Support Tool (DST): Used by the MDT to assess whether individuals had a primary health need. The DST assessed the individual’s need as low, medium or high under each of the 11 domains and determined what level of care and support they need.
  • Fast Track Tool: A means for ensuring that a person’s care was not delayed unnecessarily when an individual had a rapidly deteriorating condition, which may be in a terminal phase. This provided short-term authorisation until a full CHC assessment could take place.

Anthony Rafferty explained that, when the assessment for an eligible person had been completed, the forms were shared with the local authority to check before being sent to the ICB which was responsible for ratification and determining the funding criteria. Reviews for patients took place after 3 months and 12 months to ascertain whether their needs had changed.

Anthony Rafferty then responded to questions from the Panel:

  • Cllr Connor highlighted the low figures for CHC patients in Haringey, and in London as a whole, when compared to the national average. Anthony Rafferty acknowledged that this was an area for improvement, noting that most referrals came from local hospitals and so it was important to raise awareness of CHC for clinicians, particularly when there was a high turnover of staff in London. The ICB had recently established ‘in-reach’ nurse roles in each hospital to help identify those who may have increasing care needs and may reach the criteria for CHC. This included patients on Pathway 3 which is discharge to care homes. The ICB also had a piece of work on upscaling awareness of CHC across NCL and it was agreed that further details on this would be provided to the Panel. (ACTION)
  • Cllr Connor asked whether the areas of the country with higher CHC rates had variations  ...  view the full minutes text for item 7.

8.

Haringey Health & Wellbeing Strategy 2024-29 pdf icon PDF 3 MB

To provide details regarding the development of the new Health & Wellbeing Strategy for Haringey.

Minutes:

Will Maimaris, Director for Public Health, provided a presentation on the development of a new Health and Wellbeing Strategy for Haringey which would run from 2024 to 2029. The strategy would help to guide the partnership work with the NHS with a broad longer-term view and to engage with residents on this work and the issues that mattered to them.

Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Wellbeing, commented that the strategy was an opportunity to ensure that the Borough vision was connected with health and wellbeing and that it was important to have a structure where issues could be referred.

Will Maimaris then presented slides to the Panel which included the following points:

  • The Health and Wellbeing Board was an existing partnership board that oversaw health improvement priorities for Haringey. It was chaired by Cllr das Neves and also included representatives from the ICB, NHS Trusts, Council officers and community leadership. The Board was responsible for the Health and Wellbeing Strategy and understanding the health needs of the population. This work would also be linked to the priorities of the Haringey Borough Partnership. 
  • A map of the borough was displayed which illustrated the variations in life expectancy by ward. The borough average was now broadly comparable to London/nationally and had improved since the Covid-19 pandemic.
  • Engagement work with residents on health and wellbeing issues had been carried out last year which was carried out through a variety of forums.
  • The themes of the new strategy, which had emerged through the data and the engagement work were:

o   Housing & Health

o   Improving Mental Wellbeing

o   Healthy Place Shaping

o   Preventative Health and Care Strategies

  • The principles for delivering the strategy were:

o   Co-production and working with people

o   Knowing our communities

o   Stronger partnership working

o   Equity and challenging discrimination and racism

o   Advocating for high-quality local services that are resourced to meet the needs of our residents

o   Taking an all-age approach

  • Action plans for the first 18 months of the strategy were being developed for each theme along with an outcomes framework.
  • The draft strategy was due to be reviewed and signed off by the Health and Wellbeing Board in September. Updates on progress would then be received after 12-18 months.
  • There were links with the rest of the NCL area through the Integrated Care Partnership Council which was a forum that brought together elected leaders and senior officers from each Council to steer the partnership work on population health improvement in NCL.
  • The outcomes framework for the strategy that was being developed would track key indicators linked to the four themes of the strategy. Example outcomes were illustrated such as smokefree environments and access to green spaces and it was noted that the data for some indicators involved a time lag of up to 18 months.

Will Maimaris then responded to questions from the Panel:

9.

Cabinet Member Questions

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

Minutes:

Reporting on recent developments, Cllr das Neves said that thought was being given to the alignment between national and local policy, such as with the prevention work that had been discussed earlier in the meeting, and including through partnership working at London-wide level.

 

Cllr das Neves responded to questions from the Panel:

  • Asked by Helena Kania for her view on the future of the JPB, Cllr das Neves said that this was a very important body and that it was also important that it worked well and brought together as many different and shared voices that could participate, including ‘hard to reach’ groups. This meant examining what could be done better including that the right training and support was in place. Beverley Tarka, Director of Adults, Health and Communities, also highlighted the importance of the Board and noted that a review had been conducted and that she was now the lead for taking the next steps in terms of conversations with the co-Chairs and investment in external facilitation as recommended in the review. She added that a meeting was scheduled to discuss working together on next steps for the Board and to reflect on the review. Cllr das Neves commented that she was passionate about participation but that it was not always easy and so external facilitators could bring in skills to help with this.
  • Helena Kania queried how the future of the North Middlesex and Royal Free hospitals would be monitored by the Council following the proposed merger of the two Trusts. Cllr das Neves observed that, while the Council could monitor impact on residents, this was not an area that the Council could control. Sara Sutton added that there was some oversight through the Borough Partnership executive including a commitment that colleagues from partnership organisations that they would report back on this in the autumn. Cllr Connor noted that a paper on the proposed merger would be discussed at the next meeting of the NCL Joint Health Overview & Scrutiny Committee (JHOSC) in September. The JHOSC would also be receiving briefings/reports on the partnership between the mental health trusts and on the collaboration between the Whittington Health Trust and the University College London Hospital Trust.
  • Cllr O’Donovan raised the issue of safety for women and girls and asked about action the role of youth hubs and whether there ought to be single sex spaces. Cllr das Neves explained that there were two Youth Hubs in the Borough and that the views of young people would be needed in any discussion about single sex spaces. She added that the Council funded work in schools on various aspects of VAWG (Violence Against Women & Girls) prevention such as healthy relationship and women’s safety. There was also work funded with perpetrators of VAWG to prevent harmful behaviour. The new government had made a commitment on mental health in schools and more resources within schools to support young people.
  • Cllr Connor referred to the Haringey Opportunities Project for people with learning disabilities and  ...  view the full minutes text for item 9.

10.

Work Programme Update pdf icon PDF 385 KB

Minutes:

It was noted that the agenda item on the Haringey Adult Safeguarding Board Annual report would now be held in September rather than November due to diary clashes.

The Panel suggested additional possible topics for the remainder of the 2024/25 work programme:

·         Preparedness for a future pandemic

·         Mental health and transition from children’s services to adult services

·         Support provided to people with dementia

 

11.

Dates of Future Meetings

·         19th Sep 2024 (6:30pm)

·         5th Nov 2024 (6:30pm)

·         17th Dec 2024 (6:30pm)

·         10th Feb 2025 (6:30pm)

Minutes:

·         19th Sep 2024 (6.30pm)

·         5th Nov 2024 (6.30pm)

·         17th Dec 2024 (6.30pm)

·         10th Feb 2025 (6.30pm)