Greenwich Council

Agenda and minutes

Venue: Rooms 4 & 5, Town Hall, Wellington Street, Woolwich SE18 6PW. View directions

Contact: Jean Riddler  Email: jean.riddler@royalgreenwich.gov.uk or tel. 020 8921 5857

Items
No. Item

1.

Apologies for Absence

To receive apologies for absence from Members of the Panel.

Minutes:

Apologies were received from Councillors Mark James and Steve Offord.

2.

Urgent Business

The Chair to announce any items of urgent business circulated separately from the main agenda.

Minutes:

The draft Housing Strategy for People with a Learning Disability had been circulated and a meeting would be held with Golden Lane Housing on 19 July 2017. It was requested that any comments be fed back to the Senior Corporate Development Officer. The strategy would be considered further at a future meeting.

 

There had been an announcement regarding the consolidation of the six South East London Clinical Commissioning Groups (Bexley, Bromley, Greenwich, Lambeth, Lewisham and Southwark). In March 2017 the Chair and the Senior Corporate Development Officer wrote to Dr Anne Rainsberry, NHS England, Regional Director for London, to ask for further details regarding possible changes to the CCG arrangements across South East London. No details were received but the changes were now a reality and a new Managing Director of the 6 London CCGs was to be recruited and when the appointment was made the Panel would be informed and the new Managing Director would be invited to attend the next meeting.

 

A copy of the Council’s submission to the GCCG’s Treatment Access Policy (TAP) had been circulated.

 

One of the main recommendations of the draft Sustainability and Transformation plan (STP) for South East London ‘Our Healthier South East London’ was to establish two centres of expertise across the region for elective orthopaedics. There were very strong concerns from patient groups and providers about the impact both on the ability of hospital trusts to continue to provide full A&E and trauma services attracting the calibre of orthopaedic surgeons required, as well as the additional inevitable inconvenience for some people in terms of travelling and visiting.

 

Greenwich Council, the CCG and the joint Scrutiny Committees all asked the STP leadership to reconsider the two centre approach and look at a three centre option. The STP lead has now announced the establishment of an Orthopaedic Clinical Network which would place on each of the three acute trusts (Lewisham and Greenwich, Kings, Guys and St Thomas’s) an obligation to meet the relevant quality standards across three sites under Professor Tim Briggs.

 

Members were invited to a tour of the Eltham Community Hospital which would take place immediately prior to the next meeting of the Panel on 27 September at the Eltham Centre.

3.

Declarations of Interest pdf icon PDF 34 KB

Members to declare any personal and financial interests in items on the agenda.  Attention is drawn to the Council’s Constitution; the Council’s Code of Conduct and associated advice.

Additional documents:

Minutes:

Councillor Clare Morris declared that she had an honorary contract with Lewisham and Greenwich NHS Trust.

 

Resolved –

 

1.         That the list of Councillors’ memberships as Council appointed representatives on outside bodies, joint committees and school governing bodies be noted.

 

2.         That Councillor Morris’ declaration be noted.

4.

Minutes pdf icon PDF 116 KB

Members are requested to confirm as an accurate record the Minutes of the meeting held on 17 January 2017 and 8 March 2017.

 

No motion or discussion may take place upon the Minutes except as to their accuracy, and any question on this point will be determined by a majority of the Members of the body attending who were present when the matter in question was decided.  Once confirmed, with or without amendment, the person presiding will sign the Minutes.

Additional documents:

Minutes:

Resolved -

 

That the minutes of the meeting of the Healthier Communities and Adult Social Care Scrutiny Panel held on 17 January 2017 and 8 March 2017 be agreed and signed as a true and accurate record.

5.

Lewisham and Greenwich Trust (LGT) pdf icon PDF 49 KB

The Panel is asked to consider the Lewisham and Greenwich Trust ‘s update.

 

Additional documents:

Minutes:

The report was presented by the Chief Executive of the Lewisham and Greenwich NHS Trust (LGT). He asked the Panel to note that the earliest publication date for the Care Quality Commission’s (CQC) inspection report was likely to be August 2017. The CQC had paid a further visit in May 2017. There had been a significant improvement in the Emergency Department flow, considering that 500 patients per day were being seen. Queen Elizabeth Hospital (QEH)had an overall performance score of 93% for June 2017. He added that radiography and ultra sound testing would be available at the Eltham Community Hospital and hoped the suites would be available for the Panel to view at their visit on 27 September.

 

The Panel asked what the target figure was for Money Matters Too. The Chief Executive said that the target was £25m savings. When asked what sanctions would be imposed for not hitting the savings targets, the Chief Executive replied that there was an expectation to do all that was reasonable without compromising patient care. The Panel requested more detail regarding the tighter controls on expenditure in areas which did not affect patient care.

Action: Chief Executive Lewisham and Greenwich NHS Trust

 

In response to questions regarding funding, the Chief Executive explained that the Trust was in deficit but continued to be able to apply for funding. Money had already been saved by outsourcing the pharmacy service to Lewisham and Payroll had moved to Guys and St Thomas’s with no loss of local jobs as there was a shortage of finance officers in South East London.

 

The Panel queried the A&E performance projection for the winter and the pressures the service would have to face. The Chief Executive said that winter was a difficult challenge and would begin in October and there was a need to ensure that improvements were sustainable and to introduce more schemes by then to ensure that standards could be met.

 

The Chief Executive assured the Panel that the QEH has not reduced beds.

 

The Panel asked that following the Grenfell fire, were the Trust’s buildings safe. The Chief Executive responded that the Trust had taken part in a programme whereby samples of cladding had been sent away for testing and the Trust had been informed that they had not given cause for concern. There had also been increased controls around fire protection measures and a major incident exercise was planned.

 

Regarding recruitment; the Chief Executive said it was a matter of concern, as staff were leaving after a short period of time and the reasons for this were being reviewed. The Trust were looking to further recruitment from overseas and also looking at forming their own academy to provide home grown talent. He added that there was no data available in terms of non-medical staff retention from EU countries but medical staff from overseas were generally non-EU which should give a greater degree of protection. The main problem appeared to be that staff did not think they  ...  view the full minutes text for item 5.

6.

Cabinet Member's Progress Report on Council priorities pdf icon PDF 250 KB

To note the progress on the programmes of work to implement the Cabinet priorities adopted for Health and Social Care, including public health.

Additional documents:

Minutes:

The report was presented by the Cabinet Member for Health and Adult Social Care who highlighted that Greenwich continued to be amongst the more generous in terms of spend in London. There had been a slight reduction in care packages and a slight increase in social care costs. Progress had been made on the Transformation agenda. The difficulties with the Blue Badge scheme had been reviewed and the quality of the service had improved. With regard to Public Health, many boroughs had ceased their smoking cessation programmes but Greenwich continued to provide this.

 

The Chair asked what the implications were for the delay in the Green Paper on the future of Adult Social Care. The Cabinet Member responded that the cap of £70k had been put on ice for five years but hopefully the new Government would revisit this and there needed to be a national dialogue on a long term solution. Once the consultation was published the Council would respond as a Local Authority.

 

The Panel questioned if there was any detail available on the work undertaken by the Social Isolation Strategy Group and whether Greenwich was performing well compared to other authorities. The Cabinet Member replied that there was no detailed data but work had been done with voluntary groups and there was still a lot to do, and there was a hope that the Council would consider Community Centres acting as hubs. He explained when a resident is 70 years old they were contacted by the Council to check if they felt isolated, if they had health issues and whether they would benefit from joining local groups. There was also a directory which explained what was available.

 

The Chair said that he was disappointed that the campaign to end loneliness was not moving forward at the anticipated pace and asked that a report be brought back to scrutiny at a later date. Another Panel member asked if Ward Councillors would have a role and requested that they be engaged in this campaign.

 

The Panel questioned the progress made for the introduction of an interim sugar levy in the Council’s premises ahead of the national one and the Cabinet Member replied that it was being discussed.

 

In response to a question on the London Wide Obesity measures, the Cabinet Member said that the Borough was not doing as well as some but was slightly ahead of many regarding the implementation of a strategy. The Panel requested that following its obesity review, a more detailed report be brought forward on the progress of the Health and Wellbeing Strategy Preventing Obesity Action Plan.

Action: Director of Public Health

 

The Panel queried the Council’s work on community safety within Housing of Multiple Occupancy (HMOs). The response was that Housing were involved in the initial work for the private sector which was mandatory registration of a HMO. This enabled them to check on sanitation, appropriate kitchen facilities and gas safety. Public Health also funded some of this work.

 

A Panel Member drew  ...  view the full minutes text for item 6.

7.

Update on the bid to set up a new Specialist Perinatal Mental Health (PNMH) Service. pdf icon PDF 40 KB

To note the summary of the background to the bid and the verbal update from the Chief Officer, Greenwich Clinical Commissioning Group (GCCG).

Minutes:

The report was presented by the Chief Officer of the Greenwich Clinical Commissioning Group. She explained that the outcome of the bid for the set-up of a new Specialist Perinatal Mental Health Service was expected November 2017. A recruitment and training programme would then be undertaken by South London and Maudsley NHS Foundation Trust (SLAM) and Oxleas and the service start date was expected to be April 2018. The Panel requested that an update on the outcome of the bid be brought to the Panel in December 2017 / January 2018.

Action: Chief Officer Greenwich Clinical Commissioning Group

 

Resolved:

 

That the update on the bid to set up a new Specialist Perinatal Mental Health (PNMH) Service be noted.

8.

Update on Greenwich Clinical Commissioning Group's Quality Innovation Prevention Productivity (QIPP) Plan. pdf icon PDF 52 KB

This report sets out Greenwich Clinical Commissioning Group’s (CCG) current plans to deliver a 2017/18 savings of £19.3m.

Additional documents:

Minutes:

The report was presented by the Chief Officer, Greenwich Clinical Commissioning Group who gave an overview of the Quality Innovation Prevention Productivity Plan (QIPP). She highlighted that of the target £15.5m efficiency savings for 2016/17, only £9.4m were delivered. The programme for 2017/18 had to deliver £19m in savings.

 

It was expected that £2m savings could be found by effective joint management and focus on the Better Care Fund which had not been finalised. The negotiations needed to be mindful of the prevention agenda and good progress was being made. The report would be presented to the Health and Wellbeing Board at its meeting in August 2017 and the first quarter return for 2017/18 was due by 21 July 2017.

 

A Panel Member was concerned that the Council was being expected to pick up the savings being made on behalf of the GCCG. He questioned how this would impact on the community as a whole and that the community needed more money not less. Another Member asked for an indication of when the £1.4m of unidentified schemes was likely to be agreed, to which the Chief Officer replied that they were still being reviewed but a decision should be made by September 2017.

 

Councillor Singh asked it be noted that his partner works at a residential home.

 

The Chief Officer explained that a different use had been agreed for the intermediate beds at Time Court and Ash Green as part of the Frail Elders Programme. It was important that the right diagnostics were in place to support them. The Panel requested that a detailed report on the programme be brought to a future meeting.

Action: Chief Officer Greenwich Clinical Commissioning Group

 

The Chief Officer brought to the Panel’s attention duplication of fees for mental health services which had been identified. This had provided a saving of circa £100k. Other areas of possible duplication were being reviewed.

 

The Panel asked that the Council’s submission to the Treatment Access Policy (TAP) be published with the agenda.

Action: Committee Officer

 

A Panel member questioned the benefits of the review of the gynaecology services, and why there was a high rate of hysterectomy in the Borough. The Chief Officer referenced the lower costs of a community rather than an acute setting, improvement of referral to treatment times, the reduction of follow-ups and inappropriate admissions and a more systematic approach. She added that a contributing factor to the high rate of hysterectomy compared to benchmarked CCGs was the common incidence of fibroids amongst black African women.

 

The Chief Officer said that a saving of £1m was aimed for through Medicine Management. Ensuring the pathway is followed would reduce the need for higher cost medications and there was a need to ensure that NHS England were funding the drugs they were responsible for such as cancer meds.

 

She explained the difference between red and grey drugs. Red drugs were prescribed by specialist centres and required monitoring. Grey drugs were those with a lack of clinical value  ...  view the full minutes text for item 8.

9.

2017/18 Work Programme Schedule pdf icon PDF 34 KB

The Panel is asked to agree the attached schedule for the Healthier Communities and Adult Social Care Scrutiny Panel (HCASC) work programme for 2017/18 as set out in Appendix 1 to the reprot.

Additional documents:

Minutes:

The Panel noted that a Mental Health Forum would be held in Autumn 2017 and following the launch of the Mayor of London’s Thrive Programme, it would focus on the launch of ‘Greenwich Thrive’.

 

The Director of Public Health and Adult Social Care highlighted that there was a lack of mental health beds London-wide, and also a lack of social housing available to people with mental health needs.

 

A Panel member asked for a written update to be provided on Winter Fuel Poverty.

Action: Director of Public Health and Adult Social Care

 

Resolved:

 

That The Healthier Communities and Adult Social Care Work Programme 2017/18 be noted.