Agenda and draft minutes

Venue: Room 1, Civic Centre, Silver Street, Enfield, EN1 3XA. View directions

Contact: Elaine Huckell 

Items
No. Item

274.

WELCOME AND APOLOGIES

Minutes:

The Chair welcomed everyone to the meeting. He asked everybody to introduce themselves.  

 

Apologies were received from Councillor Neville and Councillor Ekechi and for lateness from Councillor Erbil.

275.

DECLARATIONS OF INTEREST

Members of the Council are invited to identify any disclosable pecuniary, other pecuniary or non-pecuniary interests relevant to items on the agenda.

Minutes:

Councillor Erbil works at the Royal National Orthopaedic Hospital Trust.

276.

ADHERENCE TO EVIDENCE BASED MEDICINE - pdf icon PDF 303 KB

To receive a report from Vince McCabe, Director of Commissioning Enfield Clinical Commissioning Group (CCG) on the results of the consultation

Minutes:

Dr Jahan Mahmoodi (Medical Director, Enfield CCG) introduced this report which set out proposals to implement AEBM for some procedures/ treatments in Enfield. 

 

He highlighted the following:

  • Enfield CCG is a statutory body responsible for deciding which health services should be purchased for the people of Enfield and for ensuring that there is value for money
  • There is evidence that some procedures offered by the NHS have limited or no benefits for patients. It was therefore decided, especially in light of the financial deficit, to look at a number of procedures to determine whether there was evidence that procedures were offering clinical benefit.
  • Initially 149 procedures were looked at under the programme. The programme was led by local GP’s together with a wider group of clinicians. Any clinical decision was to be evidence based.  Eventually there were 13 procedures which were identified for review.
  • These procedures were put forward for a pre- consultation phase with various groups including the Health and Wellbeing Board, the Health Scrutiny Panel, and Enfield Healthwatch.  The CCG aimed to involve as many members of the public as possible as well as representative bodies, professional bodies, providers and clinicians in the   consultation which commenced on 1 March 2017 and ended on 30 June 2017.
  • Members of the public and clinicians were able to access and review the evidence that the CCG’ had used and submit comments.
  • An independent consultation report was produced looking at the findings from the consultation. 
  • Following this it was decided that 11 procedures should go forward for change.  Of the comments received, 76% were about hearing aids also a large number about weight management outcomes re knee ops.  It was decided to take both these procedures out of the proposed list.
  • All clinical committees have looked at the evidence that the change in the 11 procedures would improve outcomes, they decided that this would also be value for money.  The decisions/conclusions have been made by clinicians – not ‘number crunchers’.
  • There would be a total decommissioning of homeopathy.  Treatments would be provided only where there would be better outcomes. However if a person is in pain along the process they would always be able to go to referral.
  • The Equality Impact Assessment had been carried out and ratified.
  • The CCG is implementing the changes as soon as possible.  Referrals are being returned back to doctors with additional information for them to inform discussions with patients.

 

The following questions/ issues were raised

 

Q: Councillor Abdullahi asked if it was the case that a large number of responses received were from people outside the borough?

A: DrMahmoodi answered that the vast majority of people who had responded were concerned about hearing aids, many were under the misapprehension that they would no longer be able to obtain hearing aids although this was not the case.

 

Q: Councillor Pearce said that as the other 4 boroughs of the North Central London region would be implementing changes by the end of 2018 would  ...  view the full minutes text for item 276.

277.

PAEDIATRIC ASSESSMENT UNIT - PERFORMANCE UPDATE pdf icon PDF 100 KB

To receive an update from Vince McCabe, Director of Commissioning Enfield Clinical Commissioning Group (CCG)

Minutes:

Vince McCabe (Interim Director of Commissioning CCG) presented a report which updated the meeting on the decommissioning of the Paediatric Assessment Unit (PAU) and the new model of paediatric care at Chase Farm Hospital. 

 

He highlighted the following:

·         The PAU had been decommissioned and closed from 18 June 2017.

·          Admissions were consistently low with an average of just 1 or 2 young children a day visiting the unit. The review recommended an alternative model where a hotline provides consultant advice to GP and rapid access outpatient slot at Chase Farm hospital.

·         There has been no impact seen at North Middlesex hospital as a result of this change and no complaints received.

·         Emergency Nurse Practitioners started working in the Chase Farm Urgent Care Centre from 1 June 2017 to enhance children’s triage.

 

Vince McCabe stated that if there were any signs of changes they would report this back to Health Scrutiny Panel.

 

The following issues were raised:

 

A member of the public pointed out that hospital services for Enfield residents was currently under a great deal of pressure and this would increase with the rise in population expected from new developments in the borough.  He was particularly concerned that there should be adequate provision to provide for children’s health. 

 

Councillor Pearce spoke of new developments in the borough including that in Cockfosters, she spoke of the lack of primary care which should be readdressed. 

Vince McCabe agreed and spoke of the Integrated Pathway review which would hopefully address this issue.  

It was noted that a report would be discussed at the January meeting of this Scrutiny Panel on Integrated Models of Care.

278.

COMMISSIONING INTENTIONS 2018/19 - pdf icon PDF 239 KB

To receive a report from Vince McCabe, Director of Commissioning, Enfield CCG and Tessa Lindfield, Director of Public Health. 

Minutes:

Vince McCabe presented a report on the system intentions for North Central London (NCL) CCGs for 2018/19.  This builds on the collaborative approach in developing the Sustainability and Transformation Plan (STP), with a move from commissioning intentions in 2017/18 to system intentions for 2018/19.

 

The following was highlighted

  • Intentions would reflect the priorities identified through engagement with patients and public.  They will signal a change in the relationship between commissioners and providers compared to previous years.
  • The Public Health team have been involved in this, especially in the setting out of priority areas e.g weight management, as a key area for health improvement.
  • At the end of September all providers were written to, with specific commissioning intentions and these findings were now being collated.
  • Changes were divided into areas such as for planned and emergency care projects

 

The following issues were highlighted:

 

The link between prevention work and budget cuts – Vince spoke of how the smoking cessation project had targeted those people who would benefit most from the scheme.

 

Vince McCabe spoke of the STP plan. He confirmed that urgent and emergency planning regarding the winter readiness system was being looked at in conjunction with Haringey CCG . It was confirmed that LB Enfield (Bindi Nagra AD Strategy & Resources HH&ASC) was working closely with NMUH and CCG - looking to identify / assessing people for discharge.

 

It was confirmed that under the Procurement Principles it will be possible for  the CCG to re-procure a service but that this should not be the ‘first port of call’.

 

Vince referred to the principle of ‘fastest first’ in terms of the AEBM and also the ‘Integrated models of care’. It is important that an authority should go ahead if they are ready, rather than wait for others to proceed, to help with shared learning.  Workshops have been held in relation to integrated models of care.

 

A Healthwatch representative made the following points – She referred to the Procurement Principles section in the report and said there is a reference to the CCG involving public in proposals to change services however it is sometimes difficult to get people involved. She thought there should be more joint commissioning work with the Local Authority.  There is  reference to CCG’s to first work with existing providers, however she thought we were losing opportunities from this.  She also thought  the NCL discussions should include representatives from LB Enfield.

 .  

NOTED

Health Scrutiny Panel noted the NCL CCG’s System Intentions for 2018/19, which were formally notified to NCL providers on 29 September 2017.  These will inform the contract negotiation with NCL providers for 2018/19, in accordance with the NHS Planning and Contracting guidance, 2017 -2019

 

279.

UPDATE ON THE NEW ROYAL FREE LONDON GROUP pdf icon PDF 148 KB

Members are asked to note this report from Ian Lloyd, Deputy Director, Communications, Royal Free London NHS Trust.

Minutes:

An update report had been prepared by Ian Lloyd, Deputy Director Communications, Royal Free London NHS Trust which was NOTED.

 

Andy Ellis, said the paper makes reference to the new Chief Executive for Chase Farm hospital who, he said will update the Health Scrutiny Panel at the January meeting, on the Chase Farm redevelopment. 

 

280.

WORK PROGRAMME pdf icon PDF 148 KB

To note and agree the Work Programme for 2017/18.

Minutes:

The Work Programme for 2017/18 was AGREED

281.

ANY OTHER BUSINESS

Minutes:

None

282.

MINUTES OF THE MEETING OF THE 22 MARCH 2017 pdf icon PDF 127 KB

To receive the minutes of the meeting held on the 22 March 2017.

Minutes:

The Minutes of the 22 March 2017 were AGREED

 

At the meeting of 22 March 2017, Councillor Pite drew attention to the lack of GP surgeries for Chase Ward although she had had some discussions about this matter, the issue was still outstanding.

283.

DATES OF FUTURE MEETINGS

Tuesday 16 January 2018

Thursday 15 March 2018

 

Please note there will be a Joint Overview and Scrutiny Committee and Health on Wednesday 8 November 2017.

Minutes:

Tuesday 16 January 2018

Thursday 15 March 2018

 

It was noted that there will be a Joint Overview and Scrutiny Committee and Health Scrutiny Panel on Wednesday 8 November 2017 the following items will be discussed

 

  • Air Quality Action Plan
  • Delayed Transfer of Care

 

284.

EXCLUSION OF THE PRESS AND PUBLIC

To consider, if necessary, passing a resolution under Section 100A(4) of the

Local Government Act 1972 excluding the press and public from the meeting

for the item of business listed in Part 2 of the agenda on the grounds that it

will involve the likely disclosure of exempt information as defined in those

paragraphs of Part 1 Schedule 12A to the Act (as amended by the Local

Government (Access to Information) (Variation) Order 2006), as are listed on

the agenda (Please note there is not a Part 2 agenda).

Minutes:

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