Agenda and draft minutes

Health Scrutiny Panel
Thursday, 15th March, 2018 7.30 pm

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

Contact: Elaine Huckell 

Items
No. Item

418.

WELCOME AND APOLOGIES

Minutes:

Apologies received from Councillor Neville

 

Apologies for lateness received from Councillor Ekechi

419.

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:

There were no declarations of interest.

420.

GP PROVISION IN ENFIELD pdf icon PDF 617 KB

To receive a report from John Piesse, Head of Primary Care for Enfield CCG 

Minutes:

Received:

 

Deborah McBeal (Director of Primary Care Commissioning and Deputy Chief Officer) and Dr Fahim Chowdhury (Governing Body Member) presented a report on Primary Care in Enfield and highlighted the following:

 

·         The hot issues were; Development of Care Closer to home , Enfield Healthcare Co-operative Limited – Enfield’s new GP Federation, Access to appointments, Service enablers – better use of technology, workforce and estates and PMS reviews

·         Extended Access Services - Since December 2016, the service have provided 58,735 primary care appointments made available regardless of where you live

·         Service enablers -to increase the use of technology regarding online services and workforce and estates including the scope of nursing, healthcare and pharmacy assistants, it was also recognised that there are capacity issues on GP provision 

·         Personal Medical Services (PMS) reviews of contracts to improve consistent service delivery

·         It was recognised that work is being done and pleased to see new innovative ways of working with I.T/online subscriptions.

 

The following questions/issues were raised:

 

Q:        How are you improving waiting times at GP surgeries?

A:        The core GP services have been extended access from the current waiting time 8am-6pm to 8am-8pm, with three sites offering pre-bookable appointments and walk in appointments.

 

Q:        How is the extended access services advertised?

A:        There have been extensive communications and also advertised within; GP surgeries, our Enfield, local press and Love your Doorstep.

 

Q:        How are you improving access for people with sensory impairment, this has been raised with councillors by members of the deaf community as a particular issue?

A:        All GP’s in Enfield must comply with the rules on accessibility and provide interpreters. The CCG are aware of concerns raised by the deaf community and are looking to improve.

 

Q:        Will there be a Walk – In service introduced at Silverpoint Health Centre?

A:        Dr Chowdhury will be moving into Silverpoint and will look into the possibility of introducing. However; the health centre does not have good parking facilities and will need to look into the accessibility of the premises.

 

Concerns were raised around the fact that the GP’s are not evenly distributed across the borough. Chase Ward was highlighted as a particular concern and it was noted that this includes areas of social deprivation, health inequalities and poor public transport.

 

The CCG agreed that there is a need to revisit maps of areas and look at all possible premises locations, in particular any owned by the local authority such as Enfield Highway library. It was confirmed that Enfield Highway library was not closed, but changed location; consultations are currently ongoing on the use of this building, with a health centre being a possibility. Discussions have also taken place on use on local authority owned buildings as potential GP’s or health centres.

 

Q:        A member of the public asked how Enfield Healthcare Co-operative Limited works.

A:        All GP practices have come together and all have a share in the company. This was originally in localities but is now whole of Enfield services. This includes  ...  view the full minutes text for item 420.

421.

SUBSTANCE MISUSE AND DAAT PERFORMANCE pdf icon PDF 198 KB

To receive a report from Tessa Lindfield, Public Health.

Minutes:

 

Doctor Glenn Stewart (Assistant Director of Public Health) went through the report of substance misuse and DAAT performance and highlighted the following:

 

·         Drug and alcohol misuse impacts upon the health and wellbeing of individuals, families and communities across Enfield.

·         Within Enfield more than 1500 people are dependent on crack or heroin with 18% having children who live with them.

·         There are an estimated 3648 people dependent on alcohol. Alcohol is now the third biggest risk factor associated with death and illness.

·         1200 patients received treatment in Enfield relating to alcohol misuse

·         In Enfield the client group is more complex as many substance abusers also have mental health issues, this is above the national average and is often the case in London boroughs

·         Enfield’s performance with regards to successful treatment completions  are above the national average

·         People can go refer back to the service post treatment should they need to do so

 

The following questions/issues were raised:

 

Q:        What is the estimated cost on drugs and substance misuse in Enfield?

 

A:        The estimated cost in Enfield is £1.2 million.

 

Q:        With low educational attainment being associated with parents who misuse drugs or alcohol, does the DAAT team visit schools to engage with young people?

A:        There is work undertaken in schools. The Therapy and Family Services focus on the whole family unit, and will support children affected by parental substance misuse.

 

Q:        How do Enfield compare with other councils?

A:        The figures are similar within London, though boroughs do not all fund to the same level but many operate in a similar fashion.

 

It was highlighted that this is a difficult area and that the commitment and work undertaken by the DAAT partnership and substance misuse treatment service has delivered overall positive outcomes.

 

422.

ACUTE ADULT MENTAL HEALTH PATHWAY AND THE CRISIS CAFE pdf icon PDF 322 KB

To receive a report from Peppa Aubyn, Head of Mental Health Commissioning NHS Enfield CCG.

 

Minutes:

Peppa Aubyn (Head of Mental Health Commissioning NHS Enfield CCG) went through her a report providing an update on Mental Health Services and highlighted the following:

 

·         Peppa began with apologies on the Crisis Café as this had not been included in the report and suggested that this be bought to a future Health scrutiny panel meeting

·         The report set out the work plan for Barnet (BCCG), Haringey (HCCG) and Enfield (ECCG) CCG’s along with BEHMHT to jointly transform Mental Health services over the year

·         The motivation behind this intention is to contribute to the 4 key outcomes:

o   Reducing any over-reliance on inpatient beds and reduce avoidable admissions

o   Eliminating Out of Area Placements by 2020/21

o   To better support people with mental health issues to remain healthy, well and connected to individuals own communities

o   To provide preventative support in the right setting at the right time to avoid crisis

·         Key projects highlighted were, Primary Care Mental Health Link workers Pilot, IAPT Network, Dementia (including GP’s, Memory clinic, Integrated care primary care management), Dementia/Older Peoples Inpatient transformation Programme, Female Psychiatric Intensive Care Units and Complex Care Rehabilitation Transformation

·         Barnet, Enfield and Haringey Mental Health Trust (BEHMHT) provides mental health services for people of all ages employing 3000 staff to serve a population of over 1 million

·         The trust has 514 inpatient beds across 5 sites, services are organised and managed within 4 discreet directorates

 

The following questions/issues were raised:

 

Q:        What improvements are been made in supporting people in primary care?

A:        There is a current Primary Care Mental Health Link work pilot in place, looking at the infrastructure around primary care. This includes nurses seeing patients at a practice at allocated times, offering support guidance and advice. This is a twelve month pilot across half of the borough. A decision on the wider roll-out to all Enfield practices will be made following evaluation of costs, benefits, outcomes and impact of both Phase 1 and Phase 2 of the pilot. There is a commitment that there will be the same level of service for mental health across the entire borough.

 

Q:        What is the status of the dementia/older people inpatient transformation programme, are there really 23 long term beds as we were advised there were 12?

 

A:        This programme was delivered by the 19th December 2017. 12 Continuing Healthcare Beds were commissioned at Bridgewood House.

 

The specification for Memory Clinics for dementia is that they provide specialist assessment to people over 65. However, concessions will be made for younger people and memory services will try to accommodate and refer to a more specialist service where appropriate.

 

There is a workforce and recruitment issue in particular with mental health nursing. Agency staff has been used to fill the gaps. There is both a high dropout rate of mental health nurses and not enough nurses qualifying. This is a national issue.

 

Discussions were held on the sensory gardens at Bridgewood and Chase Farm hospital and other therapy gardens, which have  ...  view the full minutes text for item 422.

423.

NHS INTEGRATED CARE SYSTEMS

To raise awareness of future consultation on NHS Integrated Care Systems (formerly known as Accountable Care Systems)

Minutes:

The Chair confirmed that this proposal is looking to bring together health services, adult social care and local authority provision. The purpose of having this item on the agenda was to raise awareness of the consultation process that is being planned for the spring. However, even colleagues at Enfield CCG are unaware when the consultation will be launched. Having raised awareness at this meeting, the Health Panel will review any progress on this matter in the new municipal year.

 

424.

WORK PROGRAMME pdf icon PDF 148 KB

To note the Work Programme for 2017/18.

Minutes:

NOTED the completion of the work programme for 2017/18, the Chair (Cllr Abdullahi) thanked the team for their work.

 

425.

MINUTES OF THE MEETING OF THE 16 JANUARY 2018 pdf icon PDF 135 KB

To receive the minutes of the meeting held on the 16 January 2018.

Minutes:

The minutes of the last meeting were AGREED

426.

DATES OF FUTURE MEETINGS

To be agreed at Annual Council in May.

Minutes:

NOTED that this had been the last meeting of the Panel for the 2017/18

Municipal Year. A new programme of dates for 2018/19 is currently being

prepared for inclusion on the Council’s calendar of meetings due to be

approved at the Annual Council meeting in May 2018.

 

427.

EXCLUSION OF PRESS & PUBLIC

To consider, if necessary, passing a resolution under Section 100(A) 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 no Part 2 agenda).