Agenda and minutes

Health Scrutiny Panel - Tuesday, 22nd January, 2019 7.30 pm

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

Contact: Elaine Huckell 

No. Item




The Chair welcomed all attendees to the meeting.  

Apologies had been received from Councillors Kate Anolue and Vicki Pite.


It was noted that Healthwatch Enfield had prepared a report ‘Accident & Emergency – a place of choice for addressing everyday healthcare needs’

In January 2018, over a period of one week, Healthwatch Enfield engaged with more than 600 individuals attending A & E at NMUH.  The report which was available at the meeting gave their findings.



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


There were no declarations of interest.



To receive a presentation from Trust representatives on the work being undertaken following the Care Quality Commission inspection.


A copy of the inspection report is attached.


Maria Kane (Chief Executive NMUH) and Deborah Wheeler (Director of Nursing & Midwifery NMUH) presented this item on the achievements made by North Middlesex University Hospital following on from the CQC inspection report which was published on 14 September 2018.


The following was highlighted:

  • The inspection visit took place on 22 May 2018. It was a comprehensive inspection and there is likely to be a further one by the CQC in October or November 2019.
  • The table circulated gave ratings of red (inadequate), amber (requires improvement) and green (good) comparing the CQC inspections of 2016 and 2018.  From this it was possible to see the improvements that had been made. One service that had been rated as red in 2016 regarding ‘well-led’- maternity and gynaecology service was now rated as good. The overall rating for maternity and gynaecology service was shown as good for 2018.  Altogether, 21 services were rated as good in 2018 compared to 13 in 2016.
  • One of the key areas of concern in 2018 was in the management of urgent and emergency care and was thought to be due to the high turnover of management staff.   There is now thought to be more stability in the management team as new people have been recruited. Another point of concern was that a lock on a ward had failed which reflected negatively on the services for young people. This issue had been resolved.
  • A new mental health suite is included in the £3 million refurbishment of the Emergency Department. Building work was undertaken whilst services remained operational, and this was to be commended. A registered mental health practitioner is now continually employed and based in the Emergency Department.
  • A new improved mortality review process is now in place.
  • A staff survey had previously referred to some staff saying they had been the subject of bullying.  Staff Support Officers are now used to help assist people, however Deborah referred to the need for awareness of a balance between those that may feel bullied and for those where their performance is being questioned.
  • Learning events are now being held to share learning across the Trust.


Work currently being undertaken includes:

·         The implementation of quality reviews and ward accreditation.  It was thought sometimes emphasis was placed on wards and not enough on ‘back room’ areas. 

·         Culture and leadership programme - it is necessary to encourage people to ‘buy into’ the culture of the organisation for them to embrace it.

·         Listening into Action is a programme where staff are encouraged to look at areas where improvements can be made and work through solutions.

·         The workforce redesign programme which is supported by Health Education England, looks to help in the retention of staff for them to train into new roles.

·         The Global Digital Exemplar Fast Follower Programme (GDE-FFP). - working with the Royal Free hospital to enable delivery of good services in an efficient way, through using digital technology and information.

·         Using Quality Improvement Methodology for sustainable improvements.  Aiming to ensure culture is more  ...  view the full minutes text for item 931.



To receive a presentation from Enfield Clinical Commissioning Group on primary care with reference to A&E waiting times.



Deborah McBeal (Director of Primary Care Commissioning CCG), and Dr Fahim Chowdhury (GP Member, Enfield CCG) gave a presentation on this item. ‘Primary Care in Enfield’ which set out current Primary Care developments including:

  • The NHS Long Term Plan
  • NCL Primary Care Strategy Refresh and Enfield CCG Implementation Plan
  • Quality Improvement Initiatives on Diabetes and Atrial Fibrillation
  • Primary Care Extended Access Hubs
  • Medicus Health Partners – Super partnership of 13 Enfield Practices
  • General Practice Chase Farm Feasibility Study


The following was highlighted:

  • Details of what the ‘Long Term Plan’ will deliver for patients was set out
  • NCL Primary Care Strategy Refresh and Enfield CCG Implementation. A local plan is being developed for Enfield - key workstreams including the need to retain and recruit more GP’s and looking at ways to attract them to Enfield.
  • To make best use of digital technology for instance by using ‘skype/ email for advice.
  • There is a commitment to improve out of date premises/ estate.
  • Quality improvement – initiatives to improve standards of care.
  • Aiming to reduce health inequalities.
  • Enfield Extended Access Hubs – Enfield have four extended access hubs i.e one in each locality - at Carlton House, Eagle House, Evergreen and Woodberry practices. They offer pre-bookable and walk-in services.
  • Medicus Health Partners which is a super partnership of 13 Enfield practices.
  • General Practice Chase Farm Feasibility Study – Consultants have been engaged to undertake a review of the need for a general practice facility on the Chase Farm hospital site.
  • Additional services in the community were detailed which provide alternatives to using the A&E service.


The following issues were raised:


Councillor Hamilton thought that whilst ‘Access Hubs’ were good, she did not think that there were an adequate number of GP’s in Enfield.  She welcomed the 10 year plan but she was concerned whether there would be sufficient funding provided to deliver it.


Deborah McBeal said that through the Integration programme we have opportunities to look at ‘pathways’ for patients.  CCG’s in all boroughs are looking at this.


In response to the need to retain and recruit more GP’s we are looking at the following:

  • International recruitment from Europe
  • Prepared a ‘you tube’ video extolling benefits of working in Enfield
  • Use of additional trainee newly qualified GP
  • Use of Health Education funding retention scheme
  • Discussions undertaken with doctors to understand why they may be looking to leave and how we can support their careers
  • Investigating whether doctors who have left might consider returning
  • Pharmacists training programme and to look in general at how we can encourage professionals to practice at their highest levels.


Councillor Cazimoglu said there was no reference to Social Care, and it is essential that this is properly funded as it underpins the local plan.  She was concerned that some commissioning funding is going to the private sector and some hospital sites sold.  She questioned whether Chase Farm site is most appropriate for a GP surgery and thought that one would be useful in the North Middlesex hospital area.  ...  view the full minutes text for item 932.


WORK PROGRAMME 2018/ 19 pdf icon PDF 137 KB

To note the work programme and confirm items for the next meeting.


The Work Programme was NOTED.



·         Recommendations

·         Action Plan


An updated Action Plan for the Health Scrutiny Panel was discussed and is attached to the minutes.  Members asked that visits take place at North Middlesex hospital to look at improvements.  A visit was also requested for Chase Farm hospital                                  Action:  Andy Ellis




To receive the minutes of the meeting held on the 10 October 2018.


The minutes of the last meeting were AGREED.



To note the date of the next meeting –


Thursday 14 March 2019


The following meeting date for this municipal year:


Thursday 14 March 2019.