Agenda and minutes

Health Scrutiny Panel
Tuesday, 13th October, 2015 7.30 pm

Venue: Room 6, Civic Centre, Silver Street, Enfield, EN1 3XA. View directions

Contact: Elaine Huckell 

No. Item




Apologies were received from Cllr Neville.



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


No declarations of interest were received.



To receive the minutes of the meeting held on the 18 March 2015.


It was NOTED that although the Workstream had been asked to receive the previous Minutes, only Cllr Pearce was in attendance at that meeting.  However, the former Chair, Cllr Cazimoglu, had formally AGREED the Minutes following completion.


GP ACCESS pdf icon PDF 936 KB

To receive a briefing from David Sturgeon, Director of Primary Care Commissioning, NHS England.


David Sturgeon, Director of Primary Commissioning, NHS England, introduced the presentation provided with the agenda pack as follows:


·         NHS England was the body responsible for the commissioning of Primary Care services in Enfield.

·         Key issues for GP services in Enfield were continued population growth, unregistered patients and access to appointments.

·         Primary Care budgets had increased by 4.1% nationally in 15/16.  London would receive ‘a fair share’ according to the formula used for calculating the budgets; however, this was being challenged as a number of additional factors such as population mobility, deprivation and language issues impacted on this.

·         London had received a growth uplift of 1.8% over capitation.

·         The two key cost drivers were the National Settlement (last year this was 1.1%) and an average increase of 1.3% in population; resulting in a 0.5% resourcing gap.

·         A PM Challenge Fund of £125m had been established to improve access to general practice. Wave 1 had completed a number of successful pilots and lessons learned were being taken into Wave 2.  A system of ‘Hubs’ was being considered and NHS England were working with CCGs and the new Federations of GPs to deliver these systems and other new models of care.  Enfield had not been able to demonstrate a sustainable model for revenue costs and had therefore not received PM Challenge Funding as yet.  However, Enfield was looking closely at Camden and Islington, as a successful bidder, to take forward any lessons learned.  So far, Camden & Islington had achieved a 5-10% reduction in A&E admissions and a reduction in urgent admissions through implementation of a Hub system.  Enfield would therefore still gain from the process by being able to test and refine previous schemes.  It was also the case that Enfield CCG was a significant distance from its target funding but its health outcomes were still comparable to other authorities.

·         A £250m budget had also been allocated for improving Primary Care IT.  Every London practice was now able to offer online appointment booking and repeat prescription requests; the focus would now be on increasing offers and on delivery.

·         The Government had committed to recruiting 5,000 GPs (1,200 for London).  The GP workforce was changing, with increased numbers of part time and female GPs.

·         London had a number of good training practices; the main challenge was retention, rather than recruitment of staff.

·         The CQC was currently undertaking a review of practices and there had been closures of practices in London.  NHS England wished to work with ‘struggling’ practices more closely to achieve improvements.

·         There were three types of GP contracts – General Medical Services, Personal Medical Services (a more tailored and flexible local contract) and Alternative Personal Medical Services (a fixed term, tailored contract).

·         There were a high percentage of singled handed contractors in Enfield and a high proportion of GPs over 60 – succession planning was required.  There were also a high number of small practices but these were still below the national average.

·         Enfield had a slightly lower than average GP  ...  view the full minutes text for item 168.



To receive a briefing paper on drug support services in the Borough from Andrew Thomson, Strategy Manager, Drug and Alcohol Action Team.


Andrew Thomson, Head of Drug and Alcohol Services, introduced and summarised the report as follows:


·         Establishment of Drug Action Teams had been the result of two government strategies ‘Tackling Drugs Together’ issued in 1995 and a further 10 year Strategy in 1998.  The Chief Executive was held accountable for the success of Enfield’s DAT.

·         The strategies had also established a new NHS Special Health Authority known as the National Treatment Agency and database known as the National Drug Treatment Monitoring System, which was still in use today.

·         A National Framework (Models of Care, 2002) had been set up by the NTA which had significantly helped to drive up standards of care.

·         Public Health England had replaced the NTA and the Health Protection Agency in 2012, under the Health and Social Care Act.

·         Enfield has a partnership board, the DAAT.

·         Public Health England has set a number of key indicators pertinent to drug and alcohol misuse including successful completion of drug treatment, reduction of alcohol related hospital admissions, reduction of violent crime and re-offending levels and reduction of statutory homelessness. 

·         The Council allocates the DAAT Board £4,259,877 per annum, comprising income from the Mayor’s Office for Policing And Crime and Public Health England Grant.

·         Local Authorities, under the PHE Grant, were obliged to increase qualitative and quantatitive performance for drug and alcohol treatment under Section 7 of the Agreement.

·         Services commissioned by the DAAT included targeted young people’s services, adult recovery services (working with agencies such as Job Centre Plus to rehabilitate and reintegrate), crime reduction recovery services, aftercare services and other treatment services.

·         It was recognised that there was a strong correlation between alcohol and drug misuse, crime, homelessness and mental health issues.

·         An Alcohol Liaison Service operated from Barnet Hospital.  There was a significant cost pressure on the CCG from unplanned alcohol related admissions.

·         Outcomes for successful treatment and discharge in Enfield compared well for National and London averages.  Young people’s performance in this regard was particularly positive.

·         The DAAT was currently working with Public Health colleagues to ensure that Enfield had a new Drug and Alcohol Adult and Young People’s Strategy.  This could be brought to the Workstream if Members wished, following approval of the draft by the DAAT Partnership Board and Safer Stronger Communities Board.


The following questions were then taken:


Q:        What has prompted the drafting of the new Drug and Alcohol Adult and Young People’s Strategy?  Should this have not been done before now?

A:        There is a current Strategy; but this expired in April of this year, hence the need to redraft.  It was considered whether or not redrafting of the Strategy should be postponed until the National Drug Strategy is issued by the Home Office this year, but given that the Council has now been without a current Strategy for six months, it was decided it was best to proceed straight away.


Q:        How are people referred onto the DAAT?

A:        There are a variety of routes including self-referral, referral via the Courts  ...  view the full minutes text for item 169.



To note and agree the Work Programme for 2015/16.


It was NOTED that the Item ‘North Middlesex Hospital – A&E, Ambulatory Care and CQC follow-up’ had been deferred to the meeting on 26 January.


The Workstream requested that the latest Action Plan be brought to this meeting; and that a visit be arranged beforehand ACTION: Scrutiny Officer.


It was also AGREED to defer the Item ‘Adult Social Care Performance’ to the March meeting.




The issue of s.106 revenue was discussed; it was felt that these funds were underutilised and could be put towards investment in health infrastructure. Bindi Nagra commented that the Council had attempted to discuss with NHS England the issue of s.106 funds but that there had been difficulties in doing so.


Cllr Pearce agreed to request an update from the Chair of Planning Committee ACTION: Cllr Pearce.


The Scrutiny Officer reported that an initial meeting of the Sensory Impairment Workstream had been held to look at Council service provision in this regard; a further meeting would be held on 10 December to discuss voluntary sector provision. 


It was asked whether a visit to the Claverings Drop In Centre (which leased equipment) would prove beneficial for workstream members.  It was AGREED that suggested dates/times be circulated and that Deaf Community Forum Members also be invited ACTION: Scrutiny Officer.


The issue of premature disposal of equipment was also raised by a resident, this would be looked into during the visit.





Future meetings for the year-


Tuesday 26 January 2016 and

Wednesday 9 March 2016


All meetings to commence at 7.30pm


The dates of future meetings were NOTED.



To consider, if necessary, passing a resolution under Section100(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).