Agenda and minutes

Health Scrutiny Panel
Tuesday, 26th January, 2016 7.30 pm

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

Contact: Elaine Huckell 

Items
No. Item

372.

WELCOME AND APOLOGIES

Minutes:

The Chair welcomed everyone to the meeting.

Apologies were received from Councillor Lemonides and Councillor Neville.

373.

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 Pippa Connor (Haringey Council) stated that her sister was a GP in Tottenham.

374.

MINUTES OF THE MEETING OF THE 13 OCTOBER 2015 pdf icon PDF 132 KB

To receive the minutes of the meeting held on the 13 October 2015.

Minutes:

The Minutes of the meeting held on 13 October 2015 were AGREED.

375.

NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST pdf icon PDF 363 KB

Julie Lowe, Chief Executive, will present performance information relating to hospital services.

Minutes:

Julie Lowe, Chief Executive presented the performance information relating to hospital services at North Middlesex University Hospital.

She referred to the CQC Inspection findings for 2014/15 following an inspection of the 8 core services and the examination of 5 aspects of care provided which was summarised in a table.  She said the two key issues were for Ambulatory Care and Accident & Emergency performance.

 

The inspection findings gave a mixture of ‘Good’ or ‘Requires Improvement’ ratings with an overall ‘Requires Improvement’ assessment.  There were 3 ‘must do’ recommendations where improvements were necessary in relation to -

·         responsiveness of Outpatients department,

·         training (an improvement notice was issued on this) and

·         the ambulatory care environment. 

 

In response to the findings, a Quality Improvement Plan (QIP) had been prepared and reviewed with external stakeholders. Progress had been made on the Action Plan which was detailed in the presentation.

Following on from this - ‘Quality priorities’ had been prepared for 2015/16 to improve patients’ safety and experience, and also to improve clinical effectiveness.   

 

Julie Lowe referred to the continuing challenges and issues for the hospital especially in relation to the Accident & Emergency Service.  She said this has been a serious cause of concern since July 2015.  The urgent care centre opened in June 2015 and is now seeing 40% of emergencies within an hour.  Performance data for the weekly 4hr target was given. 

 

One of the reasons given for performance data was the increased number of attendances at A&E, another was due to the struggle to recruit and retain high quality doctors. 

 

The Ambulatory Emergency Care Unit opened in October 2015.   This revamped facility has resulted in an improved fast tracked service and the resulting patient feedback has been more positive.  However there continues to be challenges for the A&E service, one of which is the number of patients who are ‘well enough’ and could be moved on to ‘free up’ places.

 

The following questions were then taken:

 

Q: The findings of the CQC inspection show that all core services met the ‘good’ rating for Caring aspect, however a number of services were rated ‘requires improvement’ under the ‘responsive’ and ‘well-led’ categories, does this indicate that staff are being let down by managers?

 

A: The ‘well-led’ category covers a number of issues and I would say for many they are doing all they can in difficult situations.  Clinical leadership is an issue and more senior doctors and nurses are needed. A new medical director has been appointed to provide a lead on this, in summary we are aiming to strengthen our leadership.

 

Q: Would you confirm that the closure of A&E and Maternity services at Chase Farm hospital has had a detrimental impact on North Middlesex hospital,  I have heard of someone who attended North Middlesex A&E department, they waited for 5 hours and eventually gave up and returned home?

 

A: The maternity services provided at both Barnet and North Middlesex hospitals are doing well and so too are the community  ...  view the full minutes text for item 375.

376.

PUBLIC HEALTH pdf icon PDF 720 KB

To receive reports on GP Engagement, Screening Services and Antenatal Services from Dr Tha Han, Consultant in Public Health and Allison Duggal, Consultant in Public Health.

 

·         GP Engagement Presentation

·         GP Engagement Report

·         National Screening Programme Report

·         Cancer Screening Report

·         Antenatal Services Report

Additional documents:

Minutes:

Reports were presented on the following :

  • GP Engagement – Dr Tha Han
  • National Screening Programme Roles and Responsibilities and Cancer Screening Update –  Dr Allison Duggal and Jo Murfitt
  • Antenatal Services –  Dr Allison Duggal 

 

Post meeting note – Dr Tha Han has pointed out that his presentation should have stated – Life expectancy gap is : 8.6y (F) and 7.4y (M)

 

GP Engagement

Dr Tha Han presented this report and highlighted

  • Despite improvements there remain significant health inequalities within the borough.  These inequalities are more pronounced within the 5 wards of Upper Edmonton, Ponders End, Enfield Lock, Chase and Jubilee.  Public health is focused within these wards and elsewhere to help to mitigate against health inequalities.
  • There is a variation in the primary care management of long term care conditions (i.e cardiovascular disease, cancer and respiratory problems) between GP practices.
  • It was thought high quality primary care was key to improving health outcomes and for lower dependency on the acute services and social care sector.
  • Enfield GP’s face huge challenges related to: a high level of long term conditions in the borough, problems of socioeconomic deprivation and the high population churn.
  • Enfield is one of the most deprived boroughs in London. In addition, NHS payment per registered patient to Enfield G.Ps, is the third lowest in London at £118.

 

He referred to a plan set out by the public health team to address issues, the aim of which is to reduce illness from preventable conditions and conditions modifiable by healthcare by collaborating with Health and Wellbeing partners. 

·         To reduce variation in clinical care of long- term conditions  among general practices across Enfield by raising awareness of best practice among GP’s

·         To improve management of long-term conditions already identified by local GPs, and also to improve identification and management of major diseases and risk factors in primary care

·         To improve access to effective community services.

 

The following questions/ issues were raised:

  • There appears to be a discrepancy in the health inequality data quoted from GLA for 2015 – Life expectancy gap: 8.6years (F) and 6.4years (M) between the worst and best ward life expectancy compared to those from Public Health England.
  • When asked how we could raise the issue of increasing the number of Enfield G.P’s, it was thought this should be discussed with NHS England.   Councillor Pearce said members were of the opinion that following the removal of some services from Chase Farm hospital there was insufficient primary care resources here in Enfield.   Jo Murfitt (NHS England) would report this comment back. She referred to the additional workload of GP’s and extra immunisations and appointments carried out by them.  It was thought that whilst the number of GP’s for Enfield was average for London, there may be a higher need as resources for Enfield was lower than it should be.
  • It was questioned what was being done to improve the prevention side of public health especially in relation to obesity and diabetes? It was pointed out that  ...  view the full minutes text for item 376.

377.

WORK PROGRAMME pdf icon PDF 149 KB

To note and agree any amendments to the Work Programme for 2015/16

Minutes:

The Work Programme was NOTED

378.

ANY OTHER BUSINESS

Minutes:

None

379.

DATE OF FUTURE MEETING

A future meeting of the Health Scrutiny Standing Workstream will be held on Wednesday 9 March 2016.  The meeting will commence at 7.30pm.

Minutes:

The next meeting would be held on Wednesday 9 March 2016 at 7.30pm.


 

 

380.

CQC Quality Report - Actions Taken pdf icon PDF 143 KB