Agenda for Health & Adult Social Care Scrutiny Panel on Thursday, 17th February, 2022, 7.00 pm

Agenda and minutes

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

Contact: Email: Democracy@enfield.gov.uk 

Items
No. Item

1.

WELCOME & APOLOGIES

Minutes:

Cllr Derek Levy welcomed all attendees to the meeting.

 

Apologies for absence were received from Cllr Birsen Demirel (substituted by Cllr Hass Yusuf).

 

Cllr Levy expressed concerns regarding the serial absence by Councillors Akpinar and Aramaz (with no substitutes on the 5 missed meetings).  It was felt this was disrespectful of the scrutiny process, by disrespecting other members who do attend and participate; also to the officers who expend time and effort to prepare the reports and attend meetings. And both disrespectful and insulting to those visitors and participants from external organisations who deserve the attention of a full complement of 8 members.

 

Cllr Levy sought permission from the Panel Members to put these concerns in writing to the Director of Law and Governance, from himself and on behalf of and bearing the endorsement of the Panel. Permission was given, and seconded by Cllr Dey.

 

2.

DECLARATIONS OF INTEREST

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

 

Minutes:

There were no declarations of interest registered in relation to any items on the agenda.

3.

MINUTES OF THE PREVIOUS MEETING pdf icon PDF 85 KB

To agree the minutes of the previous meeting on 18th November 2021.

Minutes:

The minutes of the meeting held on 18th November 2021 were agreed.

4.

PRESSURES IN GENERAL PRACTICE & WHO OWNS GENERAL PRACTICE pdf icon PDF 124 KB

To receive information related to GP Contracts.

 

Minutes:

Cllr Hamilton led on this item and advised that the concerns were initially raised by the JHOSC. 

 

1.    Vanessa Piper, Assistant Director of Primary Care Contract & Commissioning, had provided a report however apologised that it did not specifically address the panel’s concerns.  The judicial review had begun in February but there was no outcome yet. 

2.    The communication plan was being pulled together and consultation would take place with councillors and stakeholders before any contract decision is taken.

3.    Cllr Hamilton had concerns about rules and regulations when dealing with American companies.

4.    Minutes from the Primary Care Commissioning meetings could be shared with this group.  Vanessa confirmed they look carefully at the contracting body and performance.

5.    Cllr Georgiou asked who commissioned the review – Vanessa responded that they were unable to share this information.

Vanessa confirmed that contracts were monitored throughout the 15 years.

6.    Deborah McBeal, Head of Commissioning NCL CCG, confirmed that all procurement regulations are followed and the focus is on quality of the service.

7.    Bindi Nagra, Director of Health & Adult Social Care, added that correct processes were followed, and the focus was on quality and value for money over the type of provider.

8.    Dr Chitra Sankaran, GP, added that the concerns raised by Cllr Hamilton were understood, however regulations had been followed and there was confidence in the quality of the service.

9.    Cllr Hamilton clarified that her main concern was the American company who had been prosecuted in America and would welcome any additional information around this outside of this meeting.

10.Cllr Levy thanked everyone for their input and stated that if any concerns arise to bring them back to this meeting via the Governance Team.

 

  Post meeting action : additional information to be provided as requested by Councillor Hamilton; the response to the concerns raised by the JHOSC; and the outcome of the judicial review.

 

ACTION:  NCL CCG / Governance Secretary

5.

MENTAL HEALTH pdf icon PDF 517 KB

To receive a report on mental health which will provide a description of what is known about the mental health of our residents, how we are working to enhance protective factors, and an explanation of what we are doing to protect the mental wellbeing of children and young people in the borough.

 

 

Additional documents:

Minutes:

Doug Wilson, Head of Strategy & Service, introduced the item stating that the overall tone of the report was encouraging and the system response during the last two years had been brilliant.

 

1.    There had not been a huge surge in people becoming very unwell which was positive and Enfield’s performance had been one of the best in London.

2.    The system encouraged intervention at the early stage, for example keeping people in accommodation and jobs.  There was also a lot of work being done with schools to help avoid issues developing.

3.    Collaborative working with other boroughs had been very useful and it was felt the council and NHS response to the pandemic had been fantastic.  The focus now was to improve access, reduce inequalities and promote sustainability.

 

In response the following comments were received:

 

1.    Cllr Yusuf raised concerns about suicide and potential demands on services due to the increased cost of living.  Officers said they could only speculate and must not become complacent.  It was questioned if there were any links between poorer/deprived areas and suicide. This was very complicated but there wasn’t necessarily any clear links.

2.    Cllr Anolue raised concerns about domestic abuse as Enfield was the fourth highest in the London Boroughs.  Officers stated that this report did not cover domestic abuse, but it could be explored at a future meeting.

3.    Cllr Anolue highlighted the stigmas around mental health, particularly in African communities.  Officers were aware of this and were linking with community groups which had been well received.

4.    It was questioned why young black men were being specifically targeted.  Officers advised that evidence suggested that the behaviour of this group could potentially impact their mental health and it was a national issue, not just in Enfield.

Cllr Anolue felt the way the group were treated by police contributed to the issue.

5.    Cllr Levy was concerned that wider awareness may open doors not needed.  Bindi Nagra stated that statistics show 1 in 4 people have a mental health issue of some description and society need to have a better understand to identify, recognise and self-help.

 

Cllr Levy thanked everyone for their contributions to this item and was sure the subject would return at a future meeting.

 

6.

RECOVERING ACCESS TO SERVICES POST COVID pdf icon PDF 4 MB

To receive the presentation from NHS North Central London CCG.

 

Minutes:

It was noted that Covid continued to take up resources and other services were managing around this.  There were far more appointments available than ever before, however this still may not be enough.

 

1.    Cllr Dey extended thanks to the NHS for all their work.  The main issue was trying to get a GP appointment unless it’s an emergency.  Deborah McBeal advised that additional appointments were being offered including the extended access service which runs outside normal working hours and at weekends.  It was questioned if residents were aware of this service; communication was essential.

2.    Dr Sankaran felt that some of the issues may come from residents not being happy with “change”, for example telephone appointments.  There may be issues with meeting the “wants” rather than the “needs”.  Resources have to be prioritised and residents need to be educated on this.  She confirmed that all Enfield practices offer face to face appointments when necessary.

3.    Organisations and community groups were working together to communicate messages more effectively.

4.    Cllr Georgiou highlighted the fantastic service he experienced at Chase Farm Urgent Care.

5.    Cllr Hamilton emphasised there were pressures before Covid, as well as low pay particularly for nurses.  CCG colleagues advised that there were things in place and other roles were being considered, not just GP and nurses.  A Workforce Group was looking at opportunities and innovative ways to plug gaps in unemployment.  It was suggested for the People and Place departments to work together on this.

6.    Cllr Anolue stated that residents whose first language is not English struggle with online and telephone appointments.  This was a recognised issue and video lines with an interpreter were available.

7.    Cllr Yusuf had received some concerns from residents about changes to GP appointments however stated his own personal experience with the GP Service had been excellent.

 

NHS and CCG colleagues were thanked for their attendance and hard work in this area.

7.

WORK PROGRAMME 2021/22 pdf icon PDF 80 KB

To note the work programme for 2021/22.

Minutes:

The work programme was noted and agreed.

8.

DATE OF NEXT MEETING

The date of the next meeting will be confirmed after the Annual Meeting.

 

Minutes:

The date of the next meeting will be confirmed due to Purdah.