Agenda and minutes

Cllr Andy Milne, as Chair of the meeting, welcomed the representatives from the NHS, Members and Officers.  He explained that apologies for absence had been received from Cllr James Hockney, who had been substituted by Cllr Hannah Dyson.

Apologies for absence had been received from Cllr Alev Cazimoglu, Cabinet Member for Health and Social Care, and the Leader, Cllr Nesil Caliskan who were unable to attend the meeting to respond to questions from Panel Members due to a clash with their Ward forum.

Apologies for absence had also been received from Laura Andrews, Senior Engagement Manager and Enfield Borough Lead for Communications and Engagement, Corporate Affairs Directorate, NHS North Central London ICB and Stephen Wells, Head of Enfield Borough Partnership Programme, Enfield Borough Directorate, NHS North Central London ICB.

The Committee AGREED with the Chair’s proposal that, due to the distance presenting Officers had to travel and the inclement weather, the order of the items be changed.  Item 6 - Draft Independent Living Strategy (2023-2027) would be taken as Item 4.  The remaining items would continue in agenda order.  Primary Care Access as Item 5, followed by Women’s Health in Enfield, which would include a PowerPoint Presentation, copies of which would be made available to the Committee and published on the Council’s website following the meeting.                                                                        ACTION: Governance

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

To approve the minutes of the meeting held on 19 January 2023.

The minutes of the previous meeting held on 19 January 2023 were AGREED.

The report provides an update on local primary care services and systems in the London Borough of Enfield.  The attached slide pack incorporates content on workforce, primary care investment and activities undertaken to address local Primary Care Survey results (iPSOS Mori survey) together with Enfield Borough Partnership’s update and Community Services review update.

Deborah McBeal - Director of Integration, Enfield Borough Directorate, NHS North Central London Integrated Care Board (NCL ICB) introduced the report and accompanying presentation, published with the agenda on the Council’s website, which provided an update on local primary care services and systems in the London Borough of Enfield.

The report provided an update on local primary care services and systems, whilst the slide pack incorporated content on workforce, primary care investment and activities undertaken to address local Primary Care Survey results (iPSOS Mori survey) together with Enfield Borough Partnership’s update and Community Services review update.

The main considerations for the Health and Adult Social Care Scrutiny Panel were to note the content of the report and support the realisation of borough partnerships.

An invitation was extended to the Councillors to visit White Lodge Medical Practice, which had relocated to 105-109 Chase Side, Enfield, EN2 6NL. This should be a short walk, cycle or drive from Enfield Civic Centre. This would provide an opportunity for Members to see behind the scenes of a general practice and to really understand the workings. It would also provide an opportunity for questions and answers and to address any queries from Members, together with an opportunity to talk about local procedures and patient participation. The practice had indicated that it was happy to host the visit and suggested that Wednesdays may be the best day for them.

ACTION: Laura Andrews, Senior Engagement Manager and Enfield Borough Lead for Communications and Engagement, Corporate Affairs Directorate, NHS North Central London ICB/Governance

During the detailed discussion which ensued, the following points were made and addressed:

Members requested further information regarding investment in the East of the Borough in relation to development funding package, health inequalities, and community experience.

ACTION:Dudu Sher-Arami - Public Health Director

The Director of Integration, responding to a question and request from Members, confirmed that a new GP contract had just been published and would be brought to a future meeting of the Panel.

ACTION: Director of Integration/Governance

The Chair, on behalf of Panel Members thanked the representatives from the NHS for their attendance and input.

AGREED that:

1.    The updates on local primary care services and systems; together with the Enfield Borough Partnership update and Community Services review update be noted; and

2.    A further update be provided at a meeting of the Health and Adult Social Care Scrutiny Panel during the 2023/24 Municipal Year.

The report informs the Health and Adult Social Care Scrutiny Panel of the state and key challenges to women’s health in the London Borough of Enfield and outlines current activities and services for women’s health.

The report from Sophie Maule and Dr Dean Connolly, Public Health Specialty Registrars informed the Panel of the state of women’s health and outlined current activities and services for women’s health in the London Borough of Enfield, including the key challenges to women’s health.

The main considerations for the Panel were

1.    Gender-based disparities contributed to poorer outcomes across several health and wellbeing domains.

2.    Women had a higher cost per capita in A&E attendance compared to men in Enfield regardless of level of deprivation.

3.    Multi-sector work was underway to address women’s ill health, focusing on cancer, sexual and reproductive health, workplace wellbeing and intimate partner violence.

Members noted the conclusions of the report anticipated gender-based health disparities had been identified in Enfield and multi-sector work was underway to address these and support women to live healthier for longer. Future work should be informed by the National Women’s Health Strategy.

Members recognised that the commitment to the Council Plan that was in place, however queried how would the Council do this?

ACTION: Dudu Sher-Arami, Public Health Director

Members expressed the view that the voluntary sector played a crucial role in the health and wellbeing of residents, especially those with little or no family nearby or whose English was a second language. They brought the community together, seeing some residents every day and helping to resolve their issues. The involvement of the Council and Members with the voluntary sector was also paramount in supporting local residents in the community and hearing what they had to say and the concerns they raised. The current method was not as productive as the previous method. Members asked Officers to explore community hubs could be developed.

ACTION: Dudu Sher-Arami, Public Health Director

In response to questions from Members regarding the availability of period and menstruation products in and at the food banks in the Borough, Officers undertook to check and advise that there was a good supply made available.

ACTION: Dudu Sher-Arami, Public Health Director

A further question regarding menstruation, particularly with regards to young girls, was the availability of the safe single sex spaces, which females could use without the presence of males. Officers undertook to feedback Members’ comments to the appropriate body.

ACTION: Dudu Sher-Arami, Public Health Director

Referring to the very low rates of breastfeeding in the Borough, Members stated they would like to see plans for the work to be carried out to increase and improve these rates. The Public Health Director confirmed that in Enfield, only 30% of babies were fully/partially breastfed at the 6-8 week visit in 2020/21, which was lower than England (49.3%). There were plans for a Hub Working Group starting imminently at the central hub provision to encourage breastfeeding continued to six or nine months. The World Health Organisation (WHO) recommended breastfeeding for six months to two years as a supplement to food.

Members indicated that they would like to be part of the Hub Working Group to encourage breastfeeding.

ACTION: Dudu  ...  view the full minutes text for item 5.

The Health and Adult Social Care Scrutiny Panel is asked to consider the full draft Independent Living Strategy, together with appendices (weblinks for Appendices 3 & 4 are embedded within the report) and provide feedback to inform the final version.  The Independent Living Strategy sets out the Council’s headline priorities for supporting independent living for young people in transition to adulthood, adults (18-64 years) and older people (65+) with adult social care needs in Enfield over the next five years (2023-2027). 

The Health and Adult Social Care Scrutiny Panel considered the overarching report and the full draft Independent Living Strategy, together with appendices and following a short verbal introduction from Officers were invited to provide feedback and comment to inform the final version.

Members noted that the Independent Living Strategy was intended to complement existing strategies and contribute to a wholistic portfolio of documents, which set out, in partnership with those people who needed support, together with their carers, what was needed locally to better support independent living and how the Council would work with the stakeholders to deliver. That the Strategy of the Joint Health and Wellbeing Board, referred to in paragraph 9 of the Officer’s report, be circulated to Members of the Panel.

    ACTION: Lia Markwick, Service Development Manager

Regular updates on the implementation of the Independent Living Strategy, which set out the Council’s headline priorities for supporting independent living for young people in transition to adulthood, adults (18-64 years) and older people (65+) with adult social care needs in Enfield over the next five years (2023-2027) be brought to the Health and Adult Social Care Scrutiny Panel on an annual basis.

     ACTION: Lia Markwick, Service Development Manager/Governance

Members requested that a key to any acronyms used within the Independent Living Strategy be provided.

                                    ACTION: Lia Markwick, Service Development Manager

Members referring to the data capture in the Enfield Equality Impact Assessment (EqIA), Section 4 – Equality Analysis, requested that it would be helpful if the pattern of people who needed help was provided from the data gathered. This was in addition to the simple summary provided. There was room for narrative within the document, which would be good practice and provide open questions for residents to respond.

                                    ACTION: Lia Markwick, Service Development Manager

Members recognised that the purpose of the Focus Groups were to provide an opportunity for Officers to meet and understand the bigger picture and the needs of those who needed care and their carers. However, opportunities for online engagement should also be provided.

                                    ACTION: Lia Markwick, Service Development Manager

Following consideration of the full draft Independent Living Strategy it was AGREED that:

1.    The comments and feedback arising from the discussion inform the final version of the Independent Living Strategy (2023-2027); and

2.    An annual update of the implementation of the Independent Living Strategy be brought to the Health and Adult Social Care Scrutiny Panel for the duration of the plan 2023-2027.

               ACTION: Lia Markwick, Service Development Manager/Governance

To note the Health and Adult Social Care Work Programme for 2023/24 will be discussed at the first meeting of the new municipal year.

NOTED that the Health and Adult Social Care Scrutiny Panel Work Programme for 2023/24 would be discussed at the first meeting of the new Municipal Year.

It was AGREED that the following items be put forward to the Work Planning meeting for consideration to added to the Health and Adult Social Care Scrutiny Panel Work Programme for 2023/24.

Primary Care Access to Services Update and Enfield Borough Partnership Update.

Women’s Health in Enfield – Update Report

Independent Living Strategy (2023-2027) update report in one year’s time.

   ACTION: Governance

To note the dates of the future meetings will be announced following Annual Council on Wednesday 10 May 2023.

NOTED that the dates of the future meetings of the Health and Adult Social Care Scrutiny Panel would be announced following Annual Council on Wednesday 10 May 2023.