Agenda and minutes

Health Scrutiny Panel
Tuesday, 10th September, 2019 7.30 pm

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

Contact: Elaine Huckell 

No. Item




The Chair welcomed everyone to the meeting. Apologies for absence were received from Cllr Huseyin Akpinar and Cllr Elif Erbil.



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



There were no declarations of interest.



To receive a presentation from Natalie Forest, Chief Executive and Director of Nursing.  Following the presentation, there will be a discussion relating to the recent feasibility study, the Urgent Care Centre and phlebotomy services.


RECEIVED a presentation from Natalie Forrest relating to the new building and service provision at Chase Farm Hospital.


NOTED that:


1.    Having taken only 2 years to build, the new facility was opened in September 2018, on time and on budget. A core workforce of 300 is supplemented by specialist doctors and nursing, taking the staff numbers up to 1,000.

2.    The Care Quality Commission inspection in May 2019 gave an overall rating of ‘good’ for the hospital.

3.    85% of elective surgery patients are treated as day cases but patients with more serious conditions eg, hip replacements are admitted to one of the 42 single bed recovery rooms which provide on-suite facilities and an entertainment system.

4.     The range of treatments available in the Urgent Care Centre (UCC) was highlighted, including sprains, strains and broken bones. The UCC is equipped to perform a series of tests including x-rays and ECGs.

5.    The UCC has a target of 80% of patients being treated within 2 hours of arrival and this has been achieved every month to date in 2019. In addition, on the day before the Health Scrutiny meeting, 100% of patients were assessed and treated within the 2-hour target time.

6.    The numbers of patients using the UCC is increasing and will continue to increase with more of the new housing on the old hospital site being occupied.

7.    The hospital has achieved a Stage 6 in digital applications, one of the highest for a hospital trust. Some of the applications include electronic patient records, patient navigation and digital nurse call.

8.    Electronic patient records ensure that only one copy exists, providing greater efficiency.  


The following questions/issues were raised: -


In response to a question from Cllr Boztas, it was confirmed that the last

patient admitted to the UCC is at 9.00pm. Patients arriving after 9.00pm are re-directed to the Barndoc service, co-located with the UCC.


It was noted that the information on the website for Chase Side Hospital, relating to the access times of the UCC could be misleading. It was confirmed that this would be reviewed.


Cllr Neville asked whether, as the number of patients increases, are the reasons for attending tracked. The hospital is developing a strategy to encourage patients to use the most appropriate pathway, including the GP hubs.


Cllr Pite queried what proportion of patients make an inappropriate choice by visiting the UCC? In response, it is estimated that approximately 40% could make a GP appointment and wait to be seen.


Richard Gourlay commented that only 10-15% of patients presenting at North Middlesex Hospital A&E Department are admitted for further treatment.


This was emphasised by the Healthwatch Enfield Survey, undertaken at North Middlesex Hospital which highlighted that 89% of patients attending A&E were discharged to GP or self-care.


Members had attended a tour of the UCC and surgical wards earlier in the month. One of the issues raised was funding for changing dressings. Often, patients attend the UCC requesting that dressings are  ...  view the full minutes text for item 218.



Deborah McBeal, Director of Primary Care Commissioning/ Deputy Chief Officer and Laura Andrews, Senior Engagement Manager from Enfield Clinical Commissioning Group will provide a verbal update on walk-in services at the four geographic hub sites.  A letter from Enfield CCG to Health Scrutiny is included for reference.



RECEIVED a verbal update from Deborah McBeal and Laura Andrews


NOTED that:

1.    Cllr Boztas introduced this item and referenced the meeting that representatives from the Health Scrutiny Panel had with the CCG in August, when the issue was discussed initially. 

2.    Deborah McBeal outlined the minor amendments to be undertaken across the 4 geographic GP hubs – Eagle House, Evergreen, Carlton House and Woodberry.

3.    The GP hubs offer extended hours, Monday to Friday and 8.00am-8.00pm on Saturday and Sunday.

4.    There are 2 elements to the current service. The pre-bookable appointment system (in person or via telephone) and the walk-in service, however, it has been established that this is not an efficient use of resources.  The walk-in service is provided in 3 of the 4 hubs (not available at Woodberry)  

5.    The pre-bookable appointment system will remain but the walk-in service will be withdrawn. When somebody presents at the hub, they will be offered an appointment that day, rather than wait an unspecified amount of time. This will allow the pre-bookable system to be fully utilised, providing a more efficient and cost-effective use of resources. 

6.    In addition, hub staff will re-direct patients as necessary, including to pharmacy services or self-care..

7.    Neighbouring CCGs have been advised of this proposal.

8.    The engagement and communication plan was explained which will include work with community groups, patient groups and GP member practices. Signage will be adjusted as necessary and websites updated.


The following questions/issues were raised:-



Cllr Boztas queried when the amendment to service provision would take place. Deborah McBeal confirmed that the transition will begin on 1St October.


Cllr De Silva commented that it was very useful to meet with the CCG in August and then hear how the proposals have developed to date.


In response to a question on how the modelling would be implemented, the CCG confirmed that numbers of patients presenting for a walk-in appointment would be tracked and services amended as appropriate.


Cllr Brett commented that it was important to dispel any thought that this is a rationing of services and it was important to publicise which services are available. The CCG responded by confirming that comments from community groups would be addressed and patients would be directed and treated as appropriate.


Cllr Brett further commented that Patient Participation Groups are not necessarily representative of community groups and the CCG agreed that this needs to be addressed.


The Panel agreed with Cllr Neville’s comment that with better management of how we use the extended hours services and with appropriate pathway advice, this change to service provision could be viewed as an improvement.


Cllr Pite, referring to triage processes, commented that the 111 service asks a range of questions when a patient calls, however when a GP surgery is called there is very little triage undertaken. A concern was raised that GP administrative staff should be adequately trained in being able to re-direct patients to the most appropriate care-pathway.


Patricia Mecinska  ...  view the full minutes text for item 219.



To agree the work programme for 2019/20



Following a discussion, the Panel agreed to swap the items for the January and March 2020 meetings. The January meeting will now include the result of the CQC inspection at North Middlesex Hospital and in addition, immunisation services in Enfield.


The March meeting will include Continuing Health Care, GP and Primary Care Networks and /or Elective Orthopaedic Consultation.


In future, timed agendas will be produced to allow greater efficiency of the time allocated for each meeting.




To receive the minutes of the meetings held on the 14 March 2019 and 11 June 2019.

Additional documents:


The minutes of the meetings of the 14 March 2019 and 11 June 2019 were AGREED.



The dates of future meetings are as follows:


23 January 2020, 7.30pm


25 March 2020, 7.30pm


The dates of future meetings are as follows:


23 January 2020, 7.30pm


25 March 2020, 7.30pm.