Agenda and draft minutes

Health Scrutiny Panel - Thursday, 23rd January, 2020 7.30 pm

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

Contact: Elaine Huckell 

No. Item


WELCOME & APOLOGIES (7.30pm - 7.35pm)


The Chair welcomed everyone to the meeting. Apologies for absence were received from Cllr Vicki Pite, Cllr Huseyin Akpinar and Cllr Elif Erbil. Cllr Yasmin Brett advised the Panel that she would need to leave the meeting at 8.00pm.


Apologies for absence were also received from Maria Kane, Chief Executive Officer of North Middlesex Hospital. Dr Emma Whicher was attending in Maria Kane’s absence.


The Chair announced that John Wardell, Chief Operating Officer for Enfield Clinical Commissioning Group had sadly passed away following a long illness. On behalf of the Health Scrutiny Panel, Cllr Boztas wished to send condolences to John’s family, friends and colleagues.   



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



No declarations of interest were received.



To receive a presentation from Maria Kane, Chief Executive Officer and Sarah Hayes, Chief Nurse.


RECEIVED a presentation from North Middlesex University Hospital Trust


NOTED that:



1.    Dr Emma Whicher, Medical Director and Sarah Hayes, Chief Nurse summarised the findings of the Care Quality Commission (CQC) inspection, carried out in 2019.


2.    The overall rating for the hospital remains as ‘requires improvement.’ This was also the overall rating following inspections in 2016 and 2018. An improvement on previous inspections has seen the ‘Well-led’ category move from ‘requires improvement’ to ‘good.’


3.    The CQC inspected 3 core services; Urgent and Emergency Services; Medical Care (including older people’s care) and Services for Children and Young People. Both Medical Care and Services for Children and Young People remained as ‘requires improvement.’ However, the rating for Urgent and Emergency Services moved from ‘requires improvement’ to ‘good.’


4.    The presentation highlighted some areas of outstanding practice, identified by the CQC, including the outreach programme to address gun and knife crime and the emergency kits provided to children who are taken in to care in an emergency.


5.    The CQC noted that the improvements in the ‘Well-led’ domain were supported by a strong culture of collaboration and team working.


6.    The inspection identified a number of areas for improvement: Strengthening nurse leadership within the divisions; Improving patient experience; Medicine management; Mental Capacity Act, Deprivation of Liberty Standards and restraint; Mandatory and statutory training and Clinical Strategy.


7.    To address some of these issues a new Chief Nurse has been appointed, along with a Head of Patient Experience. An improvement programme has been instigated to address medicine management procedures. A range of mandatory and statutory training courses have been developed for all staff to reflect the CQC findings. The clinical strategy is under development with the aim of developing programme boards which align to the NHS long term plan.


8.    It is likely that the CQC will carry out a further inspection during 2020, concentrating on the other core-service areas. A preparation plan has been produced which focuses on particular CQC domains on a monthly basis.


9.    The presentation concluded by highlighting the success of in-house flu-vaccination rates, health service awards and new Trust Board appointments.


The following issues and questions were raised:-



The Panel noted their disappointment that Maria Kane, CEO was unable to attend the meeting.


In response to a question, the Trust identified medicines management as an area of particular focus since the inspection along with nursing leadership.


The knife crime outreach programme was raised. The Trust were mirroring the approach taken in Glasgow, where knife crime is treated as a public health issue rather than just a crime intervention. The results show a reduction in knife crime in Glasgow and it is hoped that similar successes will be noted locally.


It was asked whether complementary work such as the knife crime programme takes focus away from the basic work of the hospital. It was explained that this is actually an integral activity an such intervention work can reduce the strain on the limited capacity of the hospital.  ...  view the full minutes text for item 225.


IMMUNISATION IN ENFIELD (8.25pm - 9.15pm) pdf icon PDF 508 KB

To receive presentations from Enfield Council Public Health Team and Enfield Clinical Commissioning Group.


To receive a report from Khalida Aziz, Christopher Salt and Dr Catherine Heffernan, NHS England and NHS Improvement.

Additional documents:


RECEIVED a presentation from Enfield Council Public Health Team, NHS England and Enfield Clinical Commissioning Group


NOTED that:


1.    Cllr Uddin (Cabinet Member for Public Health) gave an overview and highlighted the importance of immunisation for children and adults. Enfield Council is currently below the 95% target for immunisations, a position mirrored across London

2.    Stuart Lines (Director of Public Health) explained that the process of immunisation was complex in respect of who is responsible for commissioning, delivery and scrutiny. In addition to Enfield Council, NHS England and Enfield CCG both have a role to play in the provision of immunisations.

3.    Dr Catherine Heffernan, (Public Health England) advises NHS London on immunisation programmes and works closely with national and regional colleagues. 

4.    Sarah Woodhall (Speciality Registrar in Public Health - LBE) summarised the joint immunisation plan for Enfield and the key actions and successes, including the positive feedback from school nurses as consent rates increased.

5.    Deborah McBeal (Deputy Chief Officer – Enfield CCG) informed the Panel that the CCG don’t commission this service but act as a support to the GP Member practices.

6.    The CCG have recently recruited to the post of Immunisation Lead, who will analyse why take up is low and will work with vaccine hesitancy groups. In addition, Practice Nurses have recently had a training session on how to improve take-up by those who are reticent to have the treatment.

7.    A dedicated page on the CCG intranet provided practices and primary care networks with information on immunisations.

8.    CCG IT systems are being used to generate reminders and this was supported by NHS England who commented that when invited, most people would respond positively.

9.    Debbie Green (NHS England) commented that access to mobile telephone numbers is vital as a means of providing reminders, rather than by letter. In addition, the power of a recommendation from a GP or Health Visitor is very useful. Ease of access to the immunisation service was also noted as being very important to encourage increased take-up.

Cllr Boztas thanked everyone for the comprehensive presentation and the following issues and comments were raised: -


Gabriella Mitchell (Public Health Strategist – LBE) informed the panel of the work being undertaken in nurseries and schools to encourage parents of young children. Schools (especially faith schools) had shown an increase in immunisations.

In response to a question relating to why children had only one opportunity to have the flu-jab in schools, it was confirmed that ‘catch-up’ sessions were offered.


Views were sought on making MMR immunisation compulsory as in other countries, for example, Germany. The panel were informed that there were arguments for and against and it would be necessary to be all inclusive without any groups being excluded.


A statement was made about difficulties gaining access to a GP, with the shortage of GP numbers currently in Enfield. In addition, health related poverty was highlighted as an issue and the important role of the Health Visitor was acknowledged.


NHS England  ...  view the full minutes text for item 226.


WORK PROGRAMME 2019/20 (9.15pm - 9.20pm) pdf icon PDF 137 KB

To note the work programme.


The Work Programme for 2019/20 was noted.


Fazilla Amide, (Acting CEO of Enfield Healthwatch) offered to provide a presentation on continuing healthcare at the next meeting.


MINUTES OF THE PREVIOUS MEETING (9.20pm - 9.30pm) pdf icon PDF 95 KB

To agree the minutes of the meeting held on 10th September 2019.


The minutes from the meeting on 10th September 2019 were agreed.



The date of the next meeting will be 25th March 2020, 7.30pm.


The next meeting of the Health Scrutiny Panel will be on Wednesday 25th March at 7.30pm.


The meeting ended at 9.30pm.