Agenda and minutes

Scrutiny Health & Social Care Sub-Committee
Tuesday, 20th November, 2018 6.30 pm

Venue: Council Chamber, Town Hall, Katharine Street, Croydon CR0 1NX. View directions

Contact: Simon Trevaskis
02087266000  Email: simon.trevaskis@croydon.gov.uk

Items
No. Item

34/18

Minutes of the Previous Meeting pdf icon PDF 106 KB

To approve the minutes of the meeting held on 25 September 2018 as an accurate record.

 

Minutes:

The minutes of the meeting held on 25 September 2018 were agreed as an accurate record.

 

35/18

Disclosure of Interests

In accordance with the Council’s Code of Conduct and the statutory provisions of the Localism Act, Members and co-opted Members of the Council are reminded that it is a requirement to register disclosable pecuniary interests (DPIs) and gifts and hospitality to the value of which exceeds £50 or multiple gifts and/or instances of hospitality with a cumulative value of £50 or more when received from a single donor within a rolling twelve month period. In addition, Members and co-opted Members are reminded that unless their disclosable pecuniary interest is registered on the register of interests or is the subject of a pending notification to the Monitoring Officer, they are required to disclose those disclosable pecuniary interests at the meeting. This should be done by completing the Disclosure of Interest form and handing it to the Democratic Services representative at the start of the meeting. The Chair will then invite Members to make their disclosure orally at the commencement of Agenda item 3. Completed disclosure forms will be provided to the Monitoring Officer for inclusion on the Register of Members’ Interests.

 

Minutes:

There were none.

 

36/18

Urgent Business (if any)

To receive notice of any business not on the agenda which in the opinion of the Chair, by reason of special circumstances, be considered as a matter of urgency.

 

Minutes:

There were no items of urgent business.

 

37/18

King's College Hospital NHS Foundation Trust - Community Dental Service pdf icon PDF 220 KB

To receive an update from representatives from King's College Hospital NHS Foundation Trust on the Community Dental Service provided by the Trust in the Borough.

Additional documents:

Minutes:

The Director of Operations for King’s College Hospital NHS Foundation Trust, Chloe Cox introduced the item by apologising to the Sub-Committee for the Trust not having consulted with the Sub-Committee prior to the closure of the Community Dental Service at the Parkway Health Centre in New Addington and before patients were notified.  It was confirmed that the Trust had learnt from the process and it was not anticipated that a similar error would be made again.

During the introduction it was confirmed that the Trust had been providing Community Dental Services in 17 Community Health Centres across 9 London boroughs since 2016/17. As part of the operation of this service the estate was continually reviewed to ensure that the facilities kept up with best practice and in light of continuing financial pressures that they were as efficient as possible.

The decision to close the service located at the Parkway Health Centre was based on a number of factors including a utilisation rate of 50% against a Service average of 62%. There was also concern about the adequacy of the facilities at the centre, particularly the ability to meet decontamination standards and limitations upon the types of dental services that could be provided. The majority of the patients used the service on a short term referral basis, with only a small number of patients with longer term needs. With all these factors taken into account, the Trust concluded that it would be possible to offer patients higher quality services from other locations.

The Consultant in Special Care Dentistry and Head of Department for Community Special Care Dentistry, Doctor Rob Hale, provided Members with further background information on the Community Dental Service provided by the Trust, highlighting that the service was commissioned by NHS England and had a contract value of £8m per year.

When the Special Care Dentistry service was introduced by NHS England in 2017, it defined special care in the broadest sense, including patients with physical, mental health and learning difficulties.  As well as the service provided from Community Health Centres, the Trust also operated a mobile dental service that could be used to treat patients at home and services in schools and care homes. Over 35,000 appointments had been delivered by the Service in the past year, with 1,110 of these provided at the Parkway Health Centre.

Looking forward, any patient who had attending the Parkway Health Centre in the past two years would continue to have full access to the service. Patients would also benefit from the higher standard of the other sites, equipment and better access to treatment options. Patient transport would be available to take eligible patients to and from appointments and home visits would continue to be provided five days per week.

Following the introduction, the members of the Sub-Committee were provided with the opportunity to question the representatives from King’s College, with the threshold for eligibility for home visits and the types of services that could be provided queried. In response, it was  ...  view the full minutes text for item 37/18

38/18

Croydon Health Service NHS Trust pdf icon PDF 471 KB

To receive an update from Croydon Health Service NHS Trust on the action taken following the Care Quality Commission (CQC) inspection in July 2018.

Minutes:

The following representatives from the Croydon Health Service NHS Trust were in attendance at the meeting to provide an update for the Sub-Committee on the Trust’s response to their Care Quality Commission (CQC) inspection earlier this year:-

·         Dr Nnenna Osuji, Deputy Chief Executive,

·         Michael Fanning, Director of Nursing, Midwifery & Allied Health Professionals and

·         Wendy Frost, the Quality, Experience & Safety Programme Manager

The Sub-Committee were given the opportunity to question the representatives on the information provided in report, with the first question relating to what the Trust was doing to regain public trust following the previous inspection of core services by the CQC which had received an overall rating of ‘requires improvement’, particular as the rating had not improved following the inspection in July 2018. It was acknowledged that there was disappointment within the Trust that the overall rating had not improved, but also highlighted that the standard of care provided remained high.

Going forward it was necessary to ensure that the delivery of future improvement was robust and could be delivered within necessary timescales. As a result a number of key changes had been put in place, including the introduction of defined improvement methodology, the integration of the Quality team and a review of the use of data to enable the availability of real-time data.

In response to a question about whether the Trust had experienced issues with staff recruitment, it was confirmed that recruitment was a big issue across the health sector with the use of bank and agency staff increasing. The Trust had a preference for using bank staff, who as former hospital staff were familiar with services. As a follow up, it was questioned whether any steps had been taken to mitigate against any further staff issues potentially arising from Brexit. It was confirmed that the Trust had written to all staff who could be effected by Brexit to reassure them that they would help with the any registration costs.

In light of staff shortages, the Trust was working a scheme for international recruitment. The process for this was informed by the experience of other partners and organisations, with the first recruitment drive due to start in December. The focus of the recruitment drive would be to bolster the number of substantive staff members, with a view to alleviating the pressure on the existing workforce and provide continuity of care.

Given the ongoing staffing issues, the moral within the team was questioned. In response it was confirmed that morale was low across the NHS, but the team in Croydon were fairly resilient and able to rise to the challenge.

In response to a question about the use of technology, it was confirmed that the Skyguard application had been introduced to provide greater protection for staff lone working in isolated locations. Work also continued around the integration of patient data with the integration of community and in-patient data now complete. The next step was to integrate data with GPs and colleagues at the South London and Maudsley NHS  ...  view the full minutes text for item 38/18

39/18

Healthwatch Croydon pdf icon PDF 725 KB

To receive an update from the Croydon Healthwatch Manager on their recent activities in the Borough.

Additional documents:

Minutes:

The Manager from Healthwatch Croydon, Gordon Kay was in attendance at the meeting to provide an update on his organisations recent activities, during which it was confirmed that the Healthwatch service had been recommissioned with a new supplier in April 2018. The three existing staff members had transferred over to the new supplier and an additional staff member had been recruited.

The role of Healthwatch was to represent the views of residents and to commission insight reports on services, with a view to influencing service provision. The most recent report produced by Healthwatch had been delivered in conjunction with the charity Crisis, which was based on South Street in Croydon, and concerned the ability of street homeless to access health services such as GPs surgeries, which could be difficult without an address.

As a result of the findings from the review, the CCG had written to all surgeries in the borough to remind them of their responsibilities to register everybody regardless of whether they have an address or not. Discussions were also underway with Groundswell, a Homeless Health Peer Advocacy Service, which currently worked in central London boroughs to expand into the local area.

Healthwatch also organised a regular event called ‘Meet the Change Makers’, which aimed to get both Commissioners and residents together in the same room to discuss issues around healthcare provision.

Looking forward, Healthwatch would be undertaking reviews of the access to services for Black and Minority Ethnic residents and the experience of adults with autism accessing services.

In light of the Community Dental Service item discussed earlier in the evening, it was questioned whether Healthwatch had a role with the NHS when services were being commissioned. In response, it was advised that they should have a role as they could assist with patient engagement, but they were unaware of the changes being made to the Community Dental Service.

It was noted that the membership of the Sub-Committee allowed for a representative from Healthwatch to become a co-opted member. It was agreed that this would be followed up after the meeting. It was also highlighted that Healthwatch was in the process of recruiting Board Members and that further information would be circulated to Members.

Given concerns about the performance of some GP surgeries, particularly regarding access to appointments and immunisation rates, it was questioned whether Healthwatch had any plans for a review in this area. It was confirmed that performance was monitored and representatives from Healthwatch were based at different GP’s surgeries each Monday to get patients views on all aspects of the service.  They were also doing a piece of work around how long it took to register with a surgery, which was due to be published early in the new year.

Conclusions

The Sub-Committee reached the following conclusions:

  1. That the work of Healthwatch in the local area should be commended.
  2. That a representative from Healthwatch be invited to fill the vacancy for a co-opted member on the Sub-Committee.

40/18

Health & Social Care Sub-Committee Work Programme 2018/19 pdf icon PDF 111 KB

The Sub-Committee is to consider whether it wish to make any additions, amendments orchanges to the agreed work programme for the Committeein 2018/19.

Minutes:

It was agreed that an item on winter preparedness would be added to the work programme.

41/18

Exclusion of the Press and Public

The following motion is to be moved and seconded where it is proposed to exclude the press and public from the remainder of a meeting:

 

“That, under Section 100A(4) of the Local Government Act, 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information falling within those paragraphs indicated in Part 1 of Schedule 12A of the Local Government Act 1972, as amended.”

 

Minutes:

Not needed.