Agenda and minutes

To approve the minutes of the meeting held on 28 January 2020 as an accurate record.

The minutes of the meeting held on 28 January 2020 were agreed as an accurate record.

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.

There were no disclosures of interest made at the meeting.

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.

There were no items of urgent business.

The Sub-Committee is provided with an update on emergency preparedness in Croydon with a view to informing a discussion on the information contained.

The Committee considered a report which provided an overview of the Council’s emergency preparedness and in particular its readiness to respond to the potential threat from Covid-19. The Director of Public Health, Rachel Flowers, introduced the report, during which the following was noted:-

• It was highlighted to the Sub-Committee that the situation surrounding Covid-19 was rapidly developing, with the update provided at the meeting based on the latest information available as of 10 March 2020.

(NOTE: The information provided at the meeting has since changed. The latest updates and guidance on Covid-19 can be found on the Public Health England website – https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response

• Croydon Council had a good reputation for responding to emergencies such as the riots in 2011 and flooding in 2014. The Council had also provided support for other London boroughs dealing with emergencies such as the Grenfell Tower fire.
• Covid-19 was a new strain of the Corona Virus, with instances first recorded in December 2019 in Wuhan, China. The Corona Virus was common throughout the world, but Covid-19 was a new strain, which in most cases had mild effects.
• Both NHS and Public Health England were well placed to deal with the outbreak of the new virus, with NHS 111 providing online guidance on Covid-19 to advise when treatment was needed.
• In order to prevent the spread of the virus it was recommended that anyone displaying the symptoms of Covid-19 should call 111 rather than visit their GP or local hospital, as it was passed on through close contact.
• It was important for people to follow public health advice, which was to wash their hands for 20 seconds, with hand sanitiser considered to be not as effective. It was also important to use tissues for cough and sneezes, and to avoid touching your eyes and mouth. The risk from Covid-19 remained low, but it was important to follow the guidance to minimise the risk of the virus spreading.
• To date there had been 373 confirmed cases of Covid-19 in the UK, with one in Croydon.
• One of the key challenges for Public Health England was how the virus was reported in the media, with a need to provide reassurance for the public.

It was confirmed that the Croydon Health Service NHS Trust (CHS) had been testing patients displaying symptoms of Covid-19 for the past three weeks at the Croydon University Hospital. Testing had now been extended to the community to help contain the virus.  The facilities at the hospital could be upscaled as required should it be needed in the coming months.

It was highlighted that there had been a similar experience in 2009 with Swine Flu, with the guidance focussed on ensuring a measured response. As the virus had only been identified in December 2019, healthcare professionals were still learning how to identify and treat Covid-19, with the genome for the virus recently mapped by Public Health England. At the moment there was a reasonable level of confidence that the systems were in place should  ...  view the full minutes text for item 11/20

The Sub-Committee is provided with an update on the performance of urgent and emergency care at Croydon University Hospital with a view to informing a discussion on the information contained.

The Committee considered a report which provided an overview on the current performance of the urgent and emergency care department at Croydon University Hospital. The report was introduced by the Chief Operating Officer for Croydon Health Services NHS Trust (CHS), Lee McPhail. During the introduction the following was noted.

• The report provided an overview of the outcomes from a high impact Improvement Programme that originally commenced twelve months ago and was targeted towards improving the responsiveness of urgent and emergency care for patients from the front door and throughout the service,
• The programme had been developed in response to a particularly difficult January and February 2019 and had seen month on month improvement in most areas throughout the summer and autumn, while also highlighting key areas of weakness such as the length of stay for patients.
• As a result, performance on the number of patients having to stay in hospital longer than 3 weeks had notably improved, with the service at one point being the most improved in London for this indicator.
• CHS had been successful in its bid for the AEC Accelerator Programme which would deliver further improvement for same day emergency care, with an increased number of patients being treated in an ambulatory environment rather than in the emergency department. 
• The winter period had seen some of the progress made go backwards, with a difficult December and January. This was in part to pressures at other hospitals having a knock on effect on Croydon University Hospital. As a result the additional bed capacity available at the hospital had been opened for an extended period.
• Initial data for February indicated that progress was starting to be made again, with the length of patients stays improving.
• It had been indicated by the Government that the target waiting time of four hours for emergency care was likely to remain in place, along with other targets focused on the quality of care to patients.
• Two of the key areas going forward were to ensure that the hospital was in a position to meet the new clinical standards and continuing to drive down the length of patient stay. Another part of the national mandate was for hospitals in normal circumstances to be operating at 92% capacity.

Following up from the introduction the Sub-Committee questioned how whether the capacity target was achievable. It was acknowledged that this would be a challenge for most hospitals, with Croydon University Hospital’s own capacity often nearer to 98%.

Regarding the performance data provided on London Ambulance Service handover times of over 30 minutes, which were currently above 20%, it was questioned whether the 5% target was achievable. It was advised that for the majority of the past year the figures were closer to the 5% target with the performance at Croydon University Hospital one of the most improved in London. However during the winter period there had been issues with congestion in the emergency unit and also spikes in attendance that had increased handover times.

A key area  ...  view the full minutes text for item 12/20

The Sub-Committee is provided with an update on the ongoing integration journey for its information.

The Sub-Committee considered a report which provided an update on the ongoing health integration programme in the borough. The report was introduced by the Joint Croydon Health Services Chief Executive and Place-Based Leader for Health, Matthew Kershaw, during which it was confirmed that the next phase of the integration programme would commence from 1 April 2020.

From April the newly merged South West London Clinical Commissioning Group (SWCCG) would go live, along with the introduction of the Committee in Common between SWCCG and the Croydon Health Services NHS Trust (CHS) which would be chaired by Mike Bell and Agnelo Fernandes. There would also be a shadow Health and Care Board established, which would include representation from the care sector, prior to the launch of a full board in 2021. The introduction of the Health and Care Board would follow a phased approach with representatives from the Adults service involved in the first instance before expanding to include representation from Children services.

Reassurance was given to the Sub-Committee that GPs were on board with the proposals and were working closely with others to develop the integration programme as it progressed, building on the work of the One Croydon Alliance. It was also highlighted that approximately 80% of GP’s in the borough had voted in support of the SWCCG proposals.

Regarding the ongoing consultation over the Improving Healthcare Together proposals that would affect acute care provision at Epsom, St Helier and Sutton Hospitals, it was highlighted that Healthwatch were planning to hold a community meeting later in March to discuss the potential impact upon people in Croydon.

The CHS response to the consultation had been based upon modelling of the three proposed options, which had indicated that should the acute site be located at St Helier the impact would be largely neutral, if it went to Sutton it would slightly reduce demand, with the biggest impact arising if the service was located at Epsom, which would require additional resources to build capacity at the Croydon University Hospital.

It was confirmed that the Vice-Chair was due to attend a meeting of the South West London & Surrey Joint Health Overview and Scrutiny Committee’s Sub-Committee on Improving Healthcare Together and would be able to report back at the Sub-Committee’s next meeting on 21 April 2020.

It was advised that the three aims of the Integration Programme were to deliver effective services that delivered outcomes for residents, efficient services that made the most of existing resources across health and care including the possibility of transferring resource between organisation, and ethical services that placed the NHS as an anchor institution influencing regeneration and tackling health inequalities in the borough.

In summarising the item the Chair noted that given the importance of the integration programme to the provision of both health and care in the borough, it was agreed that the Sub-Committee would need to continue to monitor its implementation throughout 2020-21 to ensure that the new governance arrangements were working and that improved outcomes for residents were  ...  view the full minutes text for item 13/20

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.”

This motion was not required.