Items
No. |
Item |
1. |
Minutes of the meeting held on 21 October 2014 PDF 67 KB
Decision:
Resolved: to agree the minutes of the meeting
held on 21 October as an accurate record.
Minutes:
Resolved: to agree the minutes of the meeting
held on 21 October as an accurate record.
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2. |
Declarations of interest PDF 26 KB
Minutes:
Councillor Paschoud – non-prejudicial
– member of Lewisham Parent Carers Forum, which also includes
CLASH.
Councillor Raven – non-prejudicial
– member of CLASH
Councillor Muldoon – non-prejudicial
– Lead Governor of SLaM NHS Foundation Trust.
Councillor Bell – non-prejudicial
– board director of Lewisham Homes
Councillor Kennedy – non-prejudicial
– board member of the Marsha Phoenix Trust.
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3. |
Emergency services review update: London Ambulance Service PDF 16 KB
Additional documents:
Decision:
Resolved: to note the report.
Minutes:
3.1 Graham
Norton (Operations Manager, Lewisham, London Ambulance Service) and
Kevin Brown (Assistant Director, Operations, London Ambulance
Service) provided an update on the performance of the service; the
following key points were noted:
- At a previous meeting
of the Committee, Members received information about the London
Ambulance Service’s (LAS) improvement plans.
- A roster review to
ensure adequate staffing cover was completed in September 2014.
Work was on-going on implementing improvements to rest breaks;
annual leave and active area cover.
- Ambulance crew
handovers and waiting times at hospitals had been improved by the
implementation of a new policy. Work with the urgent care centre at
Lewisham Hospital had also improved.
- The service remained
under demand and under pressure. It was on course to receive more
than 1.9 million calls this year.
- Changes had been
implemented to the control room to allow telephone advice to be
given to non-urgent calls and to redirect people with minor
injuries to appropriate services.
- Work had taken place
with the Metropolitan Police Service to reduce the number of
unnecessary calls made for ambulances; this included using fast
response vehicles; providing telephone advice and providing access
to mental health advice through the call control hub.
- 7.39% of calls from
NHS111 had been referred back to the service to provide an
ambulance. The service responded to 5299 calls per day. 700 of
these were referred to NHS111.
- There was a
recognised shortage of staff. The service would be recruiting in
Australia and New Zealand to fill vacancies; 250 staff would be
recruited by April.
- Plans were being put
in place to ensure that new paramedics would be trained. However,
it took a minimum of three years to train a paramedic.
- 150 to 180 staff were
lost from the service each year.
- There were multiple
reasons for the reduction, including, the impact of assaults on
staff, housing costs and travel times as well as the high level of
demand on the service.
- Fewer recruits felt
that being a paramedic was a long term career choice.
- In total 850 to 1000
staff would need to be recruited over the next year to bring the
service up to strength and to balance out the number of people
leaving.
- Attendance times
across London remained close to the national target at 61.75% of
priority calls reached within eight minutes, against a target of
75%; in Lewisham the most recent attendance time figure was
64.7%.
- Attendance times had
to be viewed in the context of the high levels of demand and the
complexity of the urban environment. The service remained close to
its maximum levels of utilisation, levels were currently
88%.
- Despite high levels
of utilisation, the service had retained high quality standards for
treatment of cardiac arrest and stroke.
- Levels of
coordination and communication with hospitals and clinical
commissioning groups had enhanced good practice.
3.2 Graham
Norton (Operations Manager, Lewisham, London Ambulance Service) and
Kevin Brown (Assistant Director, Operations, London Ambulance
Service) responded to questions from the Committee, the following
key points were ...
view the full minutes text for item 3.
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4. |
Community mental health review: update PDF 30 KB
Decision:
Resolved: to note the report. The Committee
also agreed that the Chair would write to the Chair of SLaM setting
out the concerns raised about the complaints process.
Minutes:
4.1 Fran
Bristow (Programme Director, Adult Mental Health Development
Programme, SLaM) introduced the report; the following key points
were noted:
- The report provided an
update on the issues raised when the community mental health
programme was considered at the Committee’s meeting in
July.
- Several issues were
highlighted by the Committee, including: the compatibility of the
changes being proposed with NICE guidance; responses to complaints,
with specific reference to an MP enquiry; and the handover process
for patients.
- The changes that had been
made were in line with NICE guidance.
- New services were being
provided as part of the changes, including additional talking
therapies; day treatment services and options for
self-management.
- The nature of some mental
health conditions meant that there were long cycles of illness and
relapse.
- Day treatment services
were being made available for a longer period in order to avoid
instances of relapse and hospitalisation.
- Primary and secondary
services were working together. Patients could access specialised
care quickly through their GPs when it was required.
4.2 Fran
Bristow (Programme Director, Adult Mental Health Development
Programme, SLaM), responded to questions from the Committee, the
following key points were noted:
- Emergency cases could be
referred within 2-4 hours, critical cases could be seen within
24-48 hours and non-urgent cases should be seen within 28 days.
SLaM was outperforming its objective for non-urgent cases and most
were seen within 7 to 10 days.
- By the end of September,
all moves of patients to new teams within SLaM had been
completed.
- 299 people were being
treated for bi-polar disorder; of these, 295 people were still
receiving support from SLaM.
- A number of patients had
to be moved between services, in line with the new structure. There
had been some anxiety about the changes.
- It would have been
difficult to implement changes and develop specialist community
services without moving people between teams.
- 46 complaints had been
received between 1st April and 30th September
2014.
- Only three of these
complains were about moves within SLaM.
- The complaints service
kept data about the number of complaints received and their
outcomes.
- Each of the complaints
raised by people who were moving services had been resolved.
- No serious incidents had
been recorded as a result of the changes; but lessons could be
learnt about the process of the reconfiguration.
- Complaints were usually
responded to within 20 working days. However, the response to Heidi
Alexander MP had been delayed because it had originally been dealt
with in the wrong department; when it reached the right department,
due to the complexity of the case, it took some time to provide a
full response.
- All care was overseen by
clinical leaders – including consultants, where
necessary.
- There had been an increase
of mental health conditions across the country; there was no
specific upward trend in Lewisham.
4.3 The
Committee also discussed the report and raised its concerns about
the time it took to respond to the complaint from Heidi Alexander.
Members were concerned the amount of time it ...
view the full minutes text for item 4.
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5. |
Autism strategy PDF 256 KB
Decision:
Resolved: to note the report, and to refer the
Committee’s views to Mayor and Cabinet.
Minutes:
5.1 Corrine
Moocarme (Joint Commissioning Lead) and Dave Shiress (Housing,
Health and Social Care Integration Project Manager) introduced the
report; the following key points were noted:
- Previous reports had
been submitted to Lewisham’s Health and Wellbeing Board,
which provided an update on the national Autism Strategy up to July
2014.
- The report included
information about the work that had taken place in the last six
months, with a particular focus on work to provide
accommodation.
- Autism awareness
training had been carried out with GPs and the diagnostic rates
would be audited.
- Three possible
options had been identified for the provision of specialist
housing.
5.2 Rita
Craft (Chair of the Campaign in Lewisham for Autism Spectrum
Housing (CLASH)) addressed the committee; the following key points
were noted:
- There were
approximately 2000 autistic people living in Lewisham, many of whom
were not known to Council services.
- Autistic adults
required help to live independently; this help was not being
routinely provided in Lewisham.
- Members of CLASH were
concerned about what would happen to their autistic children and
loved ones in the longer term, if there were no facilities to
support independence.
- Funding was
available, through the Mayor of London’s Care & Support
Specialised Housing Fund 2012, but this had not been used to
provide specialist housing in Lewisham.
- Lewisham had
responded well to the development of the national Autism Strategy
by establishing a diagnostic service, a support service for adults
with Asperger’s as well as developing Drumbeat School, and
offering training to health professionals.
- CLASH wanted a
specialist employment service and specialist housing for autistic
people to build on this work.
- Without a plan for
the development of specialist employment and housing opportunities
for young people, the costs of support could be high in the long
term.
- Those who remained
living with their ageing parents, and who were not offered
independence skills training would probably need crisis
intervention, when those parents became ill, or died, which might
become costly for other local services.
5.3 Dave
Shiress (Housing, Health and Social Care Integration Manager)
responded to questions from the Committee; the following key points
were noted:
- Lewisham’s new
housing strategy was currently being consulted on. It would include
a reference to the need for specialist housing, including from
people with autism, but this group would not be prioritised over
the claims of other groups.
- Funding from the
Mayor of London was used to develop Extra Care housing for older
people.
- People with low level
support needs, who did not meet the fair access to care services
criteria used to be supported by supporting people funding, which
was no longer available.
- The Burgess Autistic
Trust worked with registered social landlords in Bromley to provide
specialist housing. This was a reason for optimism, because this
arrangement had been shown to work in a neighbouring borough and
the potential the Trust would have the capacity to extend this work
into Lewisham.
- The Burgess Trust had
started its project in Bromley by identifying a suitable empty
property to use. ... view
the full minutes text for item 5.
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6. |
Leisure contracts PDF 63 KB
Additional documents:
Decision:
Resolved: to note the report and to consider
an item at a future meeting on the performance of the Fusion
leisure contract.
Minutes:
6.1 David
Walton (Community Assets Manager) introduced the report; the
following key points were noted:
- Usage of the
borough’s leisure facilities had significantly increased, led
by the opening of Glass Mill leisure centre.
- Monitoring
information indicated that 45% of regular users had a BeActive
card, indicating that the Council was meeting the objective of
increasing participation in all parts of the
population.
- There had been a
number of other recent positive community and social
projects.
- It was recognised
that the Bridge was the weakest link in the leisure
contract.
- Some defects had been
identified at Glass Mill, but these were being rectified in line
with the contract.
6.2 David
Walton (Community Assets Manager) and Aileen Buckton (Executive
Director for Community Services) responded to questions from the
Committee, the following key points were noted:
- The contract was
‘self-monitoring’, but the contractor was obliged to
report issues to the Council.
- The term
‘self-monitoring’ referred to the structure of the
contract, in practice there were regular formal and informal site
visits by the contract monitoring officer.
- Fusion were also
responsible for reporting user feedback and responding to
complaints.
- The contract was
outcome based, so it was up to the contractor to decide how it
would meet the specifications requested.
- Action had been taken
against the contractor and fines had been applied in a number of
instances, where problems had been identified.
- The defects at Glass
Mill leisure centre were the responsibility of the developer
(Barratt) to rectify and not the leisure contractor (Fusion), but
difficulties with new buildings were not uncommon.
- The Bridge leisure
centre was nearing the end of its useful life. There was no
investment element in the Fusion contract, so some improvement
works would take place, but there would not be any major
refurbishment of the site.
- Concerns about the
quality of the Fusion cleaning contract were recognised and had
been raised with the contractor.
- On the list of works
to be carried out at the Bridge were: the painting of the sports
hall; new gym flooring; air conditioning; repairs to the ceiling
above the main pool; retiling in wet areas as well as works to the
drains to resolve a longstanding issue.
- Work would be started
in the New Year, with much being completed by the end of the
financial year. However, a precise timescale for the completion of
works could not be given.
- Disabled people
should not be turned away from using leisure facilities. Any
reported cases should be passed to officers.
- Further work would be
carried out to determine why the levels of exercise on referral
were low.
- The swimming ability
of school age children was a concern. The inability of a proportion
of school age children to swim was the result of a combination of a
number of factors; officers were working on initiatives to improve
swimming ability of children.
6.3 In
response to a question about the Committee’s ability to
review the key performance indicators of the Fusion contract,
Georgina Nunney (Principal Lawyer) advised that ...
view
the full minutes text for item 6.
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7. |
Sustainability of community health initiatives PDF 108 KB
Decision:
Resolved: to note the report and to refer the
Committee’s views to Mayor and Cabinet.
Minutes:
7.1 Alfred
Banya (Assistant Director of Public Health) introduced the report;
the following key points were noted:
- The Council had
sustainability plans in place for initiatives in various areas of
the borough, co-terminus with the new neighbourhood model of
working.
- It would be important
to ensure that future schemes built on the local knowledge that had
been developed with the creation of Lewisham’s community
health initiatives.
- Research by the
University of East London had demonstrated the effectiveness of
Lewisham’s community health initiatives.
- Lewisham’s
programme was a strong candidate for phase three funding from the
Greater London Assembly.
Resolved: to note the report
and to refer the Committee’s views to Mayor and
Cabinet.
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8. |
Lewisham Future Programme: public health consultation PDF 39 KB
Additional documents:
Decision:
Resolved: to note the
report, and to receive the outcome of the consultation at
the Committee’s meeting on 14 January.
Minutes:
8.1 Aileen
Buckton (Executive Director for Community Services) introduced the
report; the following key points were noted:
- The Committee was
being asked to comment on the consultation process and the
proposals themselves.
- The proposals, once
they had been consulted on, might represent a substantial change in
services.
- Reconfiguration of
some services would be required, but this would not impact widely
on frontline services.
- The move of Public
Health to the local authority had highlighted areas of overlap in
the delivery of services.
- It had been
recognised that there were some areas of work which should be taken
on by others, including the CCG; there were also some services that
the Council had not been providing, which it had a responsibility
for, and would represent an additional cost.
- It was proposed to
end incentives to GPs practices to meet public health
outcomes.
- Main grant programme
funding would be used to provide advice and information services,
aligning the previous funding that had been given by public
health.
- The CCG had indicated
that it would be able to respond to the consultation within the two
week timetable.
- Depending on the
outcome of the meeting – officers would be meeting with
officers of the CCG to further discuss the proposals.
8.2 Danny
Ruta (Director of Public Health) also advised the Committee that it
was his responsibility to ensure that the proposed changes would be
carefully monitored – and that there would be no detriment to
the achievement of public health outcomes.
8.3 Officers
were not sure where the funding being saved from the public health
budget would be spent; further work would take place after the
consultation had been completed.
Resolved: to note the report,
and to receive the outcome of the consultation at the
Committee’s meeting on 14 January.
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9. |
Select Committee work programme PDF 96 KB
Additional documents:
Minutes:
9.1 Timothy
Andrew (Scrutiny Manager) introduced the work programme report. The
Committee resolved that the Chair would be asked to make decisions
about the work programme at agenda planning, incorporating the
items agreed during the course of the meeting.
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10. |
Referrals to Mayor and Cabinet
Decision:
Resolved: to refer the Committee’s views
on items five and seven to Mayor and Cabinet.
Minutes:
Resolved: to refer the
Committee’s views under items five and seven to Mayor and
Cabinet as follows-
Item 5
10.1 At its meeting on 2
December 2014 the Healthier Communities Select Committee, having
heard presentations from officers and received an address from Rita
Craft, Chair of the Campaign in Lewisham for Autism Spectrum
Housing, resolved to refer the following matter to Mayor and
Cabinet:
10.2 The Committee
requests that the Mayor consider urgently, provision to meet the
housing needs of adults diagnosed with autism spectrum disorder. To
this end the Committee recommends that the Mayor engage with CLASH
and Lewisham Homes.
Item 7
10.3 The Committee
wishes to highlight the value and success of community health
initiatives in Bellingham and North Lewisham and it welcomes
efforts to extend funding for Well London phase 3.
10.4 The Committee
places on record its support for Well London and similar projects
and asks the Mayor to do the same. The Committee recommends that
Mayor and Cabinet provide all possible support for work on
extending the project beyond 2015.
</AI10>
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