Agenda and minutes

1.1 RESOLVED: The Committee confirmed Cllr John Muldoon as Chair and

Cllr Stella Jeffrey as Vice Chair.

2.1 RESOLVED: That the minutes of the meeting held on 19 March 2013 be

signed as an accurate record of the meeting.

3.1 Councillor Muldoon declared a non-prejudicial interest as an elected

Governor of the South London and Maudsley NHS Foundation Trust

(SLaM) Council of Governors.

4.1 Rebecca Scott, Programme Director – Dulwich; and Malcolm Hines – Chief Finance officer, introduced the report and the following key points were

noted:

• The new Southwark Clinical Commissioning Group (SCCG) is

aiming to improve community access to healthcare in the south of

Southwark.

• Even though the health services are in Southwark, there are over

5,000 residents from Forest Hill ward registered with Southwark

GPs, and a few hundred from Crofton Park, Telegraph Hill and

Perry Vale.

• There was an initial ‘engagement period’ last year for 3 months,

which had over 1,000 responses. This helped narrow the

proposals for the main consultation which runs from 28 February

2013-31 May 2013.

• Another aim of the consultation is to improve community access

to health care related to long-term conditions. Services need to

be reviewed as Southwark’s population is predicted to increase

11-12% in the next 8-10 years, and a significant amount of that

increase will be in the 20yo-40yo age range.

• The Business Case is scheduled to be approved in late

2013/early 2014, and services to be commissioned over the next

two years.

• It’s highly likely that Dulwich Community Hospital site will be

developed in conjunction with Southwark Council as part of the

improvement in services.

• The proposals suggest that services could be accessed via a

local GP, a nearby GP or health centre, or a larger health centre,

which is likely to be on the Dulwich Community Hospital site.

• Two options are proposed in the consultation document, Option

A, which is a more centralised system, or Option B is a more

decentralised system.

4.2 In response to questions, the Committee were informed that:

• South East London Doctors On Call (SELDOC) is still based at

Dulwich Community Hospital, but it’s not envisaged that it will

permanently remain at the site.

• Dulwich Community Hospital is earmarked as the main health

centre, as other potential sites are not central and do not have as

much space.

• There is a Renal Dialysis Unit at Dulwich Hospital which could be

moved if necessary; however Kings, who provide the service, are

keen to remain on site.

• The consultation concentrates on the south of Southwark as the

opportunity has arisen to improve the services in this area, and

also provides an opportunity to release the £2m running costs for

Dulwich Community Hospital.

• Officers recognise that public transport to the Dulwich Hospital

site from the Forest Hill area is currently not ideal. They will

explore this further with Transport for London (TfL).

• SCCG officers would be happy to visit the Local Assembly of

Lewisham ward, primarily Forest Hill, to engage with residents.

4.3 RESOLVED: that

a) the Committee ask Southwark CCG to consult with the Forest Hill Local

Assembly before the consultation closes on 31 May 2013; and

b) Southwark CCG returns to the Committee at its September meeting to

update the Committee on the conclusions of the consultation.

5.1 Joy Ellery - Director of Knowledge, Governance and Communications,

Lewisham Healthcare Trust and Lynn Saunders - Director of Business

Development and Planning Lewisham Healthcare Trust introduced the

report and the following key points were noted:

• The Secretary of State for Health’s decision on the TSA report for

South London Healthcare Trust (SLHT) slightly altered the

recommendations in the report.

• The Secretary of State for Health decided that Lewisham Hospital

should have a smaller, fully-admitting Accident & Emergency (A&E).

• Lewisham Hospital, in light of the Secretary of State’s decision, has

been analysing the impact the recommendations will have on all of

their services.

• The Judicial Review of the Secretary of State’s decision in relation to

Lewisham Hospital is due to be heard over a three day hearing

between late May and mid-July. Its outcome will influence the

planning of services.

• In terms of the TSA recommendation to merge Queen Elizabeth

Hospital with Lewisham Hospital, Lewisham Healthcare Trust

supports this recommendation.

• Lewisham Healthcare Trust are already planning for the proposed

merger to ensure that there is a smooth and safe transition to the

new organisation so it is working effectively from day one.

• It is proposed that it will be merger by acquisition, which means

Lewisham will acquire Queen Elizabeth Hospital, with Lewisham’s

Board remaining in place.

• Work is being carried out to ensure that the bureaucracy for each

work stream (e.g. finance, governance) is fully integrated once the

merger is complete.

• Lewisham Healthcare Trust will be contacting stakeholder groups to

engage with them as the planning for the merger continues.

• Work has commenced to produce a Business Plan for the merger, to

be reviewed by the NHS Trust Development Authority (NTDA) at the

end of May.

• The ‘transaction date’ for the merger has been set at 1 July, but is

unlikely to happen at this time. The NTDA have appointed a

Programme Director for Transactions who is currently reviewing the

timetable.

• A Due Diligence questionnaire has been developed with legal

advice, and submitted to SLHT, providing a comprehensive

information request to see how the organisation is being run at

present.

• The key Clinical appointments will soon be made in anticipation of

theproposed merger.

• Consultation with staff at SLHT has begun to place. It is expected

that staff at SLHT would be integrated into the merged organisation.

• The Foundation Trust application has being put on hold until the

integration is complete.

• Lewisham Healthcare Trust have launched a ‘Business As Usual’

campaign to let residents know that Lewisham Hospital is operating

as normal at the present time. Also a staff survey has shown that

Lewisham Healthcare Trust is in the top 20% of organisations where

workers would recommend Lewisham Hospital to family and friends

if they needed treatment.

• The original TSA Special Administrator Matthew Kershaw has now

moved on to be the Chief Executive of Brighton and Sussex

University Hospitals NHS Trust.  ...  view the full minutes text for item 5.

6.1 Sarah Wainer, Head of Strategy & Performance, and Danny Ruta, Director of Public Health, NHS Lewisham, introduced the report and the following key points were made:

• It is a legislative requirement for Health and Wellbeing Boards to

produce a Health and Wellbeing Strategy.

• The Council is committed to improving the health and wellbeing of

citizens in Lewisham. In Shaping our future – Lewisham’s

Sustainable Community Strategy, one of the priority objectives that

all partners will work towards is that the borough and its communities

should be ‘Healthy, active and enjoyable – where people can actively

participate in maintaining and improving their health and wellbeing’.

• The engagement process has consisted of a number of events

between December 2012-April 2013.

• Key messages arising from the engagement so far include:

o The negative impact of social isolation on people’s physical

and mental health and wellbeing

o The numerous barriers that hinder people from pursuing a

healthy lifestyle, from cost and access to a lack of confidence

to turn up and engage with existing activities.

o The existence of a range of opportunities and activities,

already provided within the community that could support

people to feel healthier and maintain their independence.

• Lewisham produced its first Joint Strategic Needs Assessment,

Health, Well-being and Care in 2010. It has subsequently produced

an online version, accessible at www.lewishamjsna.org.uk. This has

helped to form the priorities of the Shadow Health and Wellbeing

Board.

• The CCG has worked to align its priorities with the key areas of focus

identified by the Shadow Health and Wellbeing Board.

• The draft strategy has identified nine priority areas and they are as

follows:

o Increase the uptake of immunisation

o Prevent the uptake of smoking among children and young

people and reduce the numbers of people smoking

o Reduce the harm caused by alcohol misuse

o Promote healthy weight

o Improve mental health and wellbeing

o Improve sexual health

o Delay and reduce the need for long-term care and support

o Reduce the number of emergency admissions for people with

chronic long-term conditions

o Increase the number of people who survive colorectal, breast

and lung cancer for 1 and 5 years.

• The priorities will be underpinned by specific interventions to ensure

improvement is made in these areas.

6.2 In response to questions from Members, the following was noted:

• In respect of community representation, officers said that the Board

will be asked to consider additional membership at its first meeting.

There will also be an opportunity for people to sit on one of the

groups that support and feed directly into the health and wellbeing

board.

• Feedback from all the engagement process will be collated,

analysed, and will feed into the Action Plan.

• Review of the evidence contained in needs assessments has led to

selection of the nine priority areas. This does not of course affect the

work that continues to be done in other areas. In addition, the  ...  view the full minutes text for item 6.

7.1 Salena Mulhere, Overview and Scrutiny Manager introduced the report and the following key points were noted:

• The report lays out the organisational changes to the NHS and other

bodies due to the enactment of the Health and Social Care Act 2012.

• The report notes that overview and scrutiny continues to have a

statutory role to act across the whole health economy. In Lewisham, this

will continue to be carried out by the Healthier Communities Select

Committee.

• The original Health Scrutiny Protocol was agreed in the 2008-2009

municipal year. Its purpose is to agree how the various bodies would

interact with the Committee as it exercised its statutory duties.

• The Protocol now needs to be revised in light of the changes enacted in

the Health and Social Care Act 2012.

• If the Committee is in agreement to revise the Protocol, officers will work

to bring a revised Protocol to the May meeting for confirmation.

7.2 In response to questions, the Committee were informed that:

• The Health Scrutiny Protocol is primarily concerned with local bodies in

the health economy. However, this does not preclude other health

bodies being invited and asked to give evidence to the Committee, as

has been done on numerous occasions.

7.3 RESOLVED: that the Report be noted, and a draft Health Scrutiny Protocol be presented at the next Committee meeting in May.

8.1 Diana Braithwaite, Director of Commissioning, Lewisham Clinical

Commissioning Group, gave an update on the NHS 111 roll-out.

The following key points were made:

• The NHS 111 areas that have been rolled out in South East London

have been Bexley, Bromley and Greenwich, and this took place on

12 March.

• There have been some issues related to the roll out in these areas,

leading to a delay in the NHS 111 rollout to Lambeth, Southwark and

Lewisham.

• There have been improvements in the NHS 111 service since the

initial problems.

• NHS Direct closed on 21 March, but it is still possible to contact

SELDOC. They will be encouraging GPs to update their information

so that patients are aware they can contact SELDOC now that NHS

Direct is no longer operational.

8.2 In response to questions, the Committee were informed that:

• The South-East London Commissioning Unit is overseeing the rollout

of NHS 111.

• Committee members could be sent a more detailed briefing on the

progress of NHS 111 since the roll-out began.

• A further NHS 111 update can be given at the Committee’s May

meeting to inform Members.

8.3 RESOLVED: that there be a further update on NHS 111 at the next

Committee meeting in May.

9.1 Salena Mulhere, Overview and Scrutiny Manager introduced the report.

The following key points were made:

• The proposed work programme for 2013-2014 is included in the

agenda papers.

• Once all the work programmes are agreed, they will be presented to

Business Panel so the work across the Select Committees is coordinated.

• The scoping paper for the Emergency Services Review is also

included in the agenda papers. If the Committee agree to a carry out

this review, all recommendations will be a collated with the other

Select Committees who have agreed to participate in the review, and

pulled together into an Overview and Scrutiny Emergency Services

Review Report.

• If the duration of the Council was extended so that the local council

elections were to coincide with the European Parliament Elections,

an additional meeting of the Committee could be arranged as

necessary.

9.2 Members suggested the following amendments to the work programme:

• HIV Services: be moved to the July meeting.

• Francis Report Update: an item to be added to the December

meeting.

• Hepatitis B Update: should not be added to the Work Programme at

this stage.

• Outcomes Based Commissioning: Members welcomed an informal

an afternoon meeting with service users to be arranged for the

afternoon of the July meeting.

• New Cross Gate Healthy Living: should be discussed at the next

Agenda Planning meeting to decide if it needs to go to the next

Committee meeting.

• Welfare Meals Contract: if there are substantive issues to be decided

at the 1 May meeting of Mayor and Cabinet, Committee members

should be sent the papers for that meeting.

9.3 RESOLVED:

a) the Committee agree the 2013-14 Work Programme, subject to the

amendments outlined in 9.2.

b) the Committee agree the scoping report for its participation in the

Emergency Services Review.

c) it was agreed that the items that would go the next meeting on 29th

May 2013 will be:

• Emergency Services Review (evidence)

• CQC inspection Lewisham hospital and Local compliance manager

update

• Community Mental Health Review

• Quality Accounts (Lewisham NHS and SLaM)

• Scrutiny Protocol

• NHS 111 – Update

• New Cross Gate Healthy Living (provisional)

• Lewisham Hospital - Update

10.1 There were none. However it was agreed to make a referral to the Health

and Wellbeing board as at 6.3:

a)    welcome the development of the Health and Wellbeing Strategy.

b) recommend that the Health and Wellbeing Board specifically addresses the

issue of engagement with service users, either through:

(i)            appointments to the Health and Wellbeing Board; or

(ii) a second tier of user groups feeding directly to the Health and

Wellbeing Board.

The meeting ended at 9.25pm.