Agenda, decisions and minutes

The minutes were agreed as a true record.

Councillor John Muldoon declared a non prejudicial interest as a directly elected governor of SLaM and as a fellow of the RSA which gave a grant to New Cross Library.

The Committee noted the report.

Joy Ellery and Norman McClean introduced the report. They key points to note were:

·         There are 3 PFI schemes within the current trust, 2 buildings and one equipment PFI at Queen Elizabeth Hospital.

·         The current payments per annum are 8.3% of the total trust operating income

·         The Riverside PFI cost on the Lewisham site is relatively low at 3.23% of Lewisham’s total operating income

·         The overall relative value of the two PFIs at the Woolwich site are higher at 14.11% of that sites total operating income – 12.10% being the building PFI and 2.01% being the equipment PFI

·         As part of the dissolution of the South London Healthcare Trust< Lewisham and Greenwich Healthcare Trust have received funding from the Department of Health (DOH) of 73 million over the next 5 years to offset the cost of the PFI and the DOH will provide ongoing financial support beyond the 5 years.

In response to questions, the Committee were advised that:

·         The costs of the PFI are not capped and are uplifted by RPI on an annual basis

·         The Trust has the option to buy the medical equipment covered by that PFI at the end of the contract, which is in September 2016

·         The netbook value of the assets of the trust on the two sites were assessed at different times by different valuers – Lewisham site was done 3 years ago. The value of the assets varies as it is a calculation that includes the risk of depreciation and life cycle of buildings. Both sites are now valued by the same valuer

·         It is anticipated that next year the trust will break even, taking into account the DOH support with the PFI costs

·         The PFI contract for medical equipment includes discussion with the trust if there is the need to re purpose or re-commission specific machines, such as MRI scanners

Cllr Muldoon agreed that further supplementary questions submitted to the Committee by local interested people would be forwarded to the Trust for a response.

RESOLVED: To note the report

Danny Ruta introduced the report. The key points to note were:

·         Public Health was now a function of the local authority.

·         The budget allocation for public health in Lewisham from the Department of Health (DoH) was £20 million for 2014/15

·         Public health currently manage over 70 contracts and employ a number of staff, all of which transferred over to the local authority

·         Prescription costs is a cost pressure, prescription costs as a result of public health intervention (for example nicotine replacement prescribed as a result of the stop smoking services)

·         Public health is requesting the council provide an additional £200k to be allocated to the school age nursing service in 2014-15

In response to questions the Committee were advised that:

·         This report had also been provided to the Health and Well Being Board

·         The request for additional funding for the school age nursing service had not been taken to the CYP Select Committee

·         Public health currently have no clear figures regarding the uptake and outcomes of free swimming provision

·         £50,000 funding is provided by the GLA for the Well London programme, Public health match this funding provision

·         40% of public health funding is spent on sexual health, including condom distribution and specialist clinics. A needs assessment is currently being carried out in relation to FGM and services and support that may need to be provided

·         Lewisham and Greenwich NHS Trust have trained 80-90% of all midwives in recognising and providing support to women in relation to FGM

·         There used to be a teenage pregnancy strategy, this is no longer the case, however when the current contracts are reviewed there will be work done to assess if further resources need to be targeted towards teenage pregnancy

·         The additional 200K requested for the school nursing programme would enable the provision of a full time nurse in every secondary school and support clusters of primary schools. They are focused on general support so healthy weight, mental health smoking cessation. There are no formal outcome measures assigned to the school nursing programme.

The Committee discussed the evidence given and resolved the following:

RESOLVED: To make a referral to the Mayor and Cabinet that advises that:

The Select Committee endorsed the additional spending suggested for the school nursing programme. However, the Committee recommends that appropriate outcome measurements are established, so that the social and economic value of this investment in the service can be evaluated in the future.

The Committee further notes its concern that there is not always sufficient focus on measuring the outcomes of investment in services in relation to health prevention activities and social care, to enable appropriate analysis of the value of investment in specific services. The Committee recommends that a stronger focus on measuring outcomes should be developed; to ensure that effectiveness as well as social and economic value is achieved.

Danny Ruta introduced the report. They key points to note were:

·         An alternative approach was being taken this year to the statutory requirement to issue an annual report.

·         The publication will be in the style of one of Britain’s best-selling women’s magazines, with the aim of being accessible to the general public, and will focus on the topic of obesity and ways to tackle and prevent it.

·         25,000 copies of this publication will be printed and distributed via children’s centres and other locations

·         In addition to this publication, the JSNA website will be updated with progress on achieving key Public Health Outcomes and some resources for health professionals (to support weight management) will be published electronically.

·         These will be published at the end of April 2014.

In response to the questions the Committee was advised:

·         There were no formal mechanisms to evaluate the effectiveness of this approach, although there were competitions for children to enter which would give some idea of the reach of the publication

RESOLVED: The committee noted the report, and advised that it would be helpful if the publications were all made easily available on the Lewisham website.

Danny Ruta demonstrated to the Committee a training video that has been created to provide healthcare professionals with advice on how to tackle conversations with patients about their alcohol consumption.

RESOLVED: To note the presentation.

Danny Ruta introduced the report. In response to questions Danny Ruta advised:

·         Although there are statistics to show that smoking has reduced generally, there is no clear way to be sure of the absolute figures for smokers and reduction in smokers in Lewisham as this is not routinely recorded by all GPs. Consideration is being given by Public Health London to carrying out a health and wellbeing survey.

·         Chartwells are building on the Bronze Food for Life accreditation they achieved in 2012

·         12,000 people of the 70,000 eligible have had health checks. 30% of those offered health checks to date have taken up the offer

·         Efforts are underway to increase access to basketball in Lewisham for children and young people.

RESOLVED To note the report, and to visit the basketball facilities currently being built in the borough at some point next year.

Joy Ellery Introduced the report. They key points to note were:

·         The CQC inspected the trust recently and had shared their initial findings with the trust at the end of the inspection.

·         The inspection involved an inspection team of around 50 people who were looking at particular Key Lines of Enquiry (KLOEs) that they had chosen to focus on.

·         There were two “listening” events organised and promoted by the inspection team, one in each borough – 25 people attended in total. One full day was spent on the Lewisham site and one on the Greenwich site.

·         An enormous amount of data was requested by the inspection team before the visit, and an additional 130 pieces of information were requested during the inspection week

·         There were no urgent concerns to be addressed on the day of feedback, there were a few issues that arose during the inspection that were corrected immediately.

RESOLVED: To note the report.

The Chair agreed to alter the order of the agenda to take this item after item 4 to allow the officer presenting to leave early.

Helen Hammond gave a verbal update, the key points to note were:

·         The service was inspected for one week in February and has been given a grade 2 “good” rating in all areas.

·         The inspection report will be circulated to members when it is received

·         New funding has been made available to support people with English as a Second Language (ESOL) who are in receipt of Job Seekers Allowance (JSA).

RESOLVED to congratulate CEL on passing the inspection and to note the update given.

Councillor John Muldoon advised the Committee about a visit members of the committee recently undertook with the Lewisham Dementia Advocacy Group. He advised that as a result of the visit, the group had been put in touch with the young mayor and advisors to discuss some intergenerational work, and also with the editor of Lewisham Life to discuss possible future articles to raise awareness of people living with Dementia, services and support that is available as well as raise awareness in the community of ways in which people can support people with dementia.

Councillor Jacq Paschoud advised the Committee that the visit reminded members that “accessibility” is about more than ramps and disabled access toilets – it is about awareness and acceptance and support in the local community. She further advised that the group felt strongly that although personalisation was a positive in many ways, access to group sessions for people with dementia, and their carers, to come together and support each other and share experiences was felt to be something essential that should continue to be supported.

RESOLVED: To note the update given.

The Chair moved a motion to suspend Standing orders which was unanimously agreed.

Salena Mulhere introduced the report and invited the Committee to offer any suggestions they felt should be put forward to the incoming Committee in June 2014.

The Committee discussed the suggestion put forward by PAC and agreed to suggest that the development of the local market for Adult Social Care Services and suggested this be put forward to the incoming committee.

The Committee also suggested that the potential of community enterprise hubs and time banks becoming involved in service provision be further considered by the incoming committee.

RESOLVED: To note the report and put forward to the incoming committee the outlined suggestions.

RESOLVED: To refer the views outlined under item 5 to the Mayor and Cabinet.