Agenda and minutes

To note any changes to the membership.

1.1       Cllr Maggie Carman sent apologies; Cllr Geoff Barraclough attended in her place.

To receive declarations by Members and Officers of the existence and nature of any pecuniary interests or any other significant interest in matters on this agenda.

2.1       Cllr Geoff Barraclough declared that his wife is a trustee of Healthwatch.

To approve the minutes of the Committee’s meeting held on Wednesday 28th April 2021.

3.1       The minutes of the meeting on 27 April 2021 were approved, with the Committee noting there had not yet been an update from the Clinical Commissioning Groups regarding support provided to patients accessing healthcare services remotely.

3.2       One correction was noted. In section 6.2 of the minutes, Woodfield Road was

erroneously described as being in the south of Westminster. It was agreed that the minutes would be updated to reflect its location in the north of the borough.

4.         VERBAL UPDATE: VACCINATIONS IN WESTMINSTER

4.1       The Committee received a verbal update from Pippa Nightingale, Chief Nurse for North-West London and the SRO for the COVID-19 vaccination programme locally. Pippa Nightingale noted that several events were being run at different locations, including Chelsea Football Club, to facilitate vaccination uptake and that similar events would continue to be offered throughout the summer and a booster campaign was already being planned. Ms Nightingale also advised that the vaccination programme was now six months in duration to date and characterised the current phase as a ‘sprint’. Ms Nightingale advised the Committee that in North-West London, the number of vaccine doses delivered was approaching 2.5 million and that this represented 62% of the population of North-West London having received two doses of a vaccine. No proportion was noted for those having received one dose only, but the Chief Nurse did comment there was much work to do to catch up with second doses. Pippa Nightingale also noted that those who had not received their second dose primarily had not yet received it due to the necessary time delay between receiving first and second jabs.

4.2       The Committee was informed that uptake remained lower than required, especially amongst people aged 17-30. Pippa Nightingale, the Chief Nurse, noted that particular effort had been made to communicate using social media including via TikTok, as well as door-knocking and letter drops. Special vaccination events – for example in conjunction with sporting events had been organised to attract the 17-30 age group.

4.3       The Committee heard that plans for a booster vaccine for the over-50s were in development, with the intent to deliver the boosters through primary care and community pharmacy services alongside the annual influenza vaccination campaign.

4.4       The Committee queried whether ethnicity and vaccination uptake was being monitored and was advised that the disparity in vaccine uptake amongst older people from different ethnic backgrounds was not apparent in younger people from different ethnic backgrounds who were taking up the offer of vaccination. Pippa Nightingale, the Chief Nurse, also advised the Committee about the focus on multi-generational households, with younger people bringing older family members for vaccinations.

4.5       The Committee heard that the Joint Committee on Vaccination and Immunisation (JCVI) was evaluating all available evidence to determine which vaccinations would be offered as part of any future booster programme.

4.6       The Committee was informed that the use of separate data sources had resulted in difficulty in accurately assessing Westminster’s level of vaccine uptake. The Office for National  ...  view the full minutes text for item 17.

Update to the Committee by the Cabinet Member for Adult Social Care and Public Health on current and forthcoming issues in this portfolio.

5.1       The Committee received an update from Councillor Tim Mitchell, the Cabinet Member for Adult Social Care and Public Health. Councillor Tim Mitchell noted that the incidence of coronavirus infections in Westminster had risen to 246.7 per 100,000 population, although hospital admissions continued to remain manageable for local NHS services. The Committee was advised that the local backlog of NHS patient care that had accumulated during the course of the pandemic was beginning to be addressed.

5.2       The Committee heard that there had been some frustration regarding logistics of the vaccination programme, including the use of different datasets causing difficulty assessing the proportion and demographics of the local population receiving the vaccine. Further difficulties had been caused by changes to venue availability.

5.3       The Committee was informed about the availability of support for people required to self-isolate, with eligibility for financial support being limited to those on a low income and in work. The Committee heard that other local authorities had extended such support to wider groups and queried whether Westminster might be able to do the same. The Committee heard that this was constrained by available funding.

5.4       The Committee also queried face coverings, with mask requirements on transport services noted, and whether Westminster’s businesses could be supported to make similar requirements. It was noted that the guidance required individuals to act responsibly, and that the Council was able to offer advice to businesses.

5.5       The Committee raised an issue concerning the reference to the partnership with Palantir to use NHS and Council data to analyse local populations. Bernie Flaherty explained to the Committee that, whilst work in collaboration with Palantir was in its infancy, her professional opinion was that their assistance might prove useful to grant greater understanding of patients in Westminster, within the guidelines of data sharing. The Committee noted that in these efforts, it was imperative that all due levels of security be observed in order that no data was stored or shared insecurely.

5.6      The Committee observed that, in the Cabinet Member’s report, there had

been a note that the Council would be working to improve and enhance face-to-face consultations between GPs and their patients and questioned how best the Council could attempt this. The Committee was pleased to hear from the Cabinet Member as well as from CNWL NHS Trust that the number of face-to-face consultations in Westminster was being closely monitored and reviewed on a weekly basis, allowing for flexible response and shifting provision back towards a more in-person GP model. 

To receive a report from Healthwatch Central West London.

6.1       Olivia Clymer could not attend the meeting to give the Committee a report from Healthwatch Central West London. The Committee noted that questions for Healthwatch would be noted. The Committee discussed that wanted to receive more quantitative data from Healthwatch. The Committee discussed the Healthwatch report and noted that for example, telephone calls from the St Charles Hospital were not free. Robyn Doran stated that she would look into this.           

To receive an update on the Gordon Hospital.

7.1       The Committee received an update from Robyn Doran, Director of CNWL NHS Foundation Trust, and Ela Pathak-Sen about the status of the Gordon Hospital.

7.2     The Committee requested clarity on the potential of a site at Woodfield Road to

provide in-patient care in Westminster. The Committee heard that, whilst a site in the area was one option, it was not the only option being considered, and that plans were still in their infancy.

7.3      The Committee noted that the HSJ had featured an article on 14 July focusing

on how central government was pulling back on hospital building. The Committee discussed this and questioned how long it would take to build and open a new site or hospital with capacity for in-patient care to replace the Gordon Hospital provision. The Committee and others present agreed that this would require many years. The Committee stated firmly their hope and recommendation that the Gordon Hospital would be reopened.

7.4     The Committee heard that there would be a formal consultation surrounding

the reopening of the Gordon Hospital at the end of summer 2021. Robyn Doran stated that there was no plan to reopen the Gordon Hospital.

7.5     The Committee asked where patients who needed bed care were being sent,

given the closure of the Gordon Hospital and heard that a breakdown of where Westminster patients was being sent was available in the report submitted to the Committee. The Committee also heard that the bulk of patients were being sent to the St. Charles’ Hospital. The Committee was advised that, despite the rise in mental health difficulties noted by both the Committee and CNWL NHS due to the conditions of the pandemic, there was currently no indication of a rise in need for in-patient provision.

7.6     The Committee welcomed as an external witness Philip Perkins, a

Westminster resident, who shared his lived experience and views on the closure of the Gordon Hospital. Mr Perkins informed the Committee that hi’ wife was a former in-patient at the Gordon Hospital, and that moreover he firmly believed that there remained a need for in-patient provision for south Westminster residents, who might need support to prevent them from going to hospital as a last resort. Mr Perkins further shared with the Committee his view that the location of the Gordon was crucial as from the south of Westminster, it could take one hour each way to visit the St. Charles’ Hospital in North Kensington. Mr Perkins strongly expressed his desire that the Gordon Hospital reopen and remain open with premises local to south Westminster, and that, even if it did not reopen as a hospital, it should reopen as a Wellbeing Centre, based on the model of Argo House.

7.7       The Committee discussed members’ visit to the Gordon Hospital site. The

Committee also noted, in conclusion, that whilst considerable reconstruction work to future-proof the Gordon Hospital and make it fit for high-standard in-patient care might be required, it would surely cost no more money than developing a  ...  view the full minutes text for item 20.

To receive a report from CNWL on mental health provision in Westminster.

8.1       The Committee received a report from CNWL NHS Foundation Trust, focusing on mental health provision in Westminster. The Committee noted that mental health services for provision for children and adolescents had been included in this report for a comprehensive survey of the mental healthcare landscape, though health issues relating to children and adolescents came within the remit of the Business and Children’s Policy and Scrutiny Committee.

8.2     The Committee asked about waiting times for mental health care and therapy services in Westminster, especially for the Woodfield Trauma Service. The Committee was advised that, though long waiting times were recognised, they were at times deliberate, and discussed with patients, where time was needed to prepare mentally for receiving therapeutic treatment. The Committee was pleased to hear that one of the aspirations of CNWL was to stay in contact with patients on waiting lists, to make certain that they were aware and updated about any changes.

8.3    The Committee also heard from Jackie Shaw, Service Director for CAMHS, Central and North West London NHS Foundation Trust. Jackie Shaw explained to the Committee that during the pandemic, more children and young people had presented as potentially autistic, leading to longer waiting times for assessments.

8.4       The Committee observed firmly that the listed waiting time for Autism Diagnostic Observation Schedule (ADOS) assessments in Westminster (currently ten months) was far too long. The Committee was informed that additional investment in assessments for autism had been secured in order to assist the service in training more staff and catching up. In addition, the Committee heard that, where a full ADOS assessment was not necessary, other forms of assessment had been implemented. The Committee discussed an ideal waiting time of 24 weeks as the timeframe that CNWL had been given by Commissioners. The Committee heard that measures to achieve this waiting time included a recruitment drive, an effort to give staff access to relevant training, and improving staff working conditions to drive efficiency.

8.5       The Committee had requested clarity on standard waiting times for different categories of mental health care provision. The Committee was advised that ‘emergency’ cases received a response within four hours, which was a standard met in almost 100% of cases. The Committee was advised that ‘urgent’ cases were responded to within 24 hours and that ‘routine’ response times were 27 days. The Committee was further advised that patients were allocated to these categories on a case-by-case basis based on the severity of crisis experienced, and their level of distress, either self-reported or as assessed by a member of the first response team. The Committee heard that a policy of ‘no wrong door’ had been implemented, meaning that whichever method patients used to access services, they would be directed holistically to the correct provider, specialist, or therapist.

8.6      The Committee asked for more information about Kooth, an online counselling service commissioned by North-West London commissioning group. The Committee heard that therapists accessed through Kooth were all qualified practitioners and that Kooth was aimed  ...  view the full minutes text for item 21.

To consider a report on the Committee’s work programme for the municipal year 2021 – 2022.

9.1       The Committee received a report from Artemis Kassi, Lead Scrutiny Advisor and Statutory Officer regarding the Committee’s Work Programme. The Committee noted that for the meeting in September, obesity and metabolic disease in adults had been scheduled as an agenda item. The Committee also agreed that Public Health Funerals be scrutinised at the September meeting of the Committee.

9.2      The Committee noted the exemplary work of Artemis Kassi, who had

supported the Committee alone for several months, before welcoming Lewis Aaltonen, Policy and Scrutiny Co-ordinator, who would expand the resource of Westminster’s Policy and Scrutiny Team.

9.3       The Committee heard that a more detailed Work Programme would be composed for the attention of the Committee before the next meeting.

9.4       The Committee requested that in future publicly available performance data

should be supplied to the Committee before each meeting, in order to provide better context for Committee Members.

9.5       The Committee discussed how the Adult Social Care component of its remit

might have been overshadowed by Public Health, in particular the focus on the Covid-19 pandemic, and that it would be beneficial for more items on Adult Social Care to come before the Committee. Councillor Ruth Bush requested that a briefing note on Adult Social Care be circulated for the purposes of informing the Committee.

9.6       ACTION: The Committee requested that a briefing note regarding Adult Social Care be circulated amongst the Committee members.