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Agenda and minutes

Contact: Artemis Kassi  Email:  akassi@westminster.gov.uk Tel: 078 1705 4991

Media

Items
No. Item

1.

Membership

To note any changes to the membership.

Minutes:

1.1       None received.

2.

Declarations of Interest

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.

Minutes:

2.1       None received.

3.

Minutes pdf icon PDF 619 KB

To approve the minutes of the meeting held on Monday 27th September 2021.

Minutes:

3.1       The Chairman approved the minutes of the meeting held on Monday 27th September 2021.

4.

Cabinet Member for Adult Social Care and Public Health - Portfolio Update Report pdf icon PDF 726 KB

To update the Committee on current and forthcoming issues in this portfolio.

Minutes:

4.1       The Committee received a written report from Councillor Tim Mitchell (Cabinet Member for Adult Social Care and Public Health) who also provided a short verbal update on current and forthcoming priorities in his portfolio.

 

4.2       The Committee discussed the following topics in detail:

 

           vaccination rates across Westminster and population data

           compulsory admissions into inpatient units versus voluntary admissions

           discharge to access and pressures on local authority budgets

           priority funding areas for public health

           the £3 million budget to be spent on Covid19 and health inequalities

           compulsory vaccinations for care home staff and workforce planning

           the Council’s dementia plan and how to support new carers

           how to improve Covid19 and vaccination public communications 

 

4.3       Concerning vaccination rates across Westminster, the Committee was informed that there had been a 25% reduction in infection rates, though Officers believed that the peak of infections had passed but that this should not allow complacency. The Committee also discussed the difficulty of measuring vaccination rate success across Westminster due to inaccurate population data. Officers believed that generally the older population was overstated, and the young population understated across Westminster.

 

4.4       The Committee discussed compulsory and voluntary mental health admissions and enquired as to whether the number of detainees under the Mental Health Act was always higher than voluntary admissions. The Committee discussed community treatment orders and detention under guardianship. Dr Graham Behr explained to the Committee that community treatment under section 3 of the Mental Health Act enabled clinicians to state attendance for receipt of care and treatment in the community and that if a patient did not adhere to those conditions, the patient might be subject to recall to hospital. Dr Behr further explained that guardianship under the provisions of the Mental Health Act compelled a person to reside at a particular residence, with the legislation conferring the power to convey a person in breach of the residence requirement back to that place. The Committee heard these terms were often used to require a person to stay in supported accommodation.

 

4.5       Concerning discharge to access, the Committee discussed the ongoing complexities of the relationship between local NHS Trusts and local authorities and the financial responsibility of discharging patients who have care needs from hospitals.

 

4.6       Members of the Committee discussed the public health funding priorities. The Committee was informed that the £3 million public health grant allocated to addressing the impact of Covid19 on residents constituted new funding that Public Health had in reserves from a budget underspend.

 

4.7       The Committee discussed in detail the roll-out of the booster vaccine programme in Westminster, specifically in care homes. Officers informed the Committee that they had been working hard alongside their NHS partners to increase the vaccination rates across care homes. Officers stated that just over 70% of residents in care homes had received a booster vaccine and 15% of staff in care homes. The Committee was informed that the low booster vaccination rate amongst care home staff  ...  view the full minutes text for item 4.

5.

Update on the Gordon Hospital pdf icon PDF 451 KB

To receive an update on the temporary closure of the Gordon Hospital.

Minutes:

5.1       The Committee received a written report from Ela Pathak-Sen (Director of Mental Health Services in CNWL) who provided a short verbal update on the temporary closure of the in-patient wards at the Gordon Hospital. The Committee also welcomed Ann Sheridan and Dr Graham Behr.

 

5.2       The Committee Chairman noted that, prior to the evening’s Policy and Scrutiny Committee meeting, Members of the Committee had attended a private roundtable with Claire Murdoch, Chief Executive of the Central Northwest London (CNWL) NHS Foundation Trust, to discuss the temporary closure of the in-patient wards at the Gordon Hospital. The Chairman stated his thanks to the Officers from CNWL for facilitating the session and engaging in a robust conversation about the temporary closure of the in-patient units at the Gordon Hospital.

 

5.3       The Committee discussed the following topics in detail:

 

           the rise in unwell people across Central North West London

           the number of compulsory admissions to in-patient units

           the increase in admissions under the Mental Health Act

 

5.4       Concerning the increase in admissions under the Mental Health Act, the Committee was informed that there had been a rise in unwell people presenting in crisis across Northwest London and that this was being seen across the Country. Ela Pathak-Sen advised that admissions were tracked on a 26-week basis

 

5.5       The Committee was informed that there had been a spike in unknown people presenting in crisis, with “unknown” defined as individuals living outside of the NHS Trust area where they were presenting, those new to mental health services and those that had previously been mental health service users and were re-presenting.

 

5.6       Concerning the increasing admissions to hospital under the Mental Health Act and the difference between compulsory and voluntary admissions, the Committee was advised that CNWL was trying to minimise the number of informal admissions to hospital. CNWL officers stated that this was because these individuals could usually be more appropriately treated in community, not hospital, settings. The Committee requested further statistics.

 

5.7       RESOLVED: that the Committee note the update report.

6.

Healthwatch Report pdf icon PDF 714 KB

To receive a report from Healthwatch Central West London.

Minutes:

6.1       The Commission received a written report and a short verbal update from Olivia Clymer (CEO of Central West London Healthwatch) on local experiences of accessing healthcare digitally. 

 

6.2       The Committee discussed the following topics in detail:

 

           access to face-to-face appointments with General Practitioners across the City 

           the ‘hyper local’ approach to distributing information to residents and communities

           how to upskill residents to become more digitally savvy to access appropriate healthcare

           the use of interpreters by clinicians 

           the perception of local public health messaging as confusing and unclear. 

 

6.3       Concerning access to face-to-face consultations with General Practitioners, the Committee asked if other areas across Northwest London were also being offered a mixture of face-to-face consultations and digital consultations. Healthwatch informed the Committee that this was the experience across London.

 

6.4       The Committee discussed generally how people felt about accessing information related to healthcare online. Distrust, language, and age were all cited as barriers to accessing information. Healthwatch informed the Committee that members should be heartened by the level of trust in NHS information but observed that local GP websites needed to be strengthened.

 

6.5       The Committee discussed the use of interpreters in primary care. Members raised concerns with Healthwatch regarding recommendation 7 within their report. Members of the Committee believed that the onus for sharing and using translation services should be on clinicians and not members of the public.

 

6.6       Concerning local public health messaging, the Healthwatch report found that messaging was unclear or confusing and that people reported that they did not know where to go for reliable public health information. The Committee discussed different methods of engaging with residents and suggested that public health officers spoke with residents as they were queuing for vaccinations at testing centres.

 

6.7       RECOMMENDATIONS: The Committee recommended that:

 

           Healthwatch attend a Policy and Scrutiny Committee session in the next municipal year to update on the progress of implementing the recommendations within the Healthwatch report.

 

6.8       RESOLVED: that the Committee note the report.

7.

Safeguarding Adults Executive Board - Annual Report 2020/21 pdf icon PDF 245 KB

To receive the annual Safeguarding Adults Executive Board Report 2020/21.

Additional documents:

Minutes:

7.1       The Committee received a written and short verbal update from Aileen Buckton (Independent Adult Safeguarding Chair), supported by Louise Butler (Head of Safeguarding Adults) on the Safeguarding Adults Executive Board Annual Report.

 

7.2       The Committee welcomed Professor Jill Manthorpe (Professor of Social Work, London Kings College) attending as an expert witness. The Professor reflected that the report was comprehensive and overall the ASC team was to be congratulated. The Committee heard from Professor Manthorpe that she welcomed the emphasis on safeguarding being ‘everyone’s business’ and noted that both Westminster and RBKC do not stand out against national trends. Professor Manthorpe highlighted areas covered by the report, including hoarding, self-neglect, gambling, serious adult reviews, scamming and cuckooing. The Committee also heard that, whilst the Covid context had presented challenges, it had also created opportunities to identify the shielding populations. Professor Manthorpe identified that there was no mention in the report of autistic people, often being blended into the grouping of people with learning difficulties, and that there could have been more detail on convictions as well as providers and engagement with the providing community.

 

7.3       The Committee discussed the following topics in detail:

 

           the specialist training available for staff for complex safeguarding cases

           safeguarding concerns around pressure sores

           the link between obesity and vulnerability

           the intended target audience for the Annual Report and if the report would be read by both professionals and residents 

           the process for making a safeguarding referral and if it easy to do so for residents

           the language used when describing people with learning disabilities 

           the presentation of age data within the report and whether this could be broken down further

           increases in Female Genital Mutilation (FGM) during the pandemic. 

 

7.4       Concerning pressure sores, Professor Jill Manthorpe, the independent witness, noted that this safeguarding issue was notably absent from the Safeguarding Adults Executive Board Annual Report. Professor Manthorpe observed that pressure sores presented a complex safeguarding issue and were often not mentioned in any safeguarding training. The Committee asked how to include this in Council work and was advised by Professor Manthorpe that dealing with pressure sores and ulcers was not always included in training, so it should be ensured that this is included in training. The Committee noted that the National Stop Pressure Ulcer Day was the third Thursday in November (this year 18 November 2021) and requested communications to highlight this. Professor Manthorpe observed that with more people living and dying at home, pressure ulcers would become more of an issue.

 

7.5       The Committee discussed obesity and whether there was a connection between mental health, physical appearance and obesity. Officers noted that there was a connection between obesity and increased vulnerability and also advised that a priority of safeguarding partners was often the physical health of people with learning disabilities and that this issue had become more marked during the pandemic.

 

7.6       The Committee reflected on the design of the report and its intended target  ...  view the full minutes text for item 7.

8.

Work Programme pdf icon PDF 194 KB

To consider the suggested work programme for the remainder of the municipal year 2021/22.

Minutes:

8.1       The Committee discussed its work programme for the remainder of the municipal year, including oral healthcare, vaccination uptake, care homes and the Gordon Hospital. The Committee agreed to scrutinise oral healthcare at the next meeting.