Agenda and minutes

Councillor Irene Kimm declared a personal, non-prejudicial interest as an employee of King’s College Hospital NHS Foundation Trust. She therefore left the meeting for items 5 and 7.

To agree the minutes of the meeting held on 25.01.2010 as a correct record of the proceedings.

RESOLVED: That the minutes of the previous meeting held on 25^th January 2010 be approved and signed by the Chair as a correct record of the proceedings.

(Report no 354/09-10) (All wards)

Contact for enquiries: Elaine Carter, Lead Scrutiny Officer, Tel: 020 7926 0027, Email: ecarter@lambeth.gov.uk

Helen Sharrock addressed the Committee. She outlined:

·        Concern that there was insufficient staffing to arrange activities for residents of care homes.

·        One example of there being one person organising activities for ninety-three residents, and asked where care homes were large if there could be greater provisions made for them.

Officers explained that they were supportive of activities being arranged for people in care homes. They confirmed that:

·        The introduction of the Older People’s Commissioning Strategy specifically made reference to this provision and would mean there would be greater attention paid to this important service.

·        Lambeth had a strategy of only contracting 3 and 4 star care homes.

·        They agreed with the speaker that this was an issue of national concern, and would welcome the involvement of the local community in ensuring that people in care homes received as much access to activities as possible.

RESOLVED:

(1)   That the answer and response be noted.

(2)   That Lambeth Council officers meet with Helen Sharrock and the management of the care home concerned to discuss the issue of activity provision and any further concerns.

(3)   That the committee supports the setting up of a programme of works to get residents within Lambeth care homes involved in community activities.

(Report no 354/09-10) (All wards)

Contact for enquiries: Dr Jayne Chidgey-Clark, Director End of Life Care, Tel: 020 7188 0015, Email: jayne.chidgey-clark@gstt.nhs.uk

Dr. Jayne Chidgey-Clark, Director, End of Life Care, Guy’s and St Thomas Charity presented her report. Key points included:

·        The main funding for this project came from Guy’s and St Thomas’ Charity.

·        The aim of this work was to bring together health and social care services to create an individual approach for managing end of life services.

·        A national End of Life Care strategy had been developed.

·        The emphasis of this work was on partnership working and a whole system approach with staff from different sectors sharing information.

In response to questions from Members it was confirmed that:

·        Trinity and St Christopher’s hospices were consulted particularly with regard to their specialist palliative care and access to hospices service, which would be used to improve staff knowledge on this issue.

·        Consultation had also included learning from specialists from Kings College Hospital.

·        Care should be person and family centred.

·        There was now a training programme on wards called ‘Amber’, targeted at staff working with people for whom the prognosis was uncertain in order to ensure that families were communicated with properly through this period.

·        That funding was secured for this work up until the point that it had to be demonstrated that the project was meeting its objectives.

Officers stated that they were supportive of this multi-disciplinary approach. The challenge was now to sustain these projects, and ensure there was sufficient infrastructure in place to meet the needs of people requiring end of life care and their families.

RESOLVED:

(1)   That the report be noted.

(2)   That Members be updated in a year on the work of the ‘Amber’ project.

(Report no 355/09-10) (All wards)

Contact for enquiries: Elaine Carter, Lead Scrutiny Officer, Tel: 020 7926 0027, Email: ecarter@lambeth.gov.uk

Representatives from Kings College Hospital NHS Foundation (KCH) presented their report. Key points included:

·        Between September and November 2008 a Trust risk management assessment had identified areas of concern in relation to the Albany Midwifery Service (AMS). This issue went to the Trust membership committee, who commissioned an external audit of AMS and looked at data relating to deaths from Hypoxic-Ischemic Encephalopathy (HIE) specifically.

·        In summer and autumn 2009 the external audit and internal review had been concluded. Overall it was recognised that the Albany was providing some excellent practice especially with regard to reaching hard to reach women, but on the basis of safety data and the external report the Trust executive took the view that they should terminate the contract.

·        The immediate concern of both the Albany and the Trust was for the mothers who were using the service, and both organisations had worked together to ensure a smooth transition of service provision.

·        Midwives employed by the Albany had been offered jobs within the Trust and work had started towards planning for another practice within the area.

·        KCH had the highest number of home births within London and the second highest within the country, and the Trust was very supportive of this achievement and keen to take the best of the Albany work elsewhere.

A representative from the Albany Midwives (AM) outlined their perspective. Key points included:

·        The Albany was a unique midwifery practice, which began in 1994 and was offered a unique contract with KCH in 1997.

·        The Albany offered choice, continuity and control in a community setting, and had received good feedback from service users over the years.

·        The midwives felt sad that the contract had been terminated in this way instead of working being conducted together to improve the service.

·        The external audit had not recommended that the service be terminated.

·        The women living in Peckham had now lost this service provision and there was a great deal of feeling and upset within the community against this decision.

In response to questions from Members AMS confirmed that:

·        They did not dispute that these individual cases of HIE were identified, but that in each case the hospital had never had any problems with the midwifery care. This was confirmed by KCH.

·        There was no discussion in relation to the termination of the contract from KCH.

·        As a practice they had rigorously collated statistics on admissions to hospital for neo-natal care. They were concerned about this group of cases, but felt the decision to terminate the contract was made on the basis of the Albany being an arms-length organisation over which the KCH had insufficient control.

·        HIE was now more commonly referred to as NE, and it was indicated that blame was not attributable to this condition.

·        The effect of HIE or NE was damage to the child’s brain, which was divided into three different levels of severity.

In response to questions from Members it was confirmed by KCH that:

·        The statistics were debatable and related  ...  view the full minutes text for item 5.

(Report no 356/09-10) (All wards)

Contact for enquiries: Tamsin Hooton, Assistant Director Acute Commissioning and Care Pathways, Tel: 020 3049 4303, Email: tamsin.hooton@southwarkpct.nhs.uk

NHS Lambeth presented their report. Key points included:

·        The target was for 80% of women to have a comprehensive assessment within the first twelve weeks of their pregnancy.

·        Problems identified were a combination or data quality/admin issues, and late presentation of women. As the majority of bookings for women were undertaken in the community and it took time for this booking to be processed and transferred onto the hospital system.  Since identifying this issue, data quality and timely reporting had been improved. Women were also presenting with an insufficient margin of time to be processed within twelve weeks.

·        Work had been undertaken on raising awareness of the importance of early screening via adverts. Some further social marketing was being considered.

·        Additional community premises capacity was needed, such as the service provided in Corn Street, SE1, where anyone could attend.

·        Women who had already had several pregnancies were amongst those who presented at their GP late.

In response to questions from Members it was confirmed that:

·        This was not an issue that was especially linked with teenage pregnancy.

·        NHS London was looking into social marketing this issue.

·        The challenge for NHS Lambeth was to reach 80% of women being assessed within their first twelve weeks by the end of the year.

·        Leaflets in a number of languages spoken within the Borough had been sent out to address those people who had been identified as falling within hard to reach communities on this issue.

RESOLVED:

(1) That the report be noted.

(Report no 361/09-10) (All wards)

Contact for enquiries: Elaine Carter, Lead Scrutiny Officer, Tel: 020 7926 0027, Email: ecarter@lambeth.gov.uk

Guillotine

During the discussion of this item, the guillotine fell at 9.00pm. MOVED by the Chair, and:

RESOLVED:  That in accordance with Standing Orders 9.5-9.7, the meeting to continue for a further period of up to 30 minutes.

Representatives from Guy’s and St Thomas’ NHS Foundation Trust presented their letter to the Committee which outlined what services may change given the future economic situation. Key points included:

·        There were plans to reduce bed numbers, but this was as part of a shift in service delivery towards seeing a greater number of patients without overnight stays.

·        Reducing bed numbers would be monitored closely and this information could be brought back to the Committee in the autumn.

It was noted that a letter was submitted to Members of the Committee from King’s College Hospital NHS Foundation Trust which outlined their financial position. Representatives from King’s made the point that they were working together closely with Guy’s and St Thomas’ on these saving proposals.

In response to questions from Members it was confirmed that:

·        No current redundancies were planned.

·        Guy’s and St Thomas’s were in the consultation stage of reducing bed numbers, and would ensure the quality and standard of care for patients was not affected.

·        The hospital had some of the lowest re-admission rate in the country, and would be monitoring this closely so if there was ever evidence that patients were being discharged too early this would be identified.

·        There would be tightening of restrictions on discretionary overspend so that fewer temporary staff were employed and only where appropriate.

·        The record of partnership working between the Council and PCT was good and this would continue in relation to bed reduction.

Adults’ and Community Services Officers reported:

·        Concern in relation to the potential impact on community services with fewer beds and felt this needed to be monitored.

·        The notice period for this work was too short.

·        There would need to be agreement reached between the Primary Care Trust, Adults’ and Community Services and the two Trusts to plan the way forward on this project.

·        Social care and health care were facing major financial challenges currently and there was a need to plan work together.

RESOLVED:

(1)   That the report be noted.

(2)   That the Primary Care Trust, Adults’ and Community Services, Guy’s and St Thomas’ NHS Foundation Trust and Kings College Hospital NHS Foundation Trust work closely together on the issue of savings as a matter of urgency to agree how this would proceed.

(Report no 357/09-10) (All wards)

Contact for enquiries: Kwasi Kamasa, LINk Manager, Tel: 020 7274 8522, Email: k.kamasa@aclambeth.org.uk

The Chair noted the importance of good communication across the Council and the Trusts to support the work of the LINk; and further to ensure that the funds allocated were made available to carry out its work.

RESOLVED: That consideration of this report be postponed.

(Report no 358/09-10) (All wards)

Contact for enquiries: Wendy Miller, Project Manager, NHS Lambeth, Email: wendy.miller@lambethpct.nhs.uk

Officers presented their report. Key points included:

·        Substance misuse services operated as part of the Safer Lambeth Partnership.

·        There was a second major stakeholder event planned for March.

·        There was well developed service user involvement in Lambeth.

RESOLVED:

(1)   That the report be noted.

(2)   That officers would return to the Committee in an informal manner following the consultation process on their work.

(Report no 359/09-10) (All wards)

Contact for enquiries: Maria Burton, Head of Health & Wellbeing Partnership, Tel: 020 7926 7540, Email: mfburton@lambeth.gov.uk

RESOLVED: That consideration of this report be postponed.

(Report no 312/09-10) (All wards)

Contact for enquiries: Elaine Carter, Lead Scrutiny Officer, Tel: 020 7926 0027, Email: ecarter@lambeth.gov.uk

RESOLVED: That consideration of this report be postponed.