Agenda and minutes

Apologies for absence were received from Councillor Gio Spinella and apologies for early departure were received from Councillor Nasim Ali. Councillor Anna Wright, Cabinet Member for Health, Wellbeing and Adult Social Care had given apologies for late arrival.

Members will be asked to declare any Statutory Disclosable Pecuniary Interests, Compulsory Registerable Non-Pecuniary Interests and Voluntary Registerable Non-Pecuniary Interests in respect of items on this agenda.

There were no declarations of interest.

Broadcast of the meeting

The Chair to announce the following: ‘In addition to the rights by law that the public and press have to record this meeting, I would like to remind everyone that this meeting is being broadcast live by the Council to the Internet and can be viewed on our website for twelve months after the meeting. After that time, webcasts are archived and can be made available upon request.

If you have asked to address the meeting, you are deemed to be consenting to having your contributions recorded and broadcast, including video when switched on, and to the use of those sound recordings and images for webcasting and/or training purposes.’

Any other announcements

Broadcasting

The Chair announced that the meeting was being broadcast live by the Council to the Internet and could be viewed on the website for twelve months after the meeting. After that time, webcasts were archived and could be made available upon request. Those who were seated in the Council Chamber or participating remotely were deemed to be consenting to having their contributions recorded and broadcast and to the use of those sound recordings and images for webcasting and/or training purposes.

Requests to speak at the Committee on a matter within its terms of reference must be made in writing to the clerk named on the front of this agenda by 5pm two working days before the meeting.

There were no deputations.

There were no items of urgent business.

To approve and sign the minutes of the meeting held on 18 December 2023.

RESOLVED –

THAT, subject to sentence “A few virtual wards were enabled with remote technology” being rephrased as “A number of virtual wards in North Central London were enabled by remote monitoring technology”, the minutes of the meeting held on 18^th December 2023 be approved and signed as a correct record.

Report of the North Central London Start Well Programme Director.

North Central London Integrated Care Board (NCL ICB) and NHS England (London) Specialised Commissioning are consulting on proposed changes to maternity, neonatal, and children’s surgical services in North Central London. The report sets out the options being consulted on, and the possible impact of these proposals on residents in Camden. It outlines the approach to consultation and how residents, staff and stakeholders can give their feedback on the proposals.

Consideration was given to the report of the North Central London Start Well Programme Director, presented by Anna Stewart (Start Well Programme Director, North Central London Integrated Care Board (NCL ICB)), Tim Hodgson (Medical Director Specialist Hospitals Board, UCLH), Mike Greenberg (Medical Director, Barnet Hospital, Royal Free London), and Chloe Morales Oyarce (Assistant Director Communications and Engagement, NCL ICB).

In response to a request from the Chair for the Committee to see the feedback on the consultation prior to a decision being taken, the Start Well Programme Director stated that the independent consultation outcome report would be published and brought to the North Central London Joint Health Overview and Scrutiny Committee.

It was confirmed that Camden Council colleagues had been involved in the options appraisal and that, on balance, there were more positives for Option A, retaining maternity and neo-natal service at Whittington Hospital. This was due to fewer staff needing to move to a new location from the closure of maternity and neo-natal services at the Royal Free Hospital. Modelling of patient outflows also indicated greater capacity in North West London for women who would have attended Royal Free Hospital than in North East London should the services at Whittington Hospital be closed.

There were questions about the number of labour ward and neonatal beds per 1000 female population of childbearing age in North Central London and how many there would be in the two options, as well as how this compared to the rest of England. The Programme Director agreed to provide the data after the meeting.

ACTION: Start Well Programme Director, NCL ICB

Reassurance on the time and resources spent on the Start Well programme to close maternity services that could have been spent more productively on other areas such as screening programmes was also requested.

The Programme Director responded that capacity would not be reduced but redistributed. The case for change was set out in slide 9 (page 31 of the agenda pack) and included the rationale for reducing the number of units. This had been developed over time through discussions with clinical leaders and detailed modelling. A report on the case for change had been published 18 months previously. There was a declining birth rate in North Central London but increased complexity of service users. Staffing levels did not always meet best practice in some units and there were high vacancy rates. There was low occupancy at the Level 1 Unit at the Royal Free Hospital. This led to clinical risk, with challenges in maintaining clinical competencies. Additional consultants mitigated risks but this was not a sustainable approach. There were issues with the maternity and neonatal estate at the Whittington Hospital. There were also declining numbers of women choosing to use the Edgware Birth Centre. Modelling had been conducted on the number of babies needed in neonatal units in North Central London for all units to be a minimum of a Level 2 and the staffing required. The modelling indicated this could only  ...  view the full minutes text for item 7.

Report of the Cabinet Member for Health, Wellbeing and Adult Social Care.

This report provides the Committee with an update relating to the portfolio of the Cabinet Member for Health, Wellbeing and Adult Social Care.

Consideration was given to the report of the Cabinet Member for Health, Wellbeing and Adult Social Care.

In response to questions about care staff who were employed by the Council, where staff preferred to be on a guaranteed hours contract the Council sought to offer that. This was not required from external contractors as many care staff preferred zero hours contracts, providing them flexibility. The care and support at home transformation programme included an exploration of different contractual forms to give care staff more guarantees while supporting flexibility.

In response to questions about individual cases reported in the press but not part of the papers, the Cabinet Member for Health, Wellbeing and Adult Social Care offered to discuss this outside of the meeting.

RESOLVED –

THAT the report be noted.

Report of the Director of Health and Wellbeing.

The report updates on progress for the implementation of the community connectedness and friendships short-term priority within the Camden Health and Wellbeing Strategy 2022-30. This includes how the Camden population health approach has been applied to different issues and population groups to bring partners together from across the system to identify and prioritise opportunities for collective action and intervention.

This report describes how the process has been applied in the context of the Community Connectedness and Friendships short-term priority, including work that has been undertaken to transition to delivery.

Consideration was given to the report of the Director of Health and Wellbeing, introduced by Kirsten Watters (Director of Health and Wellbeing) and Sue Hogarth (Public Health Consultant).

In response to questions about whether the community connectedness work would be included in the neighbourhood model, bringing a network of activities addressing various issues together at a community level, the Public Health Consultant confirmed that work in neighbourhoods and family hubs was being monitored. Staff have notified that it was difficult to identify who was lonely and isolated due to stigma. Questions had been developed enabling staff to ask residents about connections. The population health approach meant that staff from neighbourhoods, family hubs and others services were being upskilled to think about social isolation and connectedness and to tap into existing assets within Camden. A communications campaign aimed to destigmatise loneliness and raise awareness of existing assets.

It was noted that young people aged 16-24, including students and international students, were among the initial target groups but that there were significant challenges in reaching them. Officers acknowledged the challenges but highlighted close contacts between the service and universities who were encouraged to think about social isolation in their mental health work. A communications expert had been embedded in Public Health to support the work. Information on a deep dive communication strategy for young people aged 16-24 could be shared outside of the meeting.

ACTION:      Communications and Engagement Lead

– Camden Health and Wellbeing

In response to questions about whether there was funding for the voluntary and community sector (VCS) to develop new initiatives, it was clarified that there was no funding attached to the project but there was some funding available for communications work. It was noted that there was already a lot of existing activity in the VCS that could be better used by the Council to enhance connectedness.

Officers confirmed that older people were also a target group for the project.

It was agreed to share data on boroughs experiencing migration from other countries, including Afghanistan and Ukraine.

ACTION: Public Health Consultant

It was queried what success would look like and what measures and targets were in place over the long-term for the project. The Public Health Consultant explained that activities were being considered and agreed. Measures would be developed based on the activities and in collaboration with services. An evaluation framework would be developed for the communications campaign.

Concerns were expressed about digital exclusion and the risks of digital services to connections for older people. Officers confirmed that the Digital Inclusion Lead was involved in the project. Information would not just be relayed via a website but through upskilling staff to know what assets were available.

The Chair highlighted the vast range of people who can be impacted by social isolation and loneliness. Monica Riveros, Age UK, confirmed that the organisation had been participating in the project. The organisation offered visiting and a Telefriends service. The Chair requested that officers provide a list of groups that  ...  view the full minutes text for item 9.

Report of the St Pancras Transformation Programme Director (Camden and Islington NHS Foundation Trust), Director of Property(FL Property Services Ltd), Divisional Clinical Director(Royal Free London NHS Foundation Trust), Director of Integration (Camden borough, NCL ICB), and Director of Financial Performance and Deputy CFO (Royal Free London NHS Foundation Trust).

This paper provides an update on the:

•                transformation of St Pancras hospital, including the need to find an alternative site for the Mary Rankin Dialysis Unit (MRDU);

•                work undertaken to identify a longlist of potential locations for MRDU, using service requirements to refine this longlist into a shortlist of potential locations, and the outcome of a more detailed appraisal of these shortlisted options using key criteria to identify a preferred option;

•                potential implications of this preferred option (Peckwater Health Centre, Kentish Town) on the services currently based there, and how these implications are being responded to and overseen; and

•                links to wider borough opportunities to foster better, more connected health and care services organised around neighbourhood footprints.

This paper seeks to respond to the points raised via a deputation made to the Camden Health and Adult Social Care Scrutiny Committee on 18 December 2023, and to provide clarity and reassurance around the status of current developments and future plans.

Consideration was given to the report of the St Pancras Transformation Programme Director (Camden and Islington NHS Foundation Trust), Director of Property (RFL Property Services Ltd), Divisional Clinical Director (Royal Free London NHS Foundation Trust), Director of Integration (Camden borough, NCL ICB) and Director of Financial Performance and Deputy CFO (Royal Free London NHS Foundation Trust). The report was introduced by Alison Edgington, St Pancras Transformation Programme Director.

Questions were asked about which service users at the Peckwater Health Centre had been consulted about proposals to relocate services and where they were expected to go, in particular the users of the wheelchair and dementia services. It was noted that there was no information on this in the report as the focus had been on viability of the building for the dialysis unit. The questions raised by the deputation to the previous meeting had also not been responded to.

The St Pancras Transformation Programme Director had been an option for the relocated dialysis unit for a number of years but now was considered the only option. There was a significant challenge in finding affordable accommodation in London for NHS services. The preference was to find the best location for services at the best cost. It was acknowledged that more could have been done to engage primary care colleagues on options. There was a range of community and mental health services at the Peckwater Health Centre. Unlocking the value of the land was an important consideration for the project but not the only consideration. The review of where the existing services at Peckwater Health Centre could be relocated had not been completed but the aim was that services remained local and accessible with the volume and quality of service provision retained. Engagement with service users had been stepped up, with a group established before Christmas to ensure the project was engaging with all stakeholders. Service users would be involved in the development of future proposals for an integrated service including dialysis and there had been a strong input from service users on the mental health perspective of the transformation programme.

In response to a question about why locations in the other boroughs impacted had not been explored, the St Pancras Transformation Programme Director explained that it had been very difficult to find a suitable place for the dialysis service. A design team including clinicians, nurses, doctors and technical experts had looked at a range of options. It was hoped that the dialysis unit would not be an unwelcome addition wherever it was relocated to. The project wanted to work with partners. It was agreed that a further written response to the deputation’s questions would be provided.

ACTION: St Pancras Transformation Programme Director

The Chair highlighted that existing service users would require support to access relocated services and not just signposting. The St Pancras Transformation Programme Director commented on the desire to improve local services for communities using an integrated neighbourhood hub model. New models of delivery could offer improvements to  ...  view the full minutes text for item 10.

Report of the Executive Director of Adults and Health.

This paper sets out the Committee’s work programme for 2023-24 and tracks actions from previous meetings.

Consideration was given to the report of the Executive Director Adults and Health.

Members noted the importance of monitoring developments of the Start Well Programme and the relocation of the Mary Rankin Dialysis Unit.

RESOLVED –

(i)             THAT the work programme for 2023-24 (Appendix A) be noted, with amendments agreed as summarised above; and

(ii)            THAT the Committee’s Action Tracker (Appendix B) be noted.

There was no urgent business.