Councillors and committees
Agenda and minutes
In light of recent events and following the latest Government advice on the Coronavirus, the Council has cancelled all its scheduled council and committee meetings until 11th May 2020. At present the law does not permit local authorities to hold 'virtual' Committee meetings but the Council is committed to maintaining full transparency in the decision making process during this period and an update on how its governance will work will be provided shortly.
The Council will keep its arrangements under continual review, having regard to guidance as it emerges.
You can view the individual reports for this meeting by selecting the headings from the numbered list of items at the bottom of this page. Alternatively you can view the entire agenda by selecting 'Agenda Reports Pack' below.Watch key Council meetings here
Venue: Guildhall, Kingston upon Thames
Contact: Marian Morrison 020 8547 4623 email: firstname.lastname@example.org
There were no questions from the gallery.
Apologies for Absence
Councillor Andrew Day announced the resignation of Councillor Frank Thompson on 1 September 2014 due to ill health and requested that best wishes be conveyed to former Councillor Thompson and his family.
Councillor Day also announced that this would be Sarah Tedford’s last meeting as she would be leaving the Trust shortly to take up a post with another hospital trust. He thanked her for her contribution to the work of the Panel.
Declarations of Interest
There were no declarations of interest.
To agree the minutes of the meeting held on 8 July 2014
AGREED that: the minutes of the meeting held on 8 July 2014 are confirmed as a correct record.
Inpatient Mental Health Services in South West London: Proposed Public Consultation
To receive a verbal update on progress with the consultation arrangements and consider local impacts
Tonia Michaelides informed the Panel that the consultation would be led by Kingston CCG. A meeting took place in July between the five CCGs and NHS England to agree to consult on the proposed service changes to deliver greater care in community settings. Commissioners were waiting for clarifications from the Clinical Senate on the clinical model and a further meeting with the Trust Board will take place on 4 September. It is anticipated that the consultation will run from 15 September to 2 December enabling a 12 week consultation period.
Dr Whicher confirmed that the Trust was working closely with the CCGs and stated that improving the Trust’s estate was the underlying purpose of the proposed changes. Currently the estate was largely 19th century and this needed considerable modernisation to provide appropriate and high quality in-patient settings. The Trust acknowledged that people generally had a greater preference for community based treatment and therefore the Trust was enhancing and strengthening key elements such as the home treatment and emergency response teams.
It was noted that a planning application had been submitted regarding Tolworth Hospital. Matthew Neal confirmed that although these plans were being progressed by SWLSTG through the local authority planning process, this was separate to the consultation process and final design for the hospital could be amended to take account of the consultation outcomes. He added that the business case for the development would also be submitted to Government as a further parallel work strand.
Agreed that: the update is noted.
To consider the state of readiness to respond to the Ebola Virus
The report together with a letter from Public Health England (PHE), South West London Health Protection Team provided background information about the Ebola virus, its development and actions taken. The report confirmed that whilst the current outbreak is the largest ever, Ebola does not pose significant risks for the UK. PHE sent an alert to all GP practices, NHS Trusts, private hospitals and others on 1 August 2014 covering the latest advice and guidelines on what to do if a case is suspected and how to arrange for appropriate tests. PHE has also provide advice for humanitarian aid and healthcare workers and associated other statutory and voluntary organisations.
Dr Barry Walsh, Head of the South West London Health Protection Team provided further information on the outbreak. There had been three thousand known cases in Africa and mortality was 50%. Instability in parts of Africa has reduced capacity to respond effectively to the disease and it is likely that support from the military will be required in some countries to deal with current impacts and the aftermath.
He confirmed that the risk to London was low and that the guidance issued to the health sector would enable symptoms to be picked up early by using an algorithm. Information has also been distributed to other sectors including schools. Airline travel to affected parts of Africa had ceased, reducing the risk of infection. Porton Down are providing microbiological back up and testing. Fortunately the disease was not aerosol related and spread was by direct contact with infected body fluids.
He drew attention to the similar systems which had been in place to deal with Lassa Fever and these dealt effectively with two known cases which had occurred previously.
In response to a number of questions from members Dr Walsh explained that:
· Stocks of the virus medication are very low
· African countries are making a range of different requests for assistance
In response to a question about the Commonwealth Local Government Forum’s request for financial and other support for Sierra Leone, Councillor Andrew Day agreed to find out how the Administration was responding to this request.
Agreed that: the report is noted and information about this Council’s response to the Commonwealth Local Government Forum request is sought.
To consider the objectives of these checks and local progress
The report provided background on the NHS Health Check programme which was introduced in 2009 and it is expected to save 650 lives annually. The Check provides a risk assessment of a patient’s vascular health every five years where the patient is not already in touch with health services for specific vascular conditions. Local Authorities took over the responsibility from Primary Care Trusts for commissioning the NHS Health Check Programme in April 2013 and funding comes from the Public Health grant. The Programme is a prescribed public health service and Local Authorities have a responsibility to ensure that it is provided.
The report stated that 58% of the decrease in mortality from coronary heart disease between 1981 and 2000 is attributable to lifestyle changes. More recently the increase in obesity is leading to increased levels of type 2 diabetes and this could be reversed by lifestyle changes. The range of risk factors covered by the Health Check were listed at para 9 of the report. Advice based on outcomes of the assessment is individually tailored to each patient and can vary from general advice to specific interventions or medication eg statins, or onward referral.
Dr Hildebrand explained that whilst there have been studies suggesting that Health Checks are not effective there could be explanations for these results such as populations not being comparable and studies not being undertaken over a long enough time period. He confirmed that Public Health England is developing a more relevant evaluation strategy but explained that it is difficult to clearly demonstrate outcomes of the programme from other factors when people could have made their own lifestyle changes due to other influences.
Health checks are offered by Kingston GPs, 6 community pharmacies and there is a mobile clinic which visits target areas of the Borough. Additional outreach for minority ethnic groups is enabled by the Equalities team.
Dr Hildebrand drew attention to the excellent progress made in 2013/14 and Kingston’s performance was the highest in London at 18.2% of the eligible population, whereas the London average was 10.6%. The Vice Chair endorsed the progress made and requested that arrangements be made for a press release. The total budget for the programme is £480K which represents just over 5% of the public health grant to Kingston.
Dr Hildebrand pointed out that attendance rates for men was lower than women.
The following information was given in response to questions from Members.
· Whilst the current age range for the Health Check programme is 40 – 74, it was possible that this may change with longevity of those who are asymptomatic for vascular conditions but that this would be a national decision.
· People who have had health checks should be routinely given a results card providing guidance and advice plus a print out of their results data. However some practices are not providing this information and Public Health is asking them to rectify this. Dr Hildebrand suggested that patients should contact their GP if any test results are not ... view the full minutes text for item 18.
The Warfarin Clinic at Kingston Hospital
To receive information on the service and the process for undertaking checks on whether warfarin is required
Sarah Tedford outlined the work of the Warfarin Clinic. The Clinic is overseen by a Cardiology and in 2013 there were 4000 active patients and 1200 new patients. Tests amounted to 60K per year and these are individually tailored to patients’ needs. Testing can be requested by the Clinic, GPs, Queen Mary’s and Kingston Hospitals.
In the Clinic Patients are given booklets with appropriate information. Clinic data is routinely collected and audited and 95% of patients are within the required standard.
New drugs are becoming available which have less adverse reactions and will not require regular testing. However, these will not be suitable for all and Warfarin will been needed by some patients.
The clinic is very busy and as part of the Estates Strategy discussed at the last meeting there are plans to enlarge the service and this will lead to fewer delays for patients.
In response to questions Sarah Tedford gave the following information:
· With regard to an individual circumstance, she would be happy to take further details and look into this.
· The introduction of e-prescribing will provide further checks and balances for patients
· The Trust was reviewing the strategy for Cardiology in terms of what treatments are available on which sites, however patient safety was paramount and complex treatment is best delivered where clinical experience and expertise is concentrated.
Agreed that: the verbal report is noted and the news of alternative drug therapy is welcomed.
To agree the proposed work programme for the remainder of the Municipal year
The Work programme for forthcoming meetings was discussed and a request for minor adjustments agreed – items on Maternity Services and Transport links from south of the Borough would be taken at the January meeting. Members noted that the work programme was subject to variation eg in the event of urgent items.
South West London Joint Health Overview and Scrutiny Committee
To note that Councillor Andrew Day was appointed as Chair at the first meeting on 17 July 2014. The Committee appointed a Sub Committee to consider the Consultation on Inpatient Mental Health Services in South West London and Councillor Raju Pandya is the RBK representative on this body.
Agreed that: the formation of the Joint Scrutiny Committee (chaired by Councillor Andrew Day) and its sub group to consider the forthcoming South West London and St George’s NHS Mental Health Trust consultation on inpatient services are noted.