Councillors and committees

Agenda and minutes

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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.

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Venue: Richard Mayo Centre, Eden Street, Kingston upon Thames KT1 1HZ

Contact: Marian Morrison 020 8547 4623  email:  marian.morrison@kingston.gov.uk

Items
No. Item

34.

Dr Jonathan Hildebrand

Minutes:

Councillor Andrew Day requested that the Panel held a few moments of reflection in memory of Dr Jonathan Hildebrand, Director of Public Health, who passed away on 30 November 2016.  Dr Hildebrand attended the Panel on many occasions and gave several presentations including on the annual public health report.  He added that he along with other representatives of the Council attended both the funeral in December and the Memorial Service held at Dr Hildebrand’s home village in Surrey on Saturday 7 January.  A number of eulogies were given which extolled his contribution to public health in Kingston, South West London and beyond.  A two minutes’ time of reflection was held.

35.

Questions

To consider questions from the gallery on items which are not on the agenda

Minutes:

The Chair advised that as the meeting was being held at the Richard Mayo Centre and there was a need to conclude the meeting by 9.45pm, the question time would be shortened to 15 minutes.

 

Questions were submitted by Mr Carl Kember.  A list of the questions and verbal answers given is attached at Annex 1 to the minutes.  A response to the other questions would be provided in writing.

36.

Apologies for absence and attendance of substitute members

Minutes:

Apologies were received from Councillors Sushila Abraham and Mary Clark.

37.

Declarations of Interest

Minutes:

There were no declarations of interest.

38.

Minutes

To agree the minutes of the meeting held on 22 November 2016

Minutes:

The Panel considered an amendment to the final sentence of  minute 31 to include the words  “District Nursing” to read, “Dr Jane D’Souza added that the rapid response District Nursing Team can visit people at home”.

 

Agreed that: The minutes of the meeting held on 22 November 2016, as amended, were confirmed as a correct record.

39.

Air Quality in Kingston pdf icon PDF 1 MB

To consider a position statement on air quality in Kingston and make any recommendations

Minutes:

The Panel received a detailed position statement on the Council’s approach to air quality and the panel was asked to note the approaches and make any recommendations for further consideration including a recommendation for a Joint Strategic Needs Assessment of air quality in Kingston.

 

Air quality is an important Public Health Issue in Kingston contributing to shortening life expectancy and disproportionately impacting on the most vulnerable.  Tackling air quality contributes to increasing healthy life expectancy and reducing early death from cardio-respiratory disease and cancer.    Public Health has worked with Environmental Health in the compilation of the Air Quality Action Plan which was adopted in July 2016. 

 

Air pollutants are generated from natural and man-made processes.  Distribution can depend on the size of the molecule involved and weather patterns, notably winds.  Air Quality standards regulations set standards for:

·         Particulate matter  (PM10 and PM2.5)

·         Nitrogen dioxide (NO2)

·         Ozone O3

·         Sulphur Dioxide (SO3)

·         Lead

·         Benzene and Denso(a)pyrene

·         Carbon monoxide (CO)

 

Whilst the majority of air pollutants have declined over time in the UK, particulates, Nitrogen Dioxide (NO2) and ozone are found at levels which continue to pose a risk of harm to health.  The main focus for Kingston is on Particulate Matter (PMs) and NO2 for which an Air Quality Management Area has been established.  The report highlighted that a large proportion of PMs originate from outside Kingston and can include sea salt, forest fires and Saharan dust as well as human activity. 

 

Particulate matter aggravates respiratory and cardiovascular conditions and PM2.5 are particularly significant, because being smaller, they can deposit deeper within the respiratory tract and particularly affect children, older people and those with existing heart and lung conditions.

 

The Council monitors PM10 (for which there is a National Objective) at two kerbside sites in the borough.  The objectives are to achieve an annual average of less than 40 ?g/m3 and the 24 hour mean should not exceed 50 ?g/m3 on more than 35 days per year.   The annual averages for the two stations located at Sopwith Way and Tolworth Broadway are 21.3 ?g/m3 and 20.0 ?g/m3 respectively which are both within the target. The 24 hour objective was exceeded three times at Sopwith Way and once at Tolworth, both therefore met the objectives in 2015.

                                                                                                             

In addition, RBK also monitored NO2 at two kerb sites within the borough in 2015, at the same locations used for PM10.  The national objectives are an annual average less than 40 ?g/m3 and no more than 18 hours per year where the hourly mean exceeds 200 ?g/m3.  Whilst neither site exceeded the hourly mean, both failed to meet the annual average objective with Sopwith Way averaging 53.5 ?g/m3 and Tolworth Broadway 48.5 ?g/m3

 

David Kingstone stated that funding for the Sopwith Way monitor had run out and the site decommissioned.  Monitoring devices at a further 40 locations in the borough collect data to assess against the annual mean objective.  All data can be used in modelling  ...  view the full minutes text for item 39.

40.

Mental Health Services provided in Kingston by Camden and Islington NHS Foundation Trust pdf icon PDF 68 KB

To consider a report on the services provided in Kingston by Camden and Islington NHS Foundation Trust with reference to the Trust’s recent inspection by the Care Quality Commission

Additional documents:

Minutes:

At the last meeting during discussion on the Care Quality Commission’s (CQC) inspection report on South West London and St George’s NHS it was noted that the Camden and Islington NHS Foundation Trust were responsible for primary care mental health services in Kingston.  It was noted that their recent inspection rating was also “requires improvement” for community services.   Members requested that Camden and Islington be invited to the next meeting to discuss the rating related to primary care mental health services in Kingston.

 

The report to the panel included an outline of the CQC findings concerning community and substance misuse services at the Camden and Islington Trust together with a detailed report from the Trust which provided the Panel with a summary of the issues highlighted during the inspection and the action that the Trust intends to take to address the issues.  The report also stated that three of the seven core services when were rated as “good” across all 5 CQC domains of quality.  These services were:

·         Community Mental Health Services for people with Learning Disabilities and Autism

·         Community Based Mental Health services for Older People

·         Wards for Older people with mental health problems

 

At the meeting it was explained that the CQC inspection was focussed on the St Pancras site and also the health based places of safety at the Royal Free, Whittington and University College London Hospitals.  The report confirmed that actions were being progressed on the following areas:

·         Ligature points -  all possible steps have been taken

·         Safeguarding – training is now complete and supervision and advice is in place in each division

·         Health based places of safety – actions are taking place to address all the safety issues including around ligature risk

·         Mental Health Act (MHA) systems – MHA and Mental Capacity Act training will be included in the core training from April 2017. 

·         Governance arrangements and learning from adverse incidents and complaints – steps are being taken to change the organisational culture to foster a culture of personal responsibility and monthly clinical forums will consider learning from incidents and complaints, and learning will cascaded.

 

The report set out the services that the Trust provides in Kingston together with performance details i.e.:

 

·         Kingston iCope (Improving Access to Psychological Therapies services (IAPTS) – psychological therapy is provided on a on a stepped-care approach with a range of group interventions. The service performs very well on targets for 16 week wait and 18 week wait.  iCope is also on track to meet the recovery target. However there can be a wait if clients need a step up intervention i.e. more than group or on-line approaches.  In these circumstances they receive supportive “holding” interventions.

A Korean version of the on-line iCope has been developed and the service is actively recruiting Korean speaking therapists.

 

·         Primary Care Mental Health Team (PCMHT) – this service was introduced in late 2015.  It is a pilot multi-disciplinary team led by a psychiatrist and aims to support Kingston GPs to manage a greater proportion  ...  view the full minutes text for item 40.

41.

Kingston Safeguarding Adults Board Annual Report for 2015/16 pdf icon PDF 64 KB

To note progress and content of the Kingston Safeguarding Adults Board Annual Report for 2015/16

Additional documents:

Minutes:

The annual report for 2015/16 was presented by Julie Phillips, Head of Safeguarding Service.  It listed eleven objectives which were fully achieved.  These included some governance matters and some key objectives were:

·         Signing up to and implementing the new Pan London Safeguarding Adults at Risk policy in March 2016

·         Reviewing the Deprivation of Liberty Safeguarding (DoLS) process and  work is in progress with internal audit to identify and improve process

·         Embedding “making safeguarding personal” across all partners including the development of new safeguarding forms in line with the new Pan London Safeguarding Adults at Risk policy

 

Statistics covering a three year period from 2013/14 to 2015/16 were presented.  There has been a 6% increase in the number of reported cases of adult abuse during 2015/16 which totalled 690.  124 cases went onto investigation and 60 were substantiated.  Most of the safeguarding cases occur at the person’s own home possibly suggestive of carer stress.

 

The report also included details from partner agencies on their involvement and work on adult safeguarding:

·         Kingston Clinical Commissioning Group

·         Metropolitan Police

·         Kingston Hospital

·         Your Health Care

·         South West London and St Georges Mental Health Trust

·         London Ambulance Service

 

The following priorities are being progress 2016/17:

·         Developing greater community awareness about safeguarding and protecting vulnerable people

·         Working with care providers to improve the way they can support and protect vulnerable people

·         Ensuring that performance information from all organisations continues to be a focus to inform future target improvements and provide challenge

·         Continuing to ensure practice is embedded – “making safeguarding personal” so citizens who are safeguarded/protected can determine for themselves the outcomes they want to achieve.

·         Progress with compatible electronic data management in Kingston Adult Social Care and the mental health trust

·         Development of more robust processes and understanding around safeguarding adults at risk and children at risk of harm by close working and training with Adult Social Care and Achieving for Children

 

Fergus Keegan drew attention to the considerable progress that had been made in Kingston by partner organisations including the CCG and Kingston Hospital as a result of the direction and professionalism of the Safeguarding Service with the outcome of making people in Kingston much safer. 

 

Agreed that:  the report is noted

42.

Minutes of the Health and Wellbeing Board pdf icon PDF 116 KB

To consider the minutes of the Health and Wellbeing Board held on 15 November 2016

Minutes:

Agreed that:  the minutes of the Health and Wellbeing board held on 15 November 2016 were noted.

43.

Work Programme

Tuesday 24 March 2017

 

Kingston Co-ordinated Care including:

·         Communication and publicity about Kingston Co-ordinated Care and direct payments

·          Community arrangements to support discharge processes

 

Annual Public Health Report

 

Update on commissioning the Integrated Diabetes Service

 

Please note the work programme is provisional and subject to change

Minutes:

The work programme (which is subject to change) was discussed.

 

Agreed that:

 

1.    The following items would be considered  at the next meeting on 14 March 2017:

·         Reablement aspects of Kingston Co-ordinated Care

·         The Annual Public Health Report

·         Update on commissioning the integrated Diabetes Service

 

2.    The following items to be considered during 2017/18:

·         Telephone access to GP surgeries

·         CQC inspection report of Your Healthcare

 

3.    Members would make other suggestions for the work programme.

44.

Urgent Item authorised by the Chair - Update on the South West London Sustainability and Transformation Plan

Minutes:

The Kingston Clinical Commissioning Group made a request to update the Panel on the South West London Sustainability and Transformation Plan (STP) as an urgent item.  Further updates on the STP would be given at the SWLJHOSC on 18 January and the Kingston Health and Wellbeing Board on 26 January.  

 

Fergus Keegan, Director of Quality and Engagement, spoke about the steps taken to date.  He explained that the SWL STP is closely linked with the Five Year Forward View.  It is a collaborative approach of all provider trusts and CCGs in SWL and is not commissioning led. All regions were asked to submit STPs and South West London is one of 44 footprints.    The SWL draft plan was submitted to the NHS in October 2016 but national guidance advised not to share the document with the public as it was still at an early stage and there would be further developments.  However, the draft was published by both the CCG and the Council shortly after for public discussion.  Public engagement events will take place in the next few weeks in SWL and one is planned for Kingston in mid February to enable the public to engage with SWL plan. Earlier local engagement were captured on the issues paper which was published the last year.

 

The objective of the STP is to provide high quality and effective care and to ensure services are the best possible. This will include investment in estates and bringing services closer to people. The plan includes wide ranging initiatives.  One initiative is the development of locality teams across SW London, working in a similar way to Kingston Co-ordinated care. Each locality team would provide services for 50K people.  New technologies will be introduced including virtual clinics and the use of apps as referred to earlier in the meeting.  Workforce redesign will improve capacity and there will also be greater clinical networking to share skills and improve outcomes. However, some of the NHS estate in SWL is below standard. 

 

The plan does not specify whether there will be 3, 4 or 5 hospital sites in SWL.   The optimum is considered to be 4 or 5 hospital sites but not every hospital will necessarily provide all of the same services. There is a financial challenge of £900m across the SWL health and social care sector up to 2020. 

 

Reorganisation of CCGs is beginning to take place and Kingston and Richmond CCGs will have one management team from 1 April 2017.  Work has also commenced on potential for joining back office functions of hospitals.

 

Questions and comments made by Councillors included the lack of coordination and release of information to all members in the early dialogue with the JHOSC.  Concern was also expressed about opportunities to consider firmer proposals on potential hospital reductions.  Fergus Keegan responded that the KCCG would provide as much information as possible. Plans are still being developed and it is difficult at this point to give assurances of how services will look in 2 to  ...  view the full minutes text for item 44.