Councillors and committees
Agenda and minutes
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Venue: Guildhall, Kingston upon Thames
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To consider questions from the gallery on items which are not on the agenda
Mr Alan Moss (Kingston Mental Health Carers Forum) asked questions about the Thrive Kingston Mental Health Strategy - what has been achieved to date, what is the work programme to achieve this and could updates on progress be published in the public domain to enable people to be kept informed of their efforts?
Mr Nigel Spalding (Health Watch Kingston member) asked which social care topics had been considered by the Panel as its remit includes social care as well as health. Iona Lidington responded that the Panel had looked at provision of care closer to home and the co-ordinated care model.
Mr Spalding asked about social care provision and usage data on provision in Kingston, including home care, home care providers and costs. Iona Lidington confirmed that a range of data is collected. Dr Liz Meerabeau pointed out that Wandsworth has a useful RAG rating for social care indicators which she had sent to the Chair of the Panel with a request that Kingston could produce something along these lines.
Mr Karl Kember asked a number of questions including why there seem to be difficulties in patients being seen by a social worker and why the contact centre does not give more detailed information about how to see a social worker. Iona Lidington explained that there is no open door policy for seeing a social worker and a referral is needed (GPs can refer) followed by a process of telephone assessments co-ordinated by Kingston Co-ordinated Care which are based on social and clinical need. Referral and assessment are progressed with the permission of the individual concerned. GPs can also provide social prescribing. In response to a further question about
Autism assessments, Iona Ldington confirmed that the CCG had commis-sioned a new service but there is a waiting list for this.
Mrs Mary Clark asked why the closure of Murray House and Children’s Centres were not scrutinised by the Panel. The Chair referred to the answer given at the meeting on 11 October when the question about Murray House was raised previously. He added that the Strategic Committees include a scrutiny role within their remits.
Mrs Clark put forward a number of topics which could be considered by the Panel including Crisis cafes, the take up by SWL of the NHS 111 service and the relationship between Local Pharmacists and GPs.
Apologies for absence and attendance of substitute members
Apologies were received from Councillor Kim Bailey and Tonia Michaelides, Managing Director, KCCG.
Declarations of Interest
Councillor Munir Ravalia (Chair) declared an interest in the Dental Services item as he is a dentist by profession.
To confirm the minutes of the meeting held on 4 December 2018
The Minutes of the meeting held on 4 December 2018 are agreed as a correct record and signed by the Chair.
To consider the report, scrutinise and make any recommendations
Dr Andrew Cross gave a presentation on Dental Health Services and Oral Health in Kingston. It aimed to cover the main points in the report and the Children’s Oral Health Joint Strategic Needs Assessment (JSNA).
NHS England is responsible for commissioning NHS dental services including, primary dental services, community, specialist and out of hours services to cover both routine and urgent care but it does not include private dentists. There are 26 NHS dental practices distributed across the borough.
Any treatment that is clinically necessary to protect or maintain good oral health is available on the NHS and whilst most people will pay a contribution, some groups are entitled to free care.
Levels of access to NHS Dentists vary across Kingston. Tudor ward has the highest access rate, with 72.6% of children accessing an NHS dentist in the two years up to March 2017. However, St Mark’s ward has the lowest access rate, with 46.7% of children accessing an NHS dentist in the same period. 63.4% children aged under 18 in Kingston have accessed an NHS dentist in the last 24 months, but only 37.7% 0-5 year olds.
Variation in uptake of services may be related to many different factors including:
· Fear of the dentist
· Cost (or perceived cost)
· Socio-economic status
· Looked after children
Local Authorities are primarily responsible for oral health promotion although dentists have an important role to play. Kingston, with a number of boroughs across South London, have funded an oral health promotion service which is commissioned by NHS England and is delivered by King’s College Hospital. This provides oral health promotion interventions targeting those at greatest risk of poor health outcomes.
In 2015-16, 1.1% of 5-9 year olds in Kingston had a tooth removed in hospital and this was the 8th highest rate in London. In 2018 work took place looking specifically at children’s oral health which identified a number of key issues:
· Kingston has some scope to improve outcomes for children
· Preventative advice could reach some families earlier and could be more comprehensive
· The local environment is not always helpful for oral health
· Important to ensure systems are in place for oral health advice to reach all Kingston’s communities
Steps have been taken to ensure Health Visitors (HVs) have an important role in dental health promotion. HVs are registered nurses and midwives who have additional training in community public health nursing to provide a proactive, universal service for children aged 0-5 years. They distribute toothbrush packs at the 1 year and 2 ½ year health checks and at other appropriate times, for example during talks on weaning and introducing solids, during drop-in clinics where oral health is discussed. A particular focus is given to families who are considered to be more vulnerable to health inequalities and where more intensive work is being undertaken.
Other recent actions include:
To consider the minutes of the Health and Wellbeing Board held on 15 November 2018
RESOLVED that: The minutes of the Health and Wellbeing Board held on 15 November 2018 are noted.
3 July 2019
· Health Screening
· Update on CAMHS
RESOLVED that: the work programme for the next meeting was noted (Health Screening and update on CAMHS).
Urgent Items authorised by the Chair
There were no urgent items.