Councillors and committees

Agenda and minutes

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No. Item


Questions and Public Participation


There were no questions from members of the public on matters which were not on the agenda.


Declarations of Interest

Members of the Board are invited to declare any disclosable pecuniary interests and any other non- pecuniary interests (personal interests) relevant to items on this agenda.



There were no declarations of interest.


Apologies for Absence and Attendance of Substitute Members


Moira Ford attended the meeting in place of Siobhan Clarke on behalf of Your Healthcare. Apologies were received from Dr Naz Jivani, Jane Wilson and Dr Anthony Hughes.



To confirm the minutes of the meeting held on 15 November 2016.


The Minutes of the meeting held on 15 November 2016 were confirmed and signed as a true record.


Dr Jonathan Hildebrand

The meeting will observe a minutes silence in memory of Dr Jonathan Hildebrand, the Council’s Director of Public Health for the past 10 years, who passed away on 30th November 2016.  Dr Hildebrand, who was a member of the Board, made a very significant contribution to public health in Kingston, South West London and beyond. He was a highly popular and respected friend and colleague and will be sadly missed.


The Board observed a minutes silence in memory of Dr Jonathan Hildebrand, the Council’s Director of Public Health for the past 10 years, who had passed away on 30th November 2016.  Dr Hildebrand had made a very significant contribution to public health in Kingston, South West London and beyond. He was a highly popular and respected friend and colleague and would be sadly missed. The Board extended its sincere condolences to his wife and family.



Directors Update pdf icon PDF 106 KB

To alert the Board to emerging local and national policy and legislation, development opportunities and useful resources, provide updates on matters of interest and support the Board with forward work planning.

Additional documents:


The Board received updates from the Directors of Adult Social Care and Childrens Services, the Interim Director of Public Health and the Chief Officer of Kingston Clinical Commissioning Group, on a variety of issues.


Members noted details of the activities held jointly by the Council and CCG during national Self-Care week in November. Evaluation of the events had enabled the acquisition of valuable insight into the extent to which people understood self-care and the limited knowledge some people had about the services and support available to them. The theme of self-care was embedded in the refreshed Joint Health and Wellbeing Strategy 2017-19 and associated action plan. All health and social care partners were asked to help maintain the momentum of self-care messages throughout the year and the concept would be linked into existing events such as Dementia Awareness Week. The possibility of introducing a ‘Year of Self Care’ was under discussion. A further report would be presented to the next meeting of the Board, in March.


Other matters noted included progress with the training of pharmacy staff to become Health Improvement Champions under the Healthy Living Pharmacy Programme, the development of a social prescribing pilot at Surbiton Health Centre for patients with or previously having suffered from, cancer, and their carers, progression with joint communications initiatives between the Council and the CCG, the opening of a ground breaking dementia friendly ward at Kingston Hospital and an innovative new unit at South West London and St Georges Mental Health Trust to provide enhanced assessments for patients experiencing a mental health crisis. The Board also received details of the award of funding to the CCG to enable the provision of three extended primary care services with access from 8am to 8pm for registered and non- registered patients and the ongoing development of the new primary care access walk in service at Surbiton Health Centre.





Verbal Updates from Kingston Voluntary Action and Healthwatch Kingston


The Board received updates on activity from Patricia Turner of Kingston Voluntary Action (KVA) and Grahame Snelling of Healthwatch.


Patricia Turner reported on KVA’s ongoing participation in the Healthy Living Pharmacy initiative and the Self-Care Planning group and provided details of an Accessible Information workshop which examined assistive technology to help health professionals communicate with patients as part of the Digital Health Project. Members also noted that work was underway to develop the recommendations of the Young Peoples Emotional Wellbeing Report and examine the ways in which voluntary organisations shared data. ‘Love Kingston Day’ was scheduled for 14th February and provided the opportunity to raise funds to support small community groups. An announcement would shortly be made on small pots of funding for local groups in order to address the problem of social isolation.


Grahame Snelling advised that new funding had been secured to maintain the community café at the Quaker Centre, an important outreach facility, especially for mental health clients. A number of grassroots engagement events funded by the South West London Commissioning Collaborative had been positively received and were likely to continue through the year. Opportunities to work with the CCG to improve information sharing were being explored. It was also reported that Healthwatch Kingston had been successful in its bid for the new Healthwatch contract and was beginning to give consideration to its strategic plan for the next two years.



Sustainability and Transformation Plan - Presentation

Tonia Michaelides, Chief Officer of the Kingston Clinical Commissioning Group, will give a presentation on the latest developments in respect of the South West London Sustainability and Transformation Plan for the period October 2016 to March 2021.




Tonia Michaelides, Chief Officer of the Kingston Clinical Commissioning Group, gave a further presentation on the South West London Sustainability and Transformation Plan (STP) for the period October 2016 to March 2021. This reiterated the challenges facing the healthcare system, including the need for more effective prevention, enhanced out of hospital care, better deployment of the hospital and primary care workforce in a context of staffing shortages in key specialisms, the improvement of ageing built assets and more effective use of increasingly scarce financial resources.


Members were reminded of the five year forward plan designed to meet these challenges which sought to use money and staff differently to build services around the needs of patients, invest in more and better services in local communities, invest in estates and attempt to bring all services up to the standards of the best. This would include the development of community locality teams comprising GPs, nurses, pharmacists, social care staff and other professionals to be responsible for the care of at least 50,000 patients and the provision of improved care in the community for people in crisis and with long term conditions.


Details of the public engagement programme associated with the STP proposals were also noted, including the Health and Care Forums led by the CCG and providers to be held in each Borough. Attendance at the Kingston Forum, scheduled for 8th February, was encouraged.


In the course of the subsequent discussions Members debated ways in which people could be helped to access the most appropriate primary care service rather than automatically presenting at hospital. Work was underway to better signpost people with minor ailments to other services and encourage utilisation of primary care hubs. It was acknowledged that dialogue was required at the point when patients sought treatment rather than relying only on communications when they were well. There had been a sharp rise in the number of children attending A&E which could be addressed with extended access to out of hours primary care provision. It was emphasised that there was no conflict between advice to parents to seek advice from appropriate sources and the need to avoid unnecessary A&E attendance.


In response to questions the Board noted that the success of the Plan would be assessed against hard measures such as the reduction in hospital bed capacity. Whilst it was a difficult public message, beds could be safely removed from the system if the transformation was successful. The main risk to deliverability of the Plan was identified as social care funding while bed reduction could only be achieved with a clear understanding of where resources needed to be applied in order to meet the need in a community setting. Work was ongoing to map the need for services to replace bed based provision.


The Board was informed that an extended communications and engagement plan would be finalised after the Heath and Care Forum.


Screening in Kingston - Assurance Report pdf icon PDF 74 KB

To receive a presentation from NHS England on screening programmes in Kingston designed to provide information and assurance on the commissioning of screening services for the local population.

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The Board received a presentation from NHS England (NHSE) on performance in respect of antenatal and new-born, adult (non-cancer) and cancer screening programmes within the Borough.


It was noted that antenatal and new-born screening coverage was higher than in many London boroughs but there were issues with the implementation of failsafe processes covering Kingston Hospital and the laboratory, the identification of people for sickle cell and thalassemia screening and new-born bloodspot avoidable repeats. The Board was informed of a series of improvements due to be put in place by NHSE.


Members also noted that a deterioration of the diabetic retinopathy service following a re-procurement exercise had resulted in the implementation of performance management measures with the provider and a remedial action plan. None of the London Clinical Commissioning areas had achieved the minimum standard of 80% coverage for cancer screening but Kingston’s uptake remained higher than the London average. At 71.7% breast screening was one of the highest coverages in London, bowel cancer screening was also relatively high at 55% but still short of the national target - a number of initiatives were in hand to further increase take up. Colposcopy services had also performed well. A one off bowel scope screening at age 55 would be available to Kingston residents by 2021.Cervical screening was one of the better performing in London but reflected a downward trend in take up nationally. The abdominal aortic aneurysm screening service was due to be re-procured and consolidated into a single South London service in order to enhance resilience and overcome recruitment problems.


It was acknowledged that it was sometimes difficult to maintain effective screening performance during periods of service change and therefore risks would need to be managed during implementation of the Sustainable Transformation Plan.


Members concurred with recommendations that ongoing reports should be submitted on progress with failsafe procedures and early booking progress in respect of antenatal and new-born screening, updates be provided on progress with the service remedial action plan for diabetic retinopathy screening, further assurance provided on the impact of the re-procurement process for the Abdominal Aortic Aneurysm screening service and that work should continue to increase cancer screening and uptake. It was suggested that any local actions required should be included in the action plan for the approved Joint Health & Wellbeing Strategy.




The recommendations of the Director of Public Health/Consultant in Public Health to NHS England set out above and in paragraph K of the agenda report be noted.


Voting – Unanimous


Kingston Co-ordinated Care Programme Update pdf icon PDF 140 KB

To update the Board of the progress of the Kingston Coordinated Care Programme and provide information on the next stages of development.


The Board received a further report on progress in respect of the development and implementation of the Kingston Coordinated Care programme. The initiative brought together a variety of partner organisations across the borough to empower people to care for themselves and each other in their communities, invest in positive activities for people that encourage social interaction and wellbeing and create seamless joined up services that people could access easily and quickly and that helped them stay healthy and in their own homes.


Members noted details of recent activity and future developments in respect of various key strands. These included the transformation of the model of service to support people living in their own homes, the design of new models of care so as to develop new care pathways, a single point of access and more integrated multi-disciplinary teams, commissioning and contract activity and the Active and Supportive Communities project designed to keep adult residents happy, healthy and resilient.


Recent developments included confirmation that for 2017-18 the new model of care would be further developed and delivered by an informal alliance of existing health and social care providers in the Borough. A new outcomes framework was being developed to form part of the new service specification with a strong emphasis on supporting people to maintain their independence, hospital avoidance, reablement, early intervention, preventative support and self-care. A Memorandum of Understanding was to be put in place to form an umbrella agreement over the existing contracting arrangements.  The alliance had been asked to produce an implementation plan by the end of January. There was an ambition to have established four ‘virtual locality’ teams by 1st April.


The Board also noted details of a soft market testing event in December attended by a cross section of local and national home care organisations as part of the transformation of home care project. Approval had been given to run a dynamic purchasing process for the spot provision of home care to allow some testing of outcome based processes ahead of the main procurement. A customer advisory group had been established together with a sub-group to inform development of the home care specification and be involved with the commissioning process.


The current focus of activity in respect of the Active and Supportive Communities work was on the social prescribing model, how it could work with GP Practices and how it could consolidate information and advice to support the new model of care and self-care. A number of technical options were being explored to develop and implement an effective model. A bid to Macmillan Cancer Support for funding to pilot a social prescribing approach for people with cancer and their families had been successful and further funding to develop work in this area was being sought from the DCLG Communities Fund.




1.    The progress that is being achieved within a challenging demographic and financial environment that has the potential to create competition agendas be recognised; and


2.    The joint approach to delivering the  ...  view the full minutes text for item 44.


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

To consider the Kingston Safeguarding Adults Board Annual Report for 2015/16.

Additional documents:


Members gave consideration to the Kingston Safeguarding Adults Board Annual report for 2015/16.  This included details of the numbers and types of adult abuse recorded during the year and the work carried out by the Council and partner agencies to more effectively safeguard vulnerable residents.


The Board noted that some 690 reported cases of adult abuse had been received during the year, an increase of 6%, much lower than the national rate of increase following implementation of the Care Act. It was suspected that the manual form of data capture used at the time did not accurately reflect the local picture and newly adopted electronic recording would produce more robust figures. The main categories of abuse recorded were neglect and acts of omission, physical and financial abuse. The largest number of safeguarding alerts related to older people while women tended to be the victims of abuse more frequently than men. Most cases continued to concern people living in their own homes.


The Board also received information and data on the system of Deprivation of Liberty Safeguards relating to adults who lacked capacity to consent to treatment or care in either a hospital or care home which, in their own interests, could only be provided in circumstances which amounted to a deprivation of liberty. It was reported that the number of requests received during the year had increased by 13%, from 648 to 729, consistent with national trends.


Members noted that there was now very positive engagement from all organisations represented on the Board. Efforts were being made to identify voluntary sector partnerships.




the annual report of the Adult Safeguarding Board for 2015/16 be noted.


Voting – Unanimous




Urgent Items Authorised by the Chair


There were no urgent items.