Agenda and minutes

1.1  Apologies for absence were received from Cllrs David and Plouviez and for lateness from Cllr Adams.  Apology also received from Dr Sandra Husbands.

2.1  There were no urgent items and order of business was as per the agenda.

3.1  Cllr Snell stated he was Chair of the Trustees of DABD UK.

4.1  Members gave consideration to two reports

  (a) Briefing on Kings Park Moving Together project

(b) Note from Sport England ‘People & places the story of doing it differently’

4.2  The Chair welcomed to the meeting:

Lola Akindoyin (LA), King’s Park Moving Together, Head of Programme, LBH

Warren Leigh (WL), Strategic Lead – Local Delivery, Sport England

Jeanna Brodie-Mends Sanderson (JBMS), Director and Strategic Coach, Journey Before Success CIC – one of the providers

4.3  LA took Members through the presentation and WL described the delivery pilots and their revised approach to work in a much deeper and longer term basis than in previous projects. They were now 5 years into an 8 year relationship which would run until 2025.  LA described how they operated locally with a range of providers. JBMS, a coach/social worker and provider to the project, described developing the Walking Groups which particularly supported local women from ethnic minorities across generations and ability levels, as well as a gym access programme as part of Moving Together.

4.4  Members asked detailed questions and the following points were noted in the responses:

(a)There were 15-20 providers on the programme but they change over time and the key challenge included the need to build capacity within these. LA also described how they worked with different cohorts across a range of organisations.

(b)The Chair asked whether the focus was on those who were inactive, were lapsed inactive, or just young people needing to embed new cultural habits. WL clarified that the focus was on those who are totally inactive rather than those already engaging with local sports organisations. 

(c) Members commented on the concerns raised by residents about facilities in and around parks (toilets and food establishments) and asked if they were satisfactory and what improvements had been made. LA described the two capital projects, one in Daubney Fields and the other connected to the Pedro Club and the plans to open more and generally on the joint work with colleagues in the Regeneration Team.

(d) A Member asked Sport England about the lack of overall sports strategy for Hackney and how too many of the activities are not aligned with well established local sport organisations. He commented that some organisations were perhaps not as up to speed on standards (e.g. child welfare) as they should be and he asked how these are monitored. LA described how the safeguarding monitoring works and how they have a much more hands-on connection with the orgs being grant funded here because the project is very much place-based. WL expanded on the overall sports strategy and the linkages into communities explaining that they are not at the sports club end of the spectrum as the focus is more on people who currently are inactive.

(e) The Chair asked whether Sport England was providing iterative feedback to the project and how impacts will be monitored at the end. WL replied that they did and explained how the 12 national pilots have a lot of connectivity between  ...  view the full minutes text for item 4.

5.1  The Chair stated that in the context of the ongoing successes of Richmond Rd Medical Centre in the National GP Awards they had invited the lead Partner, Dr Mehta, to discuss the current challenges in primary care as we emerge from the pandemic and explore how they are overcoming these challenges as well as the innovative approaches they have adopted.  He added that Healthwatch Hackney had also provided two very helpful research reports to inform the discussion. He added that the broader issues here would be expanded upon further at the 16 March meeting but the aim of this item was to focus on Richmond Rd.  Dr Mehta gave a tabled presentation.

5.2  Members gave consideration to:

  (a) Tabled presentation titled Richmond Road Medical Centre

  (b) Two press reports on their success in the National GP Awards

  (c) Research report from Healthwatch Hackney Improving online information about GP services in Hackney - saving times for patients and surgery staff, Oct 2021

(d) Research report from Healthwatch Hackney GP registration in Hackney the right to access health care, Jan 2022

5.3  The Chair welcomed for this item:

Dr Gopal Mehta (GM), GP Partner, Richmond Road Medical Centre/Sandringham Practice/Aldersbrook Medical Centre; Clinical Director, London Fields Primary Care Network

Dr Suresh Tibrewal, GP Partner at Richmond Rd Medical Centre

Dr Vinay Patel, GP Partner at Stamford Hill Group Practice, Joint Clinical Director for Springfield Park PCN and Woodberry Wetlands PCN Chair of City & Hackney LMC

Dr Mark Rickets, Co Chair of HWB and CoChair of ICPB

Dr Kirsten Brown GP Partner at Spring Hill Practice and The Lawson Practice Primary Care Clinical Lead for City and Hackney

Richard Bull (RB), Programme Director Primary Care NEL CCG

Kirit Shah (KS), Member of Local Pharmaceutical Committee

Malcolm Alexander (MA), Chair, Healthwatch Hackney

Jon Williams (JW), Executive Director, Healthwatch Hackney

5.4  GM took Members through his presentation which covered their access system, how they promoted health and wellbeing, on preventing disease and long-term conditions, their patient engagement, on staff wellbeing, on becoming part of the community and their patient feedback.

5.5  Members asked detailed questions and in the responses the following was noted:

(a) The Chair asked how easy it had been to embed their model in the other GP Practices they ran. GM explained how they went all in on the other practices they took on and rolled out their Richmond Rd model there.

(b) The Chair asked if they were seeing the metrics improving for Sandringham Practice since taking over in 2019. GM replied that they were.  The order of focus was’ access’ first and then ‘health and wellbeing outcomes’. He described how for example they worked with the local Black African Churches to talk to them about blood pressure and diabetes.

(c) Members asked about the challenge of funding these special initiatives.  GM replied that they funded everything from within their GP Practice and these services (yoga and ante-natal) are completely free for patients and he added that the  ...  view the full minutes text for item 5.

6.1  Members gave consideration to two papers:

(a) Adult Social Care Transformation Programme

(b) Paper on What is Adult Social Care? originally presented in November.

6.2  The Chair welcomed to the meeting:

Leanne Crook (LC), Interim Deputy Head of Commissioning Adult Services

Georgina Diba, Assistant Director, Quality Assurance, Safeguarding and Workforce Development, Adult Services

Helen Woodland (HW), Group Director, Adults, Health and Integration

6.3  LC took Members through the presentation. It covered: the challenges faced by adult social care in hackney, the vision, meeting challenges through transformation, the transformation priorities, plan for delivery including resident engagement and how we will know if it’s working.

6.4  Members asked questions and the following points were noted in the responses :

(a) The Chair asked whether there was an ‘invest to save’ pot for these transformation programmes or whether it would be case-by-case bid. HW described how the focus was more on using resources in a different and better way.  Finance colleagues were closely involved in it.  There’s a distinction between things they can do locally and broader ‘invest to save’ e.g. better assistive technology. 

(b) A Member expressed concern that the biggest challenge with career pathways in social care was, unlike for NHS staff, there wasn’t one for social care staff.  He also asked how widely the model was partnered and how best practice would be shared.  HW replied that the social worker qualification was a national one but terms and conditions are not national and there was a big step to be crossed between being a front line care worker and becoming a Registered Manager and the challenge was how to stop staff migrating to the NHS where there were better career opportunities. She described how they were using the Neighbourhoods Model and integration work generally to find pathways for people to work across health and social care and described how the NEL ICS will have a Workforce Development group.

(c) The Chair asked about staff retention and staff culture and whether there was an embedded structural problem (because council doesn’t employ them) and what the limitations there were on the council.  HW described the enabling function of the council here and how for example occupational therapists work with home care staff to train and upskill staff within the Homecare providers and to offer reablement services to residents as well.

(d) The Chair asked whether key principles for ensuring staff wellbeing could be written into contracts with providers. HW replied that it depended on what this was. The provider landscape locally was incredibly diverse with some individual firms, some voluntary sector, some profit making and while some things could be included in contracts it depended on the nature of the contract and the service.

(e) JW (Healthwatch) asked whether the ICS fully grasped the issues facing Adult Social Care and also on the issue of patient Advocacy and how that would fit in with the support to residents. HW replied that ICS development was part of the collective  ...  view the full minutes text for item 6.

7.1  The Chair stated that he had asked Public Health to provide a further update on the Covid-19 situation in the borough. The Commission had been receiving these at each meeting during the course of the pandemic.  He welcomed to the meeting: Chris Lovitt (CL) Deputy Director of Public Health for City & Hackney.

7.2  Members gave consideration to a TABLED briefing report Covid-19 update to HiH 9 February 2022

7.3  CL took Members through the presentation in detail with slides detailing the following points: Key messages; Weekly Covid-19 incidence rates have decreased by 75% since Dec but remaining higher than this time last year; School-aged populations are currently recording some of the highest Covid-19 incidence rates; Testing rates have declined considerably over the past month in line with national testing shortages and changes in behaviour; Tracing efforts and interventions have since shifted to high risk areas and settings; Hackney and City are continuing to record some of the lowest vaccination rates in England; Vaccination rates are beginning to plateau for major cohorts; Vaccination rates vary by up to 41 % points between geographical areas; the total number of beds occupied by Covid-19 patients at Homerton has decreased each week for the last month.

7.4  He also described that day’s government  announcement on the loosening of restrictions.  He described the plateauing of covid cases but noted that the incidence remained high among children.  He noted the small reduction in hospitalisations and that Hackney still had some of the lowest rates of vaccination in the country.  He concluded with advice that even if you’ve had the Omicron variant, after 28 days,  you must restart your vaccination programme.

7.5  Members asked questions and the following was noted in the responses:

(a) A Member asked why Hackney’s vaccination rate was still one lowest in England for first doses. CL described the continuing struggle in addressing hesitancy and highlighted the success of pop-up vaccinations programmes in communities.

(b) A Member asked about the call-recall system and the value of personal contact by GPs and if we were  recording what GPs were finding in talking to the vaccine hesitant. CL replied that on the importance of call-recall with the booster programme. He also hoped that the vaccination programme might now be rolled out to GPs and community pharmacies as with flu.

(c) A Member asked what could be read into declining testing rates. CL replied that there has been difficulties in accessing Lateral Flow Test kits now that people don’t need confirmatory PCRs and so not everyone was reporting their LFT results. Another issue was that the list of covid symptoms was now much broader.  He cautioned that the R rate in London was hovering at 0.9-1.0.

(d) The Chair asked about the contrast of health data demonstrating that Hackney has high levels of health inequality yet the funding coming down from central govt has Hackney being allocated reduced funding under the new calculations. CL agreed re the structural deprivation issues.  On Long Covid a Needs  ...  view the full minutes text for item 7.

8.1  Members gave consideration to the draft minutes of the meeting held on 10 January 2022 and the Matters Arising.

RESOLVED:

That the minutes of the meeting held on 10 January be  agreed as a correct record and that the matters arising be noted.

9.1  Members gave consideration to the updated work programmes. 

RESOLVED:

That the Commission’s work programmes for 21/22 and the rolling work programme for INEL JHOSC be noted.

10.1  There was none.