Agenda and minutes

1.1  The Chair stated that at the recent Council AGM he had been appointed Chair and Cllr Patrick had been appointed Vice Chair for the year 2023/24. He welcomed to the Commission the two new members - Cllr Garasia and Cllr Turbet-Delof. He thanked Cllr Oguzakanil, who had left the Commission, for his contribution over the years.

2.1  Apologies for absence were received from Cllrs Adebayo and Samatar and from Helen Woodland. He welcomed Andreas Lambrianou (CE of GP Confederation) to his first meeting of the Commission.

3.1  There was none.

4.1  There were none.

5.1  Members gave consideration to the report from the Director of Legal, Democratic and Electoral Services.

RESOLVED:

That Cllrs Hayhurst, Patrick and Turbet-Delof be appointed as the 3 Hackney Council members of INEL JHOSC for 2023-24.

5.2  The Chair thanked Cllr Adams for his previous service on the Committee.

6.1  The Chair stated that update on the implementation of the Air Quality Action Plan and a review of the latest pollution monitoring data together with emerging evidence on links between air pollution and health.

6.2  He welcomed for the item:

Dave Trew (DT), Land Air Water Manager, Sustainability and Environmental Services, Climate Homes and Economy

Tom Richardson (TR), Environment Projects Officer - Sustainability, Climate Homes and Economy

Suhana Begum (SB), Senior Public Health Specialist, Adults Health and Integration

Dr Sandra Husbands, Director of Public Health, City and Hackney

Jayne Taylor, Consultant in Public Health, Adults Health and Integration

Sam Kirk (SK), Head of Sustainability & Environment, Sustainability & Environmental Services and Public Realm, Climate Homes & Economy

6.3  Members gave consideration to a briefing Health impacts of air pollution - progress update from Public Health and Environmental Services.

6.4  DT, TR and SB took Members through their presentation in detail, which covered: recap of key points from last year; new evidence, how 2022 compared for air quality in Hackey; changes to UK legislation and guidance, the achievements arising from Hackney’s Air Quality Action pLan 2021-25; the PHE evidence review and the NICE guidance and what Hackney is doing as a result; the expansion of the air quality monitoring and assessment of traffic schemes; the web-based tool to reduce exposure to air pollution; the quality of the environment JSNA and the updated factsheet and conclusions.

6.5  Members asked questions and the following points were noted:

a) The Chair asked why London was so slow in adopting the amended and tougher WHO standards and where was the 10 point plan to deal with the high NO2 hotspots. DT explained that the Action Plan details what they’d committed to but the WHO guidelines had changed. There was nothing to stop changes being made irrespective of the timeline of the action plan. WHO understands that a staged progression is needed and that is what they are doing and they are working towards those tighter guidelines.

b) The Chair asked where was the transparency of the datasets going to elected members  regularly. DT explained the different parameters they are working to the annual report for the GLA for example, requiring them to report against the air quality objectives set out in their own strategy. Hackney has already said it needs to go further and be more ambitious and there is an ongoing need to be transparent about where the council is against the indicators.

c) The Chair asked whether we need a specific strategy with respect to the high NO2 areas.  DT replied this is what the AQAP is designed to achieve and they will implement measures across the borough. There has been a significant improvement against the GLA baseline from 2013 for example. The AQAP is borough wide but they try to focus on hotspots and they work on such things as School Streets to protect the most vulnerable. The studies coming out since ULEZ show rapid reduction in pollutant levels and so the next set  ...  view the full minutes text for item 6.

7.1  The Chair stated that at the 12 January meeting Members had considered reports from local Primary Care leaders on issues around registration and access to local GP Services and quality more generally. This was partly driven by issues raised with Members at their ward surgeries. The Chair asked NHS colleagues to return in 6 months with an update on progress to include if possible an update on particular challenges being felt in the NE of the borough.

7.2  He welcomed for the item:

Dr Kirsten Brown (KB), GP Partner at Spring Hill Practice and The Lawson Practice and Primary Care Clinical Lead for City and Hackney, NHS NEL

Dr Tehseen Khan (TK), GP Partner at Spring Hill Practice, PCN Clinical Director for Springfield Park PCN

Dr Vinay Patel (VP), GP Partner at Stamford Hill Group Practice and Chair of City and Hackney Local Medical Committee (the local BMA branch)

Richard Bull (RB), Commissioner for Primary Care, NHS NEL

Andreas Lambrianou, Chief Executive, City and Hackney GP Confederation

Sally Beaven (SB), Interim Executive Director, Healthwatch Hackney

7.3  Members gave consideration to a briefing note entitled GP Access from NHS NEL Primary Care Commissioning and a tabled presentation Springfield Park Primary Care Network from Dr Khan.

7.4  KB and RB took Members through a detailed presentation which comprised two sections: data update on GP workforce and access Oct 22-Mar 23; GP Contract 23/24 access requirements of GPs and PCNs for the coming year. 

7.5  TK took Members through his presentation which covered: Population headlines; Insights - prevention barriers; Enablers; PCN additional roles; PCN Enhanced Access; Stamford Hill Health and Wellbeing Day; PCN agenda - focus on prevention; PCN Agenda (anticipatory care, personalised care, GP access); Take home messages.

7.6  Members asked questions and the following points were noted:

a) The Chair asked about the need for a standard roll-out of the most up to date phone system to produce consistent data and added that he greatly welcomed the Healthwatch survey on GP access, the analysis of which is just being finalised. RB replied that he welcomed the Healthwatch data which they would study and combine with other patient experience data and discuss among the PCNs. TK gave a presentation on Springfield Park PCN and underlined their work on recruiting to the additional roles explaining that they had a PCN nurse that is shared among the 3 Practices and who focuses on childhood immunisation. He also detailed the particular challenges Springfield Park PSN faces because of its demographics.

b) The Chair asked if enough was being done re digital divide in areas with low smart phone usage. TK explained that the Charedi Community are less likely to use online as they don’t use smartphones. Some Practices have a ‘Patient Partner’ system to complement digital access. He added that there are different ways to mitigate the effect of digital divide. They now run a triage system so those unable to access digitally are able to phone. With more patients accessing online eventually  ...  view the full minutes text for item 7.

8.1  The Chair stated that In June each year the Commission is asked to submit a response to the draft Quality Account which local health Trusts must submit to NHSE covering the previous financial year. The reports follow a nationally mandated template. It is customary to invite senior officers to discuss their Report and, depending on the timing, our letter of response to it. The Trust submits our letter as an appendix to their Report to NHSE.

8.2  He welcomed Jane Naismith (JN), Director of Clinical Services and Joint CEO.

8.3  Members gave consideration to the draft of St Joseph’s Hospice Quality Account 2022-23.

8.4  JN took Members through the report which covered: organisational context; priorities for improvement 23-24 (easy read project; increase access and community support for individuals with non cancer diagnosis; improvements to the hospice environment; implement new NHS Patient Safety Incident Response Framework); quality monitoring and review; improvement progress; statement of assurance from the board.

She added that as they’re not an NHS Trust, submission of Quality Accounts is not compulsory but they continue to do it as part of good clinical governance. Their 4 priorities as above are mainly focused on accessibility and inclusion. She stated they were very proud of their cancer vs non-cancer progress as both are now almost equal and she reminded members that rehabilitative palliative care can be preventative, illustrating how cases of breathlessness for example can lead to many more calls to NHS 111. She added that they benchmark against all hospices in the UK and on all measures they benchmark successfully and consistently and are higher performing.

8.5  Members asked questions and the following points were noted:

a) The Chair asked about the issue of cancer vs non cancer related patients using the hospice and on Council’s own ‘money hub’ project.  JN replied that 51% currently have cancer diagnosis. The government is re categorising Long Term Conditions as Major Conditions and this will have an impact. Those who are non cancer generally have more debilitating symptoms than the average cancer patient so outcomes can be worse for longer and this leads to a disease trajectory which is more challenging. With modern cancer treatments cancer patients generally manage and then deteriorate quickly.  But if you have respiratory or heart or lung conditions you are more likely to have a very rocky journey. St Joseph’s knows that there is a high unmet palliative care need locally, that there is a very mixed population with poor health outcomes. They do need to better meet his need and so that is why they have the emphasis on non cancer diagnoses also. On the Council’s Money Hub, she stated that they were aware of it and do link in.

b) Members asked about the schedule for CQC inspections of St Joseph’s and the special review.  JM replied that CQC are very out of date in their visits which of course had stalled totally during the pandemic. They have been doing monitoring calls with them and  ...  view the full minutes text for item 8.

9.1  Members gave consideration to the draft minutes of the meeting held on 26 April 2023.

RESOLVED:

That the minutes of the meetings held on 26 April 2023 be agreed as a correct record and that the Action Tracker be noted.

10.1  Members noted the updated work programme. The Chair stated that at the next meeting there would be the collated suggestions arising from the Scrutiny Public Survey as well as suggestions from stakeholders and he asked Members to submit their new suggestions by 22 June.

RESOLVED:

That the updated work programme be noted.

11.1  There was none.