Agenda and minutes

1.1  Apologies for absence were received from Cllr Garasia and Cllr Samatar for lateness.

1.2  Apologies were received from Cllr Kennedy, Louise Ashley and Helen Woodland.

2.1  There was none.

3.1  Cllr Samatar stated that she was employed as a Wellbeing Network Co-ordinator for Mind - City, Hackney and Waltham Forest.

4.1  The Chair stated that the Commission had been asked to look at this by Full Council. He stated that Gendered Intelligence were due to participate in the item but had to give their apologies. He stated that the draft LGBTQIA+ Strategic Framework document in the papers had been added just to provide some background information but it was not agreed and was about to go to Cabinet the following week for approval. The public would be able to make observations on it once it goes out to consultation afterwards and he encouraged people to do so. He would discuss with Cllr Gordon whether it might come back to Scrutiny Panel. He stated that there were a wide variety of views on this issue and he had received questions from Cllr Troughton with whom he’d had a conversation and he’d accepted some public questions from Women’s Rights Network/Hackney Labour Women’s Declaration. The questions on the Framework document should be part of a consultation response and other issues would be dealt with at the meeting.

4.2  He welcomed the following invitees:

Dr Katherine Coyne (KC), Clinical Lead for Sexual Health and HIV and Medical Examiner, Homerton Healthcare

Dr Sarah Creighton (SC), Consultant Sexual Health/HIV, Homerton Healthcare

Dr Paul Giluley (PG), Chief Medical Officer, NHS NEL

Laura Pascal (LP), Women's Rights Network and Hackney Labour Women's Declaration

Helen ‘Heggy’ Wyatt (HW), Advanced Nurse Practitioner, GP Confederation/Lower Clapton Group Practice

Also in attendance were:

Emmeline Bathurst, Strategic Delivery Officer, Policy and Strategic Delivery

Sally Beaven, Executive Director, Healthwatch Hackney

Cllr Alistair Binnie-Lubbock

Dr Sandra Husbands (SH), Director of Public Health, City and Hackney

Andreas Lambrianou, Chief Executive, City and Hackney GP Confederation

Chris Lovitt (CL), Deputy Director of Public Health, City and Hackney

Breeda McManus (BM), Chief Nurse and Director of Governance, Homerton Healthcare

Cllr Claire Potter

BasiratSadiq, Deputy Chief Executive, Homerton Healthcare

Cllr Carole Williams (CW), Cabinet Member for Employment, Human Resources and Equalities

4.3  Members gave consideration to:

Summary note from Gendered Intelligence

Note from Homerton Healthcare on the key points they wish to raise and links to other key resources.

For background reading an update from April on Hackney Council’s LGBTQIA+ Strategic Framework

For background reading a Gender Diversity FAQ from Hackney Council

Other background reading included NHSE’s response (June 2022) to London Assembly Health Committee’s report on Improving-access-healthcare-trans-and-gender-diverse-londoners (Feb 22)

4.4  SC gave a verbal presentation. She stated she was a sexual health consultant and so not a particular expert in this area as her focus was medical prescribing but, she also had a child who is a transgender woman. Whilst most trans people are well adjusted the health outcomes overall for the cohort are not good. They are 18-20 times more likely to die prematurely, more likely to be victims of violent crime and be survivors of domestic violence and are less likely to engage with health and social care and are often not properly availing of antenatal care and  ...  view the full minutes text for item 4.

5.1  The Chair stated that each year the Commission is required to provide comments on the draft Quality Account for the key local NHS trusts. He did this by letter because of the NHS deadlines involved and a copy of that and the draft report were in the papers. The purpose of this item was to review the report and hear back about the comments raised in the Commission’s letter.

5.2  He welcomed for the item from Homerton Healthcare:

Breeda McManus (BM), Chief Nurse and Director of Governance

BasiratSadiq (BS), Deputy Chief Executive

5.3  Members gave consideration to the Quality Account for 22/23 of Homerton Healthcare NHS Foundation Trust and to the Commission’s own letter of response.

5.4  BM took Members through the report in detail commenting that the Trust was on a two year cycle with its 7 agreed quality priorities, as listed. She also added that, despite the pressures, the Trust still was one on of the best in the country on 4 hr A&E waits.

5.5  Members asked questions and the following was noted:

a) What was the initial feedback on the CQC inspection of the maternity service; how was the Trust performing on the target for number of staff appraisals completed and; whether the A&E wait performance was due to the need to deliver mutual aid to neighbouring trusts?

BM replied that completed appraisal rates continued to improve and they were now on 86% against an 85% target. On the CQC inspection of Maternity, they had received high level feedback on 3 areas to look at but there had been no indication that there would be any Regulatory Notices.  As for the reasons for the 4 hr A&E wait performance, there were multiple factors here and it was not just down to a specific issue in relation to mutual aid. The acuity of the patients coming through was higher  and delayed discharges of care continued to present a challenge as it has with all acute hospitals.

b) What is the future of the St Leonard’s site; and on the elective backlog?

BS replied that she’d had recent meetings on the issue. There continued to be a strong commitment to running services at the site. A piece of work now has to be done with NHS Property Services and NHS NEL around how they can get the funding in place to improve the site. She was now part of a senior exec NEL wide working group on Estates and the key priority locally was to put a strong plan in place for the future of St Leonard’s. On the elective backlog BM replied that she didn’t have exact figures to hand.  Unfortunately the recent industrial action had impacted on their elective activity. Their Priority 1 and Priority 2 cancer waits were of course attended to and generally they have been making real progress in driving down the elective waiting list across all the pathways.

c) GP Practices use of texts to patients seeking  ...  view the full minutes text for item 5.

6.1  The Chair stated that this was added to the agenda because of concerns bout the implication for the local health and care partners that some patients may fall between the safety nets here should Metropolitan Police proceed with implementing this new ‘Right Care Right Person’ model.

6.2  He welcomed

Jed Francique (JF), Borough Director City & Hackney, East London NHS Foundation Trust

Georgina Diba (GD), Director of Adult Social Care and Operations

Nina Griffith (NG), Director of Delivery, City and Hackney Place Based Partnership

Chris Lovitt (CL), Deputy Director of Public Health

6.3  Members gave consideration to the following:

Briefing from the Director of Adult Social Care Operations titled “Police Approach - Right Care, Right Person - Implications for health and social care system”

Note from Met Police website announcing the change

Briefing on the issue prepared by London Councils

6.4  GD took Members through her briefing paper in detail. She stated this was a fundamental change to the way police will be deployed in these instances. The model was first implemented in Humberside where it didn’t apply just to mental health cases but also to welfare concerns e.g. missing from health facilities. The Met Police informed stakeholders about this proposed change on 24 May with an implementation date set for 31 August, yet in Humberside they trailed this model for 3 years. The challenge will be to train up call handlers to make better decisions about who needs to be deployed. She added that they agree as a partnership that the most appropriate person be deployed whether they be health, social care or police. There are concerns about the financial implications in terms of implementing this in a short time period and the costs for additional dedicated staff.  There are implications for councils and London Ambulance Service. Within Hackney the local partnership is looking at how it can alter its approach. There are 4 categories of cases here: mental health and crisis pathway; children and young people; those missing from hospital; welfare cases and those missing in the community. She added that conversations are ongoing between borough commanders and system managers at NHS NEL level as well as directors of adult and children’s services to examine the whole system pressures. The previous Friday a Police Partnership Board at New Scotland Yard had looked at the principles of RCRP, the current health demand on the Met and the legal obligations on them and on health services.  There was general support for the principles of RCRP but the go live date of 31 Aug was very concerning for all partners. Health partners have been pushing for pan-London policies on the welfare category and on those missing from health establishments. London Ambulance Services was also procuring 14 new mental health ambulances over the next 2 years and this can be part of the mix. She expected progress across London on this by early August and she was happy to report back.

6.5  The Chair asked if we were still working towards a  ...  view the full minutes text for item 6.

7.1  Members gave consideration to the draft minutes of the previous meeting.

8.1  Members noted the full list of suggestions received from stakeholders and the public and he thanked everyone for those. The Chair stated he would draw up an outline programme to share with Members for discussion and agreement.

9.1  There was none.