Agenda and minutes

1.1  Apologies were received from Cllrs Adams and Samatar. Apologies also received from Helen Woodland and Dr Stephanie Coughlin.

1.2  The Chair welcomed Holly Howlett (Divisional Operations Director, Homerton Healthcare) representing Louise Ashley.

2.1  There were none.

3.1  There were none.

4.1  The Chair stated that the purpose of the item was to consider the progress made on the development of the City and Hackney Sexual and Reproductive Health Strategy and the development of the accompanying action plan. He added that he was impressed with the Strategy but asked officers to address how much flexibility there was with existing budgets to achieve those objectives as well as delivering the statutory obligations.

4.2  He welcomed the following invitees:

Chris Lovitt (CL), Deputy Director of Public Health

Carolyn Sharpe, Consultant in Public Health

FroeksKamminga (FK), Senior Public Health Specialist

4.3  Members gave consideration to the following briefing reports in the agenda pack:

b) Overview report from Public Health on the progress of the strategy

c) Slide presentation update on the strategy

d) A copy of the original Draft Strategy which went out to consultation.

4.4  CL took Members through the report in detail. The consultation had been very successful and there had been strong engagement with most respondents very supportive of it. CYP Scrutiny Commission had also provided a very comprehensive response focusing on sex and relationships education and ensuring services are ‘young people friendly’. They would be strengthening some areas to take account of the responses. The 5 year Action Plan was ambitious. On the funding challenges Public Health is mandated to provide STI testing, to provide for partner notification and long acting specialist contraception and access to emergency hormonal contraception. In the coming years they would aim to put more services which are appropriate on-line and in 2025 there would be a recommissioning of all pan London services. On reproductive health, progress had been made in having a single lead officer for it at ICB level. Fertility services were provided locally by Homerton Healthcare but overall there was a view that there were better ways to provide a more integrated service. If services could be better integrated and some elements can go online this should allow for the current level of service provision to be maintained.

4.5  Members asked questions and the following was noted:

a) Chair asked whether there would be more joint commissioning across Public Health in the different authorities and what the Homerton was mandated to provide.

CL replied that they do consider that there is a better way of aligning services and in the past it had not always made sense to do things differently in the eight local authorities and the NEL strategy seeks to correct this. Hackney had taken a slightly different approach in bringing its Strategy as a Key Decision which will go to Cabinet in February so there can be a dedicated focus on local needs which often had been diluted at NEL level.  He added that there are clear inequalities e.g related to Looked After Children or to LGBTQIA+ which is why there is a specific section on reducing inequalities in City and Hackney’s Strategy.

Regarding the sexual health services commissioning structure, a patient can access any sexual health service in  ...  view the full minutes text for item 4.

5.1  The Chair stated that this issue was last before the Commission three years previously when they were looking at certain changes to the funding formula. The purpose of this discussion was to get an overview from Community Pharmacy NEL and an insight into what they do vis-a-vis  the constituent borough organisations which had preceded them.

5.2  He welcomed for the item:

Shilpa Shah (SS), CEO, Community Pharmacy North East London

Dalveer Singh Johal (DJ), Pharmacy Services Manager, Community Pharmacy North East London

RozaliaEnti (RE), Deputy Director, Medicines Optimisation (Primary Care and Places), Pharmacy and Medicines Optimisation, NHS North East London

Dr Wande Fafunso (WF), GP at Hoxton Practice, Prescribing Lead for City and Hackney, NHS NEL

Sally Beaven (SB), Executive Director, Healthwatch Hackney

5.3  Members gave consideration to the following:

b) Briefing from Community Pharmacy NEL

c) Briefing from Medicines Optimisation at NHS NEL

d) Healthwatch report ‘Mystery shopping exercise of access to emergency hormonal contraception in Hackney’ (Feb ‘23)

e) Healthwatch report ‘Accessibility audit of Hackney’s community pharmacies’ (April ‘22)

5.4  SS explained that Community Pharmacy NEL was the statutory body for North East London. It had covered six boroughs and City and Hackney had merged with them in July 2023. Its the statutory body if services are launched across NEL. 

5.5  DJ took Members through the presentation. He stated that generally there was a lack of awareness about what a community pharmacy does. All are registered with the GPC and they represent 375 across NEL and 60 in City and Hackney.

5.6  He detailed 3 main categories of services: Essential (commissioned nationally),

Advanced (commissioned nationally but a pharmacy can choose); and Locally Enhanced Services (commissioned by the local Public Health department but pharmacies can choose which to do).

In terms of ‘Advanced’ the Community Pharmacy Consultation Service (CPCS) would expand from 31 Jan to 7 additional conditions for which they will be able to provide prescribed medications. They will also provide flu vaccination and contraception services and there was a big national push behind hypertension case finding. They would also provide the New Medicine Service which aims to support a patient through their journey in order to improve compliance. They would also provide the Advanced Smoking Cessation Service (where the patient decides in hospital to quit smoking)

In terms of Local Enhanced Services a good example recently was the Asthma and Air Quality trail in Newham. This would take children through inhaler technique but the key aspect was to encourage them to walk though back roads or quieter roads to get to school in order to avoid the most high polluted roads. They service funded community pharmacies to have a consultation with the patient to begin the process. There had been 6 GP surgery areas with very high levels of asthma

Another Local Enhanced Service was the Vaccine Hesitancy Services in Tower Hamlets. They had been 20% behind the national average on Covid vaccine take up.  Again pharmacies were funded for advanced consultations with  ...  view the full minutes text for item 5.

6.1  The Chair stated that this item was to receive a first update on the Transforming Outcomes Programme in Adult Social Care. This had been discussed in other fora but this was the first time to discuss it at Health In Hackney.

6.2  He welcomed for the item:

Georgina Diba (GD), Director - Adults Social Care and Operations

Leanne Crook, Head of Transformation, Adult Social Care

Alan Rogers (AR), Director - Newton Europe

Ed Bailey (EB), Newton Europe

Cllr Christopher Kennedy (CK), Cabinet Member

6.3  Members gave consideration to paper Transforming Outcomes Programme.

6.4  GD stated that the detail in the report was more limited than they might have hoped at this stage due to a delay. Newton Europe had done a diagnostic of the service in 2022. The Council then went out to tender and Newton were successful but their contract had not yet been signed. She was grateful however that Newton had agreed to attend this session to outline their plans.

6.5  AR took Members through the report in detail covering the diagnostic findings from last year and what is being planned on the basis of that. Overall there was an opportunity with the programme that over half the users of the services could have better outcomes and live more independent lives. There was within it an opportunity to make a financial savings of potentially £7.6m to £11.6m per annum initially which could then deliver £30m in savings over next 7 years. EB took Members through the 4 stages of the transformation programme and what they are likely to see happening in the next year.

6.6  Cllr Kennedy commented that this was a very necessary intervention to take us forward and give us any chance of counteracting the things which had caused so many other local authorities to go under, which is not able to properly address the demands put on local authorities by adult social care. There was great engagement from staff in ASC. He chaired the Transforming Outcomes Board.  He offered to keep coming back to the Commission with ASC officers and Newton staff to provide updates on the programme as it develops.

6.7  Members asked questions and the following was noted:

a) Chair asked if Newton could demonstrate its track record here by giving some examples (without naming specific boroughs) of how savings had been achieved elsewhere.

AR replied that there was a lot to draw on. What they had found in Hackney was not unique at the broad level compared to the rest of the country but some differences emerged which were particular to Hackney and were revealed once they burrowed further down into the detail. The absolute importance of supporting reablement to accept more clients so that more people to be helped back onto their feet was common across all the boroughs where they had done this work. By increasing reablement by say 40% you meet the needs of more residents. It’s about rebalancing that flow from the acute NHS services into council  ...  view the full minutes text for item 6.

7.1  Members noted the Cabinet’s response to Scrutiny Panel’s report on ‘Net Zero’ titled  Executive response to the Overarching Scrutiny Panel Net Zero Report. This had  incorporated the input from Health in Hackney. It had been discussed by Scrutiny Panel on 4 December and by the other Commissions involved.

RESOLVED:

That the report be noted.

8.1  Members gave consideration to the draft minutes of the previous meeting and the action tracker.

RESOLVED:

That the minutes of the meetings held on 15 Nov 2023 be agreed as a correct record.

9.1  Members noted the updated work programme

RESOLVED:

That the updated work programme be noted.

10.1  There was none.