Agenda and minutes

1.1  Apologies were received from Cllrs Patrick and Samatar. Apologies also received from Dr Stephanie Couglin and Sophie Dopierala-Bull (CoppaFeel!).

2.1  There was none.

3.1  Chair stated that Cllr Sophie Conway was present but in her professional capacity as the Head of Community and Engagement for CoppaFeel!.

4.1  The Chair stated that the aim was to discuss with key stakeholders the challenges around tackling breast cancer in Hackney and explore what is being done locally, what more can be done and how partnership working here might be enhanced. There would be 6 elements as outlined below and there would be short questions after each one and then a fuller Q&A. He added that it was an item the Commission had not covered for some years so it was timely to do so.

4.2  He welcomed the following invitees:

Caroline Cook (CC), Early Diagnosis Programme Lead, NEL Cancer Alliance

Femi Odewale (FO), Managing Director, NEL Cancer Alliance

Claire Mabena (CM), Lead Breast Cancer Nurse, Central and East London Breast Screening Service

Dr Mansi Tara (MT), Health Promotional Lead, Central and East London Breast Screening Service

Dr Kathryn Hawkesford (KH), Consultant Medical Oncologist, Barts Health

Mary Flatley (MF), Lead Nurse - Cancer, Homerton Healthcare

Dr Reshma Shah (RS) GP, Chair City and Hackney Cancer Collaborative

Jessica Lewsey (JL), PCN Cancer Facilitator

Helen Farrant, Head of Services, CoppaFeel!

Emma Walker (EW), Health Information Manager, Coppa Feel!

Sophie Conway (SC), Head of Community and Engagement, CoppaFeel!

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

Jayne Taylor (JT), Consultant in Public Health

Abigail Webster (AW), Senior Public Health Analyst

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

4b Public Health - Why is breast cancer an important public health issue?

4c Central and East London Breast Screening Service - Data briefing

4d NE London Cancer Alliance - briefing

4e to g City and Hackney Cancer Collaborative (the ToR for the Cancer Collaborative; screening data; breast screening in primary care)

4h CoppaFeel! - briefing

4i Homerton Healthcare NHS Foundation Trust - briefing (TABLED)

4.4  JT and AW from Public Health introduced their paper.  She highlighted that breast cancer is a major illness of concern, age is the main factor but also it is the highest cause of death in women under 50. A key concern  was iInequalities in outcomes. Almost a quarter of deaths here are thought to be entirely preventable by taking actions on the modifiable risk factors and if identified early and treated quickly breast cancer can be tackled. She added that the papers highlighted that access to up to date data is far from optimal and this limits how much they can respond to local inequalities. Incidence and the number of new cases is relatively low but survival rates are relatively poor.  Breast screening coverage has historically lagged behind national standards and we’re seeing later diagnosis leading to poorer outcomes. There is also later diagnosis and poorer outcomes among certain groups such as Black Women. She added that there was some evidence around younger age of diagnosis for black women being linked to the younger age profile of that demographic but we do not have sufficient data to determine this.  There is some uncertainty around evidence and data generally.  She concluded  ...  view the full minutes text for item 4.

5.1  The Chair thanked officers for providing the new staffing structure. He noted that Dr Coughlin had had to give apologies for this meeting.

5.2  He welcomed for the item:

  Louise Ashley (LA), Chief Executive, Homerton Healthcare NHS Foundation Trusts and Place Based Leader for City and Hackney Place Based Partnership

  Amy Wilkinson (AW), Acting Director of Delivery, C&H Place Based Partnership

5.3  Members gave consideration to a tabled briefing paper City and Hackney Place Based Partnership - Place based structures

5.4  LA stated that Hackney Council was having discussions within partnership board and neighbourhood board on how much it can protect the resources in City and Hackney. The concern was that the finances behind the new structures sit very much with ICB and of course the NHS is under increasing budgetary pressure. She added that she works hard to ensure that resources aren’t suddenly removed for example and there are discussions on how to better secure resources for City and Hackney and how the Place Based Partnership might look at bringing these posts (as outlined in the report) closer to City and Hackney rather than sitting in the ICB.

5.5  AW stated that this area of work was in a state of flux. The local Partnership Board was working to consolidate what exists locally and they were proud of strong partnerships and outcomes they had achieved together. The financial pressures were significant and it was important to say that at ICB level the concept of Place is seen as crucial to the functioning of the system. It is currently not clear what financial allocation might go to Place level and another key risk was around clinical leadership. Locally there was a very strong history of this at City and Hackney. The system had asked for a 30% reduction in clinical leadership capacity on top of the separate 20% administrative reduction at the beginning of 2023. It would sit at around 7.5 clinical leadership sessions a week on Place based work for the clinicians involved. Locally they were proposing a cadre of clinical leaders and to secure some non recurrent funding to bridge the financial gap for the next year for the posts they wished to retain. 

5.6  Members asked questions and the following was noted:

a) Chair asked for clarity on what we were losing in terms of clinical leadership and if this included our previous commissioner for Primary Care City and Hackney.

AW replied that that individual was not a clinical or care professional and this related only to our clinical professionals.

b) Chair asked if we are talking about a reduction in the resource for our Clinical Director then and what about mental health leads?

AW replied that funding clinical leadership is currently at NEL ICB and there are conversations at this point about potential devolution of that to Place. It would be groundbreaking if it was. She added that we were facing a reduction of 50% across the board in clinical input. LA added that  ...  view the full minutes text for item 5.

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

RESOLVED:

That the minutes of the meetings held on 11 Sept 2023 be agreed as a correct record.

7.1  Members noted the updated work programme

RESOLVED:

That the updated work programme be noted.

8.1  There was none.