Hounslow Council

Agenda and draft minutes

Venue: Committee Room 1, Civic Centre, Lampton Road, Hounslow. View directions

Contact: Ian Duke, telephone: 020 8583 2540 or e-mail:  ian.duke@hounslow.gov.uk. 

No. Item


Welcome and Introductions


The Chair, Cllr Bath, opened the meeting and welcomed Members of the Scrutiny Panel and guests to the meeting.



Apologies for Absence, declarations of Interest and other Communication


Apologies were received from Cllrs Malhotra, Savin and Green.

Cllr Bath agreed to record a general declaration given that all Panel Members would be users of West Middlesex University Hospital.


Minutes of the meeting held on 19 September 2016 pdf icon PDF 143 KB


The minutes were agreed as an accurate record.


Matters Arising and actions log


Item 58 – the STP presentation from the last meeting had not been circulated.


Action: Obtain and circulate the presentation


Item 60 – Cllr Mehrban confirmed that she had attended the JHOSC in the 14 October 2016 and was happy to continue to represent the panel.


Resolved: Cllr Mehrban to be the second representative on the JHOSC.




Chelsea and Westminster acquisition of West Middlesex University Hospital pdf icon PDF 196 KB

Additional documents:


The Chair welcomed representatives from Chelsea & Westminster Foundation Trust, Lesley Watt (Chief Executive), Dominic Conlin (Director of Strategy) and Tina Benson (Site Director for West Middlesex).


Prior to making the presentation Dominic Conlin responded to a letter that the Chair had sent on behalf of Cllrs Collins and Green regarding reports received that staff at WMUH are receiving redundancy notices and that these are linked in some way to the acquisition. The detail was set out in a response dated on 21 November 2016. There have been three phases of management restructures as part of merging the two hospitals. In total 16 members of staff were issued ‘at risk of redundancy’ letters. However in each case alternative employment has been found either within the Trust or elsewhere within the NHS. There is one other ‘at risk’ process currently but this is not connected to the acquisition.


Dominic Conlin gave an overview of the presentation published with the papers. Key points from the presentation and the following question and answer session were as follows:

·         There have been good progress over the first 12 months, including financially, although this will get more difficult moving forwards

·         Quality measures remain positive. The Trust continues to have lower mortality than expected by the national index. Patient experience and staff engagement scores are higher on both sites as reported by national surveys.

·         Performance is also positive. A&E performance is the best in London and the 9th best nationally, despite having the 8th highest attendances of all acute trusts in the country. All other performance targets are currently being met.

·         Reductions in GP thresholds for cancer referrals had resulted in increased demand for clinics, resulting in overbooking and 2-3 hour delays in order to remain within the 2-week waiting target. Work was underway with GPs to develop ways in which this could best be managed.

·         This level of performance was due to the Trust taking a whole-hospital approach to A&E, and along with positive working relationships with partners, this created a real commitment to achieving targets. However demand was increasing and there is concern about how sustainable this is.

·         £23m investment was being made as part of winter planning to increase capacity and staffing. This year there is no funding for new schemes to manage demand, only to continue previous schemes. However the Trust has plans for new schemes should funding be made available at short notice.

·         Reasons for increasing demand are complex. In London there tends to be higher use of A&Es rather than GPs, because it’s open 24 hours-a-day, and there is high demand during evenings and weekends. Ambulance conveyances have also increased substantially from 20 to 80 a day. Plus there are still A&E admittances that could be dealt with in a community setting.

·         Bed blocking is an issue, but has a number of causes, including awaiting care places, availability of step down provision and some internal process issues. This is being looked into and the plan is  ...  view the full minutes text for item 68.


JHOSC update & Sustainability & Transformation Plan pdf icon PDF 176 KB

Additional documents:


Cllr Collins provided an overview of the meeting and subsequent correspondence as set out in the papers. Ian Duke then provided an overview of the latest iteration of the Sustainability & Transformation Plan, in particular where progress has been made subsequent to the version considered at the last meeting.


Cllr Collins then provided a verbal update of a recent meeting of the Pan-London Forum of JHOSCs. The purpose of this body was to look at common issues emerging across the London sub-regions. This meeting had decided to invite NHS England to talk through the principles guiding the STP process, and to engage London Councils and the Mayor’s Office to future Pan-London meetings.



·         A future item to be brought to the Panel setting out the Hounslow-level delivery of the STP and implications for Adult Social Care.



Healthwatch update


Tim Spilsbury provided a verbal update of activity. A key area of activity was around patient experience. A new digital platform for this had recently been introduced which would allow up to 400 survey result per month. Recent work on this has highlighted issues of GP Access and poor experience of GP receptions. There have also been problems for non-English speakers accessing services at West Middlesex hospital.


Other work includes reviews of the Personal Care Framework, care planning in GP practices and a longitudinal study of patient discharges. The reviews are chosen by monitoring and identifying trends, and then approaching the Council and CCG to see whether these are of interest.


The Panel asked about whether anyone should be looking at the closure of the Greenbrook practice. Tim clarified that Greenbrook had 5 practices and would be withdrawing from all of them. He understood that one would close entirely and the other retendered, but would need to confirm at the next meeting.


Action: Clarification to be provided on the future of Greenbrook practices.



Review of GP Access Update


Ian Duke provided an overview of work undertaken to date. The Panel had requested that the review be undertaken in the context of the Out of Hospital Strategy and so work had been undertaken looking at what drives avoidable A&E attendances. National data captures the wrong information and so other potential avenues were being considered.


The new Healthwatch digital platform will be a valuable source of information but a further 2-3 months of data is needed first. The surveys undertaken as part the Healthwatch review of GP Access were also being considered. A final route is work looking at community resilience and links to A&E usage, including a detailed look at the three highest areas in the borough. Once data was emerging to provide an evidence base the Task & Finish Group would meet to consider this and to scope the focus of the review.


Resolved: The Panel agreed to proceed on this basis.


Work Programme pdf icon PDF 21 KB


The Chair informed the Panel that Cllr Malhotra had requested four points were raised at the meeting. Two of these had been raised under Item 5. The third raised the issue of infectious diseases and immunisation rates within migrant communities. This fitted well with one of the items scheduled for the next meeting.


The final issue related to the closure of 10 School Road. Cllr Collins provided the Panel with an update on the situation.


Resolved: The Panel agreed the agenda for the next meeting.


Any other matters that the Chair considers urgent





Date of Next Meeting - 9 February 2017


9 February 2016, 7pm