Hounslow Council

Agenda, decisions and draft minutes

Venue: Council Chamber, Civic Centre, Lampton Road, Hounslow. View directions

Contact: Chaspal Sandhu 020 8583 2065 or email:  chaspal.sandhu@hounslow.gov.uk 

No. Item


Welcome and introductions




Councillor Mel Collins welcomed members to the London Borough of Hounslow


Minutes of the meeting held on 16 October 2014 & Matters Arising pdf icon PDF 107 KB


Agreed to adopt use of the Tracking Sheet for JHOSC issues as circulated


The Minutes of the meeting held on 16 October 2014 were agreed.



Action Tracking Sheet


Members agreed to adopt the use of the Tracking Sheet for ongoing JHOSC issues as circulated.


Terms of Reference pdf icon PDF 47 KB


Confirmed as most recent version and accepted by committee



See Terms of Reference attached at Agenda Item 4.




That the updated Terms of Reference, as attached to the Agenda, be confirmed.




London Ambulance Service update pdf icon PDF 84 KB

Additional documents:




The Committee received a presentation on the London Ambulance Service from Stuart Crichton, West London Assistant Director of Operations.  A copy of the presentation is attached to agenda at item 5.


The two main challenges faced by the service were the number of frontline staff vacancies due to a UK wide shortage of Paramedics (364 frontline vacancies) and an increase in demand for the service with 100 000 more calls in 2014 than in 2013.  West London performance was not good but the service was safe.  There had been an increase in response times but this was minimal in comparison to the increase in demand and staff shortages.  Plans to address these two issues included a recruitment campaign aimed at recruiting 1000 new members of staff with 200 new members of staff set to be in place following an international recruitment campaign by end of March 2015.  Additional new staff are on track to recruitment through two training programmes, one through a University programme and another in-house training programme for trainees with 5 good GCSEs.


There were two 999 Control Centres in London that filtered all calls through a triage system on to one of 7 types of emergency centre. (Hyper-acute Stroke Unit, Heart Attack Centre, Emergency Departments, Urgent Care Centres, Maternity, Patient Specific and Major Trauma Centres)


Cllr Byrne questioned why the performance in Ealing with regards to response to incidents was low in comparison to other areas. He also questioned why a 3 minute difference between actual and optimum response times was being reported.


Stuart Crichton stated that the increase in demand was not borough specific and that a 7% overall increase in Category A demand, together with a decrease in staff numbers had resulted in lower than optimal performance.   Response times to incidents were based on priority and not affected by borough boundaries.


The introduction of a Staff Bank, utilising qualified staff on zero-hour contracts, was having a positive impact on staffing levels.  The arrangement suited staff wanting flexibility as well as permanent staff looking for overtime hours. Stuart Crichton reported that there were approximately 100 members of staff on reserve in the bank.



Cllr Savin requested greater clarity regarding the 100 000 additional calls received in the last year as opposed to 2013.Stuart Crichton responded that a more advanced triage system meant fewer responses per number of calls was needed with a more efficient use of the Hear and Treat system and a better flow of care being delivered as patients were more quickly placed on the correct pathway to care. He stated that in the future increased publicity about the use of 111 would help redirect calls.


Cllr Pascal asked whether there was any further scope for GPs and the Ambulance Service to work together in other ways with better co-ordination ensuring greater integration with community care services.


Stuart Crichton said that the new pathways were working more effectively, following the Shaping a Healthy Future programme and in the future he envisioned even greater effectiveness.  ...  view the full minutes text for item 5.


Travel Advisory Group - Dr Raj Chandok pdf icon PDF 83 KB

Additional documents:


The TAG to consider issues raised concerning Route 204 and Sudbury Town Station and improved services for 267 from Fulwell garage and to feed back to the JHOSC ahead of the next meeting (date TBC) ahead of the next meeting (date TBC).


The TAG to provide their 2015 work plan to JHOSC members.

The TAG to confirm that satisfactory arrangements existed for hospital parking for people with disabilities and to feed back to the JHOSC ahead of the next meeting (date TBC).



See the report of the Travel Advisory Group (Agenda item 6).


Dr Raj Chandok of the Travel Advisory Group (TAG) delivered an update on the Travel Advisory Group’s activities.


TAG’s current priority was to support the changes to Maternity Services at Ealing Hospital.  A travel plan with alternative hospital sites, communications and engagement with GPs to advise women of changes would be provided. Each hospital site would also be asked to provide information on where care would be provided for women on the antenatal pathway.  GPs would have hospital prospectuses with travel information.


In respect of other developments a list of improvements to bus services to facilitate access to healthcare sites in NWL had been submitted to TfL following TfL’s request for suggestions.  Proposed changes would affect the bus routes 204, 427, 395, 223, 267, 95, 120, 235 and 237.  The TAG team would undertake some sample journeys once the changes had been implemented by TfL. TAG would also test a range of travel resources including TfL journey planner and City Mapper. 


TAG would also ensure that there were weekly updates to hospital-based maternity booking information for Ealing residents.


Cllr Byrne questioned whether the 30 minute walking distance used in the calculations included a consideration of weather, environmental and social impact on the journey. Dr Raj Chandok stated that 95% of patients fell within a 20 minute walking distance with a further 5% within the 30 minute radius.  A qualitative analysis post transition would be carried out.


Dr Mark Spencer stated that the figures demonstrated current accessibility with a plan to increase this as shown.


Cllr Shah expressed concern that the inclusion of the 204 bus route did not take into consideration the difficulty in traversing the station for users from Sudbury and requested that the issue be looked into.


Cllr Taylor said that he would like to see a work plan and that he wanted to see more emphasis of the approach to integrated care.




(i) That the TAG consider issues raised concerning Route 204 and Sudbury Town Station and improve services for 267 from Fulwell garage.

(ii) That the TAG provide their 2015 work plan to JHOSC members.

(iii) That the TAG confirm that satisfactory arrangements existed for hospital parking for people with disabilities.



Shaping a Healthier Future update - Clare Parker and Dr Mark Spencer pdf icon PDF 95 KB

Additional documents:


The Chair to write to the Shaping a Healthier Future team requesting that the Implementation Business Case is provided in draft form before the JHOSC within a period of no more than 6

A comparison of the 111 and NHS Direct services to be provided by the next meeting (date TBC).

An outline of 111 staff training and qualifications to be provided indicating appropriateness

JHOSC to be informed of the process and timetable for consulting on the future of Samaritans Hospital

Benefits Realisation report to be circulated



See report at agenda item 7.


Cllr Taylor questioned why the figures available online differed from the figures presented at the meeting. He also questioned why, following closure of the Samaritan Hospital 20/30 years ago, the asset had not been sold.  He questioned to whom scrutiny needed to refer matters they had concerns about, following the fragmentation of the Trust.


Dr Mark Spencer stated that the online figure for performance was more narrowly defined to category 1 care which would explain the difference.  Dr Mark Spencer responded that some of the difficulty in selling Samaritans Hospital had to do with holding the capital in place and a reluctance to release the capital to be gained from the sale before a decision had been made regarding its subsequent allocation.  There were a number of internal processes to be undertaken before consultation could take place with other stakeholders.  Cllr Taylor urged the Trust to engage with the local authorities at the earliest possible opportunity.


Cllr Byrne questioned why, if CQC had provided a ‘good’ report, the A and E at Central Middlesex Hospital had been closed.  He questioned what had gone wrong with the service and whether lessons had been learned. He queried whether NHS Direct had been compared with the 111 service.

Dr Spencer advised that whilst the CQC report was useful it had limited application as it could only provide a snap shot view of what the service was like on the particular day it visited.  It was important to consider the report in context.  The decision to close the A & E was taken on the basis of a longer term analysis of performance alongside a consideration of the long term potential risks involved in keeping it open.


Cllr Byrne felt that either the CQC report was accepted as accurate or not, there should not then be a choice as to whether it was valid or not.


Dr Spencer reiterated that CQC could only provide a view of quality on the day they visited not on the long term sustainability of a service. In respect of lessons learnt, he felt that some assumptions in relation to the length of a patient’s stay had led to errors in the model used.  Bed capacity at Northwick Park was not in place early enough. Dr Spencer confirmed that they had not made comparisons between NHS Direct and the 111 service.


Cllr Collins requested that 111 needed to be reassessed in general as he felt that staff running the service where not always suitably qualified.


In response to a question from Cllr Pascall, Dr Spencer confirmed that sharing of data between health agencies and with adult social care services was still work in progress with individual boroughs.  GP records were now being shared with urgent care centres.  There were issues to resolve around data governance and patient wishes.


Cllr Shah provided an example of a patient attending A & E at 2pm who was then, over the course of the afternoon and evening moved  ...  view the full minutes text for item 7.


Healthcare Commission verbal update pdf icon PDF 118 KB


Hammersmith and Fulham, and Ealing to be recorded as not supporting the case for change when the Shaping a Healthier Future proposals were discussed ahead of the JHOSC’s consultation response was submitted in October 2012.


Ian Duke provided a verbal update with reference to the Call for Evidence Response (which was circulated to members and is available on-line), for which the deadline had now passed. 


Members felt the submission was a helpful, objective and clear document.


Councillor Vaughan wished to be recorded as not supporting the case for change for the Shaping a Healthier Future proposals.



Any other matters that the Chair considers urgent


A discussion paper be prepared on the potential benefits and risks of broadening the scope of the JHOSC to other pan NW London issues at the health/social care interface, including which issues should be discussed and which are outside the scope of the JHOSC.


Cllr Pascal asked whether, following various changes to Mental Health services and the wider implications of the Care Act, the JHOSC should consider extending its area of scrutiny.


The members recognised that the areas for joint scrutiny were potentially vast and requested that officers draft a scoping paper for discussion at a future meeting.


Date of Next Meeting


Cllr Byrne agreed to host the next meeting at Ealing Council.