Agenda and minutes

Scrutiny Committee
Wednesday, 18th October, 2017 7.00 pm

Venue: Civic Offices, St Nicholas Way, Sutton SM1 1EA

Contact: Aimee Wittams-Smith, Committee Services Officer  Tel: 020 8770 4990, Email:  committeeservices@sutton.gov.uk

Items
No. Item

17.

Minutes of the last meeting pdf icon PDF 232 KB

To approve the minutes of the meeting held on 12 July 2017.

Minutes:

The minutes of the meeting held on 12 July 2017 were agreed and signed as a correct record.

 

18.

Declarations of interest

Minutes:

3. Chairs Q&A.

Councillor Nick Emmerson, Non Pecuniary, declared that as he was the Vice-Chair of Housing, Economy and Business Committee, he would be acting in that role to respond to questions during the Q&A with Councillor McCoy.

 

19.

Apologies for absence and notifications of substitutes

Minutes:

Apologies were received from Councillors Callum Morton, Mary Burstow, and Doug Hunt, Councillor Sunita Gordon attended as a substitute. Councillor McManus sent apologies for lateness.

 

20.

Chairs Q&A pdf icon PDF 193 KB

Councillor Jayne McCoy to attend in her role as the Chair of Housing, Economy, and Business Committee, to answer questions from Scrutiny Committee members.

Minutes:

Councillor Jayne McCoy attended to respond to questions in her role as Chair of Housing, Economy and Business Committee. The questions and answers are set out as an appendix to the minutes.

 

Councillor Ali informed the Committee that as a large number of questions had been received, any questions that were not reached would be answered in writing and published as part of the appendix to the minutes. Councillor McCoy offered her notes to include as part of the attachment, as such the attachment to the minutes contains her notes and any additional discussion that followed each question.

 

21.

Introduction to the new Borough Commander

An introduction to the new Borough Commander, Robyn Williams.

Minutes:

Chief Superintendent Robyn Williams and Sergeant Kathy Morteo attended to address the committee. Chief Supt Williams introduced her background, she had started in her role on 11 September 2017, and was due to begin sooner however had been working on the response to the Grenfell Tower tragedy. She started her career in the Nottinghamshire Police, was appointed as part of HM Inspectorate of Constabulary in 2003 and joined the Metropolitan Police in 2008. There, she worked in Westminster and Lambeth then became the Deputy Head then Head of Met training. Following that she joined the professionalism portfolio, and moved on to Sutton whilst maintaining her position as the Met official spokesperson for Notting Hill Carnival and NYE and other high profile events.

 

She highlighted her priorities as Borough Commander in Sutton, which were strong partnerships to collectively keep Sutton safe, safeguarding, and the development of her staff. She added that she would like to see evidence-based practice, as a fan of innovation and technology, particularly where it could assist with communication and the prevention of crime.

 

Councillor Ali asked what the key crime priorities were for the borough. Chief Supt Robyn Williams responded that burglary remained a priority particularly in the winter, and that seasonally there is a “be safe” programme around anti-social behaviour with Halloween and Bonfire Night. She added that domestic violence was a significant challenge as well as weapons and knives, and that they would be using stop and search to prevent disorder as the focus would be protecting the most vulnerable and targeting the most prolific and violent criminals.

 

Chief Supt Robyn Williams responded to concerns raised by Councillor Emmerson regarding cut funding that many assessments and management of a range of offences had changed to become more sophisticated in identifying crimes where without new evidence not much can be done. In response to a question from Councillor Bartolucci regarding the One Met Model, she described partnerships with neighbouring boroughs with two path finder areas, adding that the Mayor of London and The Metropolitan Police’s Senior Leadership were considering measures and testing how best to streamline the work. She confirmed that the model was in the design but not imminent.

 

Councillor Joyce asked a question regarding working with local communities to “police with consent” as the riots in 2011 saw some of the worst offences on the border of the borough, and how to maintain the high levels of safety in Sutton. Chief Supt Robyn Williams responded that Sutton has an engaged community, and that she would focus on those in protected characteristic areas in order to understand the communities and ensure that nobody feels isolated or disenfranchised. She added that she would want to hear from charities and voluntary groups in Sutton, was looking to refresh the Independent Advisory Group and  work more closely with young people.There was a practice exercise planned early next year to see how services would respond to work together to keep community safe for a major/critical incident.

 

22.

MOPAC: Feedback on Public consultation on the Public Access and Engagement Strategy

To receive any early feedback on the MOPAC consultation which closed on 6 October.

Minutes:

Councillor Ali asked whether there had been a theme across responses, in particular objections, to the recent public consultation on the Public Access and Engagement Strategy, which sought to close Worcester Park counter, Crosspoint, and Sutton Arena. Chief Supt Robyn Williams responded that they had heard a range of perspectives however had not yet been updated about the nature and extent of other voices and responded since the consultation closed on 6 October 2017.

 

23.

Flood Risk Management pdf icon PDF 145 KB

Sue Marwood and Mike Mair to attend from the Highways team to provide the committee with the annual report on the Flood Risk Management Strategy action plan.

Additional documents:

Minutes:

Sue Marwood (Highways Operations Team Leader), Mike Mair (Flood Risk Officer) and Ed Clarke (Environment Agency) attended. Sue Marwood introduced a report on the local flood risk management strategy.

 

Councillor Gordon asked whether gullies will be cleaned as frequently following the commissioning of road sweeping to Veolia, in particular the Wallington underpass which is known to flood. Sue Marwood responded that officers were liaising closely with managing the Veolia contract, that the Wallington bridge was closely monitored by a Highways Inspector, and that they would be inserting a probe at the location which will alert them in advance if there is a risk of flooding. Councillor Gordon raised concern that it was not addressed as part of the strategy and Sue Marwood confirmed that the new waste contract had been challenging so they were not in a position to change any contractual arrangements however that they were being proactive in ensuring that the contractor responds to any concerns they are aware of. Mike Mair added that it was difficult to identify where flooding comes from so the strategy was there to identify who is best to engage with in order to prevent the issues. Sue Marwood and Mike Mair responded to a further question from Councillor Gordon regarding the plan, that they had identified 8 areas in Sutton and Kingston to monitor, including Wallington Bridge and Worcester Park bridge.

 

Councillor Emmerson asked how frequently gullies would be cleared and inspected. Sue Marwood confirmed that gullies were inspected by four Highways Inspectors who did not have the capacity to inspect every gully every 3 months but did focus on the ones known to have caused issues and located in the town centre. She added that the cleansing regime would be carried out by Veolia and that she would be happy to investigate the details.

 

Mike Mair responded to a question from Councillor Emmerson regarding funding, that they bid for circa £140k however it was not not ring-fenced. Councillor Williams referred to Appendix A which included new ways of working to reduce flooding and new ways to pay for improvements. Mike Mair confirmed that funding comes from the aforementioned bid and the Environment Agency and DEFRA grant process. Councillor Williams raised concerns that flood risk management may be at risk if the funding was not forthcoming and Mike Mair confirmed that they were working with landowners and property owners to highlight the risks and increase awareness in order to prevent problems arising in the future.

 

24.

Epsom and St Helier NHS Trust pdf icon PDF 2 MB

Daniel Elkeles, Chief Executive of Epsom and St Helier NHS Trust to attend to discuss the written update from the Trust on performance and the 2017/18 2 selected priorities narrative report (learning from deaths in hospital and infection control), as well as progress on the recent estate engagement for the 2020-2030 project bid.

Minutes:

Daniel Elkeles, Chief Executive, and Dr James Marsh, Consultant Nephrologist and Joint Medical Director, attended. The key points in their update were:

 

  • Infection control has historically been a challenge, so the Trust have undertaken to implement measures to improve, outlined on page 30 of the agenda pack.
  • Proactively vaccinating staff ahead of the difficult flu season expected ahead.
  • Epsom and St Helier are safe hospitals with good mortality figures. Approximately 100 patients die per month. For each death there is a mortality review as a screening process to identify where care concerns may arise and system-wide learning could be shared throughout the structures. A policy has recently been developed and agreed  in line with national guidelines on mortality review.

 

Councillor Williams raised concerns about references to ‘learning from mortality’, and asked whether people would be held to account for deaths that could have been avoided. Dr James Marsh responded that people are held to account where their conduct or capability falls below an acceptable level, and that the policy had been developed in line with national guidance to ensure that the Trust acted as a ‘learning’ organisation to recognise where a series of events in the system could be altered as is most commonly seen to be the cause of an “avoidable” death.

 

Councillor Emmerson raised concerns about the gap in staff mentioned in the report with regards to the departure of the Darzi fellow working on the Sepsis program. Dr James Marsh responded that in order to prevent the loss of knowledge gained through the program they had established champions who had worked with and learned from her. Dr Marsh undertook to provide figures on the frequency of Sepsis occurring in the Trust.

 

Councillors discussed the recent media coverage  Radio 4 programme about CQC report on the London Borough of Sutton partners (CCG, NHS Trusts) on care for the elderly to keep them at home and not in care homes/hospitals. Daniel Elkeles confirmed that the Trust were top in London and 12-13th nationally for A&E and around third for the cancer target, however that in the 18 weeks referral target they were in the bottom quarter and that there had been a 20% increase in ambulance attendance in St Helier which was concerning.

 

Councillor Ali asked for an update on the Epsom & St Helier 2020-2030 estate ‘Involvement’ document . Daniel Elkeles confirmed that in the engagement period the Trust had undertaken 46 meetings, having properly engaged with over 25,000 people in their catchment and received over 1000 responses to their 5 questions asked, as well as a huge amount of correspondence. He added that they had employed the Consultation Institute (an independent body) to analyse the feedback, that the financial analysis was complete, and that they were granted permission from all commissioners and regulators to put a summary of the case out to the public on Friday 10 November.  Daniel Elkeles offered to come back and talk to the committee in more detail when the information is published.  ...  view the full minutes text for item 24.

25.

Healthwatch Sutton

David Williams (Chair) and Pete Flavell (Manager) to attend from Healthwatch Sutton to provide an update on the organisation’s work with NHS SWL and Surrey Downs.

Minutes:

David Williams, Chair of Healthwatch Sutton, provided an update to the committee, in particular:

 

  • A key piece of work in the future is to ask residents what matters to them most, and what they would like Healthwatch to look into.
  • There is an issue with mental health prevalence in the young, in particular surrounding body image.
  • They had produced a film working with young people which has been shared on social media which lead to investigating other mental health issues for young people in the borough.
  • Launching an investigation which will be undertaken via schools which intends to explore bullying, drug-use etc and to report back school-by-school in a confidential manner in case children could be identified.
  • Healthwatch England via the STP offered money to enable the “hard to reach” groups to have an event so that the team could attend and build a relationship. So far have received two applications and expect more to come.
  • Working with A&E in Epsom and St Helier to find out why satisfactory feedback for the “friends and family” test had dropped. Aim to ask a cohort of patients if they were happy to be contacted following their experience.
  • Working with the CCG and Trust to try to understand why people attend A&E as opposed to other pathways eg GP, pharmacy
  • Working with Sutton Mental Health Foundation to look at people in crisis care plans
  • A “crisis cafe” which has been successful in Merton, so will be seeking funding to set one up in Sutton.

 

26.

NHS Sutton CCG - updates pdf icon PDF 873 KB

Sian Hopkinson and Lou Naidu to attend from NHS Sutton CCG to provide updates on the Primary Care Strategy and the Central Sutton Health Centre development.

 

Presentation to follow

Minutes:

Sian Hopkinson and Clare Wilson attended from Sutton CCG in order to present on the Primary Care Strategy and the Central Sutton Health Centre development.

 

Following their presentations, Councillor Ali asked what could be done to break the culture of people wanting to see a specific GP. Sian Hopkinson responded that continuity of care is important and communication with patients is important to ensure that they are comfortable seeing a different clinician and that they will receive the same level of service throughout.

 

Councillor Ali asked if there was an issue with recruitment and referred to an incentive scheme employed by Cornwall and Devon to recruit. Sian Hopkinson confirmed that Sutton has a lot of GPs and Practice Nurses who were close to retirement age and trains a lot of GPs and nurses who unfortunately leave, so although such a scheme was not necessary, they would investigate what can be done to encourage people to stay in Sutton to work and live.

 

Councillor Williams asked for the CCG’s view on video-link consultation which was being rolled out at a £39 charge in the private sector. Clare Wilson confirmed that there was discussion in London about providing services digitally, which would be free to patients, and that there were a number of online tools expected to be released in the coming months. Councillor Gordon raised concerns that too much digitisation could be harmful to an ageing population. Sian Hopkinson responded that they would aim for a balance so that if the people who want to use apps/book appointments online are able to do so then it will free up the phone and the space in a surgery for those who prefer to telephone or need to attend in person.

 

Following a question from Councilor Gordon, Sian Hopkinson confirmed that Hub Services with extended access were located at Wrythe Lane and the Old Court Couse in the town centre and that the CCG were not looking at more hubs, but to increase the capacity and types of patients.

 

It was confirmed that work on the plans for a Central Sutton Health Centre had been paused as following preliminary approval for funding for the site, the Practises that were not already based there had indicated that they did not want to move there, particularly following concerns from patients about transport. In response to a question from Councillor Ali, there was confirmation that the deadline for the funding was for work to be completed by March 2020.  

 

27.

NHS Sutton CCG - Consultation on items prescribed in primary care pdf icon PDF 51 KB

Sarah Taylor, Head of Medicines Optimisation at Sutton CCG, to lead a consultation on items which should not routinely be prescribed in primary care.

Additional documents:

Minutes:

Sarah Taylor introduced a report in relation to an NHS England consultation on items which should not be routinely prescribed in primary care. Sutton CCG were engaging with residents and stakeholders in order to seek views locally. The NHS England consultation was due to end on 21 October 2017, however the Sutton CCG were extending their consultation. Sutton CCG sought the views of Scrutiny Committee to inform their response to the NHS England consultation.

 

Following questions from Councillors, Sarah Taylor confirmed that there was a list of medicines that are prescribed based on the evidence that has been submitted for a drug to get a license to be marketed in the first place and then used in superiority to other medicines on the market. She explained that patients are very carefully selected to take part in a clinical trial to reduce the variables and ensure more accurate results for that particular drug, however there will never be the experience with newer drugs that is there for older drugs. She informed the committee that generic drugs are the same drug as branded ones but with lower costs for making them so come at a lower price, and although some patients will feel that they prefer one generic drug over another or a brand that prescribers work to explain to patients so that they take the medication. She added that the most expensive medication to the NHS was medication that patients choose not to take as it results in their health worsening and greater costs down the line. She concluded that the research was initially about lowest cost of medicines, however it does have a knock on effect if the drug has side effects which results in patients ending up in A&E so it is about finding the most suitable.

 

A link will be available online on the NHS Sutton CCG website for stakeholders to participate in the consultation, closing at the end of November.

 

28.

Scrutiny Committee workplan pdf icon PDF 77 KB

To review the committee’s rolling annual work plan.

Minutes:

The Committee reviewed their draft annual workplan. Councillor Ali advised that Councillor Colin Stears would be attending the next meeting for the Chair’s Q&A item as Chair of the Adult Social Services and Health Committee.

 

Councillor Ali proposed that the committee held a task and finish group to investigate transport in the borough, to report back in February. Councillor Emmerson suggested that members of HEB Committee may be helpful to become involved, and also suggested a task and finish investigation into the accessibility of pharmacies. The committee agreed that they would communicate by email.

 

David Olney encouraged Scrutiny Committee members to contact the Chair with ideas.

 

29.

Any urgent business

Minutes:

There was no urgent business.