Agenda and minutes

Apologies for absence were received from Cllr. Sam Mackover. Apologies for lateness were received from Cllr. Dr Mona Ahmed.

Any member of the Council who has a disclosable pecuniary interest in a matter to be considered at the meeting is reminded to disclose the interest to the meeting and to leave the Chamber while any discussion or vote on the matter takes place.

Members are also reminded that if they have any other significant interest in a matter to be considered at the meeting, which they feel should be declared in the public interest, such interests should be declared to the meeting. In such circumstances Members should consider whether their continued participation, in the matter relating to the interest, would be reasonable in the circumstances, particularly if the interest may give rise to a perception of a conflict of interests, or whether they should leave the Chamber while any discussion or vote on the matter takes place.

No declarations of interest were made.

The minutes of the Meeting of Adult Social Care and Health Select Committee held on 1 February 2024 are submitted for confirmation. The action tracker is also enclosed.

The minutes of the meeting held on 1 February 2024 were confirmed as a correct record.

The purpose of this report is to provide an update on the range of services commissioned under the North Kensington Community Based Recovery Services for adults from April 2021 to March 2024.

The Chair invited Cllr. Josh Rendall, Lead Member for Adult Social Care and Public Health, and Gareth Wall, Bi-Borough Director of Integrated Commissioning, to introduce the report. They informed the Committee that there were two components to the way the services were commissioned: talking therapies and counselling, and peer support programmes, which had been set up following learning from other tragedies in the country.

The Chair then invited the provider organisations in attendance to share their offer, and experiences, to the Committee.

1.    Rasha El Sady, from the Association for Cultural Advancement through Visual Art (ACAVA), shared that they had established a community makerspace. It was initially funded by the NHS to tackle social isolation and loneliness and to engage men in the community. The peer support fund allowed ACAVA to design courses to upskill members of the community. Eight courses were run in the last year (2023) about the circular economy which focused on sharing, leasing, reusing, repairing, refurbishing and recycling existing materials and products as long as possible. They invested in kit so that those who complete the course had somewhere to practice their skills afterwards. ACAVA also ran tinkering sessions which had an open-door policy. Despite not being the intention of the courses, they received feedback that they had changed participants’ Christmas by helping with the cost-of-living crisis.

2.    Imane Bouzir, from Al Hasaniya, shared that they provided a psychotherapy service designed for the Arabic speaking community, as part of the Together for Grenfell programme. A lot of the community were not accessing mental health services, as they felt that they were not appropriate for them. They learnt from the community that some of the barriers to them accessing services were language choices, mistrust, lack of awareness, and stigma. Their service was delivered in French and Arabic. The model was created in collaboration with the NHS, despite them originally holding the belief that only mainstream services worked.

Cllr. Dr Mona Ahmed arrived at 6:44pm.

3.     Abderrahman Guelbozi, from Strengthening Kensington Young Families, informed the Committee that he had worked in the borough for 25 to 30 years in youth work. During the Covid-19 pandemic, Abderrahman started his own youth services called ‘men matter,’ which was funded by Sport England and was targeted at men affected by Grenfell living with post-traumatic stress disorder. It was to provide physical activity to help to relieve stress for young men. They had also worked in collaboration with Community Living Well and Mind. They offered counselling every two weeks and educated men about mental health. The organisation had also started to reach out to refugees and asylum seekers who had been placed in the borough.

The Committee Members were then invited to ask questions and the Committee:

1.    Noted that they were unaware of the Together for Grenfell programme and asked whether this work was part of the Grenfell Recovery Strategy. The Lead Member responded that the Together for Grenfell programme was well known by many groups in  ...  view the full minutes text for item 4.

This report provides an overview of GP Same Day Access Hubs and patient access to GP practices within West London.

The Chair invited Dr Andrew Steeden, Borough Medical Director, to introduce the report and he raised the following points:

1.   This was a North West London Integrated Care Board (NWL ICB) programme and none of the attendees from the NHS were leaders on the project but they did lead on local implementation of NWL ICB policy and are part of the ICB.

2.   NWL ICB was trying to address access issues which was one of the pillars outlined in the Fuller Stocktake report.

3.   NWL ICB has had a much longer programme of addressing access due to having greater finances to do so. This was reflected in patient satisfaction results and how they viewed the access offer.

4.   There was concern around the initial proposal, as there was an intention to adjoin the access programme to GP contracts. That proposal had been paused and was being redeveloped. The ICB was supporting primary care networks (PCNs) to negotiate with their communities.

Local GPs, Dr Parminder Dhanjal and Dr Yasmin Razak, who worked in the borough were then invited to share their thoughts and experiences and raised the following points:

1. There was a commitment across NWL ICB from clinical directors to reduce variation and standardise access at practices. GPs supported the work going on across NWL to make access a priority.

2. There was a desire for practitioners to see their own patients where possible and there was not an appetite for patients’ care to be separated across practitioners.

3. Practices were high performing in West London, even in areas high levels of deprivation.

4. There were concerns that patients would be triaged by a non-clinician and a patient would only be able to see a GP for complex issues. The concern from GPs was regarding the principles of the proposal rather than the link to contracts. If a patient sees someone who does not know them and their history and is not appropriately qualified, then there is the potential of the patient putting their health at risk.

5. They had been told that it was a nationally mandated programme and that was why a consultation would not take place but have since been told that it was a NWL ICB specific programme.

Cleo Chalk, from Healthwatch, added that hundreds of patients had approached them with concerns about these proposals. Themes included wanting a formal consultation, there had not been enough engagement, would like to see data on the efficacy of the proposals, and would like to see learnings from existing system regarding what was working well and what was not.

The Committee Members were then invited to ask questions on the report and the discussion included:

1.  Asked whether same day triage at scale was something that they would recommend. NHS officers responded that PCNs would be able to explore how to make it work, not all may be able to make it work.

2. Noted that the Committee was disappointed that there was no senior officer from the NWL  ...  view the full minutes text for item 5.

This report sets out an update to members on the community pharmacies in the borough and the implementation of Pharmacy First.

Appendix 1 - report from the North West London Integrated Care Board (ICB) – to follow.

At the Chair’s invitation, Hitesh Patel, the Chief Officer of the Local Pharmaceutical Committee, introduced the report and raised the following points:

1.    Explained that Pharmacy First was a new scheme which started at the end of January 2024 and provided a service for patients which meant they could access particular prescriptions directly from a pharmacy.

2.    It had been difficult to provide the scheme fully due to workforce issues. In Kensington, Chelsea, and Westminster, eight pharmacies had closed in the last 20 months, and this had impacted access and the social interaction pharmacies provided. The aim for Pharmacy First nationally was three million consultations but this would not be possible if pharmacies continued to close.

3.    There was nothing in the Pharmacy First programme to support economically disadvantaged patients who would not be able to afford medicine suggested to them by the pharmacist. Thus, they would end up going back to their GP, or in the worst case, urgent care, and would be unlikely to use the scheme again.

4.    The number of referrals by GPs was still quite low and there were other areas in North West London which were experiencing higher levels of referrals. There needed to be better IT integration for referrals and the NHS payment system which was a significant problem currently. Pharmacists were unable to access patients’ full GP records.

5.    Residents were facing problems with accessing prescriptions because of the shortage of a lot of medicines currently and the Government was not paying the correct fee to pharmacies to obtain medicines from the correct place.

Cheo Chalk, added that this feedback matched what Healthwatch had heard from residents. Residents supported pharmacy first but were concerned with the closure of pharmacies and the cost of medicines.

The Committee discussed the report and raised the following points:

1.   Queried whether GPs felt it was safer and quicker to do the work themselves and that was stopping them from referring to the scheme. The officer explained that it was related to the capacity of the GP surgery, if they had capacity to handle minor issues then they were likely to do it themselves. The scheme was intended to help GP surgeries who were overstretched. There were still things which people could walk into a pharmacy for and be treated for without a referral, but some things did need a referral.

2.  Noted that the monthly cap of referrals was 3,000 and asked how many were taking place per month currently. In response, the officer explained that the rate was increasing gradually and data from the NHS had a three to four month delay so they did not yet have any data on it. They did not think that the cap would ever be reached and shared that 30 consultations had to take place per month for the pharmacy to receive the minimum payment. In absence of GP referrals and walk-ins, the minimum target of 30 could even be too many to reach.

3.  Enquired what work  ...  view the full minutes text for item 6.

This report is an update on the work programme and scrutiny activities, setting out reports for upcoming meetings.

The Scrutiny and Policy Officer noted that the Committee needed to start to think about priorities for next year’s work programme and this would be developed at the private workshop on 17 June 2024.

The Committee asked for an update on the reports that the Committee were waiting for in the action tracker.

The Committee RESOLVED to agree the items scheduled for the meeting on 8 July 2024.