Agenda and minutes

The Chair introduced the Committee, explained its purpose and informed attendees that Cllr Dr Mona Ahmed would make a statement in relation to the Grenfell tragedy.

Cllr Ahmed explained that week beginning 22 January 2024 was Grenfell testimony week and that she represented Notting Dale; the electoral ward where the tragedy occurred. This was a time for reflection including examining what the Royal Borough of Kensington and Chelsea (RBKC) needs to do better as a Council.

Cllr Dr Ahmed noted that it was unfortunate that the Committee was meeting during the testimony week, however the meeting offered an opportunity to scrutinise the mental health support being provided to those affected by the Grenfell tragedy.

The Committee thanked Cllr Dr Ahmed for her comments. 

There were no apologies.

Cllr Dr Ahmed disclosed that she was employed by the NHS as a consultant psychiatrist, but was not employed by Central and North West London NHS Foundation Trust (CNWL) or North West London Integrated Care Board (NWLICB).

The Committee did not regard this as a disqualifying interest.

The minutes of the last meeting that took place on 11 January 2024 were published late and, as a result, members of the Committee had not had the opportunity to read them. Consideration of the minutes of 11 January 2024 was deferred to the next meeting.

The Executive Director of Strategy and Population Health (EDSPH) at NWLICB updated the Committee on six outstanding actions.

At the meeting that took place on 11 December 2023, the CNWL/NWLICB pledged to notify the Committee how much of the £2.3 billion of additional funding, relating to the Mental Health Standard (MHS), which was awarded in 2018, was allocated to each borough. The EDSPH had pledged at the meeting that took place on 11 January 2024 that he would provide this information at the next meeting.

The EDSPH said that, whilst he had the figures, he could not provide the requested information as a preliminary examination of the data indicated that there had been disproportionate investment in Westminster and Kensington and Chelsea. The EDSPH explained that the was being reviewed to ensure that it was accurate.

In relation to the other three actions the EDSPH highlighted that on the morning of 23January 2024 an email had been sent containing;

A breakdown of expenditure of the £50 million that was allocated to Grenfell Recovery had been emailed; and

A list of groups that had been consulted, and those who have been invited to participate in the consultation; and

Information on the works necessary on the Gordon Hospital site to make it suitable to house the Mental Health Crisis Assessment Service (MHCAS)

Regarding, Grenfell, a representative from Grenfell United later confirmed that they had received a breakdown of expenditure relating on the Grenfell Wellbeing Service but not the remaining expenditure.

Regarding the fourth remaining action, communication had also been sent to the Lead Member for Adult Social Care and Public Health (Lead Member) at RBKC in response to some of the concerns he raised regarding the relocation of MHCAS from the St Charles Centre to the Gordon Hospital.

The Committee expressed concern at the time NWLICB and CNWL were taking regarding the actions. The Committee also noted that a previous request had been made, nearly one year ago, by the Lead Member for a borough-based breakdown of how much of the additional funding provided to implement the MHS had been spent.

In regard to the breakdown of additional monies to implement the MHS, the EDSPH accepted the Committee’s criticism that the NWLICB and CNWL had failed to provide the requested information in good time. However, in relation to the other four actions, the EDSPH rejected the criticism stating that the last meeting of the Committee took place just over a week earlier on 11 January, and that the actions were not confirmed until 19 January. The EDSPH said that it was unfair to expect NWLICB and CNWL to provide complex information within such a short timeframe.

The Committee noted the EDSPH’s comments.

The Chair announced that, as the next date of the meeting had not been confirmed, the work programme was still being updated.

Representatives from Kensington and Chelsea Social Council (KCSC), St Mary Abbots Rehabilitation and Training (SMART), North Kensington Community Kitchen (NKCK) and Grenfell United addressed the Committee in relation to the effects on the voluntary and community sector (VCS).

The VCS representatives indicated they were sympathetic to the financial, legal and administrative concerns of CNWL; however, they were critical of CNWL’s proposals.

It was observed that the pre-consultation business case referred to ‘Hope in the Community’; a voluntary sector service that would provide open access, culturally sensitive, services in the Gordon Hospital with support from third sector organisations with particular focus on black service users. The VCS representatives said that the establishment of such a service required a truly collaborative process with the VCS, service users and the wider community. However, this would take time and would still require the provision of acute beds in the Gordon Hospital.

The VCS representatives claimed that they were dealing with the consequences of economic and social pressures and the number of people suffering a mental illness was rising. It was argued that it was inappropriate to reduce acute mental health beds at this point and CNWL and NWLICB were urged to focus on long term solutions with the aim that a gradual decrease in bed provision may be possible thereafter.

The representatives took the view that the consultation was a missed opportunity to develop a collaborative approach to care within the place-based partnership stressing that, in their option, there was no short-term way to replace acute care with community-based care. They then discussed the CNWL and NWLICB’s engagement claiming that it had been inadequate. The neutrality of the survey was also questioned, and the use of a communications agency was also questioned on the basis that some groups were hard to reach.

The VCS representatives also said that there was insufficient data on the adverse effects on the VCS if acute beds were reduced, data that, it was claimed could be provided by the VCS if they were asked.

The VCS representatives questioned the impact of circa £1.2 billion that had been spent on health services in the area and claimed that CNWL had not provided evidence on the appropriateness and effectiveness of services provided.

Responding to questioning from the Committee, the representatives said that they preferred an option co-produced with the VCS which could be based on the options outlined in the pre-consultation business case. The representatives also confirmed that they have been invited to, or had participated in, a consultation meeting but only after they raised issues about the initial lack of consultation.

Professor Jill Manthorpe (JM), Professor Emerita of Social Work at Kings College, provided her views to the Committee noting, with the consultation period likely to be extended, that;-

It would be advisable to hear from organisations in the vicinity of the Gordon Hospital and cited the Peabody Trust and Anchor Housing as examples; and

Engage with VCS that are connected to social housing; and

It would be advisable to  ...  view the full minutes text for item 6.

Two residents addressed the Committee.

The first speaker explained that they were a carer for their son who had been through the mental health system. Citing their experience, they suggested that the reopening of the Gordon Hospital was not desirable without major changes in its operation and staff training adding that the quality of care at the hospital was poor.

It was proposed that the Gordon Hospital should not be reopened and instead the money be invested in community services providing trauma informed care. The first speaker emphasised that mental health issues were often due to an underlying issue which could be physical or a result of trauma and that good diagnostics was essential to ensure that care is appropriate. The first speaker concluded with the warning that administering powerful drugs without good diagnostics was wrong and that a lack of trauma informed care often results in more trauma for patients.

The second speaker disclosed they were involved with Healthwatch and had attended meetings hosted by CNWL. The second speaker highlighted the concerns made by service users and residents at these meetings.

Among their concerns was the helpline which they claimed was inadequate. For some patients, their only option was to present at A&E.

The second speaker said that RBKC had adequate provision for its population but was under pressure owing to the effective removal of acute beds for a borough the size of Westminster and called for both boroughs to have their own separate provision.

The COO responded to the criticism of the helpline stating that the helpline was staffed by qualified persons and that 75% of calls were answered within two minutes. Where a caller was facing an emergency, the helpline could arrange for a member of staff to see them within four hours. If it was less urgent, then an appointment could be made within 24 hours and if it was not urgent then within 28 days.

The COO added that the average wait from referral to first contact with a professional was 16 days. When the Gordon Hospital was open, the average wait was 59 days.

The Committee thanked both residents for their contributions and the CNWL for its response.

There were no items.