Agenda item

Matthew Cole, Director of Public Health, presented the report on the performance for Quarter 3 and drew the Board attention to a number of improvements and need for further improvements that were needed.

The Chair commented that there were some signs of improvement, for example the number of health checks had improved, but she was disappointed that the level of immunisations had dropped and that the Borough’s two primary hospital Trusts were now in special measures. 

As part of the discussion it was noted that BHRUT and CCG would be working on improving primary care now that the acute provision is being stabilised.  In addition the CQC report on Queens Hospital was expected in the near future and it was possible that Queens Hospital may be removed from special measures.  Barts Trust was primarily in special measures due to the serious concerns about Whipps Cross Hospital and whilst the Barking and Dagenham CCG had an interest in that provision they were not directly responsible or significantly involved.

Conor Burke commented that provision across the whole of the area would need to be up-scaled to be able to deal with the population growth that was projected to occur as there would be significant effect on both the CCG provision and the local hospitals.

In response to a question from Councillor Turner about residential care homes being inadequate, Anne Bristow explained that under the new criteria care homes now either fully meet the criteria, or they don’t.  There was now no category to allow minor infringements to be noted and dealt with.  Minor infringements would now result in ‘not met’. 

In regard to starting the programme of visits to care homes in the Borough.  Helen Jenner suggested that the Ofsted model may be a good basis to work.  from.  Frances Carroll, Healthwatch, advise that they can do both announced and unannounced visits but they have some difficulty in then working out where their reports should be reported onto for action.  The Chair said that they would look at the use or adaption of the Ofsted model and would discuss with Councillor Keller, Chair of the Health and Adult Services Select Committee, to ensure that maximum scrutiny could be given to ensure improved service levels were achieved for residents.

Jacqui van Rossum did not discount that there could be a data feed delay in regards to the number of newborns not seen within 14 days, however, she suggested that it might be advisable to undertake exception reporting to identify why a baby had not been seen. for example if the baby was still in hospital or may be in another health authority area.

A member of the public present raised a question in regards to paragraph 5.4 of the report and the standards not being met by Abbeyfield East London Extra Care Society.  Anne Bristow explained the CQC would give a timeframe for the necessary action to be taken and depending on the issue that could be a requirement for immediate action or longer timeframes, for example to arrange and train staff etc.  Regular monitoring would be undertaken to ensure the required actions were progressing adequately.

Having received the report, reviewed the overarching dashboard, discussed the performance report for Quarter 3, noted the new data available and further detail provided on specific indicators, and the actions being taken to sustain or achieve good performance. 

The Board:

(i)  Noted quarterly improvements and that

·  A&E attendances had decreased between February and March, extended hours opening being introduced.

·  A 6.7% reduction in ambulance conveyances to BHRUT.

·  Chlamydia screening uptake had increased, as had detection rates.

·  NHS Health Checks for eligible residents was now above target.

·  Reductions in IAPT referral waiting times.

·  Children and young people accessing CAHMS was up by 16%.

·  Face-to-face health visitor visits for new born children had increased to 85.1%.  However, nearly 15% of newborns not being seen within 14 days needed to be viewed as a potential safeguarding risk, and exception reporting would be necessary to identify if the child was in hospital or had been seen in another health authority area.

(ii)  Noted that further improvement was indicated in regards to

·  Child immunisation take-up.

·  Reduction in teenage conception rates.

·  Health checks for looked after children.

·  Smoking quitters, although it was noted there had been some significant improvement from 4 to 34 pregnant mothers who had been admitted to the course.

·  Reports from the Care Quality Commission inspections in regard to GP practices and care homes, including six breaches at Alexander Court Care Centre.  The Liberty Centre care home was in Havering, and they were leading on that investigation

·  The number of 2 to 2.5 year olds seen by a health visitor.

(iii)  Noted that further information on the inspections of care homes, including by Councillors and other interested persons, would be provided in due course.