Declaration of Members' Interests
In accordance with the Council’s
Constitution, Members are asked to declare any interest they may
have in any matter which is to be considered at this meeting.
There were no declarations of interest.
Minutes - To confirm as correct the minutes of the meeting held on 21 September 2022 PDF 103 KB
The minutes of the meeting held on 21
September 2022 were confirmed as correct.
Updates relating to Winter Pressures, Vaccinations and the Cost of Living PDF 61 KB
Director of Integrated Care (DIC) at North
East London Integrated Care Board (NEL ICB) presented an
update on the approach that the Integrated Care System (ICS) was
taking to managing winter pressures in 2022/23, as well as an
update on a recent
winter summit that was held by the Barking and Dagenham
Partnership, to consider actions that could be taken locally to
keep people safe and well at home.
In response to questions from
Members, the DIC stated that:
- Workforce was always a risk area;
however, the ICS had received some additional funding over winter,
which had been directed to providers such as Barking, Havering and
Redbridge University Hospitals Trust (BHRUT), North East London NHS Foundation Trust (NEFLT) and
the local authority, for these to invest in workforce capacity.
Support also needed to be streamlined: in terms of Barking and
Dagenham, funding needed to be streamlined to support social work
in A&E and to increase capacity in emergency response
- Whilst the ICB did not employ
frontline staff (as these were employed by the NHS providers), it
was working to develop a Workforce Strategy so that each of the
provider organisations would have its own Workforce Development
Strategy around recruitment and retention, with some of this being
related to training and skills development. There was also a
constant review around caseloads and capacity. It was also
considering career opportunities and new models of care, such as
through looking at new roles and rotations across organisations to
encourage people to work in Barking and Dagenham.
- Work was also being undertaken
across the Partnership to consider care provider resilience and to
undertake scenario planning to best respond to any issues, such as
where care providers were no longer able to operate.
- The Barking, Havering and Redbridge (BHR) Workforce Academy was
working to understand where there were gaps in recruitment and to
provide recruitment opportunities.
- There were a
number of services in the community that focused on
proactive care; through general practice, NEL ICB had commissioned
an enhanced health care home scheme, which provided
multidisciplinary support to residents in care homes who had
complex needs. This was a collaboration between Primary Care and
community services, with links through to Rapid Response teams as
- The Barking and Dagenham
Partnership had recently piloted a population health management
approach to keeping people well at home, which was exploring a
greater collaboration between the Health and Voluntary sectors.
This had shown that a number of factors
that impacted on health were sometimes best addressed by other
services not provided by the NHS, meaning that greater integration
between Primary Care, community care and voluntary services was
- The ICB had commissioned capacity
in community urgent care services. The Community Treatment team,
which had had significant investment over recent years supported by
system development funding, was designed to ensure that people
could receive a rapid community response if their health
deteriorated more rapidly, to avoid an ambulance trip into
hospital. Generally, these services were for people ...
view the full minutes text for item 56.
Place-Based Partnership Update PDF 62 KB
Council’s Director of Public Health (DPH) introduced an
update on the place-based partnership governance arrangements,
outlining the structure and roles involved as part of
Council’s Acting Chief Executive and Place Partnership Lead
(ACEPPL), the Clinical Director for Barking and Dagenham, the
Director of Integrated Care (DIC) at NEL ICB and the Integrated
Care Director (ICD) at NELFT each outlined their vision for their
roles as part of the Place-Based Partnership arrangements, as well
as the importance of working collaboratively to address issues
across the Borough.
response to questions from Members, the ACEPPL and the DPH stated
- The Health Scrutiny Committee would continue to have a key role
in governance and the oversight of decision-making in future.
Going forward, it would be important
that the Committee’s work programme align with some of the
decisions that were to be taken across the ICS; as such, there was
still some work to be undertaken around the governance of the
- Going forward, the Committee would no longer solely scrutinise
the decisions of Health partners, but of all partners across place,
which included all system leaders, such as the NHS, the Voluntary
and Community sector, the Council and
provider collaboratives. A challenge would be for officers to
ensure that all key decisions were able to be brought to the
Committee, to ensure that it would be able to deliver its statutory
duties around service changes.
was very likely that going forward, the terms of reference for the
Committee would need to be amended to account for its wider role.
It was likely that the attendance for each meeting would also need
to be widened, to include additional key partners.
- The Council was embracing governance changes and was working
very closely with its partners.
- Partners had worked very collaboratively to address Covid-19
issues within the community and this continued close collaboration
would be vital going forward to address health inequalities issues
within the Borough. It would be essential to work as ‘one
system’ in the future.
response to further questions, the ACEPPL and the DIC at NEL ICB
- Ongoing and open dialogue would be essential to collaborative
terms of the decision-making process, there would be a
“conflict of interest” policy; however, the majority of the work that would be undertaken
through the Partnership Board would not require contractual
decisions or any decisions that could have any material impact on
any of the partners. The focus would be around quality improvement
and improving ways of working within allocated resources, rather
than considering commissioning decisions.
New Moorfields Hospital Eye Hub at Stratford, London PDF 65 KB
Chief Operating Officer (COO) and the Divisional Director and
Glaucoma Consultant (DDGC) at Moorfields Eye Hospital NHS
Foundation Trust delivered a presentation on the proposal to
provide additional eye care at a new site in Stratford from Spring
2023, which would bring together in one place a range of eye
services for the local community including glaucoma, medical retina
and cataracts, a specialist pharmacy, diagnostics, face-to-face and
surgical treatments. The existing site at Barking would become a
centre offering diagnostic tests for eyes, jointly operated by
Moorfields, BHRUT and Barts Health. All face-to-face eye clinics
provided at Barking would relocate to the new Stratford
presentation detailed the case for change, the proposals and
feedback from patients. In response to questions, the COO and the
DDGC stated that:
- Whilst there was an eligibility
criteria, the Trust did provide patient transport, which
would continue under the new proposals and those eligible would be
able to be transported from their homes to Stratford. Nevertheless,
the Trust’s aim was to support the
majority of patients who currently received their care at
Barking, to remain at Barking for their care. It was looking to
expand the number of patients that it could see at Barking, where
patients wished to be seen there. Whilst there was a small number
of patients that would have to go to Stratford for their care, the
Trust would assess each patient on an individual basis to look at
how it could support them.
- The Trust had a close working relationship with colleagues at
BHRUT and Barts; in the future, it may be possible for patients who
lived near to one of these sites, to receive their care
- The Stratford site would provide better and additional
facilities for patients. The Trust was also hoping to offer some
low visual aid appointments, so that patients did not need to
travel outside of the Borough for these.
- The proposal would enable patients to receive a range of
diagnostics within the community, through a separate pathway that
meant that they would not need to travel to a hospital
- The Trust hoped to operate the Barking Ophthalmology Community
Diagnostic Centre (CDC) five days a week, seeing around 21,000
patients per year. This was significantly higher than the 8,000
currently seen at Barking.
- The Stratford site would be based at the former MIND charity
offices, which was a four-floor 13,000 square foot building and a
four-to-five-minute walk from Stratford train and bus
- Cataracts patients were currently seen at Barking for the
initial part of their patient pathway and would then need to travel
to St. Ann’s for their surgery, outside of the Northeast
London area. The proposal would enable a “one-stop”
model for cataracts patients, who would be able to receive
all of their care and treatment at the
- Medical retina and glaucoma patients would have periods of
stability where no intervention was required, with these patients
being able to continue to receive care at Barking during
view the full minutes text for item 58.
Health Inequalities Funding PDF 62 KB
Council’s Consultant in Public Health Primary Care and
Transitions (CPHPCT) delivered a presentation on the Barking and
Dagenham Health Inequalities Programme 2022/23, which provided
context as to health inequalities in the Borough in comparison with
London and nationally, how the funding was secured for the
programme, programme workstreams and the benefits of the
response to questions from Members, the CPHPCT stated
terms of the debt and health pilot, the Council was identifying
adults who were falling into debt, such as those who were failing
to pay Council Tax, as well as those whose social care records
showed that they had low level mental health problems, as it was
aware that debt could exacerbate mental health issues and that
mental health issues could make it more challenging to manage debt.
This was a pilot that had previously been undertaken, with the
Council looking to scale this up, as well as make this more
effective through linking it to the NHS. Those identified would be
approached and offered the opportunity to access social
prescribing, with social prescribers being trained to signpost and
support these residents with expert advice on debt and
- Currently, no referrals into Talking Therapies or IAPT would be
made, as there was no medical diagnosis or clinical assessment as
part of the programme. The debt workstream was focusing on reaching
those residents who were falling into debt before the issue started
to escalate; however, referrals could be a future iteration of the
- The Council was going to look into
the data that all partners held, to ensure that all across the
system had the same understanding of health inequalities within the
Borough. This data could then be used to better support planning
delivery, through the creation of a data indicator set or dashboard
that all partners could refer to. The Council was also working
closely with its Data Insight Hub to support this work.
DIC at NEL ICB stated that there was an opportunity to look at how
residents could be better signposted to NHS services, and that
confirmation had also recently been received that the funding for
the debt workstream would become recurrent, which would help with
long-term planning. Residents could also self-refer into IAPT
services if they had any concerns.
Clinical Director for Barking and Dagenham also stated that each of
the Primary Care Networks (PCNs) had Inequality Clinical Leads;
each PCN would likely have different prevalence rates for different
conditions and the Leads would be able to identify these and
concentrate resources in a tailored way to that area.
response to further questions, the CPHPCT stated that there was a
work stream which aimed to identify interventions for children and
young people who were starting to develop low-level mental health
issues, to provide them with support within the community to build
their resilience. The ICD at NELFT stated that self-referrals could
be made into the Barking and Dagenham CAMHS service; there was a
phone number and ...
view the full minutes text for item 59.
Scrutiny Review on the potential of the Voluntary and Community Sector 2022/23 PDF 69 KB
Chair presented the proposed terms of reference for the
Committee’s Scrutiny Review on the potential of the Voluntary
and Community Sector 2022/23. The Committee agreed the terms of
reference and noted that officers would draft a project plan, with
a timeline for completion. This project plan would then be
circulated to the Committee in advance of the next formal meeting
Joint Health Overview and Scrutiny Committee
was noted that the minutes of the last meeting of the Joint Health
Overview and Scrutiny Committee could be accessed via the link
provided on the front sheet of the agenda pack for this
Work Programme PDF 61 KB
Committee agreed the Work Programme.