Agenda and minutes

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.

The minutes of the meeting held 18 September 2023 were confirmed as correct.

The Chief Executive (CE) of Barking, Havering and Redbridge University Trust (BHRUT) provided a verbal update on the appointment of Tony Chambers as Interim Chief Executive BHRUT following the investigation and subsequent sentencing of Lucy Letby.

The CE advised that throughout the multi-stage recruitment process for Tony Chambers, all measures were followed regarding the interview and pre-employment procedures, however there were no findings in relation to misconduct during his time at Chester Hospital (CH). Amongst the 11 applicants for the post, four applicants were shortlisted and interviewed, including Tony Chambers who briefly mentioned his experience and some of the challenges he faced at CH.

Tony Chambers’ experience at BHRUT was dominated by Covid-19, with him being only ten weeks in-post when the pandemic began. There had been an external review on the key decisions regarding safety and equality during the time of his appointment, for which there had been a clear governance process and there were no concerns raised. In April 2020, a whistleblowing measure was put in place as an independent guardian policy for staff who were potentially concerned that their issues were not dealt with effectively. Issues raised in relation to management, safety, work and bullying increased between April to October 2020, which signified a positive trend as staff openly proceeded with complaints without anonymisation. This worked to support a changing BHRUT workplace culture as staff could attempt to resolve issues before escalation.

The appointment of CE and Directors was also discussed. In line with the Fit and Proper Persons framework, there was transparency across an individual’s career at BHRUT. From pre-employment checks, appraisals, references, exit interviews, enhanced DBS checks and a formal completion of assessment, all senior staff experienced the same procedures. A leader competency framework was also in place; also based on transparency, the CE commented that Tony Chambers would have met the Trust standards today, although based on the media, his image was flawed.

The criminal trial focussed on the actions of Lucy Letby and did not analyse the conduct of the NHS Trust and therefore, media coverage on the topic of conduct was highly speculative.

A series of questions were asked to the CE BHRUT regarding their responses and reflections on the Letby case. On a question on the Trust’s plans for prevention of such cases in the future, the CE suggested that the Letby case was considered an isolated case which was not ideal to inform policy changes. He also ensured that there were no characteristics which would have indicated that Letby was involved in such criminal activity, where it was further noted that the potential role of race could have misinformed the response of the Senior Leadership Team at CH.

The CE outlined the progress of policy change in response to a question on rebuilding trust from the perspective of the public. A focus on behavioural characteristics alongside seeking external critical reviews and independent bodies of scrutiny would be used to improve transparency and responses to future cases. It was highlighted again  ...  view the full minutes text for item 23.

The Chief Operating Officer (COE), BHRUT, the Clinical Cancer Lead (CLL) and the Programme and Service Development Lead – Community Diagnostics (PSDL), presented a report on the progress of the new Community Diagnostics Centre (CDC) at Barking Community Hospital (BCH). 

As part of a national programme since the beginning of the pandemic, CDCs were to be introduced as a means to increase the capacity for patient investigations. By working with community providers for staff and facilities, alongside gaining funding to carry out the project, the development of this innovative service would work to reduce delays for patient services. Especially as a Borough which does not have an acute hospital to support its growing population would contribute to a 21% increase in demand for services, this would reduce deprivation levels overall, by contributing to the reduction of health inequalities in the Borough.

The PSDL highlighted the importance of engagement with the local population who supported the development of the CDC. Their suggestions were considered throughout the development and reflected the needs of service users in the Borough.

As a result of service user feedback, the BCH CDC would include:

·  Free parking for patients;

·  Calm pastel and pale colours throughout to make it more relaxing for all patients;

·  Floor to ceiling windows;

·  Ramps, lifts and accessible changing rooms run throughout, and all patient services available on ground floor;

·  Landscaped outdoor space;

·  Increasing ways to book appointments;

·  Staff to be trained on how to communicate with all patients; and

·  Continuous improvement of care and experience gathered through patient and staff survey before and after the CDC opens

With various facilities at the CDC, the PSDL explained that an extra 72,000 scans would be possible every year. Scanning equipment such as MRI, CT and ultrasound would be housed at the CDC alongside consultation rooms for a range of other tests. Early diagnoses for some cancer types would also be available as well as innovative tests such as cystosponge, colon capsules, transnasal endoscopy and a rapid asynchronous triage clinic for oral lesions. Included with this were public facilities for waiting and changing and hearing induction loops for patients with hearing impairments. Such advancements would also provide job opportunities amongst the local population, for example, where nursing staff would benefit from an expanded scope of practise when the CDC opened.

The progress of the CDC for 2024 was then outlined. Whilst the BCH CDC would open in Spring 2024, there would be ongoing engagement with stakeholders, patients and staff including site visits and a patient trial run in order to understand their first-hand experience at the centre. Furthermore, there would be collaboration with Healthwatch on accessible information standards training for staff to further improve patient care. The opening of a new CDC in St George’s (Hornchurch) embedded in the St George’s Health and Wellbeing Hub was proposed.

On a question regarding staff communication with patients of differing abilities, the PSDL explained that all staff would be trained to communicate effectively with patients to give them  ...  view the full minutes text for item 24.

The agenda reports pack and minutes of the last meeting of the Joint Health Overview and Scrutiny Committee can be accessed via: Browse meetings - Joint Health Overview & Scrutiny Committee | The London Borough Of Havering

The minutes of the last Joint Health Overview and Scrutiny Committee (JHOSC) were noted.

The minutes of the last Health & Wellbeing Board and ICB Sub-Committee were noted.

The Committee requested that a report on the impact of the financial savings due to be considered by the ICB be presented to the next meeting of the Committee.

The work programme was noted.