Agenda and draft minutes

To confirm the minutes from the previous meeting

Minutes of previous meeting agreed.

James Doe gave an update of actions points from the previous meeting:

Concerns have been raised with the Council over the general condition of a number of properties within Gade Tower, which is a Council owned block. The main concerns specifically related to damp and mould, alongside other general repair issues. In response to these concerns, the Council has arranged property MOTs on all Council properties in Gade Tower. Residents received written notification of when these would take place over a 2 week period on June of this year and the Council was able to visit 25 properties during this time. 

Minor repairs were identified and raised for 18 properties and all these repairs were completed by the end of July. There was no evidence found of widespread issue with damp and mould.  The Head of Asset Management (Ian Kennedy) in our Housing Service has maintained regular contact with Cllr Maddern who raised these issues with the Council and coordinated actions.

Follow up inspections will be scheduled in October/November for all properties to ensure there are no further issues relating to damp and/or mould that need addressing as we enter the colder months.

The Safe Homes Team has commenced a capital programme which will see all communal and flat doors and frames replaced with certified fire rated replacements, and redecoration and flooring replacement throughout all communal areas will also be completed as part of this project which is expected to be completed by early December.

Further capital investment works to be delivered during this financial year will include the replacement of both lifts, the first one will commence in October 2023 and will be completed in January 2024 following which the second lift replacement will commence to ensure an operational lift is maintained throughout.

To receive any apologies for absence

There were apologies from Cllr Elliott, Cllr Pound, Cllr Hannelll and D Southam

To receive any declarations of interest

A member with a disclosable pecuniary interest or a personal interest in a matter who attends a meeting of the authority at which the matter is considered -

(i)            must disclose the interest at the start of the meeting or when the interest becomes apparent

and, if the interest is a disclosable pecuniary interest, or a personal interest which is also prejudicial

(ii)           may not participate in any discussion or vote on the matter (and must withdraw to the public seating area) unless they have been granted a dispensation.

A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Members’ Register of Interests, or is not the subject of a pending notification, must notify the Monitoring Officer of the interest within 28 days of the disclosure.

Disclosable pecuniary interests, personal and prejudicial interests are defined in Part 2 of the Code of Conduct For Members

[If a member is in any doubt as to whether they have an interest which should be declared they should seek the advice of the Monitoring Officer before the start of the meeting]

Declarations of Interest.

The chair declared that they are an employee of two local NHS trusts, Hertfordshire and West Essex ICB and the Hertfordshire Community NHS Trust.

Working as a community nurse at the Hertfordshire community NHS and Public Health nursing shifts at the Hertfordshire community NHS.

Cllr Pringle is part of the surgery patient forum in Northchurch.

Cllr Maddern is part of the Hospital action group.

An opportunity for members of the public to make statements or ask questions in accordance with the rules as to public participation

Philip Aylett asked the following question and read a statement:

When writing to the Integrated Care Board about the continued refusal of the West Herts Trust to attend your meetings, could you please note that the Trust is doing worse than its peers on a range of key measures? These include four hour waits for serious cases, inpatient satisfaction and financial performance - with the current year deficit likely to be £21 million. Could you please emphasise that these failings make it more important than ever that the Trust makes itself available and accountable to the Committee?

I understand that the chair has written to, or is intending to write to the integrated care board about the persistent failure of the West Herts hospitals trust to attend meetings of this committee.

In this context I just wanted to ensure that the committee is aware of the following performance measures on which the trust is doing poorly:

dealing with the most serious a and e cases - type one – within four hour: in august the West Herts trust was 110^th out of 110 in the English NHS on this measure, with just 39 % being dealt with within four hours. the national average is nearly 60 % and Bedfordshire hospitals including Luton and Dunstable hit 65%.

Inpatient experience: inpatients rated their experience in Hest Herts at 7.7 out of 10, placing the trust 130^th out of about 140 English NHS hospitals. the survey was carried out by the care quality commission in November last year

Finance: the trust is forecasting a deficit of £21 million for 2023-24, with a possible £33 million deficit if cost reduction measures don’t work. This appears to be worse than other local trusts, and could make it difficult for the business case for West Herts redevelopment to go forward – the treasury does not like it when trusts with major spending plans have serious deficits.

Other issues with the trust include a very critical regulatory report on mortuary services, with descriptions of:

·         Bodies that had deteriorated due to lack of long-term storage

·         Bodies kept on the floor of mortuaries

·         Perished door seals on a freezer

·         A risk to infection control from the transfer of bodies through carpeted areas of the hospital, past wards and main reception, through car park traffic, over kerbstones, and broken pavements.

Philip noted that a new mortuary unit was being built at the back of Watford, but that there was a lack of staff. In regard to ward safety, it was identified that the

Watford Hospital ward kitchens had a food safety record of one out of five, the worst in the NHS, with one of the main issues highlighted the failure to note allergy issues. It was acknowledged that improvements might have taken place, but that this couldn't be confirmed without a re-inspection by the Borough Council. Finally, it was stated that the Trust Board had nine non-executive directors, but suggested that it might not be representative of  ...  view the full minutes text for item 4.

None noted

Item not discussed.

JMcManus identified three key points as a Director of Public Health in terms of the current situation, (1) the demography, (2) navigating a system and partnerships that seemed to be perpetually in flux, and (3) issues and potential solutions.

Demography

JMcManus explained that his team ran two websites, hertshealthevidence.org and the JSNA website, with detailed profiles on illicit drug markets, serious violence needs assessments, and an annual Dacorum District profile, which he would send a copy of to JDoe. He noted that profiles were published for all the care partnerships, by district and borough, adding that, by demography, the health issues were quite mixed, and quite stark in some places, with GP practices where outcomes had not changed for ten or eleven years, and others where they had, as well as a life expectancy gap of eight years between the wealthiest and poorest. It was identified that there was a high burden of preventable ill health, with the population in austerity and poverty in worse health than the best off, and that the demography included a higher smoking rate in the manual and routine working, and minority ethnic communities. JMcManus noted that there had been some successes in Hertfordshire and Dacorum, with some practices doing well at getting older people into strength and conditioning exercise, stopping them from needing social care and helping them remain independent, and highlighted the presence of mental health and other voluntary sector organisations. He emphasised the need to configure systems and structures to protect and improve the health of the demography.

Action: JMcManus to send a copy of the annual Dacorum District profile to JDoe.

System and partnerships

JMcManus identified that regardless of what the ICB and the integrated care system were doing, there was a distinct role for local government in regard to public health separate from, and complementary to, the NHS. He highlighted that only 20% of health outcomes could be shifted by NHS clinical care, with 30% a result of jobs, education, and living, meaning that clinical and non-clinical prevention work needed to be balanced, identifying Type 2 Diabetes and Liver Disease as two growing issues. JMcManus suggested that District and Borough Councils had an opportunity to come together and share work, suggesting that GPs should be referring people into leisure and physical activities, giving the example of fatty liver conditions where there was no clinical treatment, but improvements could be seen based on physical activity, diet, and lifestyle. It was noted that there had been an ICS workshop on working together with local government, but stated that local government had been there first, with the 2012 Public Health Partnership money guaranteed until 2025, and suggested that it would be good to see a combined health offer, particularly around physical activity. He gave the example of Stevenage and an exercise suite with assisted exercise machines that GPs were able to refer patients to after leaving hospital, adding that there was work to be done around rebuilding the population psychologically and  ...  view the full minutes text for item 7.