Tuesday 18 October 2016

Hear Melissa Benn on motherhood, daughters, selective education and much else on Thursday


From Brent Culture:

Melissa Benn will be giving a talk at Kilburn Library this Thursday 20th  October

6.30-7.30pm

Kilburn Library, 42 Salusbury Road, London, NW6 6NN
Melissa is an author, commentator and journalist and member of the famous Benn political family, daughter of the late Tony Benn and sister to Hilary Benn MP.  She is also a local resident.  She has written and campaigned on many issues but is most known for her views on education.

On Thursday Melissa will talk about the seven books she has written; Public Lives, One of Us, Madonna and Child: Towards a New Politics of Motherhood, School Wars: The Battle for Britain's Education, What Should We Tell Our Daughters?: The Pleasures and Pressures of Growing Up Female, The Truth About Our Schools, Death in the City. 

She will also be talking about her current campaign to end selective education.

It promises to be a lively evening and will include a question and answer session so get ready to voice your own opinions!   

Get involved with 'meanwhile' plans for Corrib Rest tonight




From Transition Town Kensal to Kilburn

Transition Town Kensal to Kilburn, working with other local groups and individuals, plans to re-open the Corrib Rest pub on Salusbury Road as a community hub. This is with the owners permission (of course!) for six months, possibly longer. We’re opening the doors on Tuesday 18th October so everyone can see the space, find out more and get involved. We want as many people as possible to contribute to setting up, running and enjoying the new pub!

Address: Corrib Rest pub, 76-78 Salusbury Rd, London NW6 6PA

7pm - Doors open and time to look round the building
7.30-7.45pm - Welcome and presentations
7.45-9.30pm - Mingling - this is your chance to find out more, meet the people planning to run each section, give your input and get involved:

Community pub
Spice Caravan and other catering
Cycletastic bike repairs and sales
Maker and skills workshops
Freelancers co-working space
Core planning group - open to new ideas and help with marketing, graphic design, admin and all locals with time to volunteer to help the project.

We are looking for help in many areas including graphic design, marketing, admin, running a pub and everything relevant to setting up a new not-for-profit enterprise in a meanwhile space. Your experience and skills are valuable to us. Can you volunteer some time in the set up or regular running?  Come along and let us know.

A bar will be run by QPCS PTFA and snacks will be supplied by Spice Caravan - both in return for donations.

Let us know if you are coming (if you haven't already) corribrest@gmail.com  and please bring friends and neighbours, and tell us if you have a particular interest.

Best,
Meanwhile@Corrib team

PS For anyone not aware of the term 'meanwhile' in this context it means using an empty space for a limited amount of time until it is developed by the owners.

Sunday 16 October 2016

Brent Patient Voice calls for no action on STP until public properly involved and consulted



Robin Sharp of Brent Patient Voice has submitted a critique to Carolyn Downs (Brent Council CEO) and others responsible for the NW London Sustainability and Transformation Plan (STP) which will have a major impact on health provision for years to come.

This is Robin's covering email:

Dear Colleagues

I am pleased to enclose for your consideration a critique by Brent Patient Voice of the draft NW London Sustainability and Transformation Plan of 30 June 2016, as placed on the NW London Collaboration website on 5 August.

You will see that this is a long document, though by no means as long as the draft STP.

Rather than simply complain about the proposed cuts in finance and services, as would be tempting, we have spent quite a lot of time examining the document in detail. This has been challenging because so much critical information has been withheld.

Nevertheless our conclusion is that at the level of detail the Plan, if it is a plan, does not withstand scrutiny and in that sense is not fit for purpose.

This is disappointing, though we do understand that the haste of preparation and the non-involvement of clinicians, councillors, CCG Governing Bodies and the public were ordained by NHS England.

We are asking you to advise NHS leaders to slow down this process dramatically and to open up the issues of radical change to primary care to doctors themselves and the public.  Surely it must be obvious even to the top of the NHS that this will not work without substantial consent?

We understand that you are ready to share with the public the next version of the STP shortly after 21st October. We urge the relevant bodies not to sign any agreement or contract by 23 December without fulfilling both the letter and the spirit of the law requiring the involvement of and consultation with the public in major changes to the provision of healthcare or without explaining how the bodies involved can lawfully commit to these plans. We also believe that the STP relies on a level and type of data sharing that has neither the consent of the public, nor the sanction of data protection law, and that the latest National Data Guardian review is unlikely to resolve this.
 

With best wishes

Robin Sharp
Chair Brent Patient Voice

Robin Sharp
Chair Brent Patient Voice


John Lister speaks about the NW LONDON STP here LINK

Saturday 15 October 2016

Wembley Green Car Park pre-application proposals to be presented at Planning Committee


The Brent Planning Committee on October 19th (7pm at the Civic Centre) will be given a Presentation by Quintain on one of the biggest sites  in the Wembley Masterplan.  This is a pre-planning application so most of the information will only be divulged that evening. No plans are published in advance.

Given the controversy over recent developments at the stadium and elsewhere in Wembley this is an opportunity for residents to get a glimpse of what is in store. This is a large housing development with blocks of flats up to 26 storeys.

This is what is published on the Committee Agenda:


Green Car Park, First Way, Wembley


SCHEME:
The Reserved Matters for the development of Plot E03 pursuant to outline planning application reference 15/5550 (the Quintain Masterplan).

Proposed construction of 1 to 26 storey building to provide 743 flats (397

 private rent and 346 discount market rent), 490 square metres of communtiy
or employment floorspace Use Class D1 / B1), 91 coach parking spaces for Wembley Stadium events, energy centre for outline consent area and associated external amenity space, cycle storage, hard and soft landscaping and accesses to the highway

PART 1 DEVELOPMENT PRESENTATIONS

Introduction

1.     This part of the agenda is for the committee to receive presentations on proposed developments, particularly when they are at the pre-application stage. 

2.     Although the reports are set out in a particular order on the agenda, the Chair may reorder the agenda on the night. Therefore, if you wish to be present for a particular application, you need to be at the meeting from the beginning. 

3.     The following information and advice only applies to reports in this part of the agenda. 


Advice to Members

4.     These proposed developments are being reported to committee to enable Members of the committee to view them at an early stage and to comment upon them. They do not constitute applications for planning permission at this stage (unless otherwise stated in the individual report) and any comments made are provisional and subject to full consideration of any subsequent application and the comments received as a result of consultation, publicity and notification. 

5.     Members of the committee will need to pay careful attention to the probity rules around predisposition, predetermination and bias (set out in the Council’s Constitution). Failure to do so may mean that the Councillor will not be able to participate in the meeting when any subsequent application is considered. 


Further information

6.  Members are informed that any relevant material received since the publication of this part of the agenda, concerning items on it, will be reported to the Committee in the Supplementary Report.

Public speaking

7.  The Council’s Constitution only provides for public speaking rights for those applications being reported to Committee in the “Applications for Decision” part of the agenda. Therefore reports on this part of the agenda do not attract public speaking rights.

Cabinet to consider Brent's STP

The Brent Cabinet will be considering a report on the Brent and North West London Sustainability and Transformation Plans (STPs) on 0ctober 24th, three days after the draft NW London STP is due to be delivered to NHS England.

The Brent STP fits within the NW STP and is meant to consider Brent specific issues which are listed as:
The Brent specific health and well-being gaps have been identified as:
o   · Common mental health disorders (CMD): large numbers and projected to increase - in 2014, an estimated 33,959 people aged 18 to 64 years were thought to have a CMD
o   · Severe and enduring mental illness: affects 1.1% of the population
o   · Mental well-being: the percentage of people with depression, mental health issues or other nervous disorders in employment is 23% also lower than both the England rate (36%)
o   · Significant and growing challenges to provide housing which potentially further undermine mental wellbeing
o   · Childhood obesity: Brent is in the worst quartile nationally in terms of the % of children aged 10-11 classified as overweight or obese – 38%
o   · Diabetes: by 2030 it is predicted 15% of adults in Brent will have diabetes
o   · Long Term Conditions: 20% of people have a long term condition
o   · Dementia: prevalence of dementia in people aged 65 years and over is 2,225 2016) (and 80% of prevalence is diagnosed)
o   · STIs/HIV: 1,404 STIs per 100,000 population compared to 829 in England
o   · Health-related behaviour: physical inactivity: worst in West London; nutrition: 47% get 5 a day; tobacco use; alcohol; take up of immunisations

The Brent specific care and quality gaps have been identified as:
o   · Caring for an ageing population: 35% of all emergency admissions in Brent are for those aged 65 and over; once admitted this group stays in hospital longer, using 55% of all bed days.
o   · End of Life Care: Brent has one of the highest percentages of deaths taking place in hospital in the country
o   · Primary care: wide variation in clinical performance; Brent is in the worst quartile nationally for patient experience of GP services.
o   · Long Term Condition management: Brent is in the worst quartile nationally in terms of people with a long-term condition feeling supported to manage their condition.
o   · Cancer: Brent is in the second lowest quartile nationally in terms of GP referral to treatment for cancer and worst quartile in terms of cancer patient experience.
o   · Serious and long-term mental health needs: people with serious and long term mental health needs have a life expectancy 20 years less than the average.

 Clearly these are extremely serious issues and the test is whether the STP, which many see as a cover for cuts, will address them. The full report going to Cabinet is below:



Brent Council set to increase Council Tax by 3.99%, make cuts and increase charges


Brent Council issued the following press release yesterday on its budget proposals. I drew attention recently to Camden's revision of its Council Tax Support Scheme in the light of Council Tax increases. There are, as far as I can see, no proposals for a review of Brent's scheme. LINK

BRENT COUNCIL PRESS RELEASE

Plan to protect local services by raising income set to be discussed
14 October 2016
 
Protecting local services is the top priority for Brent, the council leader has said, as a plan to get residents' views on a draft set of budget proposals for the next two years is set to be discussed.

Brent Council's Cabinet will meet on Monday 24 October to consider a paper which includes a proposal to protect local services by increasing council tax by 3.99 per cent - or 85p a week for an average Band D household.

The report sets out how councils are still in an era of austerity and are facing further cuts in Government funding despite growing demand for local services from an increasing and ageing population. The paper also includes some savings proposals although these are relatively small compared to recent council budgets.

Last year was the first year council tax had risen in Brent for six years after successive freezes despite Government funding being slashed by £117million since 2010.

Cllr Muhammed Butt, Leader of Brent Council, said:

"Imagine your household bills went up every year, but your salary kept being cut. You would have to make some tough choices and find new ways to make your money go further.

"That's what this council has been doing in finding new, more efficient ways to maintain and improve the services that we all need, but it has also meant making some very difficult decisions.

"We know how important our local services are to the people of Brent which is why, rather than cutting back on those vital services, the option of raising income through a small council tax increase to protect these services is being considered.

"The choice we face in Brent is this: will we pay a bit extra each month to keep our services available to those who need them, or will we let the Government's cuts to our budget further limit the services we can provide?"

In addition to the proposal on council tax, the paper includes proposals to:

·       Help residents with low-level nursing care needs to live independently, which will improve their quality of life and save £300,000
·       Negotiate a £500,000 reduction in spending on contracts with mental health service providers
·       Outsourcing the management of two day care centres in the borough to save £300,000
·       Negotiate a £900,000 saving in the public realm contract with Veolia
·       Charging for a next-day and 'pick your day' bulky waste collection service, generating £250,000 each year
·       Consult on saving £100,000 in the Regulatory Services team through a reorganisation
·       Participation in the London wide sexual health transformation programme to achieve better services while saving £600,000 over the next two years
·       Consultation on plans for differential parking charges to help manage pressure for spaces in high demand areas - £1million
·       Dim street lights where appropriate which would save £100,000 and benefit the environment

Cllr Butt added:

"As a Cabinet, we will discuss the draft proposals set out in the report at our next meeting and, if approved, will then put them to residents to have their say in a detailed budget consultation."

The budget consultation is set to run from November to December with a series of public meetings arranged for January. A final decision on the budget will be taken by Full Council in February 2017.

View the full Cabinet report here.
There is little information on any debate within the Labour Group or the Brent Labour Party as whole over these proposals although Cllr Michael Pavey in his letter resigning from the Cabinet LINK said, 
'I think it is clear that the Leader and myself have developed differing views regarding how Brent Council can best serve its residents at a time of brutal Tory cuts.'
Pavey may have fought against cuts in his own brief, Stronger Communities, or perhaps he had an alternative strategy which was defeated. 

As usual the devil will be in the detail and one has to look beyond the phraseology of the bullet points to see what they really mean. Some appear to be deliberately vague.

Taking the first proposal on helping people with 'low-level nursing care need to live independently' , the report  acknowledges that this 'help' may not be welcome - but it delivers 'savings' through what will be a reduced service:
Proposal to move lowest need (c.20%) of clients currently in nursing care to Supported Living which would deliver a £0.3m saving. This is based on an analysis of nursing home placements, which suggest there are a number of placements at the simpler end. 

How would this affect users of this service? 

Clients would need to agree to the move and some may find moving traumatic. Families and carers may also be averse to disrupting stable placements. Some users may prefer a less institutional environment and regain independence and skills lost through being in nursing care.
Brent's poor provision of mental health services came under sharp criticism at the recent 'Extremism' debate so the £0.5m cut in spending on contracts will need close scrutiny:

£0.5m ('savings') achieved through: 

 enabling a more effective recovery pathway – better access to housing and
employment will accelerate step down to general needs housing 

Supported by ongoing negotiations with providers to manage costs and focus
on the right support. 

How would this affect users of this service

This would support the delivery of the current objectives of the service, supporting people to move towards independence, and further efficiencies would be achieved through negotiations, which would not mean a change in service. 
The key here is 'negotiation with providers' which often means reducing the payment to providers affecting the pay and working conditions of those working for them and perhaps contradicting the Council's commitment to the London living wage.

Despite Jeremy Corbyn's remarks on Council 'in-sourcing' LINK,  Brent may decide to  outsource the management of the John Billam and New Millennium day care centres. There is little detail in the proposals but they expect to generate income by opening up the use of the buildings to outside groups.

The report notes:
Key consultations

Extensive consultation required with users and carers in both day centres would be required however the service developed, and with Unions, staff and with potential providers 

Key risks and mitigations 

Risk that users and carers will oppose the changes to the service – mitigated through extensive and ongoing communication and engagement

If the first risk becomes an issue, significant risk of adverse publicity and public protest – mitigated through extensive and ongoing communication and engagement Risk that the council cannot generate the additional income and efficiencies – mitigated through financial modelling and change management

Risk that we will need to consider outsourcing as the way to drive the change.
The almost £1m efficiency savings over two years on the Public Realm contract with Veolia which covers street cleaning, waste collection, waste recycling, parks maintenance and much more are in a proposal so vague as to be virtually meaningless:
This proposal generates £900k from operational efficiencies within the Public Realm Contract. These will rationalise operational arrangements so they better manage and properly resolve hot spots and other persistent problems. 

How would this affect users of this service? 

Service users may see revised working practices and operational schedules.
This is coupled with a proposal to raise £0.25m by charging for bulky waste collections.  Whether to charfe  for bulky waste collections has been an ongoing debate between Labour and the Lib Dems. The introduction of a charge for next day or pick your day collections follows widespread complaints about the length of time it takes Veolia to pick up bulky waste under the present free system LINK.  It is unlikely that residents expected charges to be introduced as a result of their complaints and a two tier system may well result in longer delays for the free service and increased fly-tipping.

Participation in the London wide sexual health programme and consequent savings of £0.6m are based on moving away from face-to-face consultations with health professionals to a web-based service:
Analysis of activity in current sexual health services and a waiting room survey indicates that not all current attendances at GUM clinics need that specialist service. Brent is participating in a London wide procurement of a new ‘front door’ to sexual health services. The front door into services will be web based, a single platform providing patients with information about sexual health, on line triage, signposting to the most appropriate service for their needs and the ability to order self-sampling tests.
 Tellingly one of the risk factors identified for this saving is:
  • a failure to change patient and / or clinician behaviour and so not achieve the diversion of activity on which savings are based 
Given the nature of the Opposition on Brent Council the proposal on parking charges is likely to be the most controversial, but again it is pretty vague:
This is an exercise to account for the parking pressures that are expected to arise from an increase in the borough’s population. Regeneration and increased development may result in additional cars and increased parking pressures. This creates the need to provide parking restrictions that meet current and future demand, with the revenue paying for the service and any additional revenue being reinvested in the service. This exercise will consider residential parking permits and some car parking tariffs but will not include a review of visitor parking charges.
With the exception of some fairly minor proposals on Regeneration which is Cllr Mashari's remit, all the above proposals either come under Cllr Hirani (Adult Social Care) or Cllr Southwood (Environment). There are none under Cllr Pavey's Stronger Communities remit. Perhaps he was not so keen to see services reduced.

Now that Cllr Butt has taken over that brief, pending a 'review' LINK, is there a possibilty that further proposals will be tabled?






Thursday 13 October 2016

Are Brent residents adequately represented on STP proposals?

From 'Shaping a Healthier Future' to the 'North West London Sustainability and Transformation Plan' it is often hard to cut through the public relations and jargon to see precisely what is in store for the future of NHS services in our borough.

It is also hard to see who is representing our interests and how they are doing so.

Tomorrow morning the North West London Joint Health Overview and Scrutiny Committee LINK will be meeting at Ealing Town Hall. Our representatives are Cllr Ketan Sheth and Cllr Barbara Pitruzzella. Later tomorrow at 3pm Cllr Sheth is scheduled to have a scrutiny discussion with the the public at Costa in Central Square Wembley.  The Sustainability and Transformation Plan (STP) is not on the agenda of topics (see posting below).

Tomorrow's NW London Joint Health and Overview and Scrutiny Committee will be finalising the draft for the STP submission to NHS England a week later on October 21st.

Cllr Matt Kelcher, then our representative as Chair of the single Brent Scrutiny Committee,  sent his apologies to the last meeting in May, despite it being held at Brent Civic Centre.

The leaders of Ealing and Hammersmith and Fulham Councils have refused to  endorse the STP due to concerns over the future of Ealing and Charing Cross Hospitals. No reservations are recorded from Brent Council LINK


 
There are no elected Brent representatives on the Joint Health and Care Transformation Group. Dr Ethie Kong from the Brent Clinical Commissioning Group and Carolyn Downs, Brent Council CEO are members:



To its credit Brent Patient Voice  has raised issues about the STP and their concerns are clear in this August 2016 letter to the Guardian which unfortunately was not published:
We in Brent Patient Voice are pleased that the Guardian, 38 Degrees and the BBC have at last caught up with the huge threat to the NHS represented by the Sustainability and Transformation Plan (STP) process. In fact the NW London STP of 30 June has been in the public domain since 5 August and signposted on our website www.bpv.org.uk . We have been posting stories about this semi-secret initiative since the end of May, including an earlier version of the Plan submitted in April. Despite what spokespersons for the NHS are saying today, the NW London STP has not been prepared by clinicians or councillors, but by NHS and local government officials without any public debate. There are no clear proposals for consultation or public meetings arranged.
 
While today’s reports focus on the potential for hospital closures, these are essentially the highly controversial proposals issued in 2012 and misnamed Shaping a Healthier Future. So far these have been implemented by the closure of A&E Departments at Hammersmith and Central Middlesex Hospitals and the Ealing Maternity Department. As a result A&E waits at both St Mary’s Paddington and Northwick Park Hospitals are among the worst in the country and acute beds are under enormous pressure. This is the context for STP proposals to remove 592 acute beds which was mentioned in an early summary but has now been expurgated for fear of frightening the horses.

However what is new and barely understood at all by the public or even the GPs who will be at the heart of it is the “transformation” aspect of the STP. GPs are being paid to form themselves into legal companies called “federations” in order to be awarded (with other providers) single contracts to provide all primary services in, say, a borough. The jargon title for this concept, Accountable Care Providers, comes straight out of the American healthcare system textbook but it is completely untested at the scale envisaged in the STP. Ordinary GPs who can barely cope with patient demand for routine care have no idea what it is all about. Is not NHS chief Simon Stevens intelligent enough to see that such a major upheaval, even if justified (which we doubt), cannot be implemented safely and produce savings in the space of two years?

Robin Sharp CB, Chair Brent Patient Voice