Showing posts with label Ketan Sheth. Show all posts
Showing posts with label Ketan Sheth. Show all posts

Monday 12 June 2023

Barham Park application approved. Dire implications for protection of our green spaces and validity of Neighbourhood Plans

 

 

Sudbury residents protest in the public gallery - 63 objections and a 160 signature petition

 

 Cllr Saqib Butt in a declaration at the beginning of the meeting said, 'Can I confirm that I am connected with the applicant and near enough all the signatories on the petition on social media' and Cllr Akram said he was declaring the same. * The legal officer confirmed they could take part. Cllr Rita Begum declared that she had received a gift, tickets for the developer's funfair, but confirmed these were below the £50 declaration limit. She might have well have reclused herself because her only participation in the discussion of the application was to vote for it.

 Cllr Paul Lorber, Lib Dem, (Sudbury)  made a decent fist of presenting all the things wrong with the planning application to build 4 three storey houses within Barham Park, replacing 2 small park keeper houses.

Cllr  Tea Benea, Labour (Sudbury) also spoke against the proposal and Cllr Ketan Sheth, Labour (Wembley Central) had his statement also opposing the development read out as he was chairing another meeting. Cllr Benea is a new councillor and Cllr Sheth a veteran who himself is a former chair of Planning Committee. 

Cllr Ketan Sheth said that when he was Chair of Brent Council’s Planning Committee he led on the conversations with residents for setting-up Neighbourhood Plans. Sudbury Town Residents’ Association was the first to engage with the Borough in drawing-up a plan, in consultation with the local community and planning officers. In 2015, the Sudbury Town Neighbourhood Plan was put to voters, and the community, in its area, with more than 900 people voting to accept it, 93% of the total votes cast.

 

Following that the Council then adopted the approved plan, and it remains the relevant part of Brent’s Local Plan policies for the Sudbury Town Neighbourhood, which includes the location for the planning application. A new designation - Local Green Spaces, was introduced in legislation for Neighbourhood Plans. This allowed communities to identify and protect green areas of particular importance to them. The Sudbury Town Neighbourhood Plan, at policy LGS1, identified four Local Green Spaces, one of which is Barham Park.

 

He said that today, local Green Spaces have the same protection in planning law as Green Belt land and that the Neighbourhood Plan’s green spaces policy BP1 is very clear about the nature of that protection, which applies to Barham Park, stating ‘Any proposals for the re-use or redevelopment of park buildings for residential use (Use Class C3) will not be supported.’

 

776 and 778 Harrow Road are park buildings. Originally, they were built within the park as homes for park-keepers. The proposal in this new planning application is seeks to demolish these park buildings, and redevelop the site to provide four residential townhouses. He recognised that these additional units could be a place for new residents or existing to call home but said it was clear, that this new planning application falls within the type of proposal, which policy BP1 states will not be supported.

 

Cllr Sheth went on to say that he was acutely aware that the current buildings lack any architectural merits; and suggested it is a moot point whether they are fit for habitation. However, he said it would be wrong for the current application to seek to override the Sudbury Town Neighbourhood Plan, unless there is convincing strong evidence to the contrary. To approve the application, in its current form, would be contrary to the Local Green Space policy BP1, which takes precedence over any contrary Brent planning policies, and would undermine the fundamental purpose of this Neighbourhood Plan. He suggested that the application should be reconsidered, and a revised application for a like-for-like replacement be encouraged.

When the agent for the developer spoke he said he would focus on the technical aspects of the proposal and when questioned said he knew nothing about the covenant on the site. Rather extraordinary.

One councillor on the Planning Committee had to be put right by the chair when he told an objector that the proposed houses would reduce the council's waiting list for council homes - they are not council homes, nor likely to be affordable at private sale.

 


 

Even more extraordinary though was the senior planning officer who went round in circles about the weight to be given to the Sudbury Neighbourhood Plan, the Brent Core Strategy, the Local Plan and the London Plan.

Eventually he said that all were relevant but you can ask, 'what harm would it cause if you break it?' and if the harm was less then go ahead.

This raises obvious questions about whether Neighbourhood Plans, despite all the work put into them by residents, are worth the paper they are written on.

There was an Alice in Wonderland discussion about whether buildings in parks are park buildings...

Clearly our green spaces are not in safe hands.

My impressionwas that Cllr Collymore did not vote (I was sitting behind her) but I have since been told she claims to have voted in favour along with her Labour colleagues. Cllr Michael Maurice (Conservative) voted against.

Cllr Muhammed Butt was in the room when I arrived but left before the meeting was due to start. In fact it started 30 minutes late due to technical problems.

Probably that was the least of the problems connected with this application which has succeeded at the 11th attempt but the covenant may still be the elephant in the room.


*Updated after listening to the recording of the meeting

Saturday 24 September 2022

Rokesby Place – Brent tries to justify its planning malpractice

 Guest blog by Philip Grant, in a personal capacity.

 


Architect’s drawing of the two infill houses for the Rokesby Place car park.

 

I will try not to make this guest post too long, as I will ask Martin to attach two long letters at the end of it. But I hope that as many “Wembley Matters” readers as possible will take the trouble to read this, and the letters. This is a follow-up to my article earlier this month, which included my letter of complaint to Brent’s Chief Executive over alleged planning malpractice.

 

The letters are about the level of rent which the future tenants of two “affordable” New Council Homes on an infill scheme at Rokesby Place will have to pay. More importantly, though, they deal with the way in which Brent’s Planning Officers went against the rules meant to ensure that the Council’s own planning applications are dealt with impartially and transparently – and how they have tried to justify the actions they took.

 

Extract from the Rokesby Place planning application, 22/1400.

 

The planning application for Brent’s Rokesby Place “infill” housing scheme was made in April 2022, and was quite clear that the two houses would be for Social Rent. But when the Officer Report was prepared on the application, for the Planning Committee meeting in August, no mention was made of Social Rent, and the “affordable housing” condition in the draft consent letter said that the homes must ‘be delivered as London Affordable Rent units’. 

 

There was nothing in the published documents to show how or why Social Rent had been changed to the more expensive London Affordable Rent (“LAR”). I had to issue an FoI request to uncover that information. This led to the first part of my 5 September complaint, that there was no reason for, and no justification for, any change from Social Rent to LAR, and Planning Officers had been wrong to change it.

 

I received the reply to my complaint letter from Carolyn Downs on 16 September, but I believe it was probably drafted for her by the top officer(s) in Brent’s Planning Department. This was the reason given for why they recommended LAR, rather than the Social Rent level shown by the application they were asking Planning Committee to approve:

 

Extract from the letter of 16 September from Brent’s Chief Executive.

 

I have set out my response to that in my letter of 22 September below. Briefly, Planning Officers should not be changing what an application says just because they think it should be different, to do so for one of Brent’s own applications (although why, when it’s a Council application, was the Project Manager ‘the applicant’?) was not being impartial, and no ‘clarification’ was needed, because the application was clearly for Social Rent!

 

The action which Planning Officers took raises serious concerns for other Council housing schemes, especially a number of forthcoming “infill” schemes (Newland Court, Kilburn Square, Clement Close, to name just a few): 

 

·      Will they treat other applications for Social Rent housing (as recommended by the Brent Poverty Commission Report, and as supposed to be provided under the GLA’s 2021-26 affordable housing programme) as if they should be for LAR? 

 

·      Will they interfere with other details which have been published in the application documents, and recommend different conditions to Planning Committee, without disclosing that they’ve done so?

 

Even though they had failed the “transparency” requirement in the Local Government Association’s “Probity in Planning” guidance, by not telling Planning Committee that the application was for Social Rent, the Council’s view was that members, when making their decision, ‘were aware that the application was originally for the provision of Social Rented homes.’ I could hardly believe the reason they offered to justify this:

 

Second extract from the letter of 16 September from Brent’s Chief Executive.

 

This was the conclusion which Brent’s Chief Executive came to (on the advice of Senior Planning Officers) in response to my complaint(s):

 

The conclusion from the letter of 16 September.

 

I have not accepted that conclusion, for reasons set out in detail in my letter of 22 September. In case you don’t feel like reading it in full, here are some paragraphs from near the end of it which sum-up my position:

 

‘Planning Officers seem to take the view that as Social Rent and LAR are, on the present figures, ‘very, very similar’, then it does not matter whether the affordable housing provided is one or the other. That would not matter for compliance with policy BH5, but as I pointed out in my letter of 5 September, it would matter for the tenants of the two new homes at Rokesby Place. 

 

As you quoted, from the Brent Local Plan Glossary, these affordable homes will be ‘for those whose needs are not met by the market.’ They will be Brent families in housing need, quite probably on limited incomes. By charging them LAR rent levels, rather than Social Rent, even on present figures, they will have to pay £772.20 a year more. As the annual rent increases for these two types of affordable housing are linked to CPI, by the time the houses are built each tenant will have to find nearer £1,000 a year more if LAR is charged, rather than Social Rent.

 

If a planning application states that the affordable housing tenure will be Social Rent, that complies with policy BH5, and should not be changed without good reason. And if there are reasons for changing from Social Rent to LAR, they need to be set out transparently, both for the Planning Committee and the public. That was not done on this application, so even if Brent Council believes it achieved the “right” answer, the way it was achieved was wrong. So wrong that it needs to be put right.

 

I hope you can now agree that the new Brent Council affordable housing at Rokesby Place must be for Social Rent, as applied for on the Council’s behalf under application 22/1400.’

 

I’m putting this correspondence “in the public domain”, so that anyone interested can read it and make up their own minds. If you agree that something has gone wrong here, please feel free to write to your local councillors about it, with a copy to carolyn.downs@brent.gov.uk .

 

Philip Grant.

 The letters - click bottom right corner for full page version.


Friday 24 December 2021

Quality Care Commission welcomes improvements at Northwick Park maternity services - rating improved from 'Inadequate' to 'Requires Improvement'

 From the Quality Care Commission

In October, CQC carried out an unannounced comprehensive inspection of the maternity department at Northwick Park Hospital, run by London North West University Healthcare NHS Trust*. This was to follow up on concerns identified during a previous inspection in April, when CQC told the trust to take urgent action to keep mothers and babies safe.

Following the October inspection, the overall rating for maternity services improved from inadequate to requires improvement. Safe, responsive and well-led remain as requires improvement. Caring remains good, and effective moved up from requires improvement to good.

Nicola Wise, CQC’s head of hospital inspection, said:

“I am pleased to say we saw a number of improvements in the maternity department at Northwick Park Hospital during our recent inspection.

“After our previous inspection, we were concerned there was a blame culture within the service which stopped incidents being escalated and improvements being made. This had improved, and staff are encouraged to give feedback and report incidents which are now being reviewed and learning shared, with improvements being tracked. We found a zero-tolerance policy regarding bullying and inappropriate behaviour, which was an improvement from our last inspection.

“Women using the service told us staff treated them with kindness. One person who had recently given birth, said that staff had gone above and beyond to provide safe care and treatment. They also respected people’s personal, cultural, social and religious needs. One woman who wore a hijab said that staff had respected them and their privacy regarding this.

“Following this inspection, we pointed out areas where further improvements need to be made. However, the interim leadership team is aware of the issues, and is committed to making the required improvements. Staff told us that senior managers were much more visible, and they were impressed by the change in approach from the leadership team, saying there was no longer a feeling of ‘them and us’. It is clear that leaders need time to fully embed the improvements in the maternity service and make permanent appointments to the team.

“We will continue to monitor the service to check that improvements are made and fully embedded, however, we recognise that all hospitals and healthcare professionals are under extreme pressure at the current time, and they need to be given the space to focus on delivering safe care to patients and supporting staff through this difficult period.”

Inspectors found the following during this inspection:

  • The service did not always have enough midwifery staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm and to provide the right care and treatment. Waiting times were longer for women across maternity services when staffing levels were low, though staff were encouraged to report delays as incidents. The birth centre was closed due to staff shortages. Staff shortages also impacted on home visits and clinics provided by community midwives
  • Compliance with mandatory staff training was 84%, which did not quite meet the trust’s target of 85%, although it was an improvement
  • The service had one never event in September. Never events are serious, largely preventable patient safety incidents. A swab was left inside a patient when they were being induced, even though two members of staff had signed a document showing that the correct number of swabs had been counted following the procedure. Learning from this event was shared across the trust
  • The department’s policy was to admit women on their third call in 24 hours to explore any concerns. However, there was no system of recording the time at which women with concerns had previously called
  • Some equipment on the resuscitation trolleys was out-of-date and cold cots** in the bereavement suite had been out of operation for two months, as the cooling system had failed, even though this had been reported to the trust
  • Inspectors found an open trolley on the delivery suite which contained two drugs vials, presenting a risk that unauthorised people could have access to the vials
  • One-to-one antenatal appointments with community midwives were not always being recorded. Inspectors also saw loose paperwork relating to patient assessments which could become detached from women’s notes so information could be misplaced
  • Women who were attending the service to have their pregnancy terminated often had to wait for 45 minutes for their appointment in the same waiting room as women attending antenatal and postnatal clinics, which could be distressing for them
  • Antenatal classes had been reduced as a result of the logistics of providing classes during the COVID-19 pandemic and staff availability, which meant women did not have access to information that could help them improve their health and wellbeing during pregnancy. Online classes had been planned, but these had not been implemented.

However:

  • New interim leaders had the skills and abilities to run the service. The new managers understood and managed the priorities and issues the service faced. However, the trust needed time to embed this improved leadership and also to forge a period of stability by making permanent appointments to the leadership team
  • In response to external reviews of the service, managers had produced a maternity improvement plan, which was reviewed and updated weekly
  • There had been improvement in doctors, nurses and other healthcare professionals working together as a team to benefit women
  • Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. It was easy for people to give feedback and raise concerns about the care they received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff
  • Work was in progress to ensure staff completed and updated risk assessments for each woman and took action to remove or minimise risks
  • The service had recently employed an audit midwife and a risk midwife to ensure monitoring of patient outcomes and benchmarking of service
  • Work was in progress to monitor domestic abuse being assessed at all antenatal appointments
  • The service had information boards which carried updates for staff on the maternity risk register. Policies and clinical guidelines were up to date and had dates for review
  • The service made sure staff were competent for their roles. Managers appraised staffs’ work performance and held supervision meetings with them to provide support and development
  • Staff understood and respected the personal, cultural, social and religious needs of women and how they may relate to care needs. 

On Twitter Cllr Ketan Sheth, chair of Scrutiny where he has done much to hold local NHS services to account, said: 

 Pleased to see the Care Quality Commission have upgraded London NW University Healthcare NHS Trust's Northwick Park maternity service to Requires Improvement and rated the service as Good for caring & effective. This is welcome progress for our local maternity service.

The full report is available HERE

 

Saturday 5 December 2020

Brent Council's Scrutiny Committee & public ignored as Wembley Ambulance Station closure goes ahead

 

Brent TUC demonstrate outside Kenton Ambulance Station where Wembley staff have been stationed during Covid

Cllr Ketan Sheth confirmed via Twitter this afternoon that the Wembley Ambulance Station closure had gone ahead on December 1st.

Cllr Sheth is Chair of the Community and Wellbeing Scrutiny Committee that discussed the proposed closure as an emergency item at their last meeting.  Having heard  the London Ambulance Service at the meeting, members were not satisfied and particulalrly concerned that there had been no consultation with councillors or the public as required by statute.

The Committee recommended that the closure be paused while a full public consultation was carried out.

They have been ignored.

Brent Trades Council launched a campaign to stop the closure and set up a petition addressed to the  the head of the London Ambulance Service calling for the closure of Wembley and other ambulance stations to stop.

They have been ignored.

 

Sunday 13 September 2020

Shocking report on impact of Covid19 on Brent's BAME residents will be scrutinised on Tuesday

 



With warnings of a second wave of Covid19 infections a report going to the Community and Wellbeing Scrutiny Committee on Tuesday September 15th (Virtual 6pm) assumes great importance LINK. The committee continues under the chairmanship of Cllr Ketan Sheth but with some changes in personnel including the inclusion of veteran health campaigner Cllr Gaynor Lloyd, elected at the Barnhill by-election. They will have the huge responsibility of assessing lessons from the way the pandemic has been handled so far, preparations for dealing with a second wave, and addressing the health and social inequalities revealed by the disproportionate impact on Brent’s BAME population. A task, I would suggest, much more of  a priority for Brent Council than the renaming of a local park.

 

These are some key extracts from the report:

 

BAME populations in England and Wales are younger than white populations and as age is a strong influence on death rates, it is important to take account of age. When this is done:

·Black males are 4.2 times more likely to die from a COVID-19-related death than White males;

·Black females are 4.3 times more likely to die from a COVID-19 related death than White females

 

As BAME populations tend to be more deprived, it is important to adjust for the influence of deprivation in looking at the impact of ethnicity. Doing so allows us to compare the risk for a black male living in an area of deprivation compared to one living in an affluent area: 

 

·Black males are 1.9 times more likely to die from a COVID-19-related death than White males;

·Black females are 1.9 times more likely to die from a COVID-19 related death than White females.

 

After taking into account age and socioeconomic circumstances or deprivation:

 

·Bangladeshi and Pakistani ethnic group males are 1.8 times more likely to die from a COVID-19-related death than White males;

·Bangladeshi and Pakistani ethnic group females are 1.6 times more likely to die from a COVID-19-related death than White females

 

Possible reasons for the disproportionate impact

 

There are three possible reasons for the disproportionate impact of COVID on BAME communities:

1.Increased exposure to the virus

2.Increased susceptibility to severe disease

3.Access to and use of health care

 

Exposure to the virus

1.Brent BAME population are high users of public transport. Buses in particular remained crowded during the pandemic as did bus stops in the Wembley and Harlesden area.

2.Brent BAME communities have high levels of inter-generational living with those at risk including the elderly and those with long-term conditions being exposed more than those in smaller households.

3.BAME communities have high attendance to temples, churches, mosques and other places of worship with large communal activities such as services, weddings and funerals. These were implicated in spread elsewhere and it is likely were these were factors in the early part of the epidemic

4.BAME community members are less likely to be working from home and often in zero hour contracts or cash in hand situations therefore less likely to be able to social distance or self- isolate.

5.BAME community members are more likely to be frontline workers and less likely to be managers and able to influence their working conditions.

 

Susceptibility to severe infection

1.While levels of adult obesity are relatively low in Brent (compared to England), 50% of residents are overweight or obese. It is estimated that over 11% of the adult population has diabetes, compared to an England rate of 8.5%. Diabetes is more prevalent in Black and South Asian patients, and our high levels of diabetes may be one reason for the higher death rate seen locally.

2.Fewer patients are recorded on their GP records as having high blood pressure than is the case for England (12.4% compared to 14%). While this may indicate a lower prevalence, the size of our Black and South Asian communities who would be expected to have higher rates of hypertension might suggest under diagnosis. Of those who are diagnosed, significantly fewer patients have their blood pressure controlled in Brent than nationally.

 

Access to and use of health services

1.It has been hypothesised that more deprived communities may have poorer access to health care and that this could have played a part in the pattern of mortality (the inverse care law). Early in the pandemic, NHS England instructed primary care to move away from face to face appointments in favour of telephone and on line access. There was a concern that this model of care may have disadvantaged the digitally excluded.

2.There is some evidence from elsewhere that Black men were particularly unwell on presentation to hospital and more likely to be admitted direct to ITU. This could indicate a reluctance to seek help earlier or a more rapid progression of disease in this group of patients. There is no evidence of poorer outcomes for BAME patients admitted to secondary care locally. However the completeness of recording ethnicity limits our ability to analyse this.

 

Themes from the Church End and Alperton community engagement events

 

Church End

 ·Participants praised Northwick Park Hospital’s response to the pandemic.

·People are still afraid to visit public buildings.

·Some of are not fully informed of information/advice therefore educating residents is crucial.

·Many people are not wearing masks, particularly on Church Road. Messages around facemasks need to be clear without offending people.

·Question of whether health services play a key role for self-care and those with long-term conditions (such as diabetes and hypertension)

·Need to invest in Church Road and the local community, as the area is unappealing. This is reflected by local drug dealing, crime, poor employment opportunities and run down businesses.

·Many people face multiple issues even before the pandemic including stress and financial issues.

·New people are approaching foodbanks.

·People tested for Covid-19 are not reflective of the local community – question of what we are doing to encourage people to take tests.

·Young people face mental health issues, which is a primary reason for large gatherings and house parties in the area. Young people are aware of the risks but they are battling with their mental health. Need role models/influential people from area through to communicate through songs and messages. Need to think about education, prospects and access to networks.

·Access to GPs online has been difficult, especially for those whose first language is not English. Confidence in services is low.

·Older people are more isolated now.

·Worry that people are being forgotten about if they need medical help but don’t engage with health services or local support. A helpline was suggested so people’s needs can be explored to signpost them to support and services. Need to build local people’s knowledge.

·Concern over people who are not eligible for support services but housed in HMOs.

·Educating and raising knowledge of landlords will help maintain hygiene standards.

·Need to hear from those who have lost people. ·Attendees are happy to be a part of the solution by working with us as community champions.

 

Alperton

·Messaging needs to be reinforced and shaped for people who do not speak English as their first language.

·Channelling tailored messages through places of worship and Asian radios would be effective. Could work with the Multi-faith forum.

·Measures are not being followed on high road - displays and signboards are insufficient. Signs on shops are usually handwritten. Some shops are doing well which could be replicated by other shops.

·Need to work with community leaders to identify vulnerable people eg create register of HMOs.

·Strategy needs to focus on prevention and long-term outcomes.

·Community is pessimistic as opposed to central government, which changes guidelines frequently.

·Many organic community groups exist which need to be engaged with.

·More enforcement needed where people aren’t following measures.

·Easy to get GP appointments, however many people are nervous. They need health services but uptake is low. Lack of internet and no phone line is another issue.

·National Covid-19 test system was down and busy highlighting the barriers to securing a test. Testing may not be reflective of local communities – may need to encourage people to take tests and raise awareness of sites.

·Issue of people having symptoms but not getting tested due to risk of losing job or income.

·There are opportunities despite the negatives – people are walking and being active whilst maintaining social distancing measures.

·Attendees look forward to working with us to find solution

The meeting can be observed here: https://www.brent.gov.uk/your-council/democracy-in-brent/local-democracy/live-streaming/

 


Thursday 21 May 2020

Cllr Ketan Sheth calls for councils to work closely with community on school re-openings

Cllr Ketan Sheth, the Chair of Brent's Community and Wellbeing Scrutiny Committee, has become the first senior councillor to speak out on the wider re-opening of schools. LINK

Extract from the interview:

In Brent, according to the 2011 Census, the BAME population is as high as 63.73%, with 18.64% Indians and 34.06% Asians.

Cllr Ketan Sheth, Brent Council’s Chair of Community and Wellbeing Scrutiny Committee highlighted that effective management mechanisms between national and local government are critical, “The role of education in daily life as well as society is very important and leaves a great impact on our progress as a community,” he said.

“Now, we have started discussions to ease our coronavirus lockdown, by re-opening schools in a bid to restart our economy. However concerns this might become a breeding ground for a second wave of Covid-19 cases may convince parents to keep their children at home.

“The role of local government is the key to unlocking, as it knows its people, communities and children. Daily local government delivers services to their local residents. Therefore, it only stands to reason that local government are a vital ingredient to a community solution.

“As Covid-19 shows, pandemics are complex social and behavioural challenges and not just technocratic issues. Parents, teachers, children are grappling with the threat of contracting the infection or dealing with personal loss. Effective management mechanisms between national and local government are critical.

“Anxiety will linger over infection rates, but if we work together, at a local level, in the communities where we live, we can be agile, and creative, in our services: together we can do it locally.”

Cllr Judith Blake, Chair of the Local Government Assoications s Children and Young People Board, told Asian Times:
 “We know parents are anxious about sending their children back to school or nursery.

“Plans to re-open schools and early years settings must focus on reassuring parents that it will be safe for children to return to school. Publication of the scientific advice is vital to help provide that reassurance.The safety of staff, parents and families is absolutely paramount.

“Councils need to be able to close provision where testing indicates clusters of new Covid-19 cases and it is vital that schools have the resources to provide staff with necessary protective equipment, as well as soap and hand sanitiser for cleaning.”


Monday 30 March 2020

Dedicated borough-based Covid-19 clinics to be established by NW London CCGs

Responding to Saturday's tweet (above) by Cllr Ketan Sheth (Chair of Brent Council's Commnity and Wellbeing Scrutiny Committee) a spokesperson for the MedianWL North West London Collaboration of Clinical Commissioning Groups, said:
The eight CCGs in North West London are establishing a joint primary care response to COVID-19. This will include patients being managed both remotely and face to face by GPs. Face to face management will require dedicated clinics and we are establishing these in each borough. Patients will access the clinic through referral by the NHS 111 service or their practice.’