Action promised on BAME access to GPs as Brent's Covid19 response comes under scrutiny

Melanie Smith, Brent Director of Public Health, told last night's Community and Wellbeing Scrutiny Committee that during the early months of the Covid19 pandemic many in Brent's BAME community felt disempowered and lacking in agency. Lessons had been learnt and Brent had realised the importance of engaging with the many different BAME communities in Brent and their community leaders. They had concentrated on Alperton and Church End which had the highest number of cases.  Messages had to be consistent and make sense to the communities concerned, for example over shielding in multi-generational households.

Confirming that access to primary healthcare was a major issue, Cllr Abdi Aden, who is of Somali background, said that many in the community who had been feeling sick had problems making appointments with their GP.  They had waited for hours in a queue at the medical centre only to give up and go home without receiving any help.

Cllr Mary Daly backed up the claim. Chair of the Committee, Cllr Ketan Sheth, interjected to say that many in the BAME community still suffered from a poor GP offer.

Dr MC Patel, chair of Brent CCG and NW London NHS lead on inequalities, offered to go with Cllr Aden to the surgery to address the issue of practices not affording access. He said unnecessary denial of access should not be tolerated.  He offered to talk to groups of 5 or so from the community to listen to their experiences and take action. 

Government guidelines recently issued should mean more face to face appointments with GPs rather than on-line arrangements which discriminated against those without internet access or lacking in English language,

Earlier in the discussion the high rate of BAME Covid deaths initially had been attributed to people not going to their GPs early enough. A speaker from Brent Healthwatch said that many residents had been hesitant about going to Northwick Park Hospital and were wary about getting infected there. Cllr Janice Long asked if late admissions to hospital was the cause of the higher death rate in Brent. She pointed out that there was only one medical centre in hard-hit Church End and asked what was being done to encourage people to go to their GP.

Cllr Ahmad Shahzad pointed out the structural issues affecting the BAME community including lack of opportunity and poor housing and said the death toll must not happen again - the Council had to safeguard the population. He said Public Health England and the BMA had been side-lined by the government.

Dr MC Patel said Brent CCG and NW London NHS were looking at devising an additional shielding list for Brent, that would include more people than the government list, and give them appropriate advice. The initial list did not include ethnicity as a factor and experience of the first wave means more needs to be done to include the BAME community, especially those with underlying conditions. Once offered it would be up to the individuals concerned to decide whether to be included in the vulnerable list.

Recently elected councillor, Gaynor Lloyd, said the elephant in the room was whether people would isolate as a consequence of being included in the list. She expressed doubt about a proposal to educate landlords about Covid19 and the risks stating, 'we all know about some landlords.'

 Dr MC Patel said that this was an opportunity for the local authority and health to work together. Joint work and shared commitment were necessary to make things happen and for 'Brent to do it differently.' He cited the response on care homes as being one example of success and said local hospitals had done well.  There was now a clear message to GPs to see patients face to face if that is what they wanted and the CCG were also looking at hot hubs for Covid patients.  It was a matter of 'making the best of what we've got.'

Simon Crawford of NW London Hospital Trust said that the emergency pathway at Northwick Park Hospital was now 85% of the pre-Covid level. Segregated pathways at A&E meant there were clear pathways for non-Covid patients. Presently there were 12 Covid patients in the hospital, a slight increase compared with 8 or so recently.  Patients' temperatures were taken when they first entered the hospital. Patients due for an operation were tested 3 days before the operation was due.  He emphasised, 'We are open for business. If you have an appointment, keep to it!'

He said that Northwick Park had been the busiest hospital in London at the peak and had been supported by other hospitals There had been positive coverage recently and they had been innovative in going with oxygen treatment rather than ventilating machines.  He said that Northwick Park had never run out of oxygen, contrary to reports.

The Trust has signed private sector contracts with Clementine Hospital and the London Clinic. Cancer referrals that had dropped by 50% were now coming back.

Cllr Neal Nerva, recently appointed to the Cabinet as lead member for Public Health, Culture and Leisure, said he was going to introduce a political dimension into the discussion.  Testing had become a matter of private competition and local government had been side-lined. Cllr Shahzad had been right about Public Health England being side-lined and there was also the failings of Test, Track and Trace.

Despite this, he said, the Council could not stand back, too many people were at risk in Brent.  He expressed confidence in the NHS and said people need to be seeking help for non-Covid conditions. The Alperton and Church End meetings showed the need for a wider Brent policy on social distancing and engaging with BAME communities.  Structural issues such as Housing, jobs, co-morbidities, learning for the Covid19 experience, would feed into the Council's new Health and Wellbeing Strategy.

All in all it was a useful discussion, although much more needs to be investigated and acted upon. The trio of councillors, Daly, Long and Lloyd, looked particularly effective as scrutineers.

Somali protest over Brent social services actions in removing children from family

The Somali community organisation Gaashaan held a protest outside Brent Civic Centre yesterday alleging that Brent social services had 'unfairly and unjustly' removed chidlren from their parents.

In a leaflet distributed to passersby Gaashaan  claimed matters had been misinterpreted by the local authority and it had misused its powers.  They said, 'Many, many people  including the family's friends, relatives and others from the wider community are questioning  the motives behind this absurd and unjust decision which they believe harms the family and their children's welfare and wellbeing.'

 Gaashaan are demanding an investigation into all involved in the action and the reasons why children are removed 'when there were other ways to engage with and help this poor family.'

Brent Council has not yet responded to a request for a comment. 

 

Toxic Tunnel set to cost Londoners £2bn, nearly three times original cost undermining aspirations to build back better

The Mayor of London has committed Londoners to paying £65 million a year for a quarter of a century for the Silvertown Road Tunnel, Caroline Russell AM revealed today raising doubts over the commitment to 'build back better' as a result of the lessons learned during the Covid19 shutdown.

 

Last year, Transport for London (TfL) signed a contract with Riverlinx which committed them to the Silvertown Road Tunnel project, but it was only in March after months of requests being stonewalled that the Mayor published the contract in highly redacted form. The entire document on ‘Payment Mechanism’ simply consisted of a contents table and a note stating the details were ‘excluded commercially sensitive information’.

 

A small, discreet note in TfL’s recently published accounts reveals, along with further commentary from TfL auditors Ernst and Young, a failure by the Mayor to be straight with Londoners on the cost of this polluting motorway tunnel.

 

The £65m annual cost included in TfL’s accounts indicates that the total cost from 2025 to 2050 could be £1.6bn before including inflation, which even at 1.6 per cent RPI (the current figure for July) would lead to a total payment by TfL of £2 billion by 2050.

 

Caroline Russell said:

The Mayor has not been straight with Londoners. Last year he told us Silvertown Road Tunnel would cost £1 billion, in March it was £1.2 billion, and now we finally see what TfL will actually pay and it’s heading for £2 billion. This is outrageous.

I have stood alongside many communities in opposing this tunnel which would run a belching, polluting road through the heart of some of London’s most deprived areas. 

 

The real financial cost has been hidden to avoid further opposition from the public and local politicians.
 

When my predecessor on the Assembly first started opposing this scheme in 2012 Transport for London described the cost as being about £600 million, we are stratospheres above that now and TfL will be saddled paying for this, even in our uncertain future.

 

The Mayor should have been clear about this cost implication for TfL from the start. As things stand, he should do the decent thing and cancel this polluting motorway tunnel now.

Thank you from 'chicken shop basement' blogger

Chicken Shop Basement Update

 

Following an update posted on Wembley Matters earlier I'd like to thank the readers and responders of Wembley Matters for their kind support and action.

I knew that it was an unfair and unsuitable offer but didn't know how to move past that.

 

I haven't yet heard from the Housing Department but will keep you updated on the outcome.

 

Whilst I'm delighted that the Council have apparently withdrawn the offer - ie not forced me to be intentionally homeless - it is us as Council Tax payers who are better served when the Council is held to account.

 

In the meantime I'm just so pleased that it's off their books and that no another family will be forced to live there - thank you again Martin for being an incredible and dynamic local resource.

Works on Olympic Way Bridge Rd/North End Road connection and Stadium Steps underway

Access ramp from Bridge Road to Olympic Way and North End Road on bottom left 

 

 

View of North End Road, Michaela School, Victoria Tower from access ramp (Olympic Way

Notice closing pedestrian access to ramp and stairs

Works started on Monday on the construction of the new access road and footpath connecting North End Road with Bridge Road, Wembley Park.  The notice said that the stairs and ramp would be closed to pedestrians from  yesterday but they were still open today.  The works are due for completion in April 21st 2021.

 

The view of the steps from the far end of Olympic Way

Work in progress

A view of the new steps was also available today.  They will replace the pedway as part of the £17.8m 'improvements' to Olympic Way approved by Brent Council, paid from Quintain's  Community Infrastructure contribution.

Chicken shop basement flat offer withdrawn by Brent Council after widespread public concern

Concerned residents rallied in support of the writer of yesterday's post who publicised the unacceptable state of the Harlesden chicken shop basement offered to her and her son as the final offer to a family accepted as homeless.

On Twitter, Facebook and email people made suggestions re possible actions and some wrote directly to Brent Council asking for action to be taken.

Leader of Brent Council, Muhammed Butt, wrote yesterday evening to say that he was asking Cllr Southwood (Lead Member for Housing and Welfare) to work with officers to look look into the matter.

By this morning Carolyn Downs, CEO of Brent Council, had written to another concerned residents to say that the offer had been withdrawn and another offer would be made. She went on to say that the property was managed by a housing association on Brent Council's behalf and that they are investigating that now.

Thank you for everyone who offered advice and contacts and who made representations to the council.

Shame on Brent Council: 'Today I intend to make myself voluntarily Homeless!'

A Wembley Matters reader tells us about her housing offer from Brent Council

 

Today I intend to make myself voluntarily Homeless!

 

I have been accepted as Homeless by Brent Council and they have made me an offer of accommodation that is totally unsuitable.

 

It is a two bedroomed flat in the basement of a chicken shop in Harlesden High Street and is only half a step up from a bed in a shed.

 

 

The outside door to the flat shows evidence of having been nibbled by rats and leads into a corridor shared with the kitchen of the take-away. At the end of the corridor is an extremely narrow stone staircase (down which is would be impossible to bring any furniture) which leads to a yard used by the chicken shop as an extra storage/preparation area.

 

Stepping over what look to be a permanent puddle you finally gain access to the flat which is dark and unfurnished - probably because no furniture could be brought into the flat - in fact there is no room for any furniture.

 

The lounge is so small that you'd have to choose between putting in a mini sofa or a table in as there is not room for both.

 

In the 'master' bedroom there is no room for a bed and a wardrobe and in the second bedroom you might just about be able to fit in a single bed and a bedside table.

 

There is no storage space in the place and any furniture would have to be brought in flat packed as nothing could fit down the stone steps.

 

It is a health and fire hazard and totally unsuitable for a person of my advanced years and arthritis. My son is an adult with autism, agoraphobia and anxiety issues and his mental health could only be compromised by such conditions.

 

Brent has made no concessions to my son’s condition and has told us we must move there and then appeal against our allocation from there. Failure to sign the lease and move in will result in our being intentionally homeless.

 

They will not even consider any medical circumstances or appeals under The Equalities Act until I sign a years lease on this hell hole.  The pressure to sign has been enormous.

It's quite possible that you'll read the above and think I should be grateful for any offer but Brent's use of substandard private rentals effects all of us as Council Tax payers.

 

The rent which Brent is guaranteeing the landlord - whether the flat is occupied or not is £346 per week or £17,992 per annum coming directly out of our Council taxes to line the pockets of a landlord who would be unable to rent that property at that price on the open market and which has been empty for some time.

 

I'm sure that there are light and airy 2 bedroom flats in Harlesden for which the market rent of that magnitude would be fair but a subterranean cupboard with rodent and hygiene issues should not be allowed to be rented under the umbrella of 'market rate' in the area.

 

If, as I will, I refuse to take this flat I will be bounced off the Council's waiting list despite having been on it for 8 years and having lived in Brent for 43 years. I have been desperate to get secure housing for myself and my son; as in common with most parents of disabled children I worry what will happen to him in the long term. However I genuinely believe that I would be causing him more harm by taking that flat than I will be doing by refusing it.

 

The only winner in this situation is a landlord who thinks it is acceptable to charge the Council such an extortionate rent to house the most vulnerable in society in such sub-standard accommodation.

 

MMCL

 

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/