North West London Integrated Care Systems terminates Urgent Treatment Centre provider's contract at Central Middlesex & Northwick Park sites, along with others

 From the HSJ LINK , by Nick Kituno

An integrated care system has terminated a private provider’s contract to run four urgent treatment centres following performance concerns, HSJ has been told. 

Two local acute trusts were expected to take over from provider Greenbrook Healthcare this week, following the decision by North West London ICS.

The impacted sites include Hillingdon UTC, which is co-located with the Hillingdon Hospitals Foundation Trust, as well as the Ealing, Central Middlesex and Northwick Park sites that are near to the respective hospitals run by London North West University Healthcare Trust.

Two other UTCs on the patch, at St Mary’s and West Middlesex hospitals, are unaffected.

Greenbrook Healthcare is owned by the Totally plc group and its services provided to the NHS include urgent care, planned care and insourcing.

The ICS declined to say why the contract had been ended, but a senior source close to the situation told HSJ it followed performance and staffing concerns.

Winter and performance plans published by the ICS in July and October last year cited performance problems with its UTCs, although it did not mention particular centres.

A report in the summer cited “system wide actions to understand and address weaknesses in UTC performance”, while another in October said a “remedial action plan” was in place “submitted by Totally plc in July 2022, which includes specific actions on staffing performance and re-direction initiatives”.

In a joint statement, North West London ICS and Totally plc told HSJ: 

“As Greenbrook Healthcare approaches the end of its contracts with commissioners to provide urgent care services via UTCs at Ealing, Northwick Park, Central Middlesex and Hillingdon hospitals, and whilst we agree handover plans to the local NHS trusts, the delivery of excellent patient care remains our joint priority.”

The ICS tendered for the long-term running of the UTCs in November, saying at the time that the new providers expected to be in place from early 2023. The ICS has not yet announced the result of the tender. The £26m contract would run for three years and include an option for a further two.

North West London clinical commissioning group awarded a short-term contract to run the UTCs last year, pending the longer-term procurement exercise.

The developments in north west London follow the Care Quality Commission placing four UTCs run by a different independent provider in the North East London ICS in special measures last month, but this is not directly related to Greenbrook or Totally.

Questions have been raised about the workforce model of UCCs in London.

Scrutiny Report on Brent's forthcoming budget makes many telling points - including being honest with the public by calling a cut a cut where appropriate

The Budget Scrutiny Task Force, made up of members of both scrutiny committees, has done a thorough job, and brought up issues that have concerned observers. 

The full report is available here and will be presented to the Resources and Public Realm Scrutiny Committee tonight (6pm) and be considered by the Cabinet and Full Council as part of the budget process.

The report tackles the lack of fit between the Draft Borough Plan and the Council's climate strategy (Rec.1) as well as asking for more transparency so that cuts in services are actually called that rather than 'savings' etc (2) . The likely rise in Council Tax of 4.99% brinsg a recommendation that the Council review eligibility for the Council Tax Support Scheme and the Resident Support Fund (4).  The danger of digital exclusion (6) as the Council relies more on such provision is partially addressed with a recommendation that help be provided for digital form filling. There is a call for more active lobbying of the appropriate bodies on a range of funding issues (9)  including on the reform of Council Tax.

Recommendation 1- Borough Plan 2023-27 Alignment

It is important that the proposed budget properly aligns with the strategic priorities identified in the upcoming Borough Plan 2023-27. The Task Group are concerned that the draft budget omits solid proposals to deliver on our strategic priorities around our climate commitments, including our goal to become Carbon Net Zero by 2030. There is a real opportunity for the Council to clearly communicate the relationship between its strategic priorities and budget proposals to residents, local councillors, and partners. The Council should strive to publish both the Budget and Borough Plan at the same time but the Task Group has noted that this has been challenging on this occasion due to time restraints and budget uncertainties.

 

The Task Group recommend that the Council more clearly demonstrates how public money is being spent in line with the democratically agreed strategic priorities for the borough.

Recommendation 2 – Proposal Categorisations

The Task Group are concerned with how the draft budget proposals were being presented to residents. It was noted that using language such as ‘savings’ in past budget setting processes may have been acceptable; however, on this occasion this is not applicable due to the great amount that needs to be cut from the budget moving forward. Given that the Council has to continue to deliver savings over the next two years to balance the budget, there is a greater need for resident’s expectations to be managed correctly and honestly to ensure that they are prepared for the difficult changes to important services.

 

The Task Group recommend that each budget proposal is categorised as one of: Cut; Income generation; Service transformation; Efficiency; or Investment for transparency purposes. This language should also be used in Council communications in order for residents to distinguish between the proposals which are cuts/service reductions, those which are investments, and those which are efficiencies/service transformation.

Recommendation 3 – Income Generation

The Task Group welcome and are encouraged by the Council’s efforts to identify options for income generation. We would encourage officers to continue being innovative in identifying further opportunities for income generation to offset the impact that many of the proposals will have on vital council services. Specifically, around increasing parking fees/charges and generating income from our assets, such as parks. With regards to the former, we note the Chief Executive’s comments around ensuring that if we are able to increase parking fees/charges, that the messaging to residents would have to be very clear in specifying that any charges recouped from parking fees would be reinvested in highways infrastructure as is legally required. However, any fee/charge increases must adopt a balanced approach that accounts for the impact of the Cost of Living crisis on different communities.

 

We would also like to stress that utilising our parks to generate income could assist us in our legacy work as ‘Borough of Culture 2020’.

 

The Task Group recommend that the Council:

• Increase parking fees/charges to a more comparable rate charged by surrounding boroughs to secure safe movement of traffic and adequate parking and;
• Utilise our parks to generate additional income – as part of this process, the Council should draw comparisons with other local authorities to learn from good practice.

Recommendation 4 – Additional Financial Support for Residents

The Task Group note the Chancellor’s Autumn Statement, which gives provision for local authorities to raise Council Tax by a maximum of 4.99% without a referendum. We appreciate the Council is likely to have no other viable options but to raise Council Tax by this amount to navigate the current financial challenges. However, Council Tax is a regressive tax; should this increase happen, the Task Group is concerned that this may cause greater hardship to those residents who currently do not qualify for relief under the Council Tax Support Scheme or Resident Support Fund. Additionally, the Task Group are
concerned that in response to tax increases, along with rising energy costs and unaffordable rents, it is frequently only food which is left for residents and families to sacrifice.

 

The Task Group therefore recommend that the Council:

• Increases funding and reviews the eligibility criteria for both the Council Tax Support scheme and the Resident Support Fund, should the financial modelling process allow and;
• Explores options to provide additional support to children to tackle food poverty, such as extending universal free school meals provision.

Recommendation 5 – Additional Advice & Support for our Voluntary Sector partners

It is clear that our voluntary sector partners are also experiencing significant financial difficulty and, like the Council, have been subject to consistent budget reductions over the last 10 years. The voluntary sector provide vital support for many residents and act as a safety net for the Council by going above and beyond to offer services that are beyond their traditional remit (e.g. food aid). The Task Group are satisfied that the Council is doing the best it can to protect the voluntary sector and frontline services in its proposed budget. However, it is likely that in the future funding to the voluntary sector could be scaled back. It is important we provide the voluntary sector with its own safety net.

 

To assist in building voluntary sector resilience, the Task Group recommend that the Council develops:

• An approach to increase the value of the commissioned contracts offered to the VCS to help them navigate the current volatile economic environment. The Council could also use this as an opportunity to tighten and improve its contract monitoring process to ensure further robustness and transparency in achieving outcomes.
• A collaborative strategy with the VCS to enable these organisations to identify and secure new income streams. This should also include scope for increased opportunities to make joint bids for grant funding.

• A transparent policy for distributing Council community assets to our voluntary partners in need of space. Specifically, offering capped peppercorn rents to the sector to expand their operations.

Recommendation 6 – Equal Access for All Residents

The Task Group understands the importance of the Council taking advantage of the opportunities/benefits associated with digital transformation, especially when taking into consideration the possible savings and efficiencies they can provide. However, we are still mindful that not all automated services are fit for purpose nor accessible to all residents (e.g. those who are digitally excluded, those with disabilities etc.)

 

The Task Group recommend that:

• The proposed automated services (e.g. chat bots) are tested by residents ahead of implementation, especially by those who have accessibility needs to ensure that all residents have equal access to services and;
• Additional advice and support is provided to disabled residents and those cohorts of residents with other access needs (e.g. literacy needs/English not a first language etc.) to navigate digital-form filling so they can maximise the benefits/grants they are eligible for and entitled to.

Recommendation 7 – Improving Equality Impact Assessments (EIAs)

The Task Group noted that the Council has undertaken individual equality impact assessments (EIA) on each proposal, but improvements could be made to the current process to ensure greater transparency so EIAs are not seen as a ‘tick box’ exercise.

 

The Task Group recommend that the Council:

• Include an evidence base/rationale section in the EIA for each proposal where it has been deemed that there are no potential or likely impact on service users and employees with protected characteristics (e.g. how the Council arrived at such decisions) and;
• Undertake a cumulative equality impact assessment of the budget decisions since 2018 to understand fully the medium and long-term impacts of its financial decisions. It is
recommended a cumulative EqIA is completed during financial year 2023/24 and is included in the final budget report 2024/25.

Recommendation 8- Increased Collaboration

The Task Group is not clear on how health partners will be involved in the decision-making around in agreeing step down plans into general needs accommodation (proposal AH05). This partnership is vital to ensure our most vulnerable residents have the appropriate support in place at the right time, especially considering the difficulties in recruiting and retaining high quality staff. More generally this proposal raises interest from the Task Group regarding how we can work better with the NHS and other stakeholders around hospital discharges e.g. how we collectively mitigate the risks around discharge, and how we leverage contributions from partners/agencies in providing high quality social care and support. At present we have concerns that the rising costs in Adult Social Care cannot be met by the Council alone, where there is a need for clarity on the NHS funding responsibilities.

 

To ensure a holistic approach to residents’ care, specifically ‘those with complex needs’, the Task Group recommend that:

• A collaborative mechanism is established between the Council, NHS, and other relevant stakeholders to agree discharges/step down plans. If possible, this should be considered as part of the review process currently taking place with Central and North West London NHS Foundation Trust (CNWL) in the Integrated Care Partnership and;
• The Council leverage sufficient financial contributions from the NHS (and other relevant anchor institutions) to improve the Health & Social Care function in Brent.

Recommendation 9 – Lobbying

 

We note that many of the challenges in the draft budget proposals are reliant on the powers and funding from central government to be resolved.

 

The Task Group therefore recommend that the Council works closely with neighbouring local authorities, London Councils, and the Local Government Association (LGA) to seek:

• Additional funding in the Dedicated Schools Grant (DSG), notably the High Needs Block of the DSG which is currently in deficit. Although the Task Group is pleased with the activity undertaken to manage the deficit and despite the fact that the Council will see increased funding from central government, there is still a need for additional financial support to meet rising demand.
• Powers to levy proportionate charges on parked motorcycles/mopeds. If successful, this would enable the Council to expand the parking permit system in the borough to include other forms of vehicles.
• Local Government funding reform, including reform of regressive taxes such as Council Tax.
• Changes to gambling legislation and regulations that enable local authorities to generate additional income from gambling licensing fees. This money could then be used to reinvest in vital Council services.
• The introduction of ‘Short Term Letting’ legislation that will allow local authorities to
establish licensing schemes for ‘Air B&B’ accommodation in their respective boroughs.
This would enable the Council to generate additional income from ‘Air B&B’ businesses in Brent that could then be reinvested back into  services for the benefit of residents.

Recommendation 10- Phased Reduction to Care Packages Provision

In relation to proposal CYP03, the Task Group note that the Children and Young People department has identified discrepancies between care packages and the need for clarity and consistency in regards to the eligibility criteria and presenting needs when determining the level of support to be provided. The Task Group supports the review of care packages and better aligning resources to the evidenced needs of children; however we still have concerns about the impact this proposal could have on disabled children in the borough as a whole if the cut to overall provision is made over one financial year.

 

The Task Group recommend that a proportion of the additional funding from the Local Government Finance Settlement is used to enable the Council to defer a proportion of the savings in this proposal to financial year 24/25. This is to ensure changes in provision are implemented in a phased way.

Recommendation 11- Review Areas of Focus for Town Centre Management Function

The Task Group believe the current town centre management infrastructure has made great strides in revitalising our town centres and supporting our businesses. This has been essential post-covid and in the current economic climate. We felt assured that proposal CR05 would not impact service delivery, however we believe this proposal presents an opportunity for the Council to rethink its town centre management structure to ensure more effective focus on economically deprived areas.

 

The Task Group recommend reviewing the areas of focus for the town centre management function, whereby resource can be balanced against need; and work duplication prevented.

Recommendation 12 – Mitigating the impact of reducing the library stock budget

Although proposal RS08 is likely to have a small impact in the context of the collective budget proposals, the Task Group has concerns with the potential impact that this specific proposal could have on Brent’s most vulnerable residents, and in particular children.

 

The Task Group recommend that the Council explores external options to leverage additional resources for our most vulnerable residents, such as the promotion of schemes (e.g. Letterbox Club run by BookTrust) offering free books to vulnerable and disadvantaged children. This could help offset the impact of the proposal on disadvantaged residents and children; and could assist with ensuring children in Brent have equal access to a broad range of reading material.

Recommendation 13 – Mitigating the impact of reducing the Corporate Learning and Training budget

The Task Group recommend that the Council be guided by staff satisfaction surveys when deciding what training courses to discontinue as part of the reduction to the Corporate Learning and Training budget (GOV03).

 

 

Five Minute Full Council Meeting approves new CEO

 

Muhammed Butt, Leader of Brent Council and Kim Wright, Brent Council CEO designate

 

It took just 5 minutes for tonight's Full Meeting of Brent Council to unanimously ratify the appointment of Kim Wright, currently finishing a short spell at Lewisham Council,. She is appointed Brent CEO and Head of Council Paid Services, in May 2023. 

Muhammed Butt, Leader of the Council, Anton Georgiou (Leader of the Liberal Democrat Group) and  Suresh Kansagra (Leader of the Conservative Group) all spoke in favour of the appointment.

Brent, be proud of this young person. Dana Earlington speaks out on bullying - a message for teachers and pupils

 

 

Dana is a pupil at Preston Manor High School and came third in the Brent Regional Final of the 'Speak Out' Challenge.

Forest School at Sufra, St Raph's - February dates

 

Prior planning permission for 20m mobile mast in Willesden Green refused - visually intrusive and physically obtrusive

 

Where the 20m pole and associated cabinets would have been sited (corner of Walm Lane and Dartmouth Road)

 

In a blog post on January 3rd Wembley Matters drew attention to a proposal for a 20metre phone mast and associated cabinets to be built on the corner of Walm Lane and Dartmouth Road, outside Westly Court and adjacent to the Queensbury pub in Willesden Green. There were only a few comments at the time and due to be closed on January 12th but eventually there were 26 objections including from Mapesbury Residents' Association. There were only two supportive submissions.

 

The final delegated report made on January 17th echoed many of the points made by objectors.

 

The decision

 

1 The proposed telecommunications street pole and associated cabinets by reason of their height, bulk, appearance and siting would be overly prominent and visually intrusive within the street scene adding additional clutter to a prominent location. Furthermore, the proposal would result in harm to the character, appearance and setting of the surrounding conservation area and listed buildings. This would cause unacceptable harm to the visual amenity of the area in conflict with Condition A.3 of Schedule 2, Part 16, Class A of The Town and Country Planning (General Permitted Development) (England) Order 2015 (as amended).

2 The proposed telecommunications street pole and associated cabinets by reason of their siting would create an obtrusion to the footway by reducing the available footway width and severely affecting pedestrian movement and overall safety. This is contrary to Condition A.3 of Schedule 2, Part 16, Class A of The Town and Country Planning (General Permitted Development) (England) Order 2015 (as amended).

 The delegated report describes some of the issues:

 

Siting

The application is for prior approval for a 5G telecommunications installation comprising a 20m street pole and additional equipment cabinets on the footpath adjacent to Westly Court on Walm Lane. The equipment cabinets are proposed to be located at the base of the new pole and all of the equipment is proposed to be placed in the middle of the footway. The site is located close to the road junction with Dartmouth Road, which means there are several open views from different angles in the streetscene. This would give the proposal a particularly prominent siting and be at odds with where telecoms and other equipment is generally located.

Highway considerations

The proposed 20m high pole and three cabinets would be 4m from the edge of the carriageway and 4m from the back of the footway. All of the equipment is proposed in the middle of the footway which would add lot of clutter to the footway and a nuisance to pedestrians. In addition to this, there is an existing cabinet at the back of the footway which would mean that only a 2.2m wide footway is retained between the existing cabinets and the proposed new cabinets.

It appears that the doors of the cabinets would open away from the carriageway, although it is not clear. This would further clutter the middle of the footway and force pedestrians to walk closer to the carriageway. This siting would be inappropriate generally and pose a significant obstruction in an area which has been highlighted by objectors as being busy with a high number of pedestrian. In addition the proposal would be poorly sited create a safety risk for visually impaired pedestrians.

The proposals will not obstruct visibility for vehicles at this junction as it is set back 4m from the edge of the carriageway.

Therefore, the siting is considered to be unacceptable

 

Heritage and Design

In addition to the location on the footway noted above, page 2 of the ‘Site Specific Supplementary Information’ states that the proposal is outside the Conservation Area, which is incorrect. The site is located within the Mapesbury Conservation Area.

 

There are also several designated heritage assets in the area, which would need to be taken into account.

No heritage statement has been submitted with this application to describe the significance of the heritage assets or the Conservation Area and to understand the potential impact of the proposal.

It is clear that the position of the new pole would be obtrusive and prominent in the streetscene. The new pole would be seen directly in the context and on the edge of the Mapesbury Conservation Area. It would also be seen in the eyeline of the bell tower of St Gabriel’s Church, which is Grade II listed and one of the most significant buildings in the conservation area. Even with the treelined street (acting as a foil in summer) it would stand out in views from within the conservation area and along its attractive boundary. Furthermore, the trees cannot be replied upon as a permanent screen.

There is lessor impact on the Willesden Green Conservation Area and the Underground Station (listed Grade II), but it will impact a view from Dartmouth Road.

The equipment cabinets would be located in the middle of the pavement. It should be noted that there are existing cabinets on the edge of the footway, lampposts, signage a litter bin and other features in close proximity to the proposal. Although the existing items are generally positioned more discretely, the proposal in the centre of these items would be very cluttered, prominent, unattractive and would detract from the beauty of the area.

Overall, it is considered that the proposed mast and cabinets will cause harm to the significance of the Mapesbury Conservation Area and great weight should be given to the asset’s conservation. The proposal would fail to preserve or enhance the character or appearance of the Conservation Area. Being viewed both looking into and out of the Conservation Area, the proposal would impact on its setting and the setting of the attractive buildings and listed buildings. The proposal would result in 'less than substantial harm' to the heritage assets (Conservation Area and Listed buildings) When considered against the requirements of the NPPF. The prominence, out of place appearance and the surrounding views from several public and private vantage points, would result in the proposal having a moderate to high impact on a scale of 'less than substantial harm'.

There is no evidence or clear convincing justification that another location outside the conservation area has been considered that would diminish the impact. It has been noted that the proposal would result in technological improvement for the public, however, the public benefits would be clearly outweighed by the harm that the proposal would result in on the character and appearance of the site and its surroundings, including the Conservation Area and the nearby Listed Buildings

 

 

Some creative and practical ideas on the Staples Corner Masterplan consultation. Contribute your thoughts.

 

Staples Corner from above (Brent Council)

It is all too common for Wembley Matters to hear from residents they were not aware of development proposals or consultations. Here, in a guest blog, a resident shares their message to Brent Council on the consultation over the preparation of a Master Plan Supplementary Planning Document (SPD) on the future of the Staples Corner Area.

In TRANSPORT terms, it is currently horrible for pedestrians and cyclists around Staples Corner. Even for motorists.

Brent needs either to take on in battle the London Mayor's 'Transport for London Streets' planners and reduce the amount of ugly and hostile 'severance' that his main roads create in the area, or you need to divide up your Brent plan and turn AWAY from the main roads to treat each area entirely separately.

 

 

Area Map (Brent Council)

 

Given the 'excellent' 24-hour main road access for goods, you should intensify industrial development, perhaps with flatted factories to encourage small businesses. Industrial and commercial areas need a great deal of greening as well though. Thirty years ago you attempted it in Park Royal with 'pocket parks'. Planning guidance must insist on setback and maintainable green borders around all industrial sites. Fencing design is important as well, with no ugly, cheap, bog-standard 'bayonet' galvanised-steel fencing (for a change).

Given the soon-to-open Thameslink station there and the potential 'West London Orbital' London Overground line to Neasden station, Harlesden station, HS2 Old Oak Common and into south-west London, you have high enough 'Public Transport Accessibility Level' values to build new housing at high density (which does not have to mean high buildings). 

Please clarify in your documents what is zoned as 'Strategic Industrial Land' and what is not. Are you planning to change its boundaries? Would there be mitigation (such as higher-density industry in what is retained)?

Pedestrian and cycling crossings across the A5 need to increase in number and quality, and at all side road junctions, with NO 'slip road geometry' on the road corners from the A5, so that LINKED road junction traffic lights / pedestrian crossing lights can keep speeds down to 30mph or below - which would be a novelty.

The main A5 slip roads from the A5 flyover should be reduced in length and width - not intended to reduce capacity but to reduce speeds. They are currently of a scale for 70mph traffic.

Current traffic speeds on the main roads are either near zero when there is congestion, and very high when traffic is light. 

The North Circular Road was going to be a motorway, the 'M15', but the A5 technically was NOT, and that road can be re-urbanised and humanised without much opposition, if you use planning gain money to finance the changes. 

Ex-London Mayor 'Boris-the-Now-Disgraced' had a London-wide 'Roads Taskforce'. That declared that roads should have a MOVEMENT function but also a SENSE OF PLACE function. Brent's task is create the latter on the Staples Corner main roads for the first time since the 1975 'improvements', particularly on the A5 main road.

 

This Brent Council's description of the consultation:

 

Brent’s Local Plan designates Staples Corner for housing and industrial growth, with the ambition to transform the area into a new mixed-use community with at least 2,200 new homes and new business premises fit for modern day occupiers, with an improved environment and supporting infrastructure.

 

To achieve this ambition, the Council is developing a Masterplan that will provide the detailed vision and planning policy framework for regeneration and growth in Staples Corner for the next twenty years.

Brent Council is also preparing a Design Code to set out the design requirements for new developments coming forward in Staples Corner. The design Code would provide greater certainty for communities about the design of new developments to the start of the planning process.

 

Brent will work with local communities and stakeholders to ensure the Masterplan and the Design Code for Staples Corner reflects local aspirations.

 

The Residents' Survey opened on December 1st with little response so far. It closes on 30th April 2023.

LINK TO SURVEY