Agenda and minutes

Scrutiny Health & Social Care Sub-Committee
Tuesday, 26th March, 2019 6.30 pm

Venue: Council Chamber, Town Hall, Katharine Street, Croydon CR0 1NX. View directions

Contact: Simon Trevaskis
02087266000  Email: simon.trevaskis@croydon.gov.uk

Items
No. Item

50/18

Minutes of the Previous Meeting pdf icon PDF 106 KB

To approve the minutes of the meeting held on XXX as an accurate record.

 

Minutes:

The minutes of the meeting held on 18 December 2019 were agreed as an accurate record.

 

51/18

Disclosure of Interests

In accordance with the Council’s Code of Conduct and the statutory provisions of the Localism Act, Members and co-opted Members of the Council are reminded that it is a requirement to register disclosable pecuniary interests (DPIs) and gifts and hospitality to the value of which exceeds £50 or multiple gifts and/or instances of hospitality with a cumulative value of £50 or more when received from a single donor within a rolling twelve month period. In addition, Members and co-opted Members are reminded that unless their disclosable pecuniary interest is registered on the register of interests or is the subject of a pending notification to the Monitoring Officer, they are required to disclose those disclosable pecuniary interests at the meeting. This should be done by completing the Disclosure of Interest form and handing it to the Democratic Services representative at the start of the meeting. The Chair will then invite Members to make their disclosure orally at the commencement of Agenda item 3. Completed disclosure forms will be provided to the Monitoring Officer for inclusion on the Register of Members’ Interests.

 

Minutes:

There were none.

 

52/18

Urgent Business (if any)

To receive notice of any business not on the agenda which in the opinion of the Chair, by reason of special circumstances, be considered as a matter of urgency.

 

Minutes:

The Chair advised the Sub-Committee that he had agreed to allow an update on the Community Dental Service from Kings College Hospital NHS Foundation Trust to be considered as an urgent item to ensure that the update was provided in line with the Sub-Committee’s recommended timeframe set at their meeting on 20 November 2018.

53/18

Urgent Item: King's College Hospital NHS Foundation Trust - Update on the Community Dental Service pdf icon PDF 560 KB

To received an update from representatives from King’s College Hospital NHS Foundation Trust on the outcomes from a follow-up exercise with the patients of the Community Dental Service formerly based at the Parkway Health Centre.

Additional documents:

Minutes:

At their meeting held on 20 November 2018, the Sub-Committee had raised concern about the Community Dental Service being discontinued at the Parkway Health Centre in New Addington. As such an update from the operator of the service, King’s College Hospital NHS Foundation Trust was requested for March 2019, to address the concerns raised by the Sub-Committee at their meeting on 20 November.

The following representatives from King’s College Hospital NHS Foundation Trust were in attendance at the meeting to provide the update:-

·         Doctor Rob Hale - Consultant in Special Care Dentistry and Head of Department for Community Special Care Dentistry, and

·         Paul Chandler - Deputy Director of Operations 

From the update provided, it was confirmed that the decision to discontinue the Community Dental Service at the Parkway Health Centre had not been reconsidered, as the equipment used by the service had already been decommissioned and was no longer available.

An Equalities Impact Assessment (EIA) had been undertaken following concerns raised by the Sub-Committee at the meeting on 20 November.  The EIA acknowledged the high impact from the closure for patients with disabilities and also the high impact from transport related issues for patients who now needed to travel to alternate locations to access the service. King’s College Hospital NHS Foundation Trust had written to the 250 patients who used the service, receiving six responses that would be acted upon.

Looking further forward, King’s College Hospital NHS Foundation Trust had expressed an interest locating a Community Dental Service at the new leisure facility being built in New Addington. King’s College Hospital NHS Foundation Trust had also recently participated in an Oral Health Stakeholder Workshop, which had resulted in them agreeing to be part of the Steering Group for oral health in the borough.

Following the update, Members were given the opportunity to question the representatives from King’s College Hospital NHS Foundation Trust about the provision of the Community Dental Service. The first question concerned the transportation issues highlighted in the EIA, with it questioned whether there had been any mitigating factors introduced as a result. It was confirmed that hospital patient transport had been offered to patients unable to travel to the service in Thornton Heath.

Although the undertaking of an EIA on the decision to close the Community Dental Service at the Parkway Health Centre was welcomed, there was a concern that it focussed specifically on disability and did not give consideration to socioeconomic factors that could also be a barrier to patients using public transport, which was acknowledged by the representatives from King’s College Hospital NHS Foundation Trust.

It was questioned whether consideration had been given to relocating the service at another site in the borough, with the Sanderstead Clinic and the recently refurbished Purley War Memorial Hospital suggested as possible alternatives. It was advised that King’s College Hospital NHS Foundation Trust was working with the Public Health team at the Council to explore different options, but potential barriers included the standards required to provide dental services and  ...  view the full minutes text for item 53/18

54/18

Question Time: Cabinet Member for Families, Health & Social Care pdf icon PDF 299 KB

Question time with the Cabinet Member for Families, Health & Social Care, Councillor Jane Avis.

 

Presentation slides to follow.

Minutes:

The Committee received a presentation from the Cabinet Member for Families, Health & Wellbeing, Councillor Jane Avis, providing an update on the activities within her Portfolio. During the introductory presentation to this item the following was noted

·         The strengths highlighted within the Portfolio included the One Croydon Alliance winning the Local Government Chronicle Health & Social Care Award, the Council being awarded Dementia Friendly Status and delivering a balanced budget in the context of increased demand and complexity.

·         The E-Marketplace was due to go live in June 2019 and would be a place where suppliers can demonstrate their services online, leading to greater choice for customers.

·         The new Front Door approach had been developed to reduce the number of hand offs for residents when contacting the Council, with the emphasis on answering queries at the first point of contact.

·         The locum workforce in the Adults Service had been reduced from 35% to 16%.

·         Locality based working had started to be rolled out, with a welcomed commitment from partners in embracing this approach.

·         Potential weaknesses within the Portfolio included the fragility of the provider market with the Council being the largest provider of care homes in London. Out of the Council’s 130 care homes, only three homes were of concern, with steps being taken to improve these.

·         Data quality was an issue, but it was hoped that the quality of data available would begin to improve now that there was an increasing focus on delivering a data driven approach.

·         There had been a £500,000 cut to the Director of Public Health’s budget in the past year that presented additional difficulties in the move to a more preventative approach.

·         There was a determination on the part of both the Administration and the Service to reduce the health inequalities within the borough.

·         The current case management system used by the Service was out of date and as such the process of acquiring a new system was currently underway, which would better enable staff to manage cases.

·         Potential opportunities included the new NHS ten year plan focused towards delivering an integrated care system which would bring together hospitals, GPs and community health services.

·         The expected Government Green Paper on the funding gap in social care had been delayed, but the content of the document was eagerly awaited.

·         The One Croydon Alliance was expanding its focus from residents over 65 to the whole population of the borough.  The results from the first stage, focussed on the over 65’s, had been welcomed with savings achieved, as well as improving outcomes for residents.

·         There was a plans to provide an increased amount of supported accommodation units, as social care moved away from residential care.

·         Work was currently being progressed on the insourcing of special sheltered housing care provision, which should be complete by the end of the year.

·         Potential threats within the Portfolio included an increasingly ageing population leading to increased care costs, the new NHS Plan along with the regionalisation of the Clinical Commissioning Groups leading to a  ...  view the full minutes text for item 54/18

55/18

Annual Public Health Report 2018 pdf icon PDF 170 KB

The Sub-Committee is asked to review the report and considered whether it wishes to make any recommendations.

Additional documents:

Minutes:

The Director of Public Health, Rachel Flowers, was in attendance at the meeting to provide the Sub-Committee with an update on the Annual Public Health Report.  During the introductory presentation the following points were noted:-

·         There was approximately 6,000 babies born in Croydon each year and the report from the Director of Public Health focussed on the early experiences of young children in the borough.

·         The evidence had shown that the experience of children in their early years was key to their future development, with Adverse Childhood Experiences (ACEs) having a significant impact.

·         Determinants on a person’s life included their parent’s health before, during and after pregnancy, their experiences in their first 1000 from conception and ACEs such as neglect and abuse.

·         The three key principles of the approach set out by the Director of Public Health were for staff and Members to know their role, with everybody able to make a difference, ensuring health was a consideration in all Council policies and breaking the inequalities cycle.

·         Since the report was approved by the Cabinet, it had also been considered by the Board of the Croydon Clinical Commissioning Group and the South London and Maudsley NHS Foundation Trust (SLaM), both of whom agreed with the recommendations.

·         Works streams arising from the report including improving the provision of joined up maternal mental health pathways, with conversations ongoing with SLaM about women with long and enduring mental health issues preparing for pregnancy.

·         Work was underway with voluntary and community sector organisations to feed into the public health approach towards violence reduction.

·         There had recently been a Vulnerable Adolescent Mental Health Review, which would inform the work of the Children & Young People Emotional Wellbeing and Mental Health Board.

·         As part of the work streams on promoting health during pregnancy there was support being provided for prospective parents including a Joint Health Weight Steering Group and support to help parents quit smoking.

·         The partners were continuing to work toward reaching the target of 95% MMR immunisations. As part of this, the move by the Government to remove anti-vaccination information from social media was welcomed.

·         Looking forward, consideration was being given to whether work plans needed to be adapted to ensure the delivery of the recommendations set out in the report.   A task and finish group of the Health & Wellbeing Board would be set up to have an assurance role on the delivery of the recommendations.

Following the presentation the Sub-Committee was given the opportunity to question the Director of Public Health on the content of the report. It was noted that the report contained many different work streams, involving the input from different partners. As such it was questioned how this work would be coordinated to ensure a shared focus. In response it was highlighted that the report was independent and had been informed by input from front line staff and other sources of evidence. The Public Health team had been working with the Health and Wellbeing Board to provide oversight.

It was noted  ...  view the full minutes text for item 55/18

56/18

Croydon Healthwatch Update pdf icon PDF 96 KB

Presented for the Sub-Committee’s information is the report from Healthwatch Croydon on Dementia Carers experiences of using Croydon’s health and social care services.

Additional documents:

Minutes:

Gordon Kay, the Manager of Healthwatch Croydon provided the Committee with an update on the current activities of his organisation, which included a report on the experience of Dementia Carers accessing healthcare services in the borough.

From the introduction to the report, the following points were noted:-

·         The top finding from the review was that GPs had a crucial role to play in the process as gatekeepers to health care system. The general view of GPs was good.

·         It was essential for carers that the right support was provided at the right time, as the health care system could often be a confusing and complex environment to navigate, particularly at a time of crisis.

·         Social care advice seemed to focus on the financial implications before those relating to the level of care provided at a time when carers did not want to talk about finance.

·         The Council was funding the Carers Information Service, which was doing a great job. It was found that the public were not aware that this was a Council supported service, so consideration may need to be given to potential communications to promote this link.

·         The recommendations set out in the report reflected that some of the things highlighted are already happening, but the most crucial recommendation was on the need for a clear set of pathways as the present structure was confusing.

·         The report had been shared with key service provided, who given a detailed response. The overall feedback was that it had been well received.

Rachel Carse from Croydon Dementia Action Alliance (CDAA) was also in attendance to provide the Sub-Committee with an update on their own work in this area.  The CDAA had seen an increase in size, with 400 police officers and 20 new organisations signing up. At the Council more than 1,000 staff were signed up as dementia friends.

It was highlighted that there were complicated pathways for dementia patients as there were more than 100 types of dementia. Part of the remit of CDAA was around reducing the stigma and fear of dementia. Their work included dementia friendly film screenings and working with the BME community to raise awareness of their higher risk of dementia.

It was confirmed that CDAA were open to working with voluntary and community sector groups and currently worked with a number of faith groups and Croydon Voluntary Action.

The report was welcomed by the Sub-Committee who were supportive of the recommendations. It was acknowledged that the number of carers who had contributed to the report had been relatively small, but it was proportionate to the number available. The Sub-Committee agree that it would be useful to follow-up on the report in twelve months.

Conclusions

Following their discussion of the report, the Sub-Committee concluded the following:

1.    That the report on the experience of Dementia Carers accessing healthcare services in Croydon was very good and the recommendations were supported.

2.    That the Sub-Committee would revisit the recommendations in twelve months to review progress made.

57/18

Exclusion of the Press and Public

The following motion is to be moved and seconded where it is proposed to exclude the press and public from the remainder of a meeting:

 

“That, under Section 100A(4) of the Local Government Act, 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information falling within those paragraphs indicated in Part 1 of Schedule 12A of the Local Government Act 1972, as amended.”

 

Minutes:

The following motion was moved by Councillor XXX and seconded by Councillor XXX to exclude the press and public:

 

“That, under Section 100A(4) of the Local Government Act, 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information falling within those paragraphs indicated in Part 1 of Schedule 12A of the Local Government Act 1972, as amended.”

 

The motion was put and it was agreed by the Committee to exclude the press and public for the remainder of the meeting.