Agenda and minutes

Moved from 20 September 2022, Scrutiny Health & Social Care Sub-Committee - Tuesday, 18th October, 2022 6.30 pm

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

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

Items
No. Item

20/22

Minutes of the Previous Meeting pdf icon PDF 104 KB

To approve the minutes of the meeting held on 28 June 2022 as an accurate record.

 

Minutes:

The minutes of the meeting held on 28th June 2022 were agreed as an accurate record, with the amendments that ‘quantative’ (page 6 of the agenda) be corrected to ‘quantitative’, and ‘maybe’ (page 12 of the agenda) be corrected to ‘may be’.

21/22

Disclosure of Interests

Members and co-opted Members of the Council are reminded that, in accordance with the Council’s Code of Conduct and the statutory provisions of the Localism Act, they are required to consider in advance of each meeting whether they have a disclosable pecuniary interest (DPI), an other registrable interest (ORI) or a non-registrable interest (NRI) in relation to any matter on the agenda.  If advice is needed, Members should contact the Monitoring Officer in good time before the meeting.  

 

If any Member or co-opted Member of the Council identifies a DPI or ORI which they have not already registered on the Council’s register of interests or which requires updating, they should complete the disclosure form which can be obtained from Democratic Services at any time, copies of which will be available at the meeting for return to the Monitoring Officer.

 

Members and co-opted Members are required to disclose any DPIs and ORIs at the meeting: -

 

·     Where the matter relates to a DPI they may not participate in any discussion or vote on the matter and must not stay in the meeting unless granted a dispensation.  

 

·     Where the matter relates to an ORI they may not vote on the matter unless granted a dispensation.   

 

·     Where a Member or co-opted Member has an NRI which directly relates to their financial interest or wellbeing, or that of a relative or close associate, they must disclose the interest at the meeting, may not take part in any discussion or vote on the matter and must not stay in the meeting unless granted a dispensation.  Where a matter affects the NRI of a Member or co-opted Member, section 9 of Appendix B of the Code of Conduct sets out the test which must be applied by the Member to decide whether disclosure is required.

 

The Chair will invite Members to make their disclosure orally at the commencement of Agenda item 3, to be recorded in the minutes.

 

Minutes:

Councillor Sherwan Chowdhury disclosed an interest as he was currently employed by a project run by the South London and Maudsley NHS Foundation Trust (SLAM).

22/22

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:

There was no urgent business for discussion by the Health & Social Care Sub-Committee at this meeting.

23/22

South West London Integrated Care System Update pdf icon PDF 56 KB

The Sub-Committee is presented with an update on the delivery of the South West London Integrated Care System for its scrutiny.

Additional documents:

Minutes:

The Sub-Committee considered a presentation, set out on pages 15 to 34 of the agenda, which provided an update on the delivery of the South West London Integrated Care System. An introduction was provided to the Sub-Committee by the Croydon Health Services Chief Executive and Place-Based Leader for Health, Matthew Kershaw.

 

The Sub-Committee noted the representatives on the NHS South West London Integrated Care Board, and asked if Croydon’s VOTP group could be included. The Croydon Health Services Chief Executive explained that this was not in their power to change and was a South West London Integrated Care System responsibility with the formulation of the Board led by national guidance. Members expressed disappointment at the underrepresentation of patients and service users and were of the view that these groups should be included from the beginning of the ICS; the Croydon Health Services Chief Executive stated that they would reflect this back to the ICS, but that there was already some service user representation on the Board and in the Partnership. The Corporate Director Adult Social Care & Health explained that it was important that the workstreams resulting from the Health and Care Plan in Croydon would be shaped by service users.

 

Members noted the close work between the ICS and Healthwatch and heard that funding had been received by Healthwatch for an executive lead to co-ordinate the six Healthwatch groups in the ICS areas. The Sub-Committee asked about the complexity and pace of implementation in the ICS. The Croydon Health Services Chief Executive explained that so far responses had been timely and effective; an example of this was given on securing funding for health inequalities that had been granted for Croydon at higher levels due to quick responses, as a result of strong and effective relationships in the borough, that demonstrated Croydon’s higher levels of need.

 

The Sub-Committee asked how it was ensured that the ICS provided value for money for Croydon and heard that some funding was allocated on a population basis (for example, on vaccines), but for other issues need could be greater in Croydon or other boroughs (for example, health inequalities), and for these issues funding was allocated based on the distribution of need. This helped to ensure that value for money was achieved for all areas in the ICS, but it was noted that there was a historic disparity in the funding that Croydon received that would take some time to correct and that work on this was ongoing.

 

The Chair asked about place-based accountability for the ICS and what would be done to keep the Sub-Committee abreast of upcoming workstreams. The Croydon Health Services Chief Executive responded that he was a representative of Croydon at the ICS, and was responsible for ensuring that Members remained sighted on workstreams at the Croydon and South West London level. The ICS were committed to providing good forewarning of upcoming work and it was highlighted that early work on shifting commissioning responsibility for dentistry to the ICS level was being  ...  view the full minutes text for item 23/22

24/22

Croydon Safeguarding Adult Board (CSAB) Annual Report 2021/22 pdf icon PDF 91 KB

The Health & Social Care Sub-Committee is asked to: -

1.     Note the Croydon Safeguarding Adult Board Annual Report 2021-2022.

2.     Consider whether there are any considerations or concerns it may wish to submit to the Cabinet during its consideration of the Annual Report.

3.     In particular, give consideration as to whether the Annual Report provides sufficient reassurance on the performance and effectiveness of the Croydon Safeguarding Adult Board.

 

Additional documents:

Minutes:

The Sub-Committee considered the Annual Report for 2021-22 from the Croydon Safeguarding Adults Board, as set out on pages 35 to 78 of the agenda, with a view to reassuring itself on the performance of the Board, prior to the report’s consideration by the Cabinet. The Independent Chair of the Board, David Williams, introduced the report.

 

The Chair asked about the effectiveness and key strengths and weaknesses of the Partnership. The Corporate Director Adult Social Care & Health stated that the commitment of the partners was a particular strength, with strong participation across many sub-groups from the partners; it was recognised, however, that data collection and the building of the scorecard still required additional work. The Cabinet Member for Health and Adult Social Care agreed on the importance of good up-to-date qualitative data and proper data sharing between the partners. The Detective Superintendent for Public Protection commented on the willingness of the partners to learn from each other and to engage with the action plans resulting from Safeguarding Adult Reviews (SARs) but felt that transitions between the Children and Adult Safeguarding Boards could be strengthened and would be a key area of focus for the partnership going forward. The Director of Public Health added that data interpretation was important, and that this had come a long way, although the differences in safeguarding legislation for children and adults could make it difficult to deliver a joined up multiagency approach. Members heard that increasing inequality and vulnerability in Croydon, and nationally, remained a key challenge. The Independent Chair explained that the engagement and commitment of partners were key to the success of the partnership, and that work to improve data collection would be prioritised. The Director of Safeguarding at Croydon Health Services restated that closing the gap in the transitions between the Children and Adult Safeguarding had been identified as an area for ongoing improvement work.

 

Members queried the inclusion of 2011 census data in the report and asked why more recent estimates had not been used that excluded children. The importance of good data was highlighted, and it was noted that the Mayor of London 2019 demographic predictions broke down ethnicity for white adults into ‘White – other’ and ‘White – British’; it was stressed that White – other’ was a significantly large group and that inclusion of the distinction in the report was important to allow for meaningful comparisons. The Sub-Committee commented on the ‘what has been done’ section of the report and noted that this was largely composed of assertions. Members asked for quantitative data that demonstrated outcomes the Board had achieved. The Corporate Director Adult Social Care & Health responded that the ‘Voice of the People’ (VOTP) group had been established to work with residents with lived experience to provide a strong voice in Adult Safeguarding; the group had been the first established in London and had since been rolled out London-wide as an example of best practice. Members asked that for future reports that there was quantitative data to  ...  view the full minutes text for item 24/22

25/22

Adult Social Care Budget & Reforms pdf icon PDF 122 KB

The Committee is asked to scrutinise the information provided with a view to:-

1.     Considering whether it is reassured about the delivery of the 2022-23 Adult Social Care Budget

2.     Gaining an understanding of the implications for Croydon from the Government’s social care reforms.

Minutes:

The Sub-Committee considered a report on Adult Social Care Budget and social care reform, as set out on pages 79 to 88 of the agenda, with a view to reassuring itself about the delivery of the 2022-23 Adult Social Care Budget and to understanding of the implications for Croydon from the Government’s social care reforms. The Corporate Director for Adult Social Care & Health provided an introduction to the report.

 

The Chair asked about any emerging risks or changes that had been identified since the report was written and heard that Adult Social Care was still predicted to come in on budget and that forecasting for peaks in demand in the winter had been undertaken. Pressures on Croydon University Hospital had been high throughout the year and there were a number of workstreams focussed on this, including hospital discharge and prevention work. Members heard that the department was working closely with partners, such as Virtual Wards, GPs and the voluntary sector, to mitigate and prevent hospitalisation. The NHS backlog and long waiting lists could lead residents to have contact with Adult Social Care who would normally not have. Members heard that increased isolation over the last two years as a result of the pandemic had also likely led to declines in the mental health of some individuals which had increased demands on the service. The Corporate Director for Adult Social Care & Health stated that the priorities of Adult Social Care were to meet statutory requirements, to manage demand, complete reviews in a timely way and to manage contracts and the market well. The importance with hearing the voice of every individual the service worked with was highlighted.

 

The Chair asked about IT systems that had been implemented in Adult Social Care and staff training on these systems. Members heard that the data coming out of ‘Liquid Logic’ and financial returns were improving with synergy between the two; these systems had been implemented just before the first lockdown in 2020 which had presented challenges. There was a performance board that looked at data for Adult Social Care, including the cost of care packages and the number of assessments and referrals. All managers had recently completed Chartered Institute of Public Finance and Accountancy (CIPFA) training, and there was ongoing training to ensure data could be pulled from Health and SLAM systems. The Corporate Director for Adult Social Care & Health explained that they were confident in the data, and that this would be reviewed by the CQC during their next inspection.

 

The Chair asked about the ‘Fair Cost of Care’ exercise and the challenges this could present to Croydon. The Head of Improvement explained that the exercise was to establish the fair cost of domiciliary and residential care in the Croydon market. Funding from the Department of Health and Social Care (DHSC) would be available in 2023 but the allocation that Croydon would receive would not be known until late in the financial planning period. On the Care Cap and setting up of Personal  ...  view the full minutes text for item 25/22

26/22

Healthwatch Croydon Update pdf icon PDF 60 KB

The Health & Social Care Sub-Committee is asked to note the latest update provided by the Healthwatch Croydon Manager.

Minutes:

The Sub-Committee received an update from the manager of Healthwatch Croydon, and co-opted member of the Sub-Committee, Gordon Kay, on the latest reviews conducted by his organisation. The first review was around Primary Care as it related to the Health and Care Plan Refresh, which was very Croydon focussed, and the second was on long COVID, which was in collaboration with the six other Healthwatch groups in South West London.

 

On the Primary Care as it related to the Health and Care Plan Refresh, Members heard that a focus group had been gathered of individuals with involvement in GPs Patient Participation Groups (PPGs) to gather their views on the plan and the feedback from this had then been shared. A full report had been written and published in July 2022 alongside the Health and Care Plan. There was complexity around who was responsible for what and accountability. The focus group had been formed of individuals with different backgrounds from all over the borough, involved in a number of different PPGs and those involved in social prescribing. It had been found that there was a complexity around understanding the network and roles, objectives and who was accountable for what. The role of PPGs in primary care was thought to be significant, but delivery and refresh of the groups had been inconsistent and relied on the relationship between GPs and their patients. There was a large element around volunteers and the volunteer base.

 

There were a number of recommendations made and these included:  providing clearer communications around the objectives and benefits of the Health and Care Plan; defining the role of Primary Care Networks in delivering the Plan; involving the PPGs at GP and Primary Care level; applying good practice with PPGs; ensuring grassroot level organisations were included in conversations; not overestimating the volunteer base.

 

The Chair asked about PPGs in Croydon and how well these were implemented. Members heard that there was good practice, but there was always more that could be done.

 

On Long-COVID, a survey had been produced for sufferers and the insights across South West London had been that the most severe symptoms included fatigue, headaches and anxiety. Only a quarter of respondents had symptoms but no formal diagnosis, 74% said that COVID had affected their mental and emotional health, one third had symptoms 12 months after their original COVID infection and only around half had received any help (from friends and family). The recommendations had been that there needed to be a better screening process and better insights on age/gender/ethnicity, alongside community support for Long-COVID sufferers.

 

Members asked about the ‘social contagion’ aspect of long-COVID and the lack of available testing. Gordon Kay responded that a better screening process was needed to ensure accurate reporting was happening.

27/22

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:

This motion was not required.