Agenda and draft minutes

To approve the minutes of the meeting held on 3 October 2023 as an accurate record.

The minutes of the meeting held on 3 October 2023 were agreed as an accurate record, subject to the following change:

1.    ‘It was also acknowledged that officers working on the report had a meeting with SubCommittee members and all suggestions, especially concerning accessibility, made by the Members were agreed and would be implemented before the report was published.’ amended to ‘It was also acknowledged that officers working on the report had a meeting with Sub-Committee members and all suggestions, especially concerning the CSAB Annual Reports’ accessibility, made by the Members were agreed and would be implemented before the report was published.’.

Members are invited to declare any disclosable pecuniary interests (DPIs) and other registrable and non-registrable interests they may have in relation to any item(s) of business on today’s agenda.

There were no disclosures of interest made at the meeting.

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.

The Chair advised the Sub-Committee that it had been agreed an update on a potential measles outbreak would be provided under urgent business. Rachel Flowers, Director of Public Health, provided an update on the current situation in the borough.

It was explained that the main outbreak of measles was in the West Midlands area. However, the cases in London had been rising. In the last year there had been five cases in the borough, although in the last month there was only one confirmed case. It was also added that the measles, mumps and rubella vaccination rate uptake was particularly low for children under 5. However, it was stressed that measles was a threat not only for children, but also for unvaccinated older adults.

The first question asked by the Sub-Committee concerned the threat caused by the measles outbreak. Reassurance was given that the Council was constantly monitoring the situation and appropriate action would be taken when needed. It was also added that the low number of cases did not indicate there was a high risk for Croydon and its residents.

The next question asked whether any particular groups were more vulnerable to or less aware of measles. It was explained that there was not a particular group more vulnerable to measles or with a lower vaccination rate. Many asylum seekers or other people coming to the UK would most likely have been vaccinated, although, there was often no vaccination records available. Nonetheless, it was assured that there had been work targeting specific groups to raise the awareness.

The Sub-Committee questioned whether there was any additional work on raising awareness of the risk of measles with schools. In response, assurance was given that the risks from measles had been regularly communicated within schools for a long time, but  there had been additional targeted work delivered in cooperation with the UK Health Security Agency.

An update was requested on the current levels of COVID-19 in the borough and whether there were any areas of concern. It was explained that the Council was no longer obligated to report on the number of Covid cases, and it was likely that any such data would not be particularly reliable as many people either did not test or used test that had expired.

At the conclusion of the item, the Chair thanked the Director of Public Health for the update provided.

Actions:

Following its discussion of this item, the Sub-Committee agreed the following actions for follow-up after the meeting.

1.     The Director of Public Health would circulate the latest communication on measles to all Councillors.

The Health and Social Care Scrutiny Sub-Committee is asked to:

1.    To note 2023/24 Period 6 (September 2023) budget and savings position.

2.    To note the updated performance position for the Directorate against the newly published Use of Resources report.

3.    To note the update on strategic transformation, including the progress of the Strategic Delivery Partner.

The Sub-Committee considered a report set out on pages 15 to 22 of the agenda which provided the Adult Social Care and Health (ASCH) Directorate’s financial performance at period 6 (September 2023), and current transformation progress in relation to the 2021/2024 Medium Term Financial Strategy (MTFS) and future 2024/2027 MTFS.

Annette McPartland, Corporate Director for ASCH, introduced the report, during which it was highlighted that the quality of information collected in the borough had been improving. It was also added that the Directorate was coming to the end of its original three-year MTFS transformation programme and had been meeting the savings objectives set at the outset of this programme. It was also stressed that the impact of inflation and austerity alongside the increasing demand for services made the delivery of savings even more challenging. However, it was also emphasised that it was very important to ensure that savings delivery did not compromise the safety and wellbeing of residents.

Following the introduction, the Sub-Committee was provided the opportunity to ask questions on the information provided. The first question asked for further information on the increase in the Directorate’s net budget from £129.8m to £141m. In response, it was explained that the budget increase was a result of moving a team and the associated budget from the Housing Directorate to the ASCH Directorate. A supplementary question asked about the rationale behind this move. It was explained that the funding associated with that team was assigned to and fit with the ASCH area, with many members of the team being social workers. Therefore, it was beneficial from the perspective of their supervision, accountability and learning & development opportunities. It was also highlighted that the ASCH Directorate was accountable for ensuring that the Council’s Care Act responsibilities were met. Thus, it was decided that it would be more appropriate for this team to be located within the ASCH Directorate.

The next question asked about the governmental intention to reduce the number of asylum seekers and refugees placed in the hotels, and its potential impact upon ASCH. It was explained that the numbers had been increasing. The Council had set up a multi-agency board to determine and monitor how the additional grant had been spent. It was stressed that there were risks associated with the grant, particularly whether it would be renewed. A supplementary question asked whether there was only one grant available or whether the funding was coming from different sources. It was explained that the Council also had a budget for people with no recourse to public funds, but the grant had been provided by the Government to cover the additional pressures councils had been facing. It was agreed that further information on the origin of the additional pressures grant would be circulated after the meeting.

An explanation of what no recourse to public funds meant was requested. It was explained that it referred to care recipients who did not have permission to work in the UK or claim benefits. Therefore, there was no  ...  view the full minutes text for item 4/24

To receive an update from Healthwatch Croydon Co-optee, Gordon Kay, on the latest report from his organisation.

The Sub-Committee considered a report set out in the agenda on page 23 which set out reports produced by Healthwatch Croydon.

Gordon Kay introduced two reports covering the following areas – (i) Asylum Seekers Experiences and (ii) GP Websites Mystery Shop.

The first question considered using best practice from other boroughs and sharing best practice examples with GP practices across Croydon. It was assured that Healthwatch Croydon worked closely with other Healthwatch organisations across South West London. It was also mentioned that they try to identify best practice examples within Croydon itself to account for Croydon-specific challenges.

The next question asked by the Sub-Committee considered residents without a permanent address registering with GP practices. It was explained that the GP practices generally cannot refuse registration. Only in very specific circumstances could they refer the patient to a different practice nearby. It was also mentioned that residents without a permanent address who cannot register with a GP practice should contact Healthwatch Croydon’s signposting service. A supplementary question considered the information sharing between the relevant shareholders. It was assured that there were data sharing agreements between these shareholders.

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

1.     Note the most recent version of its Work Programme, as presented in the report.

2.     Consider whether there are any other items that should be provisionally added to the work programme as a result of the discussions held during the meeting.

The Sub-Committee considered a report set out in the agenda on pages 25-30 which set out its work programme for the remainder of the year.

The Sub-Committee Members discussed how the work programme should be developed to ensure that it does not replicate the work of other ASCH-related bodies within the assurance framework, and the wider methodology behind selecting scrutinised areas. It was concluded that the Sub-Committee would meet informally to agree on the topics for the next meeting, and it was noted that the LGA Peer Review challenge should be added to its agenda.

It was also noted that the following items (i) accessing sexual health clinics; (ii) immunisation; (iii) prostate cancer check-ups; (iv) and menopause services, were added to the work programme.

Resolved: That the Health and Social Care Sub-Committee work programme is noted.

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.”

This motion was not required.