Agenda and draft minutes

To approve the minutes of the meeting held on 12 March 2024 as an accurate record.

The minutes of the meeting held on 12 March 2024 were agreed as an accurate record.

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 Sub-Committee considered one urgent item of business, specifically the recent announcement regarding the cap on adult social care and the removal of the winter fuel allowance, and the potential impact on Croydon residents. The officers explained that while the cap on adult social care had been planned and postponed several times, the Council had ample time to prepare for its implementation. They provided assurance that no significant changes were anticipated in the current budget or finances of the Council. However, they noted that, in the longer term, the cap could have a substantial impact by creating significant cost pressures.

Regarding the removal of the winter fuel allowance, officers stated that it was too early to accurately estimate its impact, as further analysis would be required.

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

The Sub-Committee considered the report presented by Gordon Kay, representing Healthwatch Croydon, which covered two key areas: (i) the Healthwatch Croydon Annual Report 2023-2024, and (ii) the experiences of vulnerable migrants in accessing health and care services in Croydon.

The Sub-Committee expressed its gratitude for the work undertaken by Healthwatch Croydon. A question was raised regarding any strategic plans to alter the current partnership arrangements. In response, Hillary Williams, NHS Managing Director for Community Services and Integration, explained that collaborative work was already underway to implement the recommendations from the Healthwatch report. It was highlighted that many recommendations required working with independent parties. As such, while certain standards and behaviours could be encouraged, they could not be mandated. Significant progress had been made, particularly concerning safe practices. Furthermore, it was noted that the current focus was on improving mental health services for migrants, with a multi-agency approach being adopted to enhance service offerings.

A subsequent question from the Sub-Committee sought clarification on the potential for expanding the work. It was noted that while substantial progress had been made in primary care, further efforts were still needed to address gaps in secondary care services.

For the reasons set out in the report, the Sub-Committee is recommended:

-        To note the progress of the Directorate’s transformation programme.

The Sub-Committee reviewed a report, found on pages 17 to 79 of the agenda, which provided an update on the transformation work within the Adult Social Care and Health Directorate. Annette McPartland, Corporate Director of Adult Social Care and Health, presented the report.

-          Councillor Yvette Hopley – Cabinet Member for Health and Adult Social Care

-          Councillor Margaret Bird – Deputy Cabinet Member for Health and Adult Social Care

-          Annette McPartland – Corporate Director of Adult Social Care & Health

-          Simon Robson - Director of Adult Social Care Operations

-          Richard Eyre – Head of Improvement

-          Daniel Sperrin – Partner at Newton Europe

-          Mike Burnett – Business Manager at Newton Europe

The first question raised by the Sub-Committee addressed the shortage of social workers. The officers responded that there was a relatively high proportion of permanent social workers in adult social care, noting that while agency workers were necessary due to grant funding and winter pressures, the overall workforce was stable. It was highlighted that the vacancy rate was currently around 5%, with vacancies mainly in hospital discharge and transition areas. The officers assured that they were working to fill these vacancies as swiftly as possible.

A follow-up question was raised about why Croydon had higher staff retention and fewer vacancies compared to other local authorities. The officers attributed this to good supervision, support, and leadership, further noting that the appointment of a Principal Social Worker had made a significant impact. The workforce was described as having a strong sense of professional pride and commitment to delivering the best results for Croydon residents.

The Sub-Committee then enquired about the number of package reviews completed over the last three months. The officers responded that 61% of annual reviews had been completed, surpassing the national average. It was also noted that the percentage had significantly improved from around 30% during the same period in the previous year, and the number of overdue reviews had decreased substantially.

The next question focused on the robustness of the potential improvements. The delivery partners explained that the improvements were measured against prudent assumptions, with economic factors taken into account. As a result, they expected to exceed their targets in many areas. When asked about specific risks related to these improvements, the delivery partners stated that the work was still in its early stages, and no material risks had been identified. The figures had been agreed upon by the heads of service and compared with other local authorities' achievements. It was also explained that the final internal governance processes were underway to transition into phase 2 of the transformation programme, now renamed 'Adults Living Independently'. Recruitment for specific workstreams was ongoing, and it was anticipated that by the beginning of September, the directorate would be fully engaged in the design phase, which would take around six months.

When asked about potential issues with overemployment, the officers stated that there were no known concerns, although some social workers worked overtime rather than employing  ...  view the full minutes text for item 20/24

The Sub-committee Members are recommended to:

-       Note the progress with the implementation of the Integrated Discharge Frontrunner programme.

-       Note that the data on performance and outcomes is under development and can be brought back to the Committee in due course.

The Sub-Committee reviewed a report set out on pages 81 to 92 of the agenda, which provided an update on the rollout of the Integrated Discharge Frontrunner Programme. The report was presented by Annette McPartland, Corporate Director of Adult Social Care and Health.

-          Councillor Yvette Hopley – Cabinet Member for Health and Adult Social Care

-          Councillor Margaret Bird – Deputy Cabinet Member for Health and Adult Social Care

-          Annette McPartland – Corporate Director of Adult Social Care & Health

-          Simon Robson - Director of Adult Social Care Operations

-          Richard Eyre – Head of Improvement

-          Liz Wells - Managing Director of Acute Services

-          Hilary Williams – Managing Director for Community Services and Integration

-          Rachel Flagg – Integrated Delivery Manager

The first question raised by the Sub-Committee addressed how the programme had evolved since its inception. The officers explained that it began with extensive diagnostic work that assessed both health and adult social care data. This diagnostic process revealed that delayed discharges were caused by a variety of bottlenecks within the system. The work also examined what was being done in the wards, particularly with regard to multidisciplinary efforts. Following this, attention shifted to discharge teams, transforming them into one integrated, multidisciplinary team. In addition to that a significant progress was made with the Transfer of Care Hub.

The next question focused on ensuring patients do not remain in a hospital longer than necessary due to unsuitable home environments. NHS officers explained that a daily multidisciplinary team meeting reviewed each patient’s discharge journey, allowing early identification of home needs. This provided sufficient time to make any necessary home adjustments, which became part of discharge planning. If needed, environmental assessments were conducted to further evaluate home conditions. When asked about delays caused by such adjustments, the officers stated they were unaware of any significant backlogs. However, potential delays could occur if very specialised equipment was required, but regular case reviews and early discharge planning helped minimise this risk.

The Sub-Committee followed up with a question regarding collaboration with third parties to prevent delays during transitions. The officers noted that most discharges were supported by families, and effective communication between families and the multidisciplinary team was crucial. Additionally, the 'Home First' workstream was launched, focusing on home discharges and patients regaining independence.

The Sub-Committee then asked how residents, including friends, family, and carers, were involved in discharge planning. NHS officers said they aimed to include these groups, although they acknowledged that this was an area needing improvement. Feedback from these groups was routinely collected, contributing to continuous communication improvements. When asked if there were designated staff for managing relationships with patient families, the officers explained that this responsibility fell primarily to the integrated discharge team, particularly the discharge navigators and facilitators.

Further enquiries were made about the objectives and outcomes of the Frontrunner Programme and the progress being made. NHS officers emphasised that the main goal was to reduce hospital stays. For example, in March, the average  ...  view the full minutes text for item 21/24

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

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

-       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 noted the work programme for the reminder of the municipal year. In addition to the topics already listed in the work programme, it was mentioned that impact of the emerging findings and initial recommendations of the review of the operational effectiveness of the Care Quality Commission and its impact on Croydon would be considered to be added into the work programme.

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.