Agenda and minutes

Scrutiny Health & Social Care Sub-Committee
Tuesday, 24th September, 2019 6.30 pm

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

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

Items
No. Item

21/18

Minutes of the Previous Meeting pdf icon PDF 98 KB

To approve the minutes of the meeting held on 25 June 2019 as an accurate record.

 

Minutes:

The minutes of the meeting held on 25 June 2019 were agreed as an accurate record.

 

It was noted that a further update was required on the work to replace the Community Dental Service that was formerly based in New Addington. It was agreed that a request for a written update would be made to the provider of the service, King’s College Hospital NHS Foundation Trust.

22/18

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 no disclosures made at the meeting.

23/18

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:

There were no items of urgent business.

 

24/18

Collaboration of Health and Care in Croydon pdf icon PDF 65 KB

The Sub-Committee is provided with a presentation on and a copy of the strategic case for the alignment of Croydon Health Service NHS Trust (CHS) and Croydon Clinical Commissioning Group (CCG) with a view to informing a discussion on the information contained.

Additional documents:

Minutes:

The Sub-Committee considered information provided on both the work to closer align the Croydon Health Service NHS Trust (CHS) and the Croydon Clinical Commissioning Group (CCG) and the integration of the six South West London CCGs into one larger CCG. Together with information set out in the agenda, a presentation was given to the Sub-Committee by representatives from CHS and the CCG. Those in attendance at the meeting for this item were:-

·         Agnelo Fernandes – Clinical Chair – Croydon CCG

·         Matthew Kershaw – Interim Chief Executive - CHS

·         Mike Sexton – Chief Financial Officer – Croydon CCG

A copy of the presentation can be found on here –

https://democracy.croydon.gov.uk/documents/s17716/Appendix%20A%20Collaboration%20of%20Health%20and%20Care%20in%20Croydon%20-%20Presentation.pdf

Following the presentation the Sub-Committee was given the opportunity to question the representatives on their plans for the closer alignment between CHS and the Croydon CCG and the wider integration of the six South West London CCGs. The first question related to the proposed £500m sub regional saving that had been identified as one of the drivers for the integration of the six CCGs, with it questioned what proportion of this saving would need to be found in Croydon. In response it was confirmed that the targeted saving from Croydon services was £100m as Croydon had approximately 25% of the population of South West London.

It was questioned what difference the changes would make to a member of the public. Regarding the alignment of CHS and the CCG it was advised that by bringing together the health bodies in Croydon it would provide a greater focus on local priorities leading to the delivery of joined up services that were reflective of the needs of the local population. Experience had found that gaps in service provision tended to arise from the hand over between services and it was hoped that closer alignment would reduce such issues.

The move to merge the CCGs on a sub-regional level had in part been prompted by the NHS Long Term Plan which set out the need for integrated care and larger regional CCGs. As it was a national policy it was important to ensure that the best outcomes were delivered from it locally.

As there would be one Accountable Officer responsible for overseeing what was formerly six CCGs, it was questioned how that person would be able to retain line of sight over service provision. It was advised that in order for an integrated care system to work it was important to get the governance processes right, while also retaining a focus on outcomes that made a difference for patients. There would be a Local Committee in Croydon to determine the majority of the commissioning decisions for the area, leaving the Accountable Officer to oversee this process and ensure that promised outcomes were being delivered as expected. 

In response to a question about the level of decision making to be retained at a local level following the integration of the South West London CCG it was advised that it was envisioned that the vast majority of  ...  view the full minutes text for item 24/18

25/18

Croydon Safeguarding Adult Board - Annual Report 2018-2019 pdf icon PDF 111 KB

The Sub-Committee is asked to consider the Croydon Safeguarding Adult Board – Annual Report 2018-2019.

Additional documents:

Minutes:

The Sub-Committee considered the Annual Report for 2018-19 from the Croydon Safeguarding Adults Board (CSAB). The independent Chair of the board, Annie Callanan was in attendance at the meeting to introduce the report and answer Members questions arising. During the introduction to the report the following points were noted:-

·         An increased amount of information had been added to the report for 2018-19 as a result of a request from the Sub-Committee for further information last year. 

·         The report recognised that there had been a high level of engagement and support from partners for the CSAB. The CSAB has been engaged with ongoing work on early intervention and commissioning.

·         There was still work needed to improve the voice of Croydon residents, particularly those from minority ethnic communities, which was being worked upon.

·         A key aim was to ensure that the individual was the focus at the centre of services.

·         The object of the exercise was to get a line of sight to understand what was happening at the frontline of the service. The CSAB was not currently achieving this, but was looking to use the expertise of their four newly formed Sub-Groups to deliver this.

Following the introduction from the Independent Chair of the CSAB the Sub-Committee was given the opportunity to ask questions about the report. The first requested a self-assessment of the current performance of the Board. In response it was advised that the accountability arrangements were in a much better place with continual improvement being seen. A strength of the current CSAB was having everybody around the table engaged in the process.

In response to a question about how the CSAB compared to other Boards, it was highlighted that Croydon operated similarly to other areas. An invitation was extended to the members of the Sub-Committee to attend a future CSAB meeting as observers.

It was highlighted that 70% more females reported abuse than males, when the number of vulnerable males was not much lower, as such there reasons for this were questioned. It was advised that steps were being taken to investigate the reasons for this including engaging with men to get a representative view. Reasons such as generational differences causing a reluctance to communicate and the fear of care being removed may be possible reasons that needed to be explored in greater detail.

It was noted that it would help the Sub-Committee to be able to make a judgement on the performance of the CASB if comparative data with other boroughs was available. It was confirmed that data was available, with an annual report due to be published in November that could be shared with the Sub-Committee. 

In response to a question about the challenges of sharing reporting data it was advised that it was essential for the Board to be kept informed and it had been highlighted that certain information was required for specific Sub-Groups.

The level of referrals made to the low number that were sustained was questioned, with it advised that there was a  ...  view the full minutes text for item 25/18

26/18

Adult Social Care Budget pdf icon PDF 2 MB

To receive an overview of the Adult Social Care Budget.

 

(Presentation to follow)

Minutes:

The Sub-Committee considered a presentation delivered by the Executive Director for Health, Wellbeing and Adults, Guy Van Dichele on the budget challenges facing the Adults service. A copy of the presentation can be found here: –

https://democracy.croydon.gov.uk/documents/s17854/Adult%20Social%20Care%20Budget%20-%20presentation.pdf

Following the presentation the Sub-Committee was given the opportunity to ask questions about the information provided. The first question related to direct payments and what the Council was doing to encourage users to opt for this approach. It was advised that at present there was a mix of people using direct payment and work was ongoing to simplify the process with support provided for users to engage with using direct payment. It was envisioned that the forthcoming Resource Allocation Programme would help to allow people to buy the right care for their needs and provide support to users in finding a Personal Assistant. Hopefully once this was in place it would increase the take up of direct payment as this approach was more cost effective as it was flexible to people’s need.

The take up of the direct payment option in Croydon may not be as high as in some other authorities who had made direct payment their default position, with users required to opt out of this approach rather than the current position in Croydon which required users to sign up for direct payment.

As it was noted that 31% of carers in the borough had been so for more than 30 years, it was questioned what the Council was doing to provide support for these individuals. It was advised that there was a network of support for carers through organisations such as the Carers Centre, with work ongoing to ensure that users understood that this service was funded by the Council. The possibility of providing small grants to carers to provide support was also being explored. It was also noted that the Council provided a series of factsheets for carers to inform them of the services available to them.

In response to a question concerning the percentage of the budget in care being spent on accommodation and food it was highlighted that the bulk of the budget arose from the cost of placements. However it was not possible to confirm the percentage spent on food as this was provided as part of the total package.

It was questioned whether the level of demand for care could be managed should free universal care be introduced. It was confirmed that this would be dependent on the funding provided as it was estimated that there was a significant amount of support being provided by unpaid carers. If care was free rather than means tested it was anticipated that there would be a substantial increase in demand.

In response to a question about the action being taken to balance the budget, it was advised that working across the Council to achieve the required savings was both important and necessary as there was a reliance on colleagues in areas such as Gateway and Housing services to  ...  view the full minutes text for item 26/18

27/18

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:

This motion was not required.