Agenda and draft minutes

To approve the minutes of the meeting held on 30 July 2024 as an accurate record.

The minutes of the meeting held on 30 July 2024 were agreed as an accurate record.

Members and co-opted Members of the Council are reminded that, in accordance with the Members’ Code of Conduct and the statutory provisions of the Localism Act 2011, they are required to consider in advance of each meeting whether they have a disclosable pecuniary interest (DPI), some 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 must urgently 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 in general to disclose any relevant DPIs, ORIs or NRIs 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 room unless granted a dispensation.

-       Where the matter directly relates to the financial interest or wellbeing of 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 or affects their or a relevant person’s financial interest or wellbeing, whether they can participate in any discussion or vote on the matter or stay in the room depends on the detailed rules in paragraphs 7 to 9 of Appendix B of the Members’ Code of Conduct.

The Chair will invite Members to make their disclosure of interests orally at the meeting and they will also be recorded in the minutes.

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.

There were no items of urgent business for consideration of the Health & Social Care Sub-Committee at this meeting.

This report continues the regular budget and savings progress updates to the Scrutiny Health and Social Care Sub-Committee. It provides the Adult Social Care & Health (ASCH) Directorate’s financial performance at Period 3 (June 2024). In addition to that this report provides a progress update on the Adults Living Independently Adults Living Independently transformation programme - an update on the investment and opportunity matrix and what to expect during the design phase.

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

1.1.        note 2024/25 Period 3 (June 2024) budget and savings position.

1.2.        note the design phase update from the Adults Living Independently transformation programme.

The Sub-Committee considered the report, found on pages 15 to 22 of the agenda, which provided an update on the budget, savings and transformation work within the Adult Social Care and Health Directorate.  This report was included on the agenda to allow the Sub-Committee to scrutinise delivery of the in-year service budget and the transformation programme.

Corporate Director of Adult Social Care & Health, Annette McParland introduced the item. It was stressed that the directorate was on target to meet its expected savings, and it was highlighted that there was a robust process around monitoring the delivery of savings, involving close cooperation with the Section 151 Officer, the wider corporate team, the Improvement Panel, and the Cabinet Member. It was also explained that while there was currently an overspend within the Adult Social Care and Health budget, assurance was provided that there was a process in place to reduce it, and each month the directorate had met its target to minimise the aforementioned overspend. Additionally, the diagnostic phase with the delivery partner Newton had recently been completed, and the focus was now shifting to the design phase.

In attendance were:

• Councillor Yvette Hopley – Cabinet Member for Health and Adult Social Care
• Annette McParland – Corporate Director of Adult Social Care & Health
• Simon Robson – Director of Adult Social Care Operations
• Andrea Fallon – Interim Director of Public Health
• Stephen Hopkins - Head of Adult Placement, Brokerage and Market Management
• Liz Wells – Managing Director for Acute Services
• Matthew Kershaw – Chief Executive of Croydon Health Services NHS Trust and Croydon’s place based leader for health

The first question raised by the Sub-Committee considered the equality impact assessment. Officers explained that there was no overall equality impact assessment completed for the Medium-Term Financial Strategy; however, separate analyses were carried out for each workstream within the strategy.

The Sub-Committee asked about the meeting with the Secretary of State mentioned at the previous meeting. Officers explained that the meeting was cancelled and that the Council was awaiting more information on the settlement and grant funding.

The next question addressed the most challenging areas in terms of recruitment and staffing gaps. Officers explained that they were continuously recruiting for various roles, noting that Adult Social Care and Health had a relatively low level of agency staff, although there would be fluctuations due to seasonal demand, for instance in winter. Some roles, such as approved mental health professionals, front door services, and hospital discharge, were more difficult to recruit to, but the Council was constantly trying to fill these vacancies and was reviewing and improving its offer through personal development and training opportunities. It was also mentioned that in some areas recruitment was purposely slowed down to help with delivering the budget or paused pending future structural changes.

The Sub-Committee asked whether there were any negative impacts or risks arising from contract underspend. Officers explained that the underspend was achieved through effective negotiation of contracts, with all contracts being reevaluated and, when possible, renegotiated or  ...  view the full minutes text for item 27/24

Health and social care are working together to prepare for the winter period 2024/25. Croydon Health Services NHS Trust (CHS) presented the draft plans at the One Croydon Health and Care Board in September.

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

1.1.        note the joint work in Croydon and across South West London to plan for winter 2024/25.

The Sub-Committee considered the report, found on pages 23 to 92 of the agenda, which provided an update on winter planning.  This item was included on the agenda to provide the Sub-Committee with an overview of the work underway to manage demand with health and social care in Croydon.

Matthew Kershaw, Chief Executive of Croydon Health Services NHS Trust and Croydon’s place based leader for health, introduced the item, highlighting the importance of robust winter planning arrangements and emphasising the collaborative approach adopted across the system. It was noted that urgent and emergency care services were experiencing challenges on a national scale, and that Croydon’s performance, in terms of key metrics, was broadly comparable to other similar areas. Liz Wells, Managing Director for Acute Services, explained that, drawing on experiences from previous winters, a number of new initiatives were being implemented, including the establishment of a dedicated frailty unit to better support older residents. It was also noted that these measures were aligned with the South West London plan concerning frailty. The Corporate Director of Adult Social Care & Health, Annette McPartland reiterated the significance of close working relationships and the ongoing efforts to identify peaks in demand and plan capacity accordingly.

In attendance were:

• Councillor Yvette Hopley – Cabinet Member for Health and Adult Social Care
• Annette McParland – Corporate Director of Adult Social Care & Health
• Simon Robson – Director of Adult Social Care Operations
• Andrea Fallon – Interim Director of Public Health
• Stephen Hopkins - Head of Adult Placement, Brokerage and Market Management
• Liz Wells – Managing Director for Acute Services
• Matthew Kershaw – Chief Executive of Croydon Health Services NHS Trust and Croydon’s place based leader for health

The first question raised by the Sub-Committee concerned the prevention and support measures available for vulnerable residents in relation to cold weather and heating. Officers explained that one element of this work involved encouraging residents to claim all entitlements that were available to them in order to maximise their income. In addition, the Council was working closely with locality teams to identify residents who were particularly vulnerable. It was stressed that the Council was proactively seeking to assist vulnerable residents in optimising their incomes and ensuring that any relevant grants were distributed expeditiously.

The following question from the Sub-Committee concerned the arrangements in place to support the most vulnerable residents in the borough following changes to the winter fuel allowance. Officers clarified that no additional funding had been allocated for the winter period, and that existing schemes would therefore be relied upon to provide necessary support. They confirmed that frontline staff would identify individuals at risk and assist them in maximising their incomes.

The subsequent question from the Sub-Committee addressed the concept of ‘periods of extremis,’ including how many such occurrences had taken place last winter and how many were anticipated this winter. The Council’s partners explained that a period of extremis arose when the system was under exceptional strain, necessitating the utilisation of all available resources and collaboration with  ...  view the full minutes text for item 28/24

This report shares the findings from the Public Health Peer review that took place 12^th-14^th March 2024 including a summary of further actions.

For the reasons set out in the report and its appendices, Scrutiny Committee are recommended:

1.1.        to note the key findings of the Public Health Peer Review contained in appendix A and summarised in section 4.4 of this report.  

1.2.        to note next steps and the transformation the Public Health function is undertaking, an outline summary for which is set out in appendix B in accordance with the peer review recommendations. 

The Sub-Committee considered the report, found on pages 93 to 132 of the agenda, which provided an update on the findings of the Public Health Peer Review and following actions. This report was included on the agenda to provide the Sub-Committee with an overview of the findings of the peer review.

Andrea Fallon, Interim Director of Public Health, introduced the item, noting that following the peer review a delivery plan had been developed to implement the recommendations. This delivery plan was being overseen by a designated delivery board and was currently on track to be delivered within the identified timeframe.

In attendance were:

• Councillor Yvette Hopley – Cabinet Member for Health and Adult Social Care
• Annette McParland – Corporate Director of Adult Social Care & Health
• Simon Robson – Director of Adult Social Care Operations
• Andrea Fallon – Interim Director of Public Health
• Stephen Hopkins - Head of Adult Placement, Brokerage and Market Management
• Liz Wells – Managing Director for Acute Services
• Matthew Kershaw – Chief Executive of Croydon Health Services NHS Trust and Croydon’s place based leader for health
• Fatai Ogunlayi – Consultant in Public Health

The first question raised by the Sub-Committee concerned the Public Health Outcomes Framework and sought additional detail. Officers acknowledged their active role in the Joint Strategic Needs Assessment but recognised that the peer review had highlighted insufficient evidence of outcomes flowing through the framework. It was explained that although a considerable amount of related work was taking place, it was not yet sufficiently formalised, and this would be addressed.

The following question considered any restrictions on the public health grant. Officers advised that central government guidance stipulated how the grant could be utilised, although there was a measure of flexibility. A recent review of services and commissioning arrangements had been undertaken to ensure that the allocation of funding accurately reflected the needs of the local population, thereby achieving maximum value for money.

The next question focused on the relationship between Public Health and Children’s Services, including the provision of support to children and young people, particularly in relation to mental health. Officers confirmed that a comprehensive review of expenditure had been carried out to ensure resources were being effectively allocated to deliver the best possible outcomes. A significant portion of the investment supported children’s services, including Best Start and Family Hubs. Additional resources that remained would be allocated towards key priorities, with young people’s mental health identified as one such focus area.

The Sub-Committee queried the extent to which a public health approach was being integrated into policies, strategies, and frameworks. Officers reported that involvement had improved. One example cited was the establishment of a Delivery Board chaired by the Assistant Chief Executive. In addition, a closer working relationship had been developed with the Cabinet Member, and Public Health was now represented at the Mayor’s Advisory Board. Furthermore, a work programme arising from the Peer Review recommendations would target increasing the visibility and strengthening the relationships of Public Health across the Council. Identifying cross-cutting  ...  view the full minutes text for item 29/24

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 his recent report on Virtual Wards.

The Sub-Committee emphasised the importance of building residents’ confidence in virtual wards and ensuring that these services are easily accessible to all.

Actions

The Sub-Committee agreed the following action to follow up outside of the meeting:

-          The Sub-Committee requested that a visit to the virtual ward would be organised.

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 noted the work programme for the reminder of the municipal year.

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.