Agenda item

Question time with the Cabinet Member for Families, Health & Social Care, Councillor Jane Avis.

Presentation slides to follow.

The Committee received a presentation from the Cabinet Member for Families, Health & Wellbeing, Councillor Jane Avis, providing an update on the activities within her Portfolio. During the introductory presentation to this item the following was noted

·         The strengths highlighted within the Portfolio included the One Croydon Alliance winning the Local Government Chronicle Health & Social Care Award, the Council being awarded Dementia Friendly Status and delivering a balanced budget in the context of increased demand and complexity.

·         The E-Marketplace was due to go live in June 2019 and would be a place where suppliers can demonstrate their services online, leading to greater choice for customers.

·         The new Front Door approach had been developed to reduce the number of hand offs for residents when contacting the Council, with the emphasis on answering queries at the first point of contact.

·         The locum workforce in the Adults Service had been reduced from 35% to 16%.

·         Locality based working had started to be rolled out, with a welcomed commitment from partners in embracing this approach.

·         Potential weaknesses within the Portfolio included the fragility of the provider market with the Council being the largest provider of care homes in London. Out of the Council’s 130 care homes, only three homes were of concern, with steps being taken to improve these.

·         Data quality was an issue, but it was hoped that the quality of data available would begin to improve now that there was an increasing focus on delivering a data driven approach.

·         There had been a £500,000 cut to the Director of Public Health’s budget in the past year that presented additional difficulties in the move to a more preventative approach.

·         There was a determination on the part of both the Administration and the Service to reduce the health inequalities within the borough.

·         The current case management system used by the Service was out of date and as such the process of acquiring a new system was currently underway, which would better enable staff to manage cases.

·         Potential opportunities included the new NHS ten year plan focused towards delivering an integrated care system which would bring together hospitals, GPs and community health services.

·         The expected Government Green Paper on the funding gap in social care had been delayed, but the content of the document was eagerly awaited.

·         The One Croydon Alliance was expanding its focus from residents over 65 to the whole population of the borough.  The results from the first stage, focussed on the over 65’s, had been welcomed with savings achieved, as well as improving outcomes for residents.

·         There was a plans to provide an increased amount of supported accommodation units, as social care moved away from residential care.

·         Work was currently being progressed on the insourcing of special sheltered housing care provision, which should be complete by the end of the year.

·         Potential threats within the Portfolio included an increasingly ageing population leading to increased care costs, the new NHS Plan along with the regionalisation of the Clinical Commissioning Groups leading to a lack of focus on the local area and the uncertainty over government funding.

·         The potential reduction in the workforce in adult social care including nursing staff from Brexit was another potential risk.

Following the presentation, the Sub-Committee was given the opportunity to question the Cabinet Member on her Portfolio. The first question related to the budget and how it was going to be managed going forward given the ever increasing pressures. In response it was advised that it was important to ensure that there was a focus on smart working to drive improvement, using digital resources to their upmost to help keep people in their own homes. It was emphasised that it would be hard to continue to protect frontline services in future budgets, with an urgent need for the Government Green Paper to address how the funding shortfall would be met.

Given the concern over the potential impact of Brexit on staffing levels, it was questioned whether any action was being taken to mitigate against this risk. It was advised that it was already difficult to recruit and retain staff, with providers having to compete against each other for staff.  The Council had introduced a scheme to attract first year social workers, with positive feedback given that some would be staying at the authority due to the level of support provided.

The confirmation that work was underway to bring special sheltered housing back in-house was welcomed by the Sub-Committee, but concern was expressed about possible costs being passed onto residents. It was highlighted that the Council was focussing on prevention to allow people to stay in their own homes if that was their preference

With the success of the One Croydon Alliance noted, it was questioned how its progress compared against other similar arrangements.  It was advised that at present the One Croydon Alliance was at a more advanced stage than others, which led to concern about how the potential Clinical Commissioning Group merger to a more regional scale would impact upon the Alliance. It was noted that the maturity of the relationships in the partnership formed a key part of its success. 

The Public Sector Equity Duty was highlighted, with it questioned what the Council did to ensure it adhered to these principles by ensuring that the access to services was the same for disabled people as possible. It was confirmed that the Council adhered to the Duty as closely as possible and the Administration was committed to ensuring that disability support was high on the Council’s agenda. All reports coming to the Cabinet for a decision included an equalities section which demonstrated the Administration’s focus on supporting disability.

It was noted that the location of the Department of Working and Pensions (DWP) Assessment Centre in the borough was not conveniently located near to public transport links and as such it was questioned whether anything could be done to encourage the DWP to relocate nearer to public transport links. The Cabinet Member agreed that the Assessment Centre location was not ideal and agreed to raise the issue at the next Mobility Forum meeting. It was also suggested that it may be useful to invite representation from the DWP to a future meeting of the Sub-Committee to discuss the issue.

It was questioned whether the Croydon Clinical Commissioning Group had started contingency planning for Brexit and in particular for a possible disruption in the supply of medicines. It was confirmed that partner organisations had started planning for Brexit a while ago, but national clarity was needed to gain a greater understanding of the potential risks.

It was recognised that the work the Council was undertaking as part of the One Croydon Alliance was pioneering, but concern was raised about how the new locality hubs would fit with the work of the Alliance. It was advised that the locality hubs were still a work in progress, but it was hoped that they would fit well with the One Croydon Alliance, with work ongoing to ensure that everything was coordinated.

As follow up, it was questioned how well the One Croydon Alliance worked with the voluntary and community sectors in the borough.  It was noted that working with the voluntary sector could be challenging because of the wide variety of organisations involved, but the Cabinet Member for Safer Croydon and Communities, Councillor Hamida Ali was preparing a strategy designed to provide better coordination of the voluntary and community sector.

Although it was acknowledged that locality based working was still at an early stage of its development, further information was requested on the possible future extension of the scheme. It was advised that a number of different options were being considered for community outreach, with it acknowledged that hubs may not necessarily be the best solution for the more rural communities in the borough, with buses being used to provide a mobile service a possible alternative.

In response to a question about the options being explored to enable people to stay in their own homes, it was highlighted that it was more cost effective for people to stay in their own homes and generally better for the individual. There was the Aztec Centre in Croydon that worked on ways to keep people in their own homes and the Council was working on many different aspects to achieve the main targets for people’s lives.

As there was an acknowledgement that there was a weakness in quality of the data currently available to the Council, it was questioned how this could be improved. It was confirmed that a number of digital packages had been purchased, which were in the process of coming online that would improve data capture. Steps were also being taken to improve the culture of the Council towards the use of data to ensure it was used to its maximum effect. It was suggested that it may be helpful for the Service to compare its data capture to that of other local authorities to be better able to judge its own performance.

Given that there was a move towards maximising the use of digital pathways as a means of communicating with the Council, the measures in place for people not able to report online was questioned. It was confirmed that the locality based working approach would provide residents with the opportunity to meet face to face with Council officers. The new Front Door system would also provide improved access to Council services. 

It was questioned how the experience of services users was used to shape the work of the Council. In response it was advised that as well as looking at the technical detail of services delivery, the perspective of the service users was also always considered.

In response to a question about other services being brought back in-house, it was advised that this option would be pursued where possible. However sometimes the Council was tied into a contract with another provider. The potential for ending a contract early would be explored, but it was essential that the cost of doing so did not impact upon council taxpayers.

The Chair of the Sub-Committee thanked the Cabinet Member for her attendance at the meeting and answering their questions. Congratulations was also extended regarding the recent success at the LGC Awards.

Conclusions

Following the discussion of this item, the Sub-Committee reached the following conclusions:

1.    That there were a number of challenging issues facing the Cabinet Member within her Portfolio, which should be revisited by the Sub-Committee in the forthcoming year

2.    That there would be a benefit in comparing the level of data captured within the Service with that of other local authorities, to better enable a judgement to be made on the Council’s performance in this area.

3.    Consideration should be given to inviting representatives from the Department of Work and Pensions to a future meeting to discuss the Sub-Committee’s concerns about the location of its Assessment Centre within the borough.

Recommendation: The Sub-Committee agreed to recommend to the Cabinet Member for Families, Health & Wellbeing that work should be undertaken to gain an understanding of the Council’s performance regarding data capture against other local authorities.