Agenda, decisions and minutes

1.1.   RESOLVED: that the minutes of the last meeting be agreed as a true record.

1.1.   RESOLVED: that the minutes of the last meeting be agreed as a true record.

1.1.      The Chair noted that under point 5.6 in the minutes, it was agreed that an informal meeting would be arranged for the Committee members and officers to further consider the Healthcare & Wellbeing Charter’s content. The Chair confirmed that this meeting had been arranged and was mentioned in the Committee’s work programme.

1.1.      The Chair also noted that under point 6.1, it was discussed that the South London and Maudsley NHS Trust (SLaM) would be invited to the November 2023 Committee meeting to present the agenda item on improving our mental health provision. However, this agenda item had been deferred to the January 2024 meeting of the Committee.

1.1.      Point 6.2 of the minutes noted the suggestion to invite Lewisham Speaking Up to this meeting for discussion on the agenda item - Learning Disabilities Implementation Plan. Pursuant to this, the Chair welcomed Marsh Stitchman from Lewisham Speaking Up and Dave King from Brighter Horizons.

2.1. Councillor Jacq Paschoud, attending under standing orders, declared a personal interest as she had a close family member in receipt of a care package from Lewisham Social Care.

2.1. Councillor Jacq Paschoud, a guest of the Committee, declared a personal interest as she had a close family member in receipt of a care package from Lewisham Social Care.

RESOLVED:

·        that the report be noted, along with the comments made by the Committee.

·        that the ambitions of the Learning Disability Implementation Plan be noted, and its seven priority areas be agreed.

·        that an informal meeting be arranged for members to further discuss the seven priority areas and the associated actions before this plan goes to Mayor & Cabinet.

·        that the annual report associated with this plan, meant to be presented at the Lewisham Care Partnership, also be presented at the Healthier Communities Select Committee annually.

Heather Hughes (Assistant Director, Complex Care & Learning Disability) and Jacob Walsh (Joint Commissioner) introduced the report. The following key points were noted:

3.1. The Implementation Plan was made up of a set of statements of intent, with a list of actions. Officers recognised the need for- clear statements of outcome, responsible officers, financial implications & timescales to be listed against each action.

3.2. The public consultation survey on the Learning Disabilities Implementation Plan was live from 13/09/2023 to 24/10/2023 and received 16 responses. Officers were disappointed with the low response rate but not surprised, as they acknowledged that the Council needed to do some work to win the trust of carers.

3.3. The public consultation survey had a range of qualitative questions. Officers shared the responses to these questions with the Committee via a PowerPoint presentation.

3.4. Along with the online consultation survey, 3 face-to-face sessions were also arranged to get feedback on the Implementation Plan. However, attendance at these was also low. Additional actions from these face-to-face sessions that weren’t included in the Implementation Plan, were included at the end of the PowerPoint presentation to the Committee.

3.5. It was discussed that a significant portion of funds was spent on 24-hour residential supported living services compared to community services directly supporting family carers. To achieve a more strategic outcome, there was a need to shift this expenditure.

The Committee members were invited to ask questions. The following key points were noted:

3.6. The Committee acknowledged the day care centre offer positively but also recognised that the offer needed to be improved. Particularly, the Ladywell Centre was mentioned which the Committee had visited in August 2023. A cohesive corporate approach was required for enhancing the day centre offer as collaboration with officers in the regeneration department was crucial to making improvements to the physical estate of the day centres. It was discussed that these centres provided services that were important to the community.

3.7. Councillor Jacqueline Paschoud attended the meeting as the Committee’s guest and mentioned that she had shown up for one of the in-person consultation sessions in the Civic Suite but had found no one there. Officers confirmed that they were present at the venue in advance for the in-person session but apologised for the confusion that had led to this missed engagement opportunity.

3.8. The Council had invested in travel training and was making sure that anyone who could be supported to travel independently was being referred to that scheme. With the impact of Covid-19 and increasing demand from children’s services, adjustments to transport were necessary. To optimise budget utilisation and make the best use of in-house assets, the decision was made to implement double running of buses- first for home-to-school services and then for adults. It was noted that the late start and finish time for the council run services was maintained.

3.9. In recognition of the consultation feedback that the borough as a whole needs to be more accessible and supportive, it was discussed that a  ...  view the full minutes text for item 3.

RESOLVED:

·        that the progress made in the implementation of recommendations from BLACHIR, and the progress of the Lewisham Health Inequalities and Health Equity Programme 20-24 be noted.

Catherine Mbema (Director Of Public Health) introduced the report. The following key points were noted:

4.1. The BLACHIR report outlined seven key themes for action along with 39 opportunities for action.

4.2. A mapping exercise revealed that out of these 39 opportunities for action- 2 were already being fully progressed from existing initiatives, 13 opportunities for action had started to make progress and 24 opportunities did not have any action mapped against them yet.

4.3. Social Inclusion Recovery Group (SIRG) had been appointed as a community partner to support the implementation of these opportunities for action locally.

4.4. SIRG was already actively engaging with the community and had established an advisory group of six Voluntary Community Sector (VCS) organisations.

4.5. The Lewisham Health Inequalities and Health Equity Programme 2022-24 had eight concurrent and intersecting workstreams. Each of these workstreams had specific projects being delivered, most of them in partnerships. The opportunities for action being implemented through each workstream and the specific details about the different projects were listed in the report to the Committee.

4.6. The two-year Health Equity Fellowship Programme involved the recruitment of 6 PCN Health Equity Fellows (one per PCN- Primary Care Network) who had received in-house training and masters-level modular training by King’s College London (KCL).

4.7. During the Covid-19 pandemic, there was a Covid-19 Community Champions programme which had now transitioned into the Lewisham Health and Wellbeing Champions programme.

The Committee members were invited to ask questions. The following key points were noted:

4.8. The Up! Up! Programme, which was a tailored weight management service for Black African and Black Caribbean residents, had been proven to be a great success.

4.9. The Committee enquired about the aspiration for the next phase of the community champions, highlighting the effectiveness of engaging with more community members through local assembly meetings. While clear targets for the community champions didn’t exist yet, the possibility of reviewing progress after a year was discussed to identify successful strategies and areas for improvement.

4.10. A member of the Committee attended the Black VCS Expo event that had taken place on the 13^th of October 2023 and reported that the event was very informative and well attended.

4.11. It was discussed that the provision of culturally sensitive services was important.

4.12. A Committee member raised concerns about the potential disproportionate offering of C-sections to certain communities. Lewisham’s active Maternity Voices Partnership, linked to the maternity services and incorporating lived experiences, was acknowledged. It was noted that officers would convey this concern to the partnership and respond back on this matter.

4.13. It was acknowledged that 2 years was a short time-frame for a programme of this scale, but that this timeframe was set based on funding availability. If the programme could demonstrate positive outcomes, it could make a case for future funding and continued investment.

4.14. A member of the Committee suggested that the Committee would be interested in hearing more about the system in place for evaluating the work in this  ...  view the full minutes text for item 4.

A presentation will be delivered at the meeting.

RESOLVED:

·        that the Adult Social Care performance highlights be noted along with Committee’s comments that the data was promising and reassuring.

·        that the need for additional work on the Council’s website to enhance the accessibility of available information be noted.

Joan Hutton (Director of Adult Social Care) and Tom Brown (Executive Director of Community Services) delivered a PowerPoint presentation to the Committee. This presentation included a review of the Adult Social Care performance data and also gave an overview of the Adult Social Care survey 2022/23 data. This was followed by questions from the Committee members. The following key points were noted:

5.1. The number of home care service users had increased which meant there were more individuals with complex needs. However, the number of care hours being delivered appeared to be reduced because of the implementation of the ‘Maximising Wellbeing at Home contract’ and as part of that some individuals opting for direct payments.

5.2. It was noted that in most cases receiving care at home was the best outcome for individuals, nevertheless it was not always cost effective.

5.3. Officers had observed some long-term trends in the performance data:

·         The number of carers needing support was increasing and the need to do more work with unpaid carers was very clear. There was a new contract in place to enable this and work was being done to actively support carers.

·         Adult Social Care was receiving an increasing number of referrals from colleagues in Mental Health and Housing.

·         The number of contacts with the service were gradually increasing.

·         With reduced length of stay in the hospital, the complexity of hospital discharges was increasing. The healthcare system was under strain and individuals were coming out of the hospitals with high level of needs.

5.4. The data on the hours of care delivered showed a reduction which was achieved through productive and efficient use of the enablement service. The ‘Empowering Lewisham’ programme had enabled the maximisation of opportunities for independence for individuals.

5.5. A member of the Committee expressed concerns about the changes introduced by the ‘Right Care Right Person’ model. It was discussed that the agenda item on ‘improving our mental health provision’ coming to the Committee’s meeting in January 2024, would provide a better opportunity to have a discussion around this issue.

5.6. The Adult Social Care survey data 2022-23 was nationally produced and available on the NHS digital website. Some survey responses could be filtered based on the ethnicity of respondents.

5.7. In light of this discussion around performance data, the Committee noted that more work needed to be done on the Council’s website to improve its accessibility.

5.8. It was noted that the performance data was very reassuring and proved that the Council was providing a quality service.

5.9. Officers acknowledged that more work was needed to make all services culturally sensitive and that this was a high priority.

RESOLVED:

·         that the Adult Social Care performance highlights be noted along with Committee’s comments that the data was promising and reassuring.

·         that the need for additional work on the Council’s website to enhance the accessibility of available information be noted.

RESOLVED:

·        that Empowering Lewisham Programme’s final report be added to the Committee’s work programme for the March 2024 meeting agenda.

·        that the agenda for the next Committee meeting on the 10^th of January 2024 be agreed.

6.1. The Committee briefly discussed the agenda for its January 2024 meeting.

RESOLVED:

·         that Empowering Lewisham Programme’s final report be added to the Committee’s work programme for the March 2024 meeting agenda.

·         that the agenda for the next Committee meeting on the 10^th of January 2024 be agreed.