Agenda, decisions and minutes

Resolved: the minutes of the last meeting were agreed as a true record with the above changes.

1.1       The committee noted that at its previous meeting it discussed receiving an update on the discussions between Lewisham and Greenwich NHS Trust and the Save Lewisham Hospital Campaign on health visitor ratios and the role of health visitor assistants.

1.2       The committee agreed to reflect this in the minutes and work programme.

Resolved: the minutes of the last meeting were agreed as a true record with the above changes.

Cllrs John Paschoud and Jacq Paschoud declared non-pecuniary interests in item 6 (older adults’ day services and day activities) as voluntary drivers for Voluntary Services Lewisham.

Resolved: the committee noted the response.

3.1       The committee received the Mayor and Cabinet response to its referral on advice and support services previously provided by the Lewisham Disability Coalition.

3.2       The committee asked if grant funding for any replacement service would be the same.

3.3       Officers informed the committee that because the council agreed an overall 19% cut to the grants budget, grant funding for the replacement advice and support service will be less than it was previously. The council will work closely with all organisations affected, but the impact will be a reduction of service.

3.4       The committee noted that when the council gives grants to user-led organisations, like the Lewisham Disability Coalition, the trustees need to be given adequate support to fulfil their duties. This is particularly the case with groups like the Lewisham Disability Coalition, where the majority of users were vulnerable people with learning disabilities or mental health problems.

Resolved: the committee noted the response.

Resolved: The committee agreed to refer its views to Mayor and Cabinet and the Health and Wellbeing Board in the following terms:

1.    That the progress of the work on BAME Mental Health inequalities is set out, with clear timelines, responsibilities and proposed actions, in line with our commitments in the new corporate strategy, for both adults and children and young people.

2.    To hold a one-off joint meeting with the Children and Young People Select Committee before the summer recess to further consider the work being undertaken by the council to address BAME mental health inequalities; to receive evidence at this meeting on the progress of this work with clear timescales and proposed actions, on who is responsible for overseeing and monitoring the progress of this work at senior officer and cabinet level, and on whether there are any barriers to making quick progress; and to receive evidence at this meeting from the Cabinet Member for Health and Adult Social Care, the Cabinet Member for Children’s Services, and the Chair of the Health Wellbeing Board.

Kenneth Gregory (Joint Commissioning Lead, Adult Mental Health) introduced the report. The following key points were noted:

4.1       In July 2018, the Health and Wellbeing Board (HWB) decided that BAME health inequalities in Lewisham would be its priority area of focus and that mental health would be its first specific area of work.

4.2       A BAME mental health summit was held in October, which was attended by members of the BAME community, voluntary and community sector organisations and officers.

4.3       The event identified a number of key themes which it was felt needed to be addressed to make mental health services more attractive and relevant for BAME communities.

4.4       An externally facilitated workshop was subsequently held with HWB members and representatives from the Lewisham BME Network to discuss how to work together to improve services.

4.5       Officers then met with the BME Network Health lead to establish an approach to co-production and it was agreed that the BME Network would work with the Mental Health Provider Alliance.

4.6       The next step is to develop a programme plan on health inequalities and some of the other changes that can be made to improve access to services, people’s experiences and outcomes.

4.7       The Children and Young People’s Strategic Partnership Board (CYPSPB) will be considering BME access to mental health services at their June meeting.

4.8       Some of the recommendations of a councillor-produced report on mental health inequalities in relation to children will be considered by the CYPSPB as part of their work on BAME health inequalities.

4.9       The committee noted that addressing BAME mental health inequalities is a corporate priority and commented that the scope of the council’s work in this area was still unclear. The committee requested more detail on the plans and specific actions in relation to this work.

4.10    It was noted that the council’s work on BAME health inequalities is a large-scale and ongoing piece of work. The council has done a lot of work to build trust and establish channels of communication with people and groups in the community and work has already started on how services can be improved based on feedback received so far.

Resolved: The committee agreed to refer its views to Mayor and Cabinet and the Health and Wellbeing Board in the following terms:

1.    That the progress of the work on BAME Mental Health inequalities is set out, with clear timelines, responsibilities and proposed actions, in line with our commitments in the new corporate strategy, for both adults and children and young people.

2.    To hold a one-off joint meeting with the Children and Young People Select Committee before the summer recess to further consider the work being undertaken by the council to address BAME mental health inequalities; to receive evidence at this meeting on the progress of this work with clear timescales and proposed actions, on who is responsible for overseeing and monitoring the progress of this work at senior officer and cabinet level, and on whether there are any barriers  ...  view the full minutes text for item 4.

Resolved: The committee thanked South London and Maudsley NHS Foundation Trust for presenting the report and engaging with the committee.

Beverly Murphy (Director of Nursing, SLaM) introduced the report. The following key points were noted:

5.1       The quality accounts monitor the progress on the trust’s quality priorities in the previous year. They also set new priorities for the coming year. The quality priorities for next year are unchanged. Quality priorities are set with the involvement of service users, carers, governors, and staff.

5.2       It was noted that acute wards for working age adults and psychiatric intensive care units had been rated by the CQC as “inadequate”. The CQC has since carried out a further inspection, finding that significant changes had been made, and does not intend to take any further action. The trust anticipates that the rating will improve to at least “requires improvement”.

5.3       The Improving Access to Psychological Therapies (IAPT) service has achieved its targets, but there needs to be closer working with primary care to make sure people get to the right pathway without delay. The service is receiving real-terms investment from Lewisham NHS commissioners.

5.4       SLaM is transforming the way its community services work in order to work more actively in the community with different third-sector providers and make the best use of the resources there are. It is hoped that this will help to reduce the number of readmissions and help SLaM manage its bed stock more effectively. 

Resolved: The committee thanked South London and Maudsley NHS Foundation Trust for presenting the report and engaging with the committee.

Resolved: The committee agreed to refer its views to Mayor and Cabinet in the following terms:

The committee recommends to Mayor & Cabinet that the proposed consultation period for these proposals is varied in order to avoid the school summer holidays – a time when the consultation is unlikely to receive the maximum number of responses.

Heather Hughes (Joint Commissioning Lead, Complex Care & Learning Disability) introduced the report. The following key points were noted:

6.1       Demand for building-based day service for adults has reduced from 56 places per day in 2012/13 to 34 places per day in 2018/19.

6.2       Mainstream adult day services are currently delivered at the Calabash Centre, Cedar Court, and Cinnamon Court.

6.3       Officers are seeking permission to consult on proposals to combine the three services into a single service providing 30 places per day.

6.4       The council has heavily invested in alternative offers for day activities for older adults. With the increased use of direct payments, more people who may have historically gone to day services are using the wider community offer.

6.5       Increasingly, the council is supporting people who have significant care needs to remain at home in the community and this is reflecting in the increase in referrals for people with high needs to day services.

6.6       The committee noted the planned consultation timetable and commented that consulting over July and August would not get the maximum response.

6.7       In response, officers would explore extending the consultation period.

6.8       The committee asked if the council has a sense of why the BME-specific day service at the Calabash centre is being underused and whether service users had been asked about this.

6.9       The day service at the Calabash centre is tailored specifically for older people from Afro-Caribbean backgrounds and the number of older people in Lewisham from that community being referred to the service at the Calabash centre is decreasing. This may be because people from this community are accessing other formal and informal services.

6.10     The committee also asked if the proposed consultation would engage people who meet the criteria for day services but who are not currently service users.

6.11     The proposed consultation is an open consultation. The council will be making direct contact with people who use the services and their families and will also be contacting key stakeholder groups.

6.12     The committee noted that, while the culturally-specific needs of older people will change over time, it may be too soon to discontinue the BME-specific service at the Calabash centre as this is still an extremely important service for a lot of people.

6.13     The committee also noted that if the existing day services are to be consolidated at one location, the Calabash centre, then the council will need to consider the practicalities of greater numbers of accessible vehicles being parked on the road outside the centre at the same time.

6.14     Officers said that the number of places per day commissioned reflected the numbers that were commissioned under the previous historical contract for Calabash where parking had been manageable.

Resolved: The committee agreed to refer its views to Mayor and Cabinet in the following terms:

The committee recommends to Mayor & Cabinet that the proposed consultation period for these proposals is varied in order to avoid the school summer holidays – a time when the consultation is unlikely  ...  view the full minutes text for item 6.

Resolved: the Committee noted the work programme.

John Bardens (Scrutiny Manager) introduced the work programme.

The committee made the following comments and suggestions:

6.1       The committee requested an update on the aspects of the council’s Early Help Review which are relevant to the remit of the committee, particularly health visiting. 

6.2       The committee asked if it would be possible to explore the possibility of receiving the item on Lewisham Hospital system resilience earlier than December.

Resolved: the Committee noted the work programme.

Resolved: The committee agreed to refer its views to Mayor and Cabinet in relation to items 4 and 6 as set out in the minutes above.

Resolved: The committee agreed to refer its views to Mayor and Cabinet in relation to items 4 and 6 as set out in the minutes above.

The chair announced the reasons for the exclusion of press and public for the following item.

Resolved: the committee noted the report.

James Lee (Director of Culture and Community Development) introduced the report. The following key points were noted:

10.1     In response to changes in the leisure market, with a significant increase in the number of budget gyms, Fusion tightened expenditure control, which led to persistent performance and cleanliness issues, an increase in complaints and membership numbers reducing. Many leisure providers are experiencing similar issues to Fusion. Health and safety and fire safety issues have not been compromised.

At 10pm the committee agreed to suspend standing orders to complete the remaining agenda.

10.2     The council is in the second year of in-depth contract management talks with Fusion in order to try to improve performance. There has been a positive change in Fusion’s response in recent months. The council’s procurement team has also been involved in the latest round of contract monitoring.

10.3     Officers are in discussion with executive members of the council about the best way to move forward and whether there needs to be a change to the contract with Fusion or if the council should continue to deal with complaints and try to drive up performance.

10.5     The committee asked if the council was satisfied with business intelligence at Fusion.

10.6     Fusion collect a large amount of business intelligence data but does not have the resources to be able to analyse and use the data productively.

Resolved: the committee noted the report.