Agenda, decisions and minutes

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

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

The following non-prejudicial interests were declared:

Cllr John Muldoon is a day patient at Guy's and St Thomas' NHS Foundation Trust (in relation to item 7).

The following non-prejudicial interests were declared:

Cllr John Muldoon is a day patient at Guy's and St Thomas' NHS Foundation Trust (in relation to item 7).

Resolved: the committee noted the responses.

Cllr Muldoon (Chair) informed the committee of the following responses to referrals from the committee:

4.1       Lewisham and Greenwich NHS Trust provided their communications plan on the changes to the opening hours of sexual health services in the borough. This is in response to the committee’s referral at its meeting on 27th June.

4.2       At its meeting on 20th September, Mayor and Cabinet resolved to circulate the Lewisham Healthwatch annual report to all cabinet members. This is in response to the committee’s referral at its meeting on 4th September.

Resolved: the committee noted the responses.

Resolved: the committee agreed to note budget cuts proposals COM 3 to COM 7 and refer its views on COM 1 and COM 2 to the Public Accounts Committee in the following terms:

The committee notes the greater demand on voluntary and community sector (VCS) organisations which would result from the proposals in COM 1 and COM 2 and expresses concern about the impact of funding reductions for VCS partners (as set out in COM 12) at a time when they are being expected to do more. Given this, the committee requests that Mayor and Cabinet does not decide to make these budget cuts until it has carried out and considered an assessment of the extent to which VCS organisations will be able to meet the increased demand as a result of the proposals in COM 1 and 2.

David Austin (Head of Corporate Resources) introduced the report. The following key points were noted:

5.1       The council’s Medium Term Financial Strategy identified the need for continued cuts to be made to the council’s budget over the coming four years.

5.2       This report sets out £21m of cuts proposals against the target of £30m cuts in the two years to 2020/21 - £17m in 2019/20 and £13m in 2020/21.

5.3       The proposals are aligned to the 10 corporate objectives and Lewisham 2020 strategy.

5.4       Officers will be developing and returning with further cuts proposals for the second year (2020/21).

Aileen Buckton (Executive Director for Community Services) introduced budget cut proposal COM1: Managing demand at the point of access to adult social care services. The following key points were noted:

5.5       In order to manage increasing demands on adult social care services, officers are working towards a preventative approach focussed on identifying people who may need support in the future earlier, and working with individuals and organisations in the community to provide support which could delay the need for a formal package of adult social care services.

5.6       Social workers will look at an individual’s strengths, what they can do for themselves, and what other organisations and people, including relatives, in their community may be able to do, in order to make the best use of the available support and make the best use of the social care resources there are.

5.7       COM 1 is part of the Council’s work to manage increasing demands on adult social care.

5.8       National guidelines suggest that local authorities should not spend more than 15% of their adult social care budget on care packages of 10 hours or less, as this level of care can often be accessed by other means and by ensuring that correct levels of benefits are in place.

5.9       Lewisham currently spends 15.5% of its adult social care budget on packages of 10 hours or less. To reduce this the council will look at what else it might be able to do for this group of residents and whether there is other support in the community which can be utilised.

5.10    Officers do not expect a large increase in complaints as social workers will be working closely with individuals and their families to reach agreement.

5.11    The eligibility criteria for adult social care services are national criteria set out in the Care Act and are not expected to change.

5.12    In complex cases benefits advice will be available from advice services in the voluntary sector.

5.13    The people who would be affected by this proposal are by and large younger and likely to be able to gain a level of independence.

5.14    If someone has very complex needs they will be provided with the appropriate support.

5.15    A panel of senior managers will have oversight of all care package reviews and care packages will be reviewed carefully in line with what is feasible.

5.16    It is also important to  ...  view the full minutes text for item 4.

Resolved: the committee thanked the chair of the LSAB and noted the report.

Professor Michael Preston-Shoot (Independent Chair, Lewisham Safeguarding Adults Board) introduced the report. The following key points were noted:

3.1       The Lewisham Safeguarding Adults Board (LSAB) is well established. It is well supported by the council, the police and the Lewisham CCG, and has good engagement from third-sector organisations. It has good budget contributions from the council and the CCG as well as contributions from the two local NHS trusts. There are no current concerns about the health of the LSAB.

3.2       The LSAB has completed two safeguarding reviews – a third is in progress. One potential concern is that all the reviews have related to men of African/Caribbean origin, and two have related to mental health.

3.2       People who may have previously relied on lower-level support are increasingly finding that it is no longer available and as a result are increasingly at risk of experiencing significant harm, which eventually comes to the notice of the council. This means that many referrals are demonstrating increased acuity and complexity. This trend is expected to continue.   

The committee asked a number of questions. The following key points were noted:

3.3       The committee queried whether there is enough training on adult safeguarding for councillors and council staff.

3.4       Adult safeguarding training has been provided for councillors and can be repeated annually, or more frequently if required. Safeguarding training for council staff is monitored alongside training for police and health staff. Council staff have received the required level of safeguarding training.

3.6       The committee asked about the level of awareness of safeguarding issues among the wider public.

3.7       Awareness of safeguarding among the wider public is variable. This is why the LSAB is holding an awareness raising conference in November aimed at the third sector. The LSAB has also run faith-based training which resulted in the appointment of adult safeguarding champions in faith groups in Lewisham.

3.8       The committee expressed concern about the operation of unregulated providers.

3.9       The LSAB knows where most of the unregulated providers are and the council (with its partners) is using its statutory powers to address this issue. Unregulated providers are an area of concern across London and elsewhere in England. The Chair of the LSAB suggested that the Department of Health and Social Care should consider extended regulation in the hope of raising standards in the sector.

Resolved: the committee thanked the chair of the LSAB and noted the report.

Resolved: The committee noted the report.

Diana Braithwaite (Director of Commissioning & Primary Care, Lewisham CCG) introduced the report. The following key points were noted:

6.1       This report provides the committee with an update on the CCG’s management of the transition process following the closure of the New Cross walk-in centre.

6.2       In February 2018 the committee expressed concerns about the impact on A&E services and vulnerable groups, such as undocumented migrants and rough sleepers.

6.3       The CCG has been closely monitoring A&E activity and is confident that there has not been a surge in activity as a result of the closure. Officers referred the committee to graph on page 5 of the agenda.

6.4       The CCG established two new services for rough sleepers to provide access to primary care. However, the number of people using the services has been low.

The committee made a number of comments. The following key points were noted:

6.5       The committee queried whether there had been an increase in demand at the GP Extended Access service.

6.6       The CCG has re-launched the GP Extended Access service and targeted promotion at the north of the borough, around the area that the walk-in centre was based. There has been an increase in usage since the walk-in centre was closed, but there has also been an increase in the number of available appointments.

Resolved: The committee noted the report.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Resolved: the Committee agreed the work programme.

John Bardens (Scrutiny Manager) introduced the work programme.

9.1       The Scrutiny Manager informed that committee that officers had agreed to postpone the item on the work programme on Leisure Centre Contracts until the January meeting as the agenda for the committee’s December meeting is already very busy.

Resolved: the Committee agreed the work programme.

Resolved: the committee agreed to refer its views on item 5, Budget Cuts, specifically proposals COM 1 and COM 2, to the Public Accounts Committee in the following terms:

The committee notes the greater demand on voluntary and community sector (VCS) organisations which would result from the proposals in COM 1 and COM 2 and expresses concern about the impact of funding reductions for VCS partners (as set out in COM 12) at a time when they are being expected to do more. Given this, the committee requests that Mayor and Cabinet does not decide to make these budget cuts until it has carried out and considered an assessment of the extent to which VCS organisations will be able to meet the increased demand as a result of the proposals in COM 1 and 2.

Resolved: the committee agreed to refer its views on item 5, Budget Cuts, specifically proposals COM 1 and COM 2, to the Public Accounts Committee in the following terms:

The committee notes the greater demand on voluntary and community sector (VCS) organisations which would result from the proposals in COM 1 and COM 2 and expresses concern about the impact of funding reductions for VCS partners (as set out in COM 12) at a time when they are being expected to do more. Given this, the committee requests that Mayor and Cabinet does not decide to make these budget cuts until it has carried out and considered an assessment of the extent to which VCS organisations will be able to meet the increased demand as a result of the proposals in COM 1 and 2.