Agenda item

Aileen Buckton (Executive Director for Community Services) introduced the report; the following key points were noted:

In response to questions from the Committee, Aileen Buckton and Freddie Murray (Group Manager for Asset Strategy and Technical Support) the following key points were noted:

·         The plans presented to the Committee were not in a finished document.

·         Six boroughs had been working to look at health and social care collectively and had developed a new strategy together through the Sustainability and Transformation Plan (STP). This work benefitted from the good relationship between partners in Lewisham.

·         Partners were listening to what residents were saying about the delivery of services. It was recognised that people wanted provision of services near to where they lived at times that were convenient to them. Partners were also focused on stopping people from being admitted to hospital unnecessarily.

·         There would be further consultation and opportunities for the community to feed in to potential changes.

·         Officers were aware of the concerns about the closure of Lewisham A&E. The STP was focused on the deficit that would be created if nothing changed in terms of local health provision.

·         The proposals would allow local authorities to make greater use of the public estate.

·         Lewisham had put forward an expression of interest to government, which asked for half a million pounds of funding to develop local improvements.

·         Future work was likely to take place at neighbourhood level, alongside groupings of GP surgeries.

·         Lewisham’s neighbourhoods were split into four geographical areas across the borough. In different areas, there were different opportunities for joint working and future developments.

·         Partners were looking at the Waldron centre; the Ladywell centre on the Lewisham hospital site; Downham health and leisure; the Forest Hill/Sydenham Green health centre for improved joint working.

·         As part of the devolution pilot, partners in Lewisham were asking for delegated powers to enable integration of health and social care staff. There were also opportunities for the creation of multi-disciplinary teams.

·         The devolution pilot would look at the scope of new roles – aligning different responsibilities rather than allowing the false divide between responsibilities to remain. The devolution pilot would give organisations the opportunity to do some more of this work together.

·         Further decisions on this work would be taken in the autumn.

Aileen Buckton and Freddie Murray responded to questions from the Committee. The following key points were noted:

• Through One Public Estate, Partners were asking whether there were parts of the local estate that could be disposed of to provide better community services at local level. At present, money from disposals was kept centrally. It was proposed that, if receipts were kept locally it would enable innovation.
• GP surgeries were already working together to provide services across neighbourhoods in clusters.
• GPs were developing proposals to formally federate their practices in order to provide 8am – 8pm services.
• The Ladywell site at Lewisham hospital, was not fit for its intended purpose. The new initiative would enable partners to think about how community mental health services were provided.
• There were examples of integration and the development of multi-disciplinary teams working well together. One such was the Deptford Lounge, which had teams from different organisations in the same building sharing space and providing services to the public from a combined use building.
• There were also a number of multi-disciplinary teams working from shared buildings across London.
• The work carried out developing Lewisham’s asset register had provided a greater understanding of the composition of the Council’s assets.
• Work needed to be completed for 2020 in order to ensure that the local health economy was on a sustainable footing.
• There was no plan so far for for managing liabilities association with PFI deals.
• In terms of integration of IT services, there was more work to do. The Connect Care project enabled some level of integration, but the aim was to have access to detailed information on secure mobile devices.
• Requirements for teaching space at the hospital site would be taken in to consideration.

The Committee highlighted the difficulties inherent in combining systems and processes between organisations. It also highlighted the difficulty in delineating responsibilities in a private finance initiative (PFI) buildings.

The Committee agreed that it would add scrutiny of any pilot project to its future work programme.

Resolved: that - the Committee endorses the previous call by Members for the publication of the Sustainability and Transformation Plan; it notes that further consultation on the plans set out in the report will be required.

The Committee believes that the raising of capital receipts from disposal of land should be balanced against organisations’ long-term revenue requirements; it also believes that NHS property should be viewed as a public asset and the NHS should retain freeholds on land used for development.

The Committee asks that clarity be provided on the proposed future governance arrangements for the scrutiny of devolution proposals; it also notes that Lewisham’s Healthier Communities Select Committee and Sustainable Development Select Committee may wish to become involved in scrutiny of the details of these projects.