Agenda, decisions and minutes

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

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

There were no interests declared.

There were no interests declared.

There were no M&C responses to note.

There were no M&C responses to note.

RESOLVED: that the health system recovery update is noted and that the committee thanks NHS partners for going above and beyond in unprecedented times and while under extreme pressures.

Sarah Wainer, Director of System Transformation, Lewisham Health and Care Partners, introduced the report noting that while progress with recovery activity has been impacted by the Omicron variant, partners have risen to the challenge and worked collaboratively.

Ben Travis, Chief Executive, Lewisham and Greenwich NHS Trust, and Paul Larrisey, Divisional Director of Operations, Medicine and Community Division, Lewisham and Greenwich NHS Trust gave a presentation on the key issues for the Trust. The following was noted:

1.1  The key challenges for the Trust are: high demand at the front door; the Omicron variant and any future waves; and lengthy waiting lists.

1.2  After having to stand down a number of services during the first and second waves of Covid, there are now 1,900 patients across Lewisham, Greenwich, and Bexley who have waited more than 52 weeks for surgery.

1.3  Another key challenge is around staffing numbers. Although many are vaccinated, many are still getting Covid and this is making it a challenge to staff all services. For example, elective care had to be stood down to deal with challenges at the front door.

1.4  The Trust’s 4-hour A&E target performance currently stands at 77%, against a target of 95%.  The Trust is exploring alternative to meet this challenge, including: streaming people at the front door; increasing use of the same day emergency care unit; creating separate entrance for A&E; working with partners on the Urgent Community Response Service. 

1.5  The Trust has also received funding from the CCG to increase other community services.

1.6  Going forwards, focus will be on: elective care recovery; meeting new national targets on discharge; making the most of Lewisham’s Population Health System; working with partners to deliver ambitions of adult social care changes.

1.7  In response to questions about the number of people having to wait in ambulances because they can’t be admitted to A&E, it was noted that on most days there reasonable numbers of people waiting more than 15 minutes and small numbers waiting for more than an hour.

1.8  In response to questions about vaccination requirements for staff it was noted that the Trust has been collecting data and working with staff to better understand the risk. There also needs to be a conversation across southeast London to discuss and manage risks.

1.9  Catherine Mbema, Director of Public Health, also delivered a presentation on local prevention measures.

1.10      IN response to questions about ‘long Covid’, it was noted that the prevalence of this will be looked at as part of the council’s Covid Impact JSNA (joint strategic needs assessment) which will feed into a refresh of the Lewisham Health and Wellbeing Strategy.

1.11      Simon Parton, Chair of Lewisham Local Medical Committee, noted that primary care is seeing fewer patients presenting with acute Covid, but that there has been a significant increase in staff sickness and absence which has been a challenge. It was also been difficult to recruit to primary care, nurses in particular.

1.12      In terms of unplanned  ...  view the full minutes text for item 4.

RESOLVED: that the budget reduction proposals discussed above are noted.

Tom Brown, Executive Director for Community Service, introduced the report by providing some context in which this round of cuts in coming.

1.1  The financial impact of Covid for next year is forecast to be £22m. No new funding for this has yet been announced.

1.2  The impact of additional costs and lost income on council tax and business rates in expected to be more than £10m in the coming year.

1.3  There is also significant pressures on services in excess of £6m - £5m in relation to adult social care and £1m in relation to children’s social care.

1.4  The provisional local government settlement included an increase in funding of less than 1%. There will also be a one-off ‘new services’ grant of £6.6m next year.

1.5  In this context, the medium term financial strategy has identified a gap of at least £18.3m.

1.6  The first budget cut proposal allocated to this committee is C-40, Substance misuse - contract review and staffing. This is an efficiency saving that came out of contract negotiations. This has resulted in £92k being able to be invested elsewhere.

1.7  The second budget cut proposal allocated to this committee is E-14, Changes to leisure concessions for older people. This is a reduction in automatic entitlement to universal free swim and gym for people over 60. The Be Active programme with affordable concessionary “pay and play” rates will continue. People registered as disabled will still able to benefit from free swim and gym.

1.8  In response to questions about eligibility for disabled residents, it was noted that free swim and gym will continue to be available for those in receipt of disability benefits.

RESOLVED: that the budget reduction proposals discussed above are noted.

RESOLVED: that this item is adjourned to the next ordinary meeting of the committee.

RESOLVED: that this item is adjourned to the next ordinary meeting of the committee.

RESOLVED: that the work programme is noted and that Cllr Sophie Davis is appointed as the committee’s Climate Change Champion.

RESOLVED: that the work programme is noted and that Cllr Sophie Davis is appointed as the committee’s Climate Change Champion.