Agenda, decisions and minutes

RESOLVED: That the minutes of the meeting held on 23 October 2013 be signed as an accurate record of the meeting.

1.1       RESOLVED: That the minutes of the meeting held on 23 October 2013 be signed as an accurate record of the meeting.

Councillor Muldoon declared an interest in relation to item 4 as a fellow of the Royal Society of Arts which had provided a grant to the New Cross Library; and in relation to item 6 as an elected Governor of the Council of Governors of the South London and Maudsley NHS Foundation Trust and member of its Quality Sub Group.

Councillor Till declared an interest in relation to item 4 due to his long standing involvement with the North Downham Training project.

2.1       Councillor Muldoon declared an interest in relation to item 4, as he was a fellow of the Royal Society of Arts which had provided a grant to the New Cross Library; and in relation to item 6, as he was an elected Governor of the Council of Governors of the South London and Maudsley NHS Foundation Trust and a member of its Quality Sub Group.

2.2       Councillor Till declared an interest in relation to item 4, due to his long standing involvement with the North Downham Training Project.

RESOLVED: That the response be noted.

3.1       RESOLVED: That the response be noted.

RESOLVED: That a referral be made to the Mayor and Cabinet stating that the Select Committee, having received an update on the performance of the Library and Information Service in Lewisham, welcomed the progress made by the Community Libraries since 2011 but was concerned about the inequality of resources made available to the providers of Community Libraries; and therefore calls on the Mayor to consider a more generous settlement to assist New Cross Learning to meet the library needs for that deprived part of the Borough.

4.1       Antonio Rizzo introduced the report and stated that the Lewisham library model was unique and had resulted in longer opening hours, increased visits, increased issues and increased satisfaction. Problems around the issue of books in community libraries were being examined but were probably the result of (a) the substantial work being carried out at those venues which had entailed temporary closures in many instances; and (b) a change in audience and user priorities following the change in offer at those venues.

4.2       In response to questions from Members of the Committee; Councillor Bell, under standing orders; and Councillor Ibitson, via e-mail, the following key points were noted:

·           Library technology has been introduced to the Pepys Resources Centre linking their collection to the main library service and the London Library Consortium, making it a sixth community library for Lewisham.

·           Eco Communities was hoping to introduce a library offer in Bellingham and would talk to Phoenix Community Housing about potentially using one of their buildings and also investigate whether the leisure centre might be a good and feasible venue for library provision.

·           Lewisham was the only London borough increasing library service points.

·           Specific services were offered for homebound residents with around 300 regular users; and talking books and newspapers were offered for the blind. There were examples of community providers supporting similar services, subject to the vetting of volunteers that would be required for home visits.

·           The three community providers had each negotiated different lease arrangements with the Council (New Cross Learning were due to sign their lease imminently subject to a few legal details being finalised) and had different funding arrangements.

4.3       Representatives from the community libraries made a short presentation each and responded to questions from the Committee. The following key points were noted:

            Darren Taylor (Eco Communities)

·           The Council had invested £60k per library to install self-service terminals, and Eco Communities had signed a 25 year lease which allowed the organisation occupy the library buildings rent free providing the buildings were repaired and maintained.

·           £120k had already been spent on repairs.

·           The ‘Croftmas’ event in Crofton Park had seen the library receive 1000 visits in one day.

·           40 staff were now employed, 80% were Lewisham residents and 60% of those were long-term unemployed immediately prior to gaining employment with Eco Communities.

·           The Generation Play Centre had just been taken on and local residents would be consulted to find out what they wanted from the venue. Books would be provided via the centre as soon as possible.

Sir Ian Mills (Age Exchange)

·           Age Exchange had received £200k funding from the Council and had raised £700k funding itself to refurbish the Reminiscence Centre.

·           Footfall in the first year had been 130,000 and it was estimated that this would rise to 160,000 in the next 12 months.

·           It was estimated that 45% of the footfall to the centre was people using library services.

·           Goals for the next 12 months included (a) extending partnership working; (b) opening the second hand bookshop two  ...  view the full minutes text for item 4.

RESOLVED: That the following written submission be made to the Public Accounts Select Committee in relation to its consideration of this item: The Healthier Communities Select Committee commends the Interim Head of Adult Social Care, and her team, on managing savings affecting adult social care services in response to the Government's austerity regime, and in meeting the challenges associated with the integration of health and adult social care.

5.1       David Austin introduced the item and, in response to questions from Members, the following key points were noted:

·           In terms of shared services the Council was looking at working with other local authorities, in particular with regard to joint procurement opportunities.

·           COM01: This proposal built on earlier savings and was dependent on further integration with Health. Reviews of care packages would happen in a more timely manner, and a more effective way of providing care would be provided, whilst ensuring that all eligible care needs were met. There would be more preventative work and reablement; and the joining up of separate social care and health assessments would be pursued. There had been a mixed response from users to the service changes implemented thus far: some had welcomed the increased personalisation of services and the emphasis on reablement; others had become dependent on an intensive level of care and wished to remain receiving care at this level. There had been, however, no stage 3 complaints or referrals to the ombudsman. Social workers were working with families to manage expectations and explain the options for returning to home as opposed to moving into residential care. The numbers requiring care packages were not going up at present although, given the ageing population, a rise was expected in the future.

·           COM02: it was proposed to use £200k of the remaining unallocated public health budget (of between £500 and 800k) to fund free swimming for under 16s and over 60s. A priority for the remaining budget was likely to be school nursing.

·           COM04: This saving was due to procurement efficiency – a better contract than expected had been negotiated.

·           COM05: Ambulatory detox in the community was cheaper than residential detox, and arguably resulted in better long-term outcomes; although it was dependent on high quality aftercare services.

5.2      RESOLVED: That the following written submission be made to the Public Accounts Select Committee in relation to its consideration of this item: The Healthier Communities Select Committee commends the Interim Head of Adult Social Care, and her team, on managing savings affecting adult social care services in response to the Government's austerity regime, and in meeting the challenges associated with the integration of health and adult social care.

RESOLVED: That the updates be noted.

6.1       The Committee received a report which provided an update on the progress made to date by local health and care partners in response to the Francis Report. The following comments were made in relation to the presentations from Trusts:

LCCG (Dr Faruk Majid, Graham Hewett, Diana Braithwaite)

·           The LCCG was focussing on the recommendations it had identified as being a priority and had divided the recommendations into four thematic workstreams. However, the aim was to build the recommendations into the way people worked on a daily basis.

·           The patient view was essential as the major thrust of the Francis report was that patients had been complaining but had not been listened to.

·           A recent important innovation had been the introduction of GP quality alerts, whereby GPs could alert the LCCG about service quality concerns via a computerised system. This allowed the LCCG to identify trends.

·           A People’s Health Quality summit was planned for March to try to identify what quality means to service users.

·           The LCCG had set up Clinical Quality Review Groups so that quality measures from SLaM and Lewisham and Greenwich NHS Trust could be considered.

·           Although the LCCG did not have a particularly strong brand at the moment as it was a relatively new organisation, it had good relationships with a number of local organisations and had engaged with a large number of stakeholders.

            Lewisham and Greenwich NHS Trust (Joy Ellery)

·           Gap analysis had been conducted to assess the work that needed to be carried out to fully implement the recommendations and further embed the culture of making the patient central to everything that is done.

·           The Trust was implementing an Organisational Development Strategy which aimed to reinforce the behaviours and values necessary throughout the new organisation. Correct behaviours were being discussed at every staffing level and staff and ward contracts were being reviewed.

            SLaM (Steve Davidson)

·           A working party had been set up to co-ordinate a response and cultural measures in particular had been looked at: the behaviours expected from staff and the support that staff needed to perform well.

·           Five key commitments had been generated as a result of speaking to service users.

·           An early warning system (QUEST) was in place to monitor quality of care and the quality sub group of the Board would be reporting to the Board in January on further action needed.

6.2       RESOLVED: That the updates be noted.

·         Establishing a SE London urban public health collaborative across Lambeth, Southwark and Lewisham

·         Interim evaluation of the North Lewisham Plan

RESOLVED: That the updates be noted.

7.1       Dr Danny Ruta introduced the item and the following key points were noted:

Public health collaborative across Lambeth, Southwark and Lewisham

·           The Collaborative was tackling big issues which required complex interventions and had funding for a further year.

·           In Lewisham there had been a fitness training programme for primary school pupils which had been very successful and it was now hoped to roll this out to Southwark and Lambeth.

·           An Alcohol dependency training app had been developed to take health professionals through the difficult conversations that they might need to have with patients around alcohol misuse. It was hoped that similar apps would be developed for smoking and obesity.

·           Tackling obesity required a large number of different interventions coming from a variety of different angles.

·           Incentives tended to work in situations where you needed people to make short term lifestyle changes (such as breastfeeding a baby for a period of time) but were less successful for long term lifestyle changes (e.g. losing weight then maintaining a healthy body weight).

Evaluation of the North Lewisham Health Improvement Programme  and the Transfer of Learning

·           This ground-breaking programme had produced some amazing outcomes and had been very successful in raising awareness, changing behaviour and improving health outcomes for a number of people living in Evelyn and New Cross wards, in a cost effective way.

·           A grant application would be made in January to the Medical Research Council to establish similar projects in the Downham and Lewisham Central wards.

7.2       RESOLVED: That the updates be noted.

RESOLVED: That the update be noted.

8.1       Joy Ellery provided an update and the following key points were noted:

·           There would be a CQC inspection the week beginning 24 February 2014 which would (a) involve both sites and between 60 and 80 inspectors; (b) last 2 or 3 days; and (c) be followed up by an unannounced visit at night or on a weekend.

·           The upcoming inspection had accelerated work on integration and every ward and department was being audited, starting with areas of concern (so re-audits could take place pre-inspection).

·           Electronic Patient Records were going live at The Queen Elizabeth Hospital shortly after the inspection and at Lewisham Hospital in September and business continuity plans were being worked on.

·           The Foundation Trust Project would only be restarted once the new organisation was ready to take it forward. The merging of the Lewisham and Queen Elizabeth Hospitals had meant that the Trust was not likely to receive an “excellent” rating as a result of the CQC Inspection (and might not achieve a “good” rating) so would need to be inspected again before the project was restarted.

8.2       RESOLVED: That the update be noted.

RESOLVED: That the report be noted.

12.1    RESOLVED: That the report be noted.

RESOLVED: That the work programme be noted and that (a) the Public Health items scheduled for the February meeting be postponed to the March meeting; and (b) the following two items be added to the March meeting: Public Health Apps and Lewisham and Greenwich NHS Trust PFI costs.

10.1    Charlotte Dale introduced the report.

10.2    RESOLVED: That the work programme be noted and that (a) the Public Health items scheduled for the February meeting be postponed to the March meeting; and (b) the following two items be added to the March meeting: Public Health Apps and Lewisham and Greenwich NHS Trust PFI costs.

RESOLVED: That a referral be made in relation to the Library and Information Service item.

11.1    RESOLVED: That a referral be made in relation to the Library and Information Service item.