Agenda, decisions and minutes

Resolved: to agree Councillor Muldoon as Chair and Councillor Jeffrey as Vice-Chair of the Committee.

1.1      Timothy Andrew (Scrutiny Manager) opened the meeting and invited the Committee to agree the outcome of the Council’s annual general meeting on 26 March, confirming Councillor Muldoon as Chair of the Committee and Councillor Jeffrey as Vice-Chair of the Committee.

Resolved: to agree Councillor Muldoon as Chair and Councillor Jeffrey as Vice-Chair of the Committee.

Resolved: that subject to the amendment discussed, the minutes be agreed as a true record.

2.1      Members noted that they had thanked Val Fulcher for her significant contribution Committee. The Chair requested that this amendment be noted.

Resolved: that subject to the amendment discussed, the minutes be agreed as a true record.

Councillor Bell - non-prejudicial – member of King’s College Hospital NHS Foundation Trust.

Councillor Muldoon – non-prejudicial- lead governor of SLaM NHS Foundation Trust

Councillor Paschoud - non-prejudicial - family member in receipt of a package of social care.

Councillor Raven - non-prejudicial - family member in receipt of a package of social care.

Resolved: to agree the additions and changes to the work programme as discussed and to submit the programme to business panel.

This item was considered after item five.

4.1      Timothy Andrew (Scrutiny Manager) introduced the work programme report. The Committee then discussed the work programme; the following key points were noted:

·         Members were interested in scrutinising the outcome of the consultation about day centres. Following discussion at previous meetings, the Committee was particularly interested in the potential loss of transport provision to MENCAP’s evening club provision.

·         It was agreed that the day centres consultation paper would be placed on the work programme for pre-decision scrutiny.

·         The Committee also talked about the agenda item relating to the development of the market for adult social care services. Members indicated that they were interested to find out about the levels of pay for care workers.

·         The Committee agreed to scrutinise the public health annual report when it became available.

·         It was agreed that an item would be added to the Committee’s work programme to review the implementation of the Health and Wellbeing strategy in the autumn.

·         Members discussed the suggestion of adding an item on transition from children’s to adult’s social care. It was agreed that because of the cross over with the terms of reference of the Children and Young People select committee, the issue would be referred to Business Panel for discussion.

·         It was agreed that information would be requested during the course of the year from the Lewisham and Greenwich NHS trust as issues arose – alongside the regular update on the Trust improvement plan.

·         It was noted that the Committee had been invited to visit Kings College Hospital.

·         The Chair informed Members that a proposal had been put forward to carry out a review of issues relating to patients who did not attend their appointments. Charles Malcolm-Smith (Lewisham CCG) informed the Committee that Lewisham was not seen as an outlier in regards to availability of appointments – and that information about patients who did not attend appointments was not routinely collected, which would limit the effectiveness of a review of this issue.

·         The Committee also discussed the options for reviewing the letting of CCG contracts. Charles Malcolm-Smith (Lewisham CCG) informed the Committee that a register of CCG contracts was available on the Group’s website. Members noted their concerns about increasing privatisation of the NHS. It was agreed that an item on the CCG commissioning intentions would be brought to the Committee in October.

·         The Committee discussed the idea of carrying out a review of complaints management by the NHS and agreed it would not take the idea forward.

·         The Committee also discussed the idea of carrying out a review of vitamin D supplementation. It was agreed that further information would be provided to the Committee about existing work in this area.

Resolved: to agree the additions and changes to the work programme as discussed and to submit the programme to business panel.

Resolved: to submit the Committee’s views to the Trust Board of the South London and Maudsley NHS Foundation Trust.

This item was considered before item four.

Councillor Muldoon declared a prejudicial interest in the item and withdrew from the meeting. Councillor Jeffrey assumed the Chair.

5.1      David Norman (Service Director, Mental Health of Older Adults & Dementia Clinical Academic Group) introduced the report; the following key points were noted:

·         Two reports had been provided to the Committee. Firstly, an interim report, which outlined the consultation process and secondly a full report, which provided additional details about the responses received for the consultation.

·         The patients in the centre had been involved in the consultation process.

·         Relatives were most closely involved in the consultation. The other main group of stakeholders included organisations such as Healthwatch, Age UK and the Alzheimer’s society.

·         The individual implications and repercussions of the changes had been discussed with family members.

·         Relatives wanted to understand the reasons for the changes being proposed and they had expressed concerns about the future of specialist provision.

·         There were concerns about the financial implications of the changes.

·         The low levels of current demand created additional cost pressures because of under-occupation of the centre.

·         The national rates of dementia diagnosis had been raised a number of times during the consultation.

·         The response from Healthwatch also highlighted the concern that rates of dementia appeared to be increasing but that specialist services were being reduced.

·         There had been a reduction in demand for specialist dementia services in Lewisham. This was the result of changes in medical practice, increased awareness and improved diagnosis, referral and management of dementia.

·         Savings generated from the proposed changes to specialist services would be reinvested into other services.

·         SLaM had committed to working with individuals to meet their care needs.

·         The remit of Inglemere was to provide treatment for people with severe symptoms.

·         Whilst there was increased awareness and diagnosis of dementia, people with the most severe symptoms made up only a small number of cases.

·         The Clinical Commissioning Group had an experienced clinical team to support the transition process; SLaM also had access to high level support placements to support patient’s needs, if required.

5.2      David Norman (Service Director, Mental Health of Older Adults & Dementia Clinical Academic Group), Helen Kelsall (Service Manager, Inpatient Care) and Dee Carlin (Head of Joint Commissioning) responded to questions from the Committee and the following key points were noted:

·         Private sector care provision was regulated by the Care Quality Commission through a stringent process of announced and unannounced inspections as well as reactive interventions based on safeguarding concerns.

·         Places in private sector provision were often well resourced and had staff with the appropriate skill mix to ensure that people could be supported in the care home environment.

·         In many cases, care homes had become people’s homes – and were more suitable and familiar places for them to be supported, rather than as patients in specialist facilities.

·         70 people were under the care of specialist teams in care settings in Lewisham.

·         Seven people were in the unit at present.

·         One resident had been at the centre  ...  view the full minutes text for item 5.

Resolved: to refer the Committee’s views to Mayor and Cabinet as agreed.

6.1      Dee Carlin (Head of Joint Commissioning, LCCG/LBL) introduced the report, the following key points were noted:

·         The health and social care integration programme was moving forward. The programme was developing neighbourhood teams and increased neighbourhood working.

·         The programme was aligned with other changes in the delivery of health services.

6.2      Dee Carlin (Head of Joint Commissioning, LCCG/LBL) responded to questions from the Committee, the following key points were noted:

·         The Care Act had an advocacy requirement. In Lewisham this was being provided by Voiceability.

·         A range of partners were working in the Local Care Networks. This information could be provided to the Committee.

·         Community Connections had been funded through the Main Grants programme’s investment fund; the service was designed to support people who might not meet the threshold for adult social care services.

6.3      The Committee agreed to share its views with Mayor and Cabinet, as follows:

·         Having received a report about health and social care integration, the Committee acknowledges the value of work by Community Connections and is concerned that it is not receiving core funding. The Community Connections service in Lewisham has as its priorities ‘Five Ways to Wellbeing’. It provides interventions for adults who do not meet the eligibility criteria to receive care services from the Council. As such, its health and wellbeing focus is preventative in nature.

·         The Committee recommends that Mayor and Cabinet give serious consideration, when re-investing public health savings, to providing core funding for Community Connections.

Resolved: to refer the Committee’s views to Mayor and Cabinet as agreed.

Resolved: to refer the Committee’s views under item five with the Trust Board of the South London and Maudsley NHS Foundation Trust and the Committee’s views under item six to Mayor and Cabinet.

Resolved: to refer the Committee’s views under item five with the Trust Board of the South London and Maudsley NHS Foundation Trust and the Committee’s views under item six to Mayor and Cabinet.