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.

There were no interests declared.

There were no interests declared.

There were none.

There were none.

Resolved: the committee thanked those who spoke; noted the information presented; and agreed to receive an update in 6 months

The chair reminded the committee that this item follows on from concerns previously raised by the committee about the local hospital trust’s use of Experian to check residency and eligibility for free NHS care. And that Lewisham and Greenwich NHS Trust (LGT) then set up an independent review chaired by Peter Gluckman.

Jim Lusby (Director of Strategy and Integrated Care, LGT) and Peter Gluckman (Independent Chair of oversight panel for overseas charging) introduced the item and the following key points were noted:

1.1  The Trust noted their thanks to the Save Lewisham Hospital Campaign and Trust staff for highlighting their concerns about the Trust’s process.

1.2  It was noted that the Trust’s use of Experian was quickly ended after the concerns were raised.

1.3  The ambition for the panel was to find how best to implement national and legal requirements on eligibility in the most compassionate and respectful way while repairing and strengthening relationships with the community.

1.4  The panel included seven patient advocates, international clinical expertise, vice chair of the Trust Board, representation from all three local authorities, and people who were opposed the requirement to check eligibility.

1.5  The panel had a real focus on inequalities and the inadvertent impact on protected groups.

1.6  The final report of the panel was support by everyone involved and has been proactively shared with other NHS organisations.

1.7  The panel took evidence from patients and staff, local, regional and national advocacy groups, and other NHS trusts.

1.8  The importance of closely monitoring the impact of the changes on outcomes for patients was noted.

1.9  The Chair invited representative from the Save Lewisham Hospital Campaign and Lewisham Refugee & Migrant Network to give evidence to the committee.

1.10      The representatives noted that they welcomed the panel’s final report and recommendations.

1.11      The representative also noted that they have asked for there to be a public meeting on the issues facing migrants in Lewisham.

1.12      The committee noted the complexity of the legalities around this issue, in particular the definition of destitution, and queried whether the rules needed to be better explained to public practitioners.

1.13      The committee also queried whether the Trust was developing stronger relationships with advocacy groups and legal advisers to provide easily available advice.

1.14      The Trust noted the importance of the continuation of this work and relationships with the community.

1.15      The Trust noted the importance of getting clear communications out through different channels, including trust staff, to raise awareness of best practice on how these rules should be applied.

1.16      The Trust noted that it had already shared the final report and recommendations with the NHS Providers’ Network

Resolved: the committee thanked those who spoke; noted the information presented; and agreed to receive an update in 6 months

Resolved: the committee thanked officers for their presentations and resolved to refer its views to Mayor and Cabinet in the following terms:

The committee notes the ambitious proposals for the design and implementation phase of the adult social care review. The committee requests the provision of regular progress updates with evidence of outcomes and improvements. The committee also requests assessments of the impact of changes on residents receiving a service as well as staff.

Tom Brown (Executive Director for Community Services) and Kathy Freeman (Executive Director for Corporate Resources) introduced the report and the following key points were noted:

1.1  The proposals in the report are about the modernisation and transformation in adult social care.

1.2  The council awarded a contract to Newton Europe in summer 2021 to help identify opportunities for improvement and provide extra capacity with data analytics.

1.3  It was noted that the Public Account Select Committee had initially requested a review of adult social care in response to budget cuts proposals in 2020.

1.4  There will be savings from reductions in spend with external providers.

1.5  Kathy Freeman (Executive Director for Corporate Resources) provided a presentation with benchmarking information on adult social care spending and a detailed breakdown on Lewisham expenditure.

1.6  It was noted that 80% of adult social care spending is on external providers.

1.7  It was noted that the contract for Newton Europe is equivalent to around 4% of the adult social care budget.

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

1.8  The committee asked about the lessons learned from previous transformation programmes and noted the importance of embedding the changes in the culture of the organisation.

1.9  It was noted that a draft organisational development strategy, currently being consulted on with staff, sets out how change will be embedded over time.

1.10      The committee stressed the importance of the voice of the user and queried the how residents’ views will be taken into account.

1.11      It was noted that there has been significant amounts of national research on what people want from their services and that changes will be co-produced as much as possible.

1.12      The committee also stressed the importance of having detailed feedback systems in place, in relation to users and staff, in order to understand what is and isn’t working.

1.13      The committee also queried the potential impact of the proposed national changes allowing self-funders to access local authority-commissioned services.

1.14      It was noted that there is currently around a 40% difference between what self-funders and local authorities pay.

1.15      It was also noted that in Lewisham there is little evidence of cross­­-subsidy between self-funders and local authority funders and that Lewisham has very low levels of self-funders compared to other boroughs.

1.16      The committee requested regular feedback on the progress of the review process.

Resolved: the committee thanked officers for their presentations and resolved to refer its views to Mayor and Cabinet in the following terms:

The committee notes the ambitious proposals for the design and implementation phase of the adult social care review. The committee requests the provision of regular progress updates with evidence of outcomes and improvements. The committee also requests assessments of the impact of changes on residents receiving a service as well as staff.

Resolved: The committee agreed to include updates on both of this meeting’s items in its work programme.

Resolved: The committee agreed to include updates on both of this meeting’s items in its work programme.