Agenda, decisions and minutes

RESOLVED: that Cllr Chris Best and Cllr Aliya Sheikh be elected as the Chair and Vice-Chair of the committee.

RESOLVED: that Cllr Chris Best and Cllr Aliya Sheikh be elected as the Chair and Vice-Chair of the committee.

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

There were none.

There were none.

RESOLVED: that the report be noted; that Martin Wilkinson be thanked for his service to Lewisham over the last 14.5 years; and that the committee works with partners to refresh the Lewisham Health and Social Care Scrutiny Protocol.

Tom Brown (Executive Director for Community Service) introduced the report, noting that the architecture of the NHS is due to change on 1st July 2022, with many of the Lansley reforms being undone and a move towards a more co-productive structure with health and social care working together to address health and care challenges.

1.1  As part of the new architecture, local government will be represented at the South East London Integrated Care System (ICS) level on both the Integrated Care Partnership and the Integrated Care Board. There will also be a local care partnership focused on the community in Lewisham.

1.2  Martin Wilkinson (Director of Integrated Care and Commissioning) noted that the local care partnership for Lewisham will feed into and report to the Health and Wellbeing Board and that the Health and Wellbeing Strategy will be worked through the local care partnership. There will also be a broad range of clinical and care professionals working within the structure and lots of continuity with existing staff and plans.

1.3  The ICS will decide on what happens with a large amount of NHS spending and this will allow there to be joint conversations about where the pressures are and where the money should go. It was noted that money has already be directed towards social care so that it can support elective recovery and prevent hospitals getting clogged up.

1.4  The committee stressed the importance in any new structure of a continuing focus on children, families and early intervention.

1.5  In response to questions from the committee about the priority of the replacement of the Ladywell Unit, it was noted that the focus is currently on remedial and immediate safety work but work is progressing on planning for a new unit as a high priority.

1.6  In response to questions from the committee about the scrutiny of the ICS, it was noted that scrutiny will continue to be key and that scrutiny colleagues have begun conversations with the ICS about future arrangements for the previous Our Healthier South East London Joint Health Overview and Scrutiny Committee. It was also suggested that it might be helpful to refresh the local health and social care scrutiny protocol.

RESOLVED: that the report be noted; that Martin Wilkinson be thanked for his service to Lewisham over the last 14.5 years; and that the committee works with partners to refresh the Lewisham Health and Social Care Scrutiny Protocol.

RESOLVED: that the report be noted and that the committee explore opportunities for public engagement on the proposed Health Care and Wellbeing Charter, working in partnership with Healthwatch Lewisham.

Martin Wilkinson (Director of Integrated Care and Commissioning) introduced the item noting that the Health and Wellbeing Board has been requested to develop a health care and wellbeing charter and that the next step is to get initial comments on how this might be co-designed and co-produced.

1.1  It was noted that it would be helpful set out the responsibilities that health and care would have in offering reasonable access to appointments in GPs and hospitals, but to also cover the various responsibilities around the system in relation to this.

1.2  It was also noted that issues of inequality of access had been identified through the Birmingham and Lewisham African and Caribbean Health Inequalities Review (BLACHIR) and that the charter will develop over time.

1.3  Nigel Bowness (Healthwatch Lewisham) noted that Healthwatch already provides a wealth of information on residents’ views on access to health and care services and are happy to support the process of developing the charter going forward. It was noted that the Lewisham Disabled People’s Commission will be reporting in October, which may offer further insights into inequality of access, and that insight could also be gathered from regulator and ombudsman reports. Healthwatch also suggested aligning any resident engagement activity with that already happening at ICS and local level to avoid duplication.

1.4  The committee noted that it would be could to engage with stakeholders to get their views and to work in partnership with the Health and Wellbeing Board. It was also noted that dashboard of key data, such a missed appointments, for example, could be helpful. The committee suggested setting up an informal session to meet some stakeholder, such as patient panels, to talk about what’s important to them.

1.5  The committee also stressed that importance of the charter striking the right balance between acute and early intervention and remembering with stakeholder engagement that not everybody is IT literate and has the tech to find information online.

RESOLVED: that the report be noted and that the committee explore opportunities for public engagement on the proposed Health Care and Wellbeing Charter, working in partnership with Healthwatch Lewisham.

RESOLVED: that the report be noted; that the committee receives further information on the number of workshops for staff carried out; and that the committee continues to receive regular updates on the Empowering Lewisham programme.

Tom Brown (Executive Director for Community Service) introduced the report, providing an update on the Empowering Lewisham programme and its various work-streams. A discussion followed and a number of key points were noted:

1.1  There have been regular staff surveys throughout the programme and it is felt that staff recognise that this programme is an opportunity to really make a difference to people’s lives at the same time as getting more value for the public pound.

1.2  The programme in on track to deliver the cashable efficiencies planned, although there has been some slippage in the timeline.

1.3  The consultants who are supporting the programme are contractually obliged to continue working with the council until a minimum of £8.6 cashable savings are delivered, or to reduce their fee.

1.4  The finances are being closely monitored and the council is confident that the savings will be achieved within the estimated 4-year period.

1.5  The Cabinet Member also stressed that the consultants will be asked to demonstrate very clearly where those cashable savings have been achieved.

1.6  The committee stressed the importance of service user input into the process and closely tracking any barriers to progress throughout the programme. The committee asked about the kind of outreach that the council is doing and the number of service use engagement workshops it has carried out. Officers agreed to provide further information.

1.7  The committee also expressed concern about the mental health issues that may arise if additional pressure is put on families who would also consequently be in less contact with care professionals.

1.8  In response, it was noted that the intention of the programme is not to shift the burden to family carers but to help people to be able to better direct what they do with their lives and to make a local offer that allows people to stay connected to their communities and families.

1.9  The number of young people receiving children’s services coming into adulthood is presenting particularly significant pressures this year. It is estimated that this will create an additional cost of £1-2m over the coming year.

1.10      The council is also currently working to understand the increasing cost of living pressures on care homes and care workers, with the significant increasing costs of heat and fuel.

RESOLVED: that the report be noted; that the committee receives further information on the number of workshops for staff carried out; and that the committee continues to receive regular updates on the Empowering Lewisham programme.

RESOLVED: that the committee agrees its work programme for the year ahead, notes the suggestions made by the committee and agrees to programme these in at an appropriate time.

John Bardens (Scrutiny Manager) introduced the report and the following work programme suggestions were noted:

1.1  That the committee schedules an update on the health and wellbeing strategy and invites the chair of the health and wellbeing board.

1.2  That the committee schedules an item on adult safeguarding and invites the chair of the Lewisham Safeguarding Adults Board.

1.3  That the committee continues to receive regular updates on the Empowering Lewisham programme.

1.4  That the committee continues throughout the year to support the work to develop the proposed Health care and wellbeing charter.

1.5  That the committee explores the possibility of considering transitions from children’s to adults’ mental health services alongside the item at its next meeting on social care transitions.

1.6  That the committee incorporates the consultation on the replacement for the Bridge leisure centre in its leisure update in January.

1.7  That the committee explores the possibility of a site visit to the Ladywell unit in advance of it considering an update in February.

1.8  That the committee explores the possibility of providing committee members with a dashboard of key health and care data.

RESOLVED: that the committee agrees its work programme for the year ahead, notes the suggestions made by the committee and agrees to programme these in at an appropriate time.