Agenda, decisions and minutes

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

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

1.2.       The Chair of the Committee mentioned that at its meeting in June 2023, the Committee provided comments on the draft Physical Activity Strategy which was later submitted to the Mayor & Cabinet.  A follow-up would be conducted on how the Committee’s comments were presented and to explore whether using a formal template for documenting comments and responses would be a sensible way forward. The Chair added that in the Physical Activity Strategy, only the Committee’s comments about minor wording changes were addressed, leaving some other comments unaddressed.

None.

None.

The Chair informed the committee that the items on the agenda would be considered in the following order- Lewisham Health and Care Partners (LHCP) Local Care Plan 2023-28, Health & Wellbeing Strategy and Healthcare & Wellbeing Charter and then A Vision and Strategy for Adult Social Care in Lewisham.

RESOLVED:

·         that the report be noted, along with the comments made by the Committee.

·         that the Committee expressed its gratitude to Sarah Wainer and wished her all the best for her retirement, marking her last Committee meeting with a heartfelt note.

Sarah Wainer (Director of System Transformation, Lewisham Health and Care Partnership) introduced the report. The following key points were noted:

3.1. In October 2022, Lewisham Health and Care Partners discussed the priority areas on which they wanted to work, in order to achieve substantial improvements in health and care outcomes and to address existing inequalities. 5 priority areas were agreed that formed the basis of the Local Care Plan (LCP) 2023-28.

3.2. The first high level priority objective was to strengthen the integration of primary and community care. To achieve this objective, it was important to focus on delivering effective integrated care at a neighbourhood level. Through the neighbourhood focus, two long term conditions would be identified for which local models of care would be established, along with developing a local network support for older people. This approach would also include a focus on expanding the provision of early intervention and community support for mental health.

3.3. The second priority was to build stronger, healthier families and to provide families with integrated support services. This was being achieved through an integrated model for family hubs across Lewisham which was being delivered by the Children and Young People’s Directorate.

3.4. The third priority focused on addressing inequalities throughout Lewisham’s health and care system. Dr Catherine Mbema, Director of Public Health was leading the work around this priority objective.

3.5. The fourth priority was to maximise the roles of health and care partners as anchor organisations to build a happier and healthier workforce. To achieve this objective, joint apprenticeship programmes were being identified and workforce planning was also being carried out in collaboration.

3.6. The fifth priority was to attain financial sustainability across the system. All the work related to the other four priorities would be executed in a manner that bolstered the fifth priority.

3.7. To facilitate the delivery of the LCP, several programme boards and groups were in place. The LCP and its objectives also aligned with existing programmes such as Empowering Lewisham, Mental Health Alliance programmes and initiatives being delivered by colleagues in the Children and Young People directorate. The report mainly discussed the LCP which was a high-level document. All the specific details, action plans, engagement and co-production with residents was happening at the programme levels.

3.8. All the programmes across the system where joint work was taking place, reported to the Place Executive Group which ensured effective oversight of all programmes.

The Committee members were invited to ask questions. The following key points were noted:

3.9. During the consultation phase, it became evident that certain portions of the Local Care Plan (LCP) were written using highly corporate language. Feedback was provided to the programme board, emphasising the need to translate it into a more user-friendly language.

3.10. The Integrated Neighbourhood Network Alliance was responsible for bringing together partners across primary care and community health.

3.11. The Integrated Care System (ICS), via the Integrated Care Partnership (ICP) Board, had been exploring ways to enhance the community and voluntary  ...  view the full minutes text for item 3.

RESOLVED:

·         that the report be noted, along with the comments made by the Committee.

Tom Brown (Executive Director for Community Services) and Joan Hutton (Director of Adult Social Care) presented this item to the Committee. The following key points were noted:

4.1. This was the first draft of the Adult Social Care Strategy and officers wanted to take this forward in a co-productive way. It was discussed that partnerships were really important in delivering this strategy, this included partnerships within the system and partnerships with residents.

4.2. The vision for the strategy was to work jointly with residents, carers, partners and providers to co-produce it in order to enable the right care to be provided to residents.

4.3. It was noted that Lewisham was due to be inspected by the CQC (Care Quality Commission) and that the Council was preparing for that by doing mock inspections and by being part of a peer review in February 2024.

4.4. Officers highlighted the key objectives detailed in the report to the Committee that the Adult Social Care strategy would focus on, including:

·         Independence and safety- working together to enhance Quality of Life and maximising independence for residents.

·         Motivated and sustainable workforce- working towards Lewisham being a place that people want to work in and developing, supporting and motivating staff to feel empowered to make the right decisions.

·         Ensure a sustainable and diverse care market

·         Co-production and collaboration- working jointly with citizens, carers, partners and providers to co-produce and provide the right support to residents, as close to home as possible.

·         Improvement and innovation- focusing on innovation and improvement, in readiness for CQC and wider ASC reforms.

·         Equality and accessibility- ensuring equality and accessibility by improving access and simplifying and streamlining communications, data, processes and systems.

·         Effective budgets and resourcing- delivering value for money, making the best use of resources across the system.

The Committee members were invited to ask questions. The following key points were noted:

4.5. Nigel Bowness (Healthwatch Lewisham) stressed the importance of a corporate ‘One Lewisham’ approach to co-production with an agreed definition of what co-production means in Lewisham context. Councillor Paul Bell shared a helpful definition of co-production with the Committee and agreed that a corporate approach was required. The definition stated- “Co-production refers to a way of working where service providers and users work together to reach a collective outcome. The approach is value-driven and built on the principle that those who are affected by a service are best placed to help design it”. Officers reported that Social Care Institute for Excellence (SCIE) had been commissioned to help better understand the co-production approach in Adult Social Care but learning from that would be applicable to wider Council areas as well.

4.6. It was noted that the equalities implications in section 6 were helpful as broad statements, but it was suggested that they should place a clearer emphasis on the barriers to hearing residents’ voices and the mitigations required to overcome those barriers.

4.7. Councillor Jacqueline Paschoud attended the meeting as the Committee’s guest and highlighted residents’ concerns about inconsistent reviews of  ...  view the full minutes text for item 4.

RESOLVED:

·         that the Committee’s dissatisfaction with the current draft of the Charter be noted and an informal follow-up meeting be arranged for the members of this Committee, relevant officers, Cabinet Member for Health and Adult Social Care and Cabinet Member for Communities, Refugees and Wellbeing to further discuss the development of this Charter.

Charles Malcolm-Smith (People and Provider Development Lead, SEL ICS) and Catherine Mbema (Director of Public Health) presented this item to the Committee. The following key points were noted:

5.1. Following the meeting of the Healthier Communities Select Committee on the 20^th of June 2023, officers had carried out more engagement on the Charter through the People’s Partnership Committee.

5.2. The draft Charter was a high-level document which would form an integral part of the Health and Wellbeing Strategy.

5.3. The existing Health and Wellbeing Strategy was due to expire this year. The aim was for the new strategy to look at the interface between health and care services and wider determinants of health.

5.4. Two strategy development workshops were being planned that would bring together all the stakeholders. At these workshops, discussions would be had about how the Healthcare and Wellbeing Charter could support the actions that would be articulated in the Health and Wellbeing Strategy.

The Committee members were invited to ask questions. The following key points were noted:

5.5. The Committee expressed its dissatisfaction with the Charter as they were expecting a more collaboratively developed, co-produced document. It was understood that the initial draft of the Charter was quite high-level, but there was a need to make it more relevant and meaningful for residents. Committee members had advocated for the Charter to centre on empowering residents to take proactive steps. They had previously provided feedback that the Charter should emphasise the importance of practical measures such as the role of pharmacies, residents’ ability to self-refer and addressing the 8am GP rush.

5.6. The Chair of the Committee requested that an informal meeting be arranged for the Committee members and officers to further consider the Charter’s content. This meeting would focus on discussing how the Charter could reflect what the residents could do themselves for their health and wellbeing, and what they could expect from the health and care partners. It was noted that Committee members were seeking a draft Charter that they could present to residents for further engagement.

5.7. It was acknowledged that keeping appointments posed a more significant challenge for individuals suffering the cumulative impact of disadvantage. It was suggested that the Charter should ideally encourage people, whenever feasible, to prioritise keeping their appointments.

5.8. Officers noted that this Charter served as a foundational framework for them to reference when developing system intentions. It was also recognised that there was no mechanism for enforcing this Charter on residents, but its guiding principles would be integrated into service specifications.

RESOLVED:

·         that the Committee’s dissatisfaction with the current draft of the Charter be noted and an informal follow-up meeting be arranged for the members of this Committee, relevant officers, Cabinet Member for Health and Adult Social Care and Cabinet Member for Communities, Refugees and Wellbeing to further discuss the development of this Charter.

RESOLVED:

·         that the addition of the Learning Disabilities Implementation Plan to the Committee’s work programme be noted.

·         that the agenda for the next Committee meeting on the 2nd of November 2023 be agreed.

6.1. It was discussed that the South London and Maudsley NHS Trust (SLaM) would be invited to the next Committee meeting to present the agenda item on improving mental health provision.

6.2. It was suggested that Lewisham Speaking Up be invited for the agenda item on the Learning Disabilities Implementation Plan.

RESOLVED:

·         that the addition of the Learning Disabilities Implementation Plan to the Committee’s work programme be noted.

·         that the agenda for the next Committee meeting on the 2nd of November 2023 be agreed.