Agenda item

Roz Hardie (Director, Lewisham Disability Coalition) spoke and the following key points were noted: 

·         The integration of health and social care is an important issue for members of the Lewisham Disability Coalition. Members want to help shape things by sharing their experience of where services do and don’t join up, but are currently unsure about where they can take their ideas.

·         The Lewisham Disability Coalition welcomed the engagement events organised by the Scrutiny Manager and Healthwatch. They said it’s essential to hear from the people using services.

·         The voluntary sector is involved in a lot of innovation and collaboration on the front line of support provision, but it should also be more involved in strategy and planning. The Lewisham Disability Coalition is very keen to be involved, and are pleased to hear that the integration programme has recently been talking to voluntary sector organisations.

·         Many of those who approach to the Lewisham Disability Coalition for support are experiencing complex health problems. Given this, the Lewisham Disability Coalition are particularly keen to explore opportunities to work closer with health professionals.

·         The impact of welfare reform, and the crisis around benefits sanctions, is also a huge issue having a detrimental impact on people living with disabilities in the borough.

·         A significant proportion of people who come to the Lewisham Disability Coalition for help have a complex series of needs – often welfare-related financial or housing problems – and usually need some form of advocacy or casework support.

·         The Lewisham Disability Coalition do not have a position on universal basic income, but think that it could be, in principle, a good thing.

·         The Lewisham Disability Coalition work closely with partners on issues such as safeguarding and keeping warm, and are also looking to work more closely with social care.

Nigel Bowness (Chair for Work Plan Committee, Healthwatch) spoke and the following key points were noted:

·         As part of the Committee’s review, the Scrutiny Manager worked in partnership with Healthwatch to organise a series of engagement events to hear the views of specific groups of people who use health and social care services.

·         Three events were held and the experiences of more than 70 people were gathered. This included people with physical disabilities, learning disabilities and mental health needs.

·         Overall, the evidence from the people engaged with indicates that the challenges faced by the wider health and care system are impacting on vulnerable people.

·         People did not tend to distinguish between good and bad providers, they just wanted to be supported by compassionate, polite, respectful, and culturally competent professionals.

·         The majority of people valued the services they received, but they were concerned that they were being reduced. People were particularly concerned about a reduction in choice and control over what they could do.

·         There was some particular concern about customer service-related issues – for example, how long it took to get an assessment and how easy it was to communicate with social services.

·         People particularly valued those care workers who gave that little bit extra – for example, helping someone read a letter or deal with changes to their benefits. For many people, this made a whole world of difference. Conversely, care workers who were unkind, patronising or disrespectful, whether intentional or not, had a significant negative impact on the lives of those who need help.

·         People also said that having advocates, key workers, and care coordinators that were resourceful and competent made the whole world of difference to accessing services. People found the health and social care landscape complex and difficult to navigate and said that having someone to help them through the system, not just signpost them, is very important.

·         The Lewisham Disability Coalition, Community Connections, Lewisham Homes, Stepping stones, Sydenham Gardens, and the Samaritans were organisations specifically mentioned as being helpful. 

·         Many people said that they were unhappy with the professionalism of the health professionals they had seen. Some said that they felt like they were being unfairly judged and that the professionals who were meant to be assessing their condition were taking irrelevant matters into account when deciding whether or not they are eligible for support.

·         People were also either unaware of the complaints process, or didn’t understand it and feel confident enough to use it.

·         Many people had problems with the enablement process. People said that the support didn’t last long enough and that after it ended they were just told to rely on friends and family.

Cathy Ashley (Lewisham Pensioners’ Forum) spoke and the following key points were noted:

·         Cathy said that it is essential to look at what’s happening on the ground to the people that are “left behind” or “just about managing”.  Cathy stressed that a lot of pensioners are very poor.

·         The Lewisham Pensioners’ Forum carried out a local survey to gather views of those who use community-based health and social care services. They only received 29 responses, which they found worrying as it could mean that a lot of people are either now being excluded from services or isolated at home and unable to make their voice heard. Cathy stressed that it is crucial that all people are contacted and listened to.

·         Cathy also commented that spending less than 1% of GDP on adult social care nationally is insufficient for a decent and moral society.

The Committee made a number of comments. The following key points were noted:

·         The Committee noted the great value in the evidence of real life situations, and feedback from service users, provided by the engagement events.

·         The committee noted that it is crucial that the council engages with all communities affected, and potentially affected, by the changes the health and care services.

Resolved: the Committee noted the witnesses’ evidence and agreed to make a referral to the Health and Wellbeing Board based on the questions submitted in written evidence by the Lewisham Pensioners’ Forum.