Agenda item

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 sector’s role as an equal health partner within the ICS. During a recent meeting, the ICP Board deliberated on a draft for the South East London Voluntary, Community and Social Enterprise (VCSE) Charter. Councillor Paul Bell (Cabinet Member for Health and Adult Social Care) informed the Committee that he would share this Charter with them.

3.12. Nigel Bowness (Healthwatch Lewisham) enquired about the impact that the quality of housing had on programmes like Home First. Officers acknowledged that the availability of decent housing was a significant determinant of health outcomes, but there were limited actions that LHCP alone could take to improve housing outcomes. Nevertheless, strong partnerships existed, and health and care colleagues collaborated with housing counterparts to enhance outcomes to the best of their abilities.

3.13. Due to the cumulative delays caused by the Covid-19 pandemic and various isolation measures, there was a noticeable increase in hospital admissions, affecting not just older people but a broader demographic. The entire healthcare system was experiencing heightened pressure due to the pent-up demand stemming from the epidemic’s impact. The GP appointment data indicated that appointments were now back up to pre-pandemic levels. However, it was clear that the system was still under pressure with increased demand and full recovery would take time.

3.14. A member of the Committee requested to see the risk registers for the various programme boards.

3.15. Handyman services by housing department were no longer available for residents being discharged from the hospitals. However, there were alternative arrangements to ensure that residents were returning to a safe home/ environment. There were voluntary sector organisations that assisted with making changes to people’s homes to make them safe. The Council also established a safe micro-environment for residents which involved things like moving the furniture to make the property safe.

3.16. It was acknowledged that there was a wider workforce challenge. With reduced budgets in the public sector, more services were being expected with less resources. Diminishing resources meant shortages in critical roles like nursing staff, GPs and therapists. The real challenge was in recruiting and fairly compensating these essential professionals.

3.17. The recent launch of the ‘Maximising Wellbeing at Home’ contract underscored the importance of a comprehensive staff skills development programme. The intention was for the training opportunities to function as a ‘skill escalator’ to support staff in advancing to more qualified positions, fostering career progression.

3.18. The Council had a small enablement service, but the care service was all externally commissioned. Currently, 80% of purchased care was from outside the Council. The recently launched contract of maximising wellbeing at home, offered more competitive compensation to care workers compared to neighbouring boroughs. While acknowledging the importance of offering flexible working hours to staff members, there was also a clear intent to stay away from zero-hour contracts, thus providing staff with guaranteed hours that could be extended as desired.

3.19. In 2019, the Council signed up to UNISON’s ethical care charter which included paying travel time to carers. The new maximising wellbeing at work contract that went live on the 1^st of September 2023 contractually required providers to pay travel time to carers. The contract also required providers to pay occupational sick pay. The Council received monthly reports through the commissioners to ensure effective implementation of these payment policies.

3.20. There was a parking permit scheme in place that NHS workers and care workers could use. Care providers were also giving out train and bus passes to their staff.

3.21. It was discussed that referring to areas by geographic location instead of the formal terminology of ‘Neighbourhood 1’, ‘Neighbourhood 2’ and so on, would be easier to understand for councillors as well as residents.

3.22. The Committee Chair stated that she was delighted to hear about the development of a business case for the Twilight scheme.

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.