Venue: Committee Room (B6) - Lambeth Town Hall, Brixton, London, SW2 1RW. View directions
Contact: Gary O'Key, Tel: 020 7926 2183, Email: email@example.com
To agree the minutes of the meeting of 6 June 2019 as an accurate record of the meeting.
RESOLVED: That the minutes of the meeting held on 6 June 2019 are approved as a correct record of proceedings.
Declaration of Pecuniary Interests
Under Standing Order 4.4, where any councillor has a Disclosable Pecuniary Interest (as defined in the Members’ Code of Conduct (para. 4)) in any matter to be considered at a meeting of the Council, a committee, sub-committee or joint committee, they must withdraw from the meeting room during the whole of the consideration of that matter and must not participate in any vote on that matter unless a dispensation has been obtained from the Monitoring Officer.
There were no declarations of pecuniary interest.
Contact for information: Sam Bailey, Deputy Democratic Services Manager; 020 7926 6157, SBailey3@lambeth.gov.uk
Dr Tony O’Sullivan, of Lambeth Keep our NHS Public, made a representation to the Committee on this item, which focussed on the following key points:
· Provision of pathology services was a vital element of NHS care.
· The proposed contracts were so large that no single NHS provider was able to bid to provide the service.
· The procurement was financially focussed, and did not take into account the best option in relation to the service provided and the terms and conditions of staff employed in the service.
· The decision to procure the service in this way had been imposed without a proper, thorough public consultation.
· There were alleged conflicts of interest in the procurement process, including King’s College NHS Trust and Guy’s and St Thomas NHS Trust being the awarding body, whilst also submitting their own bid to run the service.
· Lambeth Keep Our NHS Public requested that the procurement process be paused so that a full public consultation could be held. They also requested that this item be scrutinised by the Joint Health Overview and Scrutiny Committee.
The Chair thanked Dr O’Sullivan for his contribution to the meeting on this item, and committed to raise the issue through a question at Council and through consideration of this item at the Our Healthier South East London Joint Health Overview and Scrutiny Committee.
RESOLVED: That the concerns raised about the procurement of Pathology Services in South East London be referred to the Our Healthier South East London Joint Health Overview and Scrutiny Committee.
Contact for information: Tom Barrett, Lambeth Together Transition Programme Lead; 020 7926 2235, TPBarrett@lambeth.gov.uk
Councillor Edward Davie, Cabinet Member for Health and Adult Social Care, updated the Committee on the progress of Lambeth Together. Councillor Davie explained that:
· Lambeth Together was the overall programme that aimed to integrate Health and Social Care in the Borough of Lambeth.
· Lambeth Together’s programme focused on a framework of outcomes and principles agreed by all partners.
· Lambeth Together’s work had led Health and Social Care to delegate their budgets into a single pooled budget, which enabled a holistic view of care to be considered when funding health interventions.
· The management teams of Health and Social Care in the Borough had been integrated, including the appointment of a joint Strategic Director for Integrated Health and Adult Social Care which was a post that was shared between the Clinical Commissioning Group (CCG) and the Council.
· This approach had allowed the organisations involved to move away from a medicalised model of care, and instead look at the social circumstances that a person was living in and sought to address these too. An example given of this approach was social prescribing, where interventions were being reviewed by service users in order to gather data on their effectiveness.
· Additionally, through taking this approach, the barriers to access to services were being reduced as it was recognised that early intervention reduced need for acute services. For example, an open access hub was due to open in Waterloo, which would provide advice and assistance without service users having an established clinical need.
· Lambeth Together was moving towards a neighbourhood based approach to care.
Andrew Eyres, Chief Officer NHS Lambeth CCG, and Fiona Connolly, Acting Strategic Director for Adults and Health, gave evidence to the Committee on the governance arrangements for Lambeth Together:
· Lambeth Together’s leadership team was drawn from the main organisations involved. This included a diverse range of organisations including NHS trusts, Lambeth CCG, the voluntary sector and the Council.
· Lambeth Together received feedback from organisations such as Black Thrive and Healthwatch to ensure that the interventions and care arrangements were effective.
The Chair invited Natalie Creary, Programme Director for Black Thrive, to provide the Committee with information on Black Thrive’s involvement in Lambeth Together:
· Black Thrive was an organisation which aimed to improve the mental health and wellbeing of black communities across Lambeth. Black Thrive worked as a partnership between service users, communities and service providers across the mental health, social care and wellbeing services in Lambeth.
· An important element of Black Thrive’s work was setting up the Shared Measurement System, which tracked the Public Health outcomes of the work of the partners to improve the outcomes of Lambeth’s black communities.
· One of the trends that had been identified by the Shared Measurement System was that there were barriers to black people accessing preventative services, leading to a disproportionate amount of black people being detained under the Mental Health Act. Therefore some further work had been identified to be required around removing these barriers and encouraging help seeking at an early ... view the full minutes text for item 4.
Contact for information: Richard Outram, Acting Director, Adult Social Care; 0207 926 7750, firstname.lastname@example.org
Councillor Edward Davie, Cabinet Member for Health and Adult Social Care, presented the Lambeth Adult Social Care Assurance Report to the Committee. Councillor Davie confirmed that performance was positive overall. Most of the indicators at ‘red’ status related to Placement Reviews. Performance had improved in this area, but was still not at the level required. There was a backlog of work in the team that carried out the checks, however short term staffing resources had been allocated to deal with the backlog.
In response to questions from the Committee, Councillor Davie confirmed that:
· Feedback had been positive from the community regarding the services provided for adults with learning difficulties.
· Voluntary adult carers were offered an assessment as well as respite care. These assessments were carried out at the same time as the assessment made on the person being cared for. It was important voluntary carers were supported as without them the care system would collapse. Around £1 million per year was spent to support voluntary carers.
· The workload for Deprivation of Liberty Safeguards was increasing. There were upcoming changes to legislation that were due to be implemented, and this would have a further impact on the workload in this area.
· Occupational Therapy Assessments had a backlog of cases. However further capacity to clear this backlog was being funded through the Disabled Facilities Grant (DFG). Rules had changed around DFGs which allowed the council to fund the Occupational Therapy Assessment through the DFG.
· A particular issue with DFG adaptations was where an adaptation had been identified, but the service user was living in private rented sector accommodation. Some landlords were reluctant to give permission for the adaptation to go ahead, leading to the adaptations not being made.
Richard Outram, Director of Adult Social Care, and Liz Clegg, Interim Director of Integrated Commissioning, provided the Committee with additional information on neighbourhood working in the care sector. The Committee noted that:
· Nearly 70% of homecare providers lived and worked within the Borough.
· Lambeth did not commission homecare time for less than 15 minutes.
· Commissioning of care was moving to a neighbourhood based model. This meant most carers lived close to those they provided care for, and would rely on walking or public transport to travel between appointments. This meant less time was wasted through travel.
The Committee raised the issue of safeguarding, and how to ensure safe care from homecare providers. Liz Clegg clarified that a comprehensive risk register had been created to monitor all the providers used by Lambeth. The Council would cease to order care packages from providers that were of concern. However care providers were inspected by the Care Quality Commission on a regular basis, in addition to checks by the Council before commissioning care packages. It was noted that the local market for home care providers was strong in Lambeth.
Fiona Connolly, Acting Strategic Director for Adults and Health, confirmed that the Council provided some care services in house, such as services for learning disabilities and older people ... view the full minutes text for item 5.
Contact for information: Ruth Hutt, Director of Public Health; RHutt@lambeth.gov.uk
Ruth Hutt, Director of Public Health, presented the Lambeth Public Health Report to the Committee. Ruth explained that neighbourhood based care was the focus of the report, and the key question that needed to be the focus of this approach was ‘what are the wider determinants of health in our neighbourhoods’. The report contained information on health inequalities within the borough, as well as the social determinants of health that drove these inequalities.
In response to questions from the Committee, Ruth Hutt confirmed that:
· An example of work with social landlords and other housing providers was the staying healthy partnership board – which included the Council, CCG and housing providers.
· Social Housing providers were eager to get involved in public health initiatives, but often did not know how. The private rented sector was harder to engage with.
· The Public Health team had worked with philanthropic and charitable organisations to carry out specific pieces of work. For example a childhood obesity project was funded by the Guys and St Thomas’ Trust and the Battersea Power Foundation.
Contact for Information: Gary O’Key, Senior Democratic Services Officer; 020 7926 2183, GOKey@lambeth.gov.uk
The Committee considered its Work Programme for 2019-20 and made the following comments:
· It may be beneficial to combine an update on Homes for Lambeth with the meeting focussing on Contract Monitoring.
· The Committee should hold a dedicated meeting focussing on Climate Change, as well as other environmental concerns such as air quality and sustainable transport.
· The Youth Violence Strategy could be considered by the Children’s Services Scrutiny Sub-Committee, which would allow the Crime and Disorder meeting to be held in March.
In response to a question from the Committee, Sam Bailey, Deputy Democratic Services Manager, confirmed that the response to recommendations from the June meeting were blank as the responses had not been finalised. This was due to short time period between the June and July meetings. Once the response to recommendations had been finalised they would be circulated to the Committee, and included on the next work programme item at the meeting scheduled for October.
The Chair confirmed that the comments members had made would be taken into account and an updated Work Programme would be circulated after the meeting.
RESOLVED: That the 2019-20 Overview and Scrutiny Committee Work Programme be noted.