Venue: Lewisham/Greenwich Rooms, 4th Floor, 1 Lower Marsh, London SE1 7NT
Contact: Nazyer Choudhury, Email: firstname.lastname@example.org, Tel: 0207 926 0028
Note: This meeting is not open to the public
Apologies and Introductions
Apologies were received from Pete Hesketh.
Declarations of Conflict of Interest
None were declared.
RESOLVED: That the minutes of the meeting held on 31 October 2018 be approved as an accurate record of the proceedings. ?
A considerable amount of work was going on in Lambeth Together and the Local Care Networks (LCNs).
The current LCN business case had been agreed through the CCG Governing Body. This would be submitted to the Informal Cabinet within the week and the Cabinet meeting in December 2018. Work was being done on the overall implementation plan and the charity business case. The meeting would report interim information on this, including some proposals around the future overall plan and charity support.
Other work included planning for procurement recommendations for the CCG. National NHS guidance soon to be released would examine the integrated care system and this may have an effect on recommendations.
Notes from the governance discussion at the Health and Wellbeing Board away day would be circulated. Points of discussion would be gathered for the CCG Governing Body and would be addressed in some of the informal meetings in the next few months. The Communities of Practice papers would be circulated through the normal routes.
The Chair stated that he and Councillor Davie had been involved in discussions which focused on how the Council would appropriately contribute to the voluntary sector. The CCG and the health elements were cited on some of the voluntary work but more could be done in this area.
Conversations at the Health and Wellbeing away day included the role of this meeting, a need for work on citizen involvement (such as the democratic deficit issues and the citizen’s role in governance), implications and discussions needed in each organisation on the Lambeth Together governance and how that may happen, the consideration required on conflict of interest issues. These issues needed to be considered extensively - potentially over a long term period.
Chief Financial Officer,Ms Christine Caton introduced the report and explained that in relation to the announcement of the budget, the additional funds allocated for social care was £2.577m for both Adults and Children’s services. This was in addition to Lambeth’s already allocated share of £1.5m.
The Committee heard that:
· Feedback/learning lessons from acute admissions used be put into practice packs but practices struggled to understand what they could practically do to avoid admissions. To help resolve this, focus was placed on monitoring referrals to admissions avoidance services such as Home and Enhanced Rapid Response but the CCG was looking at what else could be done to constructively support practices. The emergency admissions data did not show a volume increase but a cost increase.
· The outpatient follow up overspend was due to the Trust’s under delivery of their plans.
· About 70-80% people a month who were admitted were known to services. Many of the services were geared towards men (such as supported housing) and more focus was required on services towards women.
· The total length of bed-stay which was longer than expected. Many long-stayers had been discharged in one month which was why the report showed a high level of bed days
· The average length of stay should be about 30 days.
· There were a number of reasons why patients were staying in hospital for a lengthy period of time. Some of it was partly due to the breakdown of community offers. Some patients, for whatever reason, would not be able to return to their home environment and sometimes there were issues in relation to supported housing. Work was being done so that a patient’s individual circumstances would be monitored to ensure that something positive was happening everyday.
· A composite action plan would be put in place partly to assist the progress of those who had excessive lengths stay.
· The community offer was not at the level that it needed to be. Medicine was not necessarily a solution for all issues and effort needed to be made to address wider issues.
· Crisis care proposals needed to be outlined. A number of proposed interventions would have a significant impact as in cases of crisis, people headed to accident and emergency services.
· Complexities sometimes increased when dealing with patients who did not have mental capacity.
· There was around 15-16 people at a time who were exceeding the average length of stay.
· Healthwatch had a duty to inform and signpost service users. Part of this involved providing feedback voluntarily given to them by service users. Feedback, either positive or negative, on the Living Well Network was likely to increase as the voluntary sector across Lambeth was more aware of the Hub and was using it to refer potential service users who may be suffering from some kind of distress to the Living Well Hub. The data appeared to show people were attending the Hub when they perhaps should be going elsewhere. Monitoring of phone calls during the year appeared to show negative ... view the full minutes text for item 4.
Director of Integrated Commissioning (Adults), Ms Moira McGrath presented the report.
The Chair stated that the Council’s advice services appeared to have seen an increase in issues relating to universal credit where a decrease in universal credit appeared to invite significant problems.
The Committee commented that:
· Universal credit issues had an indirect impact on children with mental health issues. Part of the growth in the Living Well Network was related to issues concerning universal credit.
· 336 Brixton Road had seen service users come into the office and refuse to leave because they had had nowhere else to go.
· Southwark Council had completed a study undertaken by an independent organisation regarding the rollout amongst their own tenants. This should be examined and Policy Officers could be asked to submit further information where appropriate.
· Councilor Davie would assist in putting together a short commission of examining poverty and public health in Lambeth.
· A new financial resilience strategy was due and universal credit could be addressed in the strategy.
· The Safe As Houses report had been written by the Smith Institute.
That the report be noted.