Agenda and minutes

Apologies for absence were received from Councillors Nasim Ali and Gio Spinella.

Members will be asked to declare any Statutory Disclosable Pecuniary Interests, Compulsory Registerable Non-Pecuniary Interests and Voluntary Registerable Non-Pecuniary Interests in respect of items on this agenda.

Councillor Lorna Greenwood declared for transparency that she worked for a not-for-profit creative health CIC called Breathe Arts Health Research.

Broadcast of the meeting

The Chair to announce the following: ‘In addition to the rights by law that the public and press have to record this meeting, I would like to remind everyone that this meeting is being broadcast live by the Council to the Internet and can be viewed on our website for twelve months after the meeting. After that time, webcasts are archived and can be made available upon request.

If you have asked to address the meeting, you are deemed to be consenting to having your contributions recorded and broadcast, including video when switched on, and to the use of those sound recordings and images for webcasting and/or training purposes.’

Any other announcements

Broadcasting

The Chair announced that the meeting was being broadcast live by the Council to the Internet and could be viewed on the website for twelve months after the meeting. After that time, webcasts were archived and could be made available upon request. Those who were seated in the Council Chamber or participating remotely were deemed to be consenting to having their contributions recorded and broadcast and to the use of those sound recordings and images for webcasting and/or training purposes.

Requests to speak at the Committee on a matter within its terms of reference must be made in writing to the clerk named on the front of this agenda by 5pm two working days before the meeting.

There were no deputations.

There were no items of urgent business.

To approve and sign the minutes of the meeting held on 12 September 2023.

RESOLVED –

THAT the minutes of the meeting held on 12th September 2023 be approved and signed as a correct record.

Report of the Director of Strategic & Delegated Commissioning (North Central London Integrated Care Board (NCL ICB)); and Head of Primary Care Commissioning; Dentistry, Optometry and Pharmacy (DOP) (London DOP Commissioning Hub, hosted by North East London (NEL) ICB).

This report:

·       Summarises the status with regards to the delegation of Dental Services to the North Central London Integrated Care Board (NCL ICB) that occurred in April 2023.

·       Outlines the scope of what the ICB can and cannot make changes to within the area of Primary, Community and Secondary Dental Services.

·       Provides an overview of our Current Community and Acute services.

·       Summarises the principles and priorities for the NCL ICB around improving oral health including working with Local Authority partners on our shared agenda.

·       Overview of Dental Provision within Camden.

·       Current delivery position including existing challenges to access.

·       Details of additional in-year investment in Primary care dental services.

·       Focus on Oral Health Inequalities with associated National Epidemiology data.

·       ‘Pilot Schemes’.

The report also includes some key statistics and data drawn from the deep dive undertaken by the ICB as part of our due diligence work prior and post delegation of Dental Services.

Consideration was given to the report of the Director of Strategic & Delegated Commissioning North Central London Integrated Care Board (NCL ICB); and Head of Primary Care Commissioning; Dentistry, Optometry and Pharmacy (DOP), London DOP Commissioning Hub, hosted by North East London (NEL) ICB.

In response to concerns raised about affordability and residents self-excluding from dental care, Jeremy Wallman, Head of Primary Care Commissioning, explained that patient charges were set nationally. Those who were not exempt from the charges were liable to pay. It was acknowledged that cost of living pressures were impacting on use of routine dental care by some residents. While NHS services were relatively cheap compared to private services, the costs were still a lot for those who could not afford to pay. It was considered that the national contract was overdue a review for patient charges. The Chair highlighted the difficulties faced by people with disabilities and older people on low income. The Head of Primary Care Commissioning highlighted the community dental services at the Whittington Health NHS Trust that was targeted at vulnerable groups. Communications could be improved to so that there was more awareness of the service. Patients could be referred to the Whittington if they met certain eligibility criteria. There were greater challenges with access to routine, high street dentistry. It was noted that those on low incomes could complete a HC1 form to receive a certificate enabling them to pay a lower amount towards dental services. There had been national communication work on this but further work would be done locally to increase awareness.

With regard to children’s oral health, there was a defined paediatric pathway across London. They had a gatekeeping role for children who were referred into hospital, so that only the children with more complex needs were admitted to hospital with most children cared for within the community dental service. Officers agreed that deprivation was a major factor in dental care needs. However, while prevention was key, the current dental contract did not reward prevention. Caries were entirely preventable and advisory projects such as GULP in Enfield were effective. Other projects to prevent caries were also in train. It was noted that, while there was a correlation between deprivation and the prevalence of dental caries, this correlation was not as strong in London partly due to other demographic factors such as ethnicity. Public Health teams across North Central London were coordinating oral health promotion programmes. Public Health worked with families rather than focusing on children under a specific age. In response to a question about Camden-specific issues to be targeted by prevention programmes, the Director of Public Health confirmed that there were no issues specifically related to Camden. It was noted that the data from the pandemic had not yet been released and it would be interesting to analyse if there were any patterns emerging.

In response to questions about addressing dental health in the homeless population, it was confirmed that the community dental service liaised with homeless centres  ...  view the full minutes text for item 7.

Report of the Cabinet Member for Health, Wellbeing and Adult Social Care.

This is the annual report of the Cabinet Member for Health, Wellbeing, and Adult Social Care. This report presents the strategic landscape for health and adult social care in Camden. It details a range of transformative initiatives across services and partners which are helping to ensure the Council meets its residents’ needs and deliver services in line with the Council’s strategic aims and vision for the borough.

Consideration was given to the report of the Cabinet Member for Health, Wellbeing and Adult Social Care.

The Chair acknowledged the breadth of the annual report and queried progress on the new mental health service to be delivered from April 2024. Jess McGregor, Executive Director Adults and Health explained that the current arrangements for mental health day services were being reviewed and the options were being considered. A decision was due soon and it was suggested that a report be brought to committee.

ACTION: Senior Policy and Projects Officer

The Chair commended the Carers Action Plan and the use of co-production with unpaid carers. In response to questions about support for the mental health of carers, the Executive Director Adults and Health noted that carers were focused on the needs of the person they are caring for. During the pandemic, the Council brought in Mobilise, which provided virtual and online support to carers. The Carers Centre and Mobilise were key partners to support carers. The Carers Action Plan would enable the identification of further opportunities to provide support. Mobilise was being advertised through the usual channels such as Camden Care Choices and partners, and through writing to carers directly. Communications was a key part of the Action Plan.

In response to questions, it was explained that the new Health and Wellbeing Department was led by Kirsten Watters, Director of Public Health and provided a population health function for Camden.

Use of the term ‘health inequalities’ was queried as it covered many issues, affecting the ability to be focused and target specific issues. The Cabinet Member for Health, Wellbeing and Adult Social Care agreed that the term was very general but the more detailed data had been gathered and could be cross-referenced in analysis. The general themes were that those with lower incomes, poorer housing, from minority ethnic groups, and with lower levels of education had poorer health outcomes. The Director of Public Health explained that ‘health inequalities’ was used to simply describe the differences between groups. It was known that health was distributed unequally. The main drivers were smoking, housing and employment status. The Health and Wellbeing Strategy focused on those determinants. On trends, there was a weakening of the correlation between income and health from the mid-1990s. This flattened in the 2010s and then strengthened again since the pandemic.

In response to a question about the top priorities for CQC inspection preparations, the Cabinet Member for Health, Wellbeing and Adult Social Care stated that the Association of Directors of Adult Social Services (ADASS) Peer Review had been helpful in informing where to focus. The Executive Director Adults and Health explained that key priority area of focus was practice. The CQC inspection would be focused on delivery of the service’s Care Act responsibilities. They would have key lines of enquiry based on national outcome data. The process was new to many in Adult Social Care as it had been many years since the previous inspection framework was in place. The  ...  view the full minutes text for item 8.

Report of the Executive Director of Adults and Health.

This paper sets out the Committee’s work programme for 2023-24 and tracks actions from previous meetings.

Consideration was given to the report of the Executive Director of Adults and Health.

It was noted that the Interim Report of the Screening and Prevention Panel would be delayed from the December meeting and agreed that it would be submitted to the Committee by the February 2024 meeting.

ACTION: Senior Policy and Projects Officer

There was a further request for a progress update on the Bangladeshi Health and Wellbeing Scrutiny Panel report agreed in 2016. The Director of Public Health proposed that the data be reviewed before it was scheduled for the committee. The Chair suggested that an update be brought in February 2024, with further detail following an updated data analysis to follow.

ACTION: Senior Policy and Projects Officer

In response to a request for consideration of an advised approach to scrutinising changes in maternity and neonatal alongside Children, Schools and Families Scrutiny Committee, it was noted that discussions were taking place with ICB colleagues on timings.

There was a discussion about the heavy programme of work and backlog of items and updates to be scheduled. Officers agreed that there was a need for ongoing prioritisation and commented that items could be held over to the next municipal year.

RESOLVED –

(i)             THAT the work programme for 2023-24 (Appendix A) be noted, with amendments agreed as summarised above; and

(ii)            THAT the Committee’s Action Tracker (Appendix B) be noted.

There was no urgent business.