Agenda and minutes

Apologies for absence were received from Councillor Lorna Greenwood.

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.

There were no declarations of interest.

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.

The Chair announced that a deputation would be heard from Roderick Allison, Caversham Practice Patients Participation Group (PPPG), regarding draft proposals to permanently close the Peckwater Centre to convert it into a secondary care dialysis unit, relocating it from St Pancras Hospital.

Consideration was given to the deputation.

There was agreement with the deputation’s concern for any impact of the draft proposals on integrated health and social care services. In response to questions about the communications with the PPPG, it was clarified that there had been no communications from the St Pancras Hospital redevelopment and that the PPPG had learnt of the plan through it regular meetings with the Caversham Group Practice. Dr Kevin Clarkson, Managing Partner of the Caversham Group Practice explained that the Practice had become aware of the proposals two years previously when people in hard hats had been noticed in the Listening Space Garden. The Practice had strived to be involved in discussions on the various options at that point and made the point that closing the Peckwater Centre would be a bad idea. While no decisions had been made, they were aware that the proposal was the only option now being considered.

Councillor Anna Wright, Cabinet Member for Health, Wellbeing and Adult Social Care, thanked the deputation and supported the concerns expressed. The Council had been unaware of the proposals. While a location was required for the dialysis service, this had to be within the context of being forward-thinking and strategic in approach. The Council would be willing to work with the NHS to ensure that any proposals did not undermine the goal of integration at the community level.

Simon Wheatley, Director of Integration at the Integrated Care Board (ICB), thanked the deputation and expressed an understanding with the depth of feeling displayed. Given the short notice, it was suggested that a report be brought to a future meeting and colleagues more closely involved in the St Pancras redevelopment be invited to attend. There was recognition in the Programme Team of the need for wider consultation and no decision had been taken with regard to the Peckwater Centre. The Peckwater Centre option was being assessed for viability. There was no proposal to change the space available for the Caversham Group Practice and no change proposed at present for the dialysis unit at St Pancras Hospital.

The Chair thanked the deputation and requested that an urgent report be scheduled for January 2024, with relevant officers invited, to enable a more in-depth discussion.

ACTION: Senior Policy and Projects Officer

There were no items of urgent business.

To approve and sign the minutes of the meeting held on 13 November 2023.

RESOLVED –

THAT the minutes of the meeting held on 13^th November 2023 be approved and signed as a correct record.

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

This report provides the Committee with an update relating to the portfolio of the Cabinet Member for Health, Wellbeing and Adult Social Care.

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

The Chair requested that a report on the Healthy Weight Action Plan be scheduled for a future meeting.

ACTION: Senior Policy and Projects Officer

Details of Voluntary and Community Sector (VCS) health days and events were requested for circulation to enable committee members to provide support.

ACTION: Senior Policy and Projects Officer

Members expressed interest in the Shared Lives scheme and requested more information including how many people were involved and the cost-benefit analysis. Chris Lehmann, Head of ASC Strategy and Commissioning, explained that the scheme supported 13 residents. Financial information around cost benefit, alongside impact for residents and Shared Lives carers could be brought to a future meeting, with the manager of the scheme.

ACTION: Head of ASC Strategy and Commissioning

The cost implications were being examined with finance colleagues, with the Start Well Maternity Services Review was on the work plan for January 2024. The public consultation was open and would end in March 2024. All councillors were encouraged to respond to the consultation.

In response to concerns about the percentage of adults in Camden with excess weight, the Cabinet Member commented on the obesogenic environment that removes people’s ability to make the right choices. Rather than focus on individual choice, there was a need for a strategic approach, involving all partners using all levers available and campaigning on levers that were not available such as in the food production industry. A rights-based campaign would argue for the right not to live in an environment that pressurises them to make bad choices. It was recognised that families were facing many pressures and that it did not help to just tell people to eat more healthily. Greater sensitivity was needed.

The Head of ASC Strategy and Commissioning explained that the Camden Society was an arm of a national organisation that had taken the decision for financial reasons to close services. Learning disability services and commissioners had been working with providers to ensure continuity of support for residents. Work was also ongoing to understand the wider financial pressures faced by providers.

RESOLVED –

THAT the report be noted.

Report of the Director of Integration (Camden borough), North Central London Integrated Care Board (NCL ICB).

This report sets out:

• An overview of NCL NHS’ preparations around winter, as captured within a new dynamic document – the NCL winter playbook
• How this is guiding our collective work around population health improvement, improving vaccination rates, maximising timely and safe patient discharge from hospital (including using virtual wards), and delivering resilient primary care
• How we are currently delivering as a system, as demonstrated through recent data
• The partnership oversight and assurance arrangements in place to continue to scrutinise system demand, performance, and to inform alternative approaches in line with the winter playbook.

It provides detail around specific initiatives that we are working towards as health and care partners, and the appendix offers a specific focus on the preparations that general practices (working as primary care networks) have undertaken to ensure access over the coming months.

Consideration was given to the report of the Director of Integration (Camden borough), North Central London Integrated Care Board (NCL ICB).

Concern was expressed at the use of acronyms and lack of explanation of the functions of the various partners listed in the slides at Appendix A to the report. A number of the acronyms and groups were explained. It was requested that future reports from the ICB include a glossary of terms where necessary.

ACTION: Senior Policy and Projects Officer

The Director of Public Health explained that there was a mixed picture emerging on respiratory viral pressures since the report was written. Levels were low but there were now indicators of increased infection rates through 111 calls and positive testing. Influenza levels were also low but there were indications that this was rising through testing and from GP surveillance.  Respiratory illness in children was at a high level but this was now declining. There was an increase in calls to 111 for norovirus which could put pressure on wards. With regard to vaccines, 51% of eligible residents receiving the Covid booster vaccine was high compared with other London boroughs but low for England. The latest data could be circulated to the Committee.

ACTION: Director of Public Health

While there were a number of reasons for Covid-19 vaccine resistance, it was suggested that there was now a degree of vaccine fatigue, with not many people being aware of others suffering from Covid-19. Targeted communications was being undertaken and the use of Camden Vaccine Bus for outreach. An NCL vaccine webinar had been provided to staff. It was unclear at present whether offering both the Covid-19 vaccine and flu vaccine together had increased or decreased uptake. The seasonal vaccine programme would end soon and lessons would be explored on how the programme had been delivered.

In response to questions about whether the Winter Resilience plans were designed to meet worst case scenarios, Kate Lawrence, Head of Urgent and Emergency Care, NCL ICB, confirmed that at the previous Flow Operational Group meeting the Chair had raised the question of what the plans would be if the pressures were to increase further. The system was starting to consider this but the mitigations currently in place to provide additional capacity should be sufficient to meet anticipated winter pressures. The Director of Integration explained that collaboration on winter pressures had increased in the past five years. While all hospitals in north central London apart from UCLH were operating at the highest level of escalation, UCLH was providing a backstop. There was also increased collaboration to manage demand across primary care. The Director of Public Health highlighted that communicable diseases were now at baseline levels, with the surges seen following the Covid-19 lockdowns not re-emerging.

A Member commented on the industrial action among healthcare staff as a result of the Government undervaluing NHS staff.

In response to a question about the response of patients and family members to the use of virtual wards, the  ...  view the full minutes text for item 8.

Report of the Executive Director, Adults and Health.

The Camden Safeguarding Adults Partnership Board (SAPB) annual report is a statutory requirement under Section 43(5) and Schedule 2 of the Care Act 2014. The 2022/23 annual report sets out the work undertaken over that year and the achievements of its partner agencies. The full report is attached at Appendix A.

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

A Member commented that a separate one-to-one briefing on the work of the Safeguarding Adults Partnership Board (SAPB) had been requested from the Independent Chair, SAPB, which the Independent Chair had agreed to. In response to a question about assuring safeguarding support remained locally following the structural changes in the NHS, the Independent Chair informed the meeting that the Camden North Central London (NCL) Integrated Care Board (ICB) had a good approach to the SAPB, being the only ICB in London with a Director of Safeguarding covering children and adults.

In response to questions about the data presented, including who it relates to and how it compares to Camden-wide data, the Independent Chair acknowledged that there was a lot of data in the report and that it was not easy to see how it came together. The next year’s report would include higher level data, making it easier to see what the SAPB was responsible for. Data was scrutinised on a quarterly basis and did relate to the adult population in Camden and those in receipt of Adult Social Care. The data for the 18 to 64 age group was being broken down, particularly looking at 18 to 25 year olds, which linked to the partnership with Children’s Services. The Safeguarding Children’s Partnership Board (SCPB) had oversight of the Cass review of gender identity services for children and young people and the issues at the Tavistock. A meeting would be coming up in January where the SCPB could raise any issues that were relevant for the 18+ age group.

With regard to the timing of the Annual Report, there was a statutory requirement for its production. Data collection was finalised in July and August, followed by validation by NHS Digital. The role of the Scrutiny Committee was to scrutinise what the SAPB was doing as a partnership to safeguard and promote the welfare of adults with care and support needs. The earliest the report could potentially be brought to Scrutiny Committee would be October.

The Independent Chair considered that learning from Safeguarding Adults Reviews (SAR) was the most important thing for the SAPB to be focused on during the year. This followed on from the public consultation on the new five-year safeguarding strategy. One of the priorities from the consultation was concerning community safety and this also came out of learning from a SAR on cuckooing. Cuckooing guidance was then developed and published. The three top priorities were domestic violence, neglect and cuckooing. The first annual Safeguarding Adults Conference had taken place on the subject of financial abuse.

There was a request to have an informal training session to understand the work of the SAPB. The Chair offered to explore options with officers.

ACTION: Senior Policy and Projects Officer

In response to questions about the dementia diagnosis rate, it was clarified that the figure for Camden was good, being high. It meant that Camden was better  ...  view the full minutes text for item 9.

Report of the Executive Directors of Adults and Health, Children and Learning, Supporting Communities and Corporate Services.

This report focusses on Quarter 2 2023-24 using a broad range of measures from each directorate and division across the organisation. This quarter, directors have been asked to provide a narrative covering key areas of challenge, opportunity, and learning (both current and future needs).

This report is divided into two main sections:

• A summary which highlights key responses from directorates and highlights particular cross-cutting themes;  
• A detailed summary of individual service responses Quarter 2 2023-24 across each of our three Directorates. 

Appendix A contains the data dashboard with key measures and latest data from services across the Council.

Consideration was given to the report of the Executive Directors of Adults and Health, Children and Learning, Supporting Communities and Corporate Services.

In response to questions about the action plan to address waiting lists in the Support and Safeguarding teams, including what the targets were, Avril Mayhew, Head of ASC Operation and Deputy DASS, explained that the action plan was multi-faceted. It included a process to engage external suppliers providing Occupational Therapists and Social Workers to undertake work on behalf of the service. Internal staff were being invited to work additional hours, including weekends, where willing. A report on the waiting list action plan could be scheduled for a future meeting.

ACTION: Senior Policy and Projects Officer

The Head of ASC Operation and Deputy DASS explained that there were different waiting times for different areas of work and the existing waiting lists were being continously reprioritised and triaged. The lists were under regular review, with the data being cleansed, so that it could be ensured the data was robust.

It was noted that Occupational Therapists were very difficult to recruit but work was ongoing with external providers to undertake occupational therapy work to help reduce waiting lists.

Concern was expressed about the risk identified for Health and Wellbeing of the substance misuse service transfer complexity impacting service development. It was queried whether this could have a knock on effect given substance misuse prevalence in the borough. The Director of Public Health responded that there was not an increase prevalence of substance misuse but increased complexity of substance misuse and the cohort involved in substance misuse. The risk concerned data transfer but the council had a good substance misuse service offer, with a recent CQC inspection finding that the service was good. It was noted that councillors could visit the service which operated as a one stop offer. The outreach offer had been increased due to concerns about an increased availability of synthetic opioids on the streets. The committee was assured that the transfer of services had been operationally successful. It was agreed that a report could be scheduled exploring issues of substance misuse, alcohol misuse and sexual activity.

ACTION: Senior Policy and Projects Officer

In response to questions about the NHS Health Checks, it was clarified that Camden was one of the highest performing boroughs. A target was set for a proportion of the eligible population to receive a Check each quarter. There was an aim to evolve the programme by including a digital offer while encouraging those at highest risk to visit the GP or pharmacist. Further investigation of the equity of the Health Checks offer was underway, to explore who was taking up the Health Checks, who was being referred and what the outcomes were.

The committee discussed the disproportionate tendency for men not to visit the GP and the lack of research in this area.

RESOLVED –

THAT the report, including the most recent data and trends and the emerging challenges identified, that relate to  ...  view the full minutes text for item 10.

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 Adults and Health.

James Fox, Senior Policy and Projects Officer, noted that a number of additional reports had been requested during the course of the meeting.

Information on the Food Mission was requested, including locations of groups and organisations. The Cabinet Member for Health, Wellbeing and Adult Social Care offered to share a recent paper on the Food Mission with the committee.

ACTION: Cabinet Member for Health, Wellbeing and Adult Social Care

The Director of Public Health confirmed that there was a commitment to continue funding the Community Champions programme. An evaluation was going to the Health and Wellbeing Board to consider its future format, including whether the Champions should be topic-based or general, lessons from what had worked well, and how the service could support the programme.

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.