Agenda and minutes

To note the Committee’s terms of reference as set out below:

1. To scrutinise matters relating to health, public health and adult social care and to hear the views of local residents, with a view to improving health/care services, reducing health inequalities and improving the health/care of local residents.
   
   
2. To scrutinise the impact of the Council’s own services and of key partnerships (including the Health and Wellbeing Board) on the health of its population.
   
   
3. To respond to consultations by local health trusts and by the Department of Health.

4. To consider whether changes proposed by local health trusts amount to a substantial variation or development and, if so, to take appropriate action including appointing members to any joint committee where proposals cover more than one local authority’s area.

5. To undertake all statutory health scrutiny functions.

6. To receive and respond to referrals and reports from Healthwatch relating to health services in the area of Camden.

7. To receive and respond to referrals and reports from the Local Involvement Network relating to adult social care services in the area of Camden, in accordance with the Local Government and Public Involvement in Health Act, 2007 regulations and guidance.

RESOLVED –

THAT the Committee’s terms of reference be noted.

Apologies for absence were received from Councillors Nasim Ali, Rebecca Filer and 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 Item 10 on the agenda on plans for the St Pancras Hospital Kidney and Diabetes Centre. It was proposed and agreed to take the deputation at the start of Item 10.

There were no items of urgent business.

To approve and sign the minutes of the meeting held on 27 February 2024.

RESOLVED –

THAT the minutes of the meeting held on 27^th February 2024 be approved and signed as a correct record.

Report of the Director of Health and Wellbeing.

This report provides an update on the first year of delivery of Camden’s integrated drug and alcohol service and the three years of delivery of the designated drug and alcohol treatment service for people experiencing homelessness including areas of development across the services. A summary of additional grant investment is also included with a description of how this has been allocated to ensure better outcomes for those receiving support for their drug and alcohol needs.

The report also outlines how commissioned services and officers are working across different services and organisations to provide multi-disciplinary support to people experiencing homelessness, and the current challenges in providing this support.

Services have made progress in developing their delivery models but there is further work required in a number of areas such as attracting more people in to drug treatment and improving the focus on alcohol support.  These developments have been complicated by the emergence of adulterated drug supplies and the short term nature of recent grant funding.

Consideration was given to the report of the Director of Health and Wellbeing, which was introduced by Emma Stubbs, Head of Drugs Alcohol and Sexual Health.

In response to questions about support for people with mental health problems, officers noted the evidence of an overlap between mental health needs and drug and alcohol misuse needs. The drug and alcohol service was working closely with mental health service partners, driven by grant funding. This had enabled the commissioning of specific posts to work between the two services. There were challenges for people with substance misuse problems to access mental health treatments, for example there was debate over how far an active user could engage with therapy. The drug and alcohol misuse service was encouraging mental health teams to think more creatively about how to engage active users. Dedicated posts were being funded within Mental Health Core Teams to support those with co-occurring needs.

With regard to concerns about drug activity on estates, officers explained that the drug and alcohol service had close working relationships with partners in community safety. Community safety interventions were being funded through the Supplementary Substance Misuse Treatment and Recovery Grant. Lisa Luhman, Substance Misuse Commissioning Manager, stated that the strategic-level relationship with community safety colleagues had improved over the previous 12 to 14 months. The service had insight into the work planned by community safety due to community safety involvement in Substance Misuse Strategic meetings and had been able to feed into the Community Safety Action Plan. The relationship with the police was also developing, with posts funded to work within the custody suite to assess people arrested for drug offences. A comprehensive piece of work was also being undertaken with the local probation service to review the casework of anyone with a drug and alcohol need. Over 400 cases had not been previously known to the drug and alcohol misuse service. They would be assessed and directed to the appropriate care pathway. The service had been asked to present to colleagues across London on the work.

The Executive Director, Adults and Health confirmed that as the Integrated Neighbourhood Teams became established they would be linking into services such as the drug and alcohol misuse service.

A Member highlighted a link between ADHD and substance misuse where early diagnosis and support had not been provided. In response to questions about enabling earlier diagnosis, officers clarified that the drug and alcohol misuse service could not offer that but could signpost to the appropriate services. However, it was noted that there were long waiting lists. A piece of work had been undertaken with Change, Grow, Live (CGL) to map out the potential pathways for people with neurodiversity but this was at an early stage.

The Head of Drugs Alcohol and Sexual Health informed the meeting that scenario planning work with commissioned services, alongside lobbying activity, was underway due to the uncertainty of grant provision. Where grant funding ended, it would impact service users but the impact would be managed.  ...  view the full minutes text for item 8.

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.

In response to a query about coordinating responses to Members’ Enquiries where a number of cross-service issues were raised, it was confirmed that the East Integrated Neighbourhood Team was already looking at Members’ Enquiries to develop learning about working together. There were a number of different neighbourhood teams focusing on different concerns and connections were being built between them. The ambition was that they would work with Members’ Enquiries in a different way.

Officers assured Members that none of those waiting for assessment were due to a safeguarding referral or a Deprivation of Liberty safeguard assessment. The numbers of people waiting for an assessment were significantly lower than for a review. Up to date figures on the numbers waiting for entry and assessment could be shared with the Committee.

ACTION: Executive Director, Adults and Health

It was noted that since the previous committee meeting, the final report of the Cass Review of gender identity services for children and young people had been published. With a high number of the children who had been seen at the Tavistock Clinic Gender Identity Service (GIDS) having been looked after, it was queried whether safeguarding and the Cass recommendations were being thought about for care experienced young adults who had received care at GIDS. The Executive Director, Adults and Health commented that young adults without adult social care needs were supported by children’s social care. The Chair suggested that issues concerning young people transitioning to adults’ services could be brought to committee. It was agreed to bring information to the Committee about care experienced young adults and the Cass report.

ACTION: Executive Director, Adults and Health

Allegra Lynch, Camden Carers, was invited to talk about the Carers Action Plan that was being launched in Camden Carers 30^th anniversary year. Camden Carers had been engaged in the work to coproduce the Carers Action Plan over 18 months, with carers from different groups involved. The Cabinet Member would be writing to all councillors to invite them to attend the art exhibition showcasing carers’ art work.

RESOLVED –

THAT the report be noted.

Report of the Chief Strategy and Population Health Officer North Central London Integrated Care Board, and Programme Director of St Pancras Transformation Programme.

This reports updates Members on the progress of the St Pancras Hospital Transformation Programme. It specifically updates Members on the plans to relocate the Mary Rankin Dialysis Unit from its current site in North Wing St Pancras Hospital.

The report sets out how the St Pancras Hospital Transformation Programme (SPHTP) will undertake a revised options appraisal process to find a new location for the Mary Rankin Diaysis Unit.

This report also addresses a number of the challenges made by this Committee and other stakeholders, including members of the Caversham Patient and Public Group (PPG), and updates Members on the range of user and carer engagement and how this will be further strenghthened.

Consideration was given to the deputation by Roderick Allison, Caversham Practice Patients' Participation Group (CPPPG), which was introduced by Mick Farrant.

In response to a question about whether the Peckwater Centre was still in the mix of options, the deputee noted that the process was being restarted. The Chair suggested that following concerns being raised at Scrutiny Committee and elsewhere, the relocation plans were now in a better place.

Consideration was then given to the report of the Chief Strategy and Population Health Officer North Central London Integrated Care Board, and Programme Director of St Pancras Transformation Programme.

In response to comments by the Chair about the questions raised by the CPPPG and the Scrutiny Committee, Marian Ridley, who had recently been appointed as Programme Director of St Pancras Transformation Programme, agreed that the questions had been good and pertinent. The process was being restarted from scratch, with knock on consequences assessed. A workshop had been held with the wider stakeholder group to review criteria that had been identified as important. A new site search would be commissioned based on the new agreed criteria. With regard to questions about the Peckwater Centre, it was not impossible that it would be included on the longlist. 

Joanne Murfitt, Director of Service Configuration St Pancras Programme, discussed the exercise with the wider stakeholder group that undertook some detailed work, giving people the opportunity to contribute in shaping decision-making criteria. There were some new suggestions that had been raised such as decoupling the dialysis and diabetes services, this required further consideration. Population growth was discussed and was being factored in. The Transformation Programme was becoming increasingly aware of work in London on the increase in people with diabetes who go on to develop chronic renal disease and require dialysis. The need for additional dialysis stations would impact on the space required. At the wider stakeholder group meeting, the criteria were discussed and agreed as far as possible. The weighting of the criteria was also considered. There were some differences in views and there was further work to do. There was discussion over whether some of the criteria were hurdles that needed to be satisfied before a site option could be further considered. The possible sites identified would be reviewed at a meeting on 20 September 2024, to which those who had attended the first stakeholder workshop, held on 8^th July would be invited. The intention would be to identify a couple of options to do further work on. There was a commitment for transparency and engagement in the process.

The Chair expressed pleasure that the process to relocate the Mary Rankin Dialysis Unit (MRDU) was moving on in a better way but requested that all the questions raised by the deputation and the committee from previous meetings and the present meeting be answered.

Officers provided the following responses:

·       Work would be undertaken on the necessary colocation or otherwise of diabetes and dialysis services. Some investigation would also be carried out into what  ...  view the full minutes text for item 10.

Report of the Chair of Screening and Prevention Panel.

This report sets out the final recommendations of the Health and Adult Social Care Scrutiny Committee’s Screening and Prevention Panel.

Consideration was given to the report of the Chair of Screening and Prevention Panel. In Councillor Anna Burrage’s (Panel Chair) presentation, it was noted that a recently published research paper on a pilot study assessing the impact of having community health and wellbeing workers integrated into GP practices and the local authority had found significant improvements to immunisation and screening services uptake. The paper would be shared with officers for information. The Char went on to thank all those who had participated and supported the Panel, and particularly commended the work of the Panel members Councillors Judy Dixey and Sylvia McNamara.

The Chair of the Committee welcomed the report and requested that an officer report be submitted to a future meeting responding to all recommendations and providing timescales for actions.

ACTION: Senior Policy and Projects Officer

Piers Simey, Assistant Director for Public Health, welcomed the focus on the issue of screening and prevention, including the observation that accountability had drifted from the borough.

The Cabinet Member for Health, Wellbeing and Adult Social Care welcomed and supported the report and recommendations. It was acknowledged that the Panel had been in constant dialogue with officers to sense check recommendations and a formal response could be submitted to a future meeting. It was noted that a number of the recommendations were to external partners such as to health bodies and Healthwatch. Responses from those organisation would also need to be requested and a report coordinated.

In response to a suggestion that the work of the Panel be shared more widely, the Committee Chair proposed that prior to this a response be received on what actions could be taken forward.

The Panel Chair clarified that a number of people had talked about cultural and social barriers to screening uptake, where people did not see the relevance to their lives or their lives were too complicated, such as for carers who felt they had very little time available. There was a need to increase the priority of screening in people’s lives. The issue of low uptake of cervical screening by younger women would become less of a problem over time due to programmes such as the HPV vaccine, however, the figures do raise concern about whether younger women were taking responsibility for their own health and wellbeing in other areas.  

Allegra Lynch, Camden Carers, welcomed the idea of a Women’s Health Hub. There were a lot of issues with young women, particularly those of colour, and health, with conditions not being recognised. Camden Carers had been involved in the Panel’s work and it was well-documented that carers neglected their own health.

RESOLVED –

THAT the recommendations of the Screening and Prevention Panel be agreed.

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

This report focusses on the year 2023-24 using a broad range of measures from each directorate and division across the organisation. In this report, Camden Directors have been asked to provide a narrative covering key areas of challenge, opportunity, and learning.

This report is divided into two main sections:

• An overview of key themes: a summary which highlights key responses from directorates and highlights particular cross-cutting themes  
• A more detailed account of individual service responses across each of our three Directorates. 

Appendix A contains the data dashboard with key measures and data for 2023-24 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 a request for clarification on the data insight work on young carers, officers agreed to arrange for a written response.

ACTION: Executive Director, Adults and Health

With regard to performance in supporting residents who experience social isolation, feel less safe and experience loneliness, the measures rely on using process performance as proxy outcome indicators and self-reported outcomes through annual surveys. The measures that Camden Council performs less well in are satisfaction with quality of life, linked to social contact and feelings of safety. There was work through the Health and Wellbeing Strategy and through the neighbourhoods work and estates mission to address social isolation. Social isolation was a key theme in safeguarding referrals.

Officers advised that the Provider Oversight Board was part of the overarching approach to provider assurance. There was a log of any provider issues, which might result in enhanced monitoring through more regular meetings, audits, and an increase in opportunities to speak with residents, carers and loved ones. An improvement plan might be developed with the provider with specific actions outlined. A number of providers were subject to improvement plans over the previous year.

Officers confirmed that Adult Social Care was determined to increase contact with carers in the borough, to enable them to draw on the support available. It was an ambition of the Carers’ Action Plan. The Plan was live and where communications could be improved this would be included. The Chair noted that a lot of carers did not realise that they were carers and that there was a need to advertise what a carer service was so that people recognised that it applied to them. Allegra Lynch, Camden Carers, commented that according to the Census there was 14,603 carers in Camden but there were 4,400 registered with Camden Carers. There was a national problem that people did not identify themselves as carers. People often come into the caring role gradually as support needs increase and were more focused on the person they were caring for. Young carers were also not getting the service they should but the service had changed in the past year and there was hope that this would see improvement. As a service provider, Camden Carers was monitored quarterly, meeting with commissioners and being questioned on results.

Questions were asked about the structure for five North Central London boroughs working together to model future demand for adult social care services, noting different expectations and costs across the councils. The Director of ASC Strategy and Commissioning explained that cost and the market was explored across the five boroughs. There was also collaborative work on areas such as staffing, the Accelerated Fund on carers, market management and strategic work. Allegra Lynch, Camden Carers, explained that it would be working with the five carers centres across the boroughs on a project around hospital discharge funded by the Accelerated  ...  view the full minutes text for item 12.

Report of the Executive Director of Adults and Health.

This paper sets out the Committee’s work programme for 2024-25 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 findings of the CQC inspection of Adult Social Care and a response to the Screening and Prevention Scrutiny Panel recommendations had been requested.

RESOLVED –

(i)             THAT the work programme for 2024/25 be noted; and

(ii)            THAT the Action Tracker be noted.

There were no items of urgent business.