Agenda and minutes

Apologies for lateness were received from Councillors Lorna Greenwood and Rebecca Filer.

Apologies for absence were received from Councillor Anna Wright, Cabinet Member for Health, Wellbeing and Adult Social Care.

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.

There were no deputation requests.

There were no urgent items.

To approve and sign the minutes of the meeting held on 9 July 2024.

RESOLVED –

THAT the minutes of the meeting held on 9^th July 2024 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 by the Cabinet Member for Health, Wellbeing and Adult Social Care.

In response to questions about the slowdown in the rate of reduction for numbers waiting on Adult Social Care Services, it was confirmed that the numbers waiting continued to fall. There had been significant resources engaged in reducing waiting times which would continue during September. A risk-based approach was being taken, with a particular focus on safeguarding and deprivation of liberty assessments.

Officers were thanked for quickly responding to a safeguarding issue raised by a councillor.

Officers informed the committee that they had engaged with care providers during the recent racist and Islamophobic activity to ensure care workers felt safe while in the community. A trauma-based approach was taken.

With regard to safeguarding issues, the Executive Director Adults and Health confirmed that hoarding was a big challenge. It was included in the Care Act within neglect or acts of omission. A report could be brought to committee on work to address hoarding and cuckooing.

ACTION: Senior Policy and Projects Officer

It was clarified that anti-social behaviour did not feature as a safeguarding category. However there was a huge amount of work being carried out within the council addressing anti-social behaviour. A cross-Cabinet group of Members had been working on this issue, exploring how to pursue a preventative and population-based approach. Adult Social Care was working closely with Community Safety in response to residents with safeguarding concerns who were either perpetrators or victims of anti-social behaviour.

The committee was informed that the Executive Director Adults and Health was now sitting on the St Pancras Transformation Programme Board to forge closer connections between the project and the council. Updates would be provided to the committee and the Joint Health Overview and Scrutiny Committee later in the year. The committee was assured that the Programme Board had understood the concerns that information on the options being considered should be communicated before a final decision.

In response to a question, the Director of Health and Wellbeing informed the committee that respiratory syncytial virus (RSV) was a significant contributor to GP appointments and hospital admissions. The RSV vaccine was being offered to pregnant women and 75 to 79 year olds. Public Health was supporting the vaccine drive with a communications campaign and the vaccine bus. The flu and covid vaccine could be received at the same appointment as the RSV vaccine but it was not a combined vaccine.

It was requested that an update be provided on the food mission.

ACTION: Senior Policy and Projects Officer

RESOLVED –

THAT the report be noted.

Report of the Group Chief Executive Royal Free London NHS Foundation Trust and Chief Executive North Middlesex University Hospital NHS Trust.

This paper provides an update on progress with the merger of the Royal Free London NHS Foundation Trust and North Middlesex University Hospital NHS Trust and development of the full business case for the Health and Adult Social Care Scrutiny Committee’s information.

Consideration was given to the report of the Group Chief Executive Royal Free London NHS Foundation Trust and Chief Executive North Middlesex University Hospital NHS Trust.

In response to a question about the potential offer of a shuttle bus for patients who see their care moved to another facility, Peter Landstrom (Group Chief Executive Royal Free London NHS Foundation Trust (RFL)) confirmed that a shuttle bus had been offered to patients when Chase Farm Hospital merged with the Royal Free London group. However, there would be very little movement for staff and patients due to the proposed merger with North Middlesex University Hospital NHS Trust (North Mid). Services were being designed so that they would be offered as close to home as possible. For example, a specialist team may be based in one facility but diagnostics could be offered at a closer facility. A shuttle bus was being explored but improved transport links within north London was also being advocated.

Carers and disabled people had not been explicitly targeted for engagement so far although they would be targeted during the design of services in the future. Carers had been engaged in conversations on cancer pathways.

In response to concerns about mergers being a potential distraction from improving services, the Group Chief Executive RFL agreed it was important to keep a focus on patient care improvement and high quality services. There were areas where learning was done poorly in the NHS and a challenging CQC report on maternity services at North Mid. RFL had similar challenges a few years previously but a recent CQC report recognised its learning journey and improvement with maternity services rated as good. Sharing best practice needed to be facilitated across services and units. It was a risk that the merger could become a distraction but the governance arrangements would enable strong leadership at a local level to retain a focus on delivery of core services. The Group Chief Executive had a role in supporting learning and the best use of resources across the group. In selecting the areas for early integration, services in need of improvement had not been included.

It was confirmed that there were no plans to integrate the Tavistock and Portman NHS Foundation Trust into the RFL.

It was highlighted that collaboration and integration could help with bringing down organisational boundaries for individuals accessing different services.

The risks of the merger include the RFL being spread too thinly and missing local population nuances. It was the Group Chief Executive’s responsibility to prevent this. The group clinical strategy had been developed over the past eight months with all the health units. It reflected the group and local priorities. It was important that local identity be strengthened rather than weakened by the proposed merger.

In response to questions about interaction with the Start Well proposals and potential closure of the RFL maternity unit, the Group Chief Executive noted that RFL and its staff had engaged with the Start Well proposals. RFL had excellent maternity services  ...  view the full minutes text for item 8.

Report of the Director of Adult Social Care Strategy and Commissioning.

The Carers Action Plan was launched, alongside a themed debate, at the 22nd of July’s full Council meeting.

This report provides an update on the launch; activities that have taken place since July’s launch, and the activities that are planned before the end of the year. This includes planning for the Borough Partnership Carers Board.

This report also provides an update on the recommissioning of carer support services, emphasising how the proposed activities align with the Carers Action Plan.

Consideration was given to the report of the Director of Adult Social Care Strategy and Commissioning.

The committee commended the effective development of the co-produced Carers Action Plan and the debate at full Council that had enabled the voices of carers to be heard. Allegra Lynch, Camden Carers, reiterated Members’ comments, highlighting the contribution of carers over many months and the plans for a Borough Partnership Carers Board.

In response to questions about increasing the uptake of support services, Allegra Lynch suggested it was too early to see an increase. Low engagement with carer support services was a national issue. Many people found it hard to identify themselves as carers. While it was known there were about 15,000 carers in Camden, Camden Carers only reached 4,500. About 300 to 350 new carers were registered each year. The young carers’ service had been recently awarded to the Children’s Society and it was hoped that a pathway could be developed for young carers to be referred on to the support service for adult carers. There was a lot of good work across the country to support young carers in schools. It was recognised that young carers risked missing out on education, socialising and career opportunities.

Jessica Lawson, Service Manager Prevention and Wellbeing, clarified that the posts to support the work of the Carers Action Plan were for two-year terms as the project was in implementation phase. This would allow exploration about what longer-term roles would look like further through the implementation period. In response to concerns about sustainability of funding, Chris Lehmann, Director of Adult Social Care Strategy and Commissioning, confirmed that the Better Care Fund was one of the ways that support for carers would continue to be funded. It provided an ongoing opportunity to fund this support, together with health partners. The Service Manager Prevention and Wellbeing informed the meeting that the outcome framework was being co-produced, identifying the measures within national and local frameworks that mean most to carers.

It was noted that the Commissioning Strategy for the Carers Support Service was being considered by Cabinet on 9 October 2024. The Director of Adult Social Care Strategy and Commissioning explained that the specification would reflect the Carers Action Plan. However, the organisations who bid would propose through the tender process how they would fulfil that specification.

The Chair suggested that councillors were well-placed to identify carers and help them to seek support. Officers could support councillors to do this.

The Chair wished Camden Carers a happy 30^th birthday.

RESOLVED –

(i)             THAT the matters set out in the report be noted; and

(ii)            THAT the receipt of periodic updates from the Borough Partnership Carers Board be agreed.

Report of the Executive Director 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 Adults and Health.

There was a discussion on potentially including a section on housing allocations criteria and support to residents from Adult Social Care and Housing to navigate the systems in the report on neighbourhood programmes in January 2025. The Executive Director Adults and Health noted that Housing Scrutiny Committee received reports on allocations and could invite Health and Adult Social Care Scrutiny Committee to attend and explore those issues further.

ACTION: Senior Policy and Projects Officer

The Executive Director Adults and Health explained that the report on how Camden’s health and care system supported disabled residents had been requested by the committee to hear about experiences of service users, with the intention that this be the beginning of a longer conversation.

It was noted that during the meeting reports had been requested on cross-Cabinet work to address anti-social behaviour, hoarding, and an update on the merger of Royal Free London NHS Foundation Trust and North Middlesex University Hospital NHS Trust.

There were proposals that reports be scheduled on other mergers or partnerships, the process for supporting residents experiencing mental health problems, and an update on the food mission.

ACTION: Senior Policy and Projects Officer

RESOLVED –

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

(ii)            THAT the Committee’s Actions Tracker be noted.

There was no urgent business.