Agenda and minutes

Apologies for absence were received from Councillor Nasim Ali. Councillor Joseph Ball substituted for Councillor Ali.

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 5 November 2024.

RESOLVED –

THAT the minutes of the meeting held on 5^th November 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 of the Cabinet Member for Health, Wellbeing and Adult Social Care.

Councillor Anna Wright, Cabinet Member for Health, Wellbeing and Adult Social Care noted that at the previous meeting there had been a question on whether the Disability Oversight Panel should have been reported on within the Cabinet Member Annual Report. It was clarified that the Panel was part of the Equalities brief and not within the portfolio of the Cabinet Member for Health, Wellbeing and Adult Social Care.

In response to questions about future services at the Peckwater Centre, the Cabinet Member for Health, Wellbeing and Adult Social Care confirmed that it would continue to accommodate a number of community-based services. A strategic, joined-up approach to the centre was planned, with health partners conducting well-managed engagement on what would be provided there.

Members noted that some of the GP practices that had been operated by AT Medics Ltd had been some of the worst performing on screening uptake but queried the impact of an 18-month extension period on improving service performance. The Cabinet Member assured the committee that assurance had been given that there would be continuity and lack of disruption for patients during that period. Contracts would continue to be monitored with additional scrutiny given.

It was explained that ‘SALT data’ referred to ‘short and long term’ waiting list data. Individuals waiting for a full assessment would have received an initial assessment, with regular contact and support. If someone’s situation changed whilst they were waiting, this would be picked up through other contacts. With focussed efforts around safeguarding, waits for initial assessment were as short as possible, although some people may therefore be waiting longer for reviews.

Clarification was given that the suicide prevention update referred to in paragraph 2.17 of the report had been given to the Safeguarding Adults Board meeting. The Chair agreed that an update be provided to the committee.

ACTION: Director of Health and Wellbeing

While the report was considered to be mostly clear and understandable, the verbiage of paragraph 5.4 was criticised. 

In response to concerns that a reduction in the number of Home Fire Safety visits was due to a new focus on providing more intensive support to the most vulnerable individuals, the Cabinet Member reported that the London Fire Brigade had considered the previous approach to be more like a tick-box exercise. By targeting resources, there would be better outcomes.

With regard to AT Medics Ltd, the Cabinet Member commented that their early performance had been good. The change of ownership at Operose Health Ltd took place without the contractually required consent of the Integrated Care Board, contributing to the decision to end the GP practice contracts.

In response to a question about the timescale in rolling out Integrated Neighbourhood Teams (INTs), the Cabinet Member noted that there had been a lot of learning from the experience of developing the East INT. The Executive Director Adults and Health commented on the challenges of funding and  ...  view the full minutes text for item 7.

Report of the Director of Health and Wellbeing

This report updates on progress for developing and delivering effective employment support for Camden residents, including the population health approach taken towards the Good Work and Employment priority of the Health and Wellbeing Strategy 2022-2030, progress made by Good Work Camden and the Disability Job Hub in supporting residents to access good work, and an outline of upcoming work and health programmes and plans to manage and effectively integrate these into the existing offer.

Consideration was given to the report of the Director of Health and Wellbeing, presented by Sue Hogarth (Deputy Director of Health and Wellbeing) and Michael Godfrey (Public Health Strategist – Healthy Lives).

In response to a question about permitted work limits before becoming ineligible for certain benefits, it was confirmed that this affected voluntary work remunerated through vouchers as well as paid work. A letter was being drafted to government highlighting how volunteering could help build skills, confidence and experience. Legal counsel had been sought on clarifying the technical distinction between volunteering and volunteer work.

Recognising that supporting 57 residents into work was a good result, it was queried what the proposed outcomes of the employment and health support offer were. The Public Health Strategist – Healthy Lives, replied that Good Work Camden captured a variety of outcomes including those covering soft skills, motivation and confidence. These progress markers were valuable given that some of the supported residents were still some distance from entering employment. The employment support offer was conscious of ensuring that people find good work that benefitted their health. The Individual Placement Support (IPS) service had performance outcomes that addressed sustainment, measuring the number of people who enter employment and stay in employment over a period of time.

Officers agreed to share information on the experience of the people working in the Disability Job Hub with the committee.

ACTION: Public Health Strategist – Healthy Lives

Concern was expressed about the short term nature of funding for projects, including the difficulty in achieving decent outcomes and what happens after the funding ends. Officers agreed to bring the evaluation for the Disability Job Hub, which would include performance outcomes, to the committee.

ACTION: Public Health Strategist – Healthy Lives

It was noted that Workwell was constrained by national timelines and its continuation would depend on its performance. Officers acknowledged the difficulties of short term funding and highlighted how projects were knit into the local infrastructure so that the work would continue once funding ended.

Members requested that greater granularity be provided in future reports through the inclusion of measures of success.

With regard to questions about referral pathways to Good Work Camden and other more detailed questions about employment outcomes, it was noted that Public Health were involved in coupling health and wellbeing outcomes to employment support rather than delivering the broader programmes. Specifically considering the inclusion of people who were experiencing health inequalities and therefore not in employment, this was being explored nationally and the service was awaiting policy announcements.

In response to a question about the potential circularity of residents with greater risk of taking time off sick due to ill health being found placements in sectors with high sickness rates, the Director of Health and Wellbeing assured the committee that support services were ensuring that placements were right for individuals. Support was being offered to large employers on what it mean to be a good employer.

Members noted that there were advantages for employers in employing  ...  view the full minutes text for item 8.

Report of the Director and Projects Lead of Healthwatch Camden

Healthwatch Camden (HWC) have produced a report which provides a snapshot of the health impact of a condition called endometriosis on women and young girls. Endometriosis is a chronic inflammatory disease related to a woman’s reproductive and menstrual health.

HWC coproduced their research and findings through a series of in-depth one-to-one interviews with 16 women, all of whom were either diagnosed or were currently obtaining a diagnosis of endometriosis from their health providers.

This report includes personal lived experiences of endometriosis and the services that support women’s health in Camden. The report is summarised with a set of recommendations aimed at existing services as well as outlining the urgent need for additional provisions which HWC would like the committee to consider for endorsement and action.

NB: For the purpose of this report, the term ‘Woman’ is used throughout to refer to anyone assigned female at birth (AFAB), i.e., people who menstruate of average menstruating age (12-49 years old), girls of pre-menstrual age, and women post menopause age.

Consideration was given to the report of the Director and Projects Lead of Healthwatch Camden, introduced by Stephen Heard (Director) and Nikita Limbu (Projects Lead).

Members thanked Healthwatch for their work addressing a condition that affected a lot of women. It was noted that health inequalities for women in Camden did need to be addressed and the establishment of a women’s health hub was essential. The Projects Lead clarified that the hub would not necessarily be a physical space.  

In response to questions about education beyond schools, the Projects Lead highlighted the intergenerational nature of the condition and proposed that education could take place in family hubs or other support groups for parents.

The Cabinet Member for Health, Wellbeing and Adult Social Care thanked Healthwatch for the report, commending the inclusion of women’s voices. It was noted that a formal response from the council would be provided.

In response to a question about the similarity with fibroids, it was confirmed that many of the women had both conditions. Fibroids affected Black women disproportionately.

In response to questions about progress in the recommended areas, the Projects Lead welcomed the inclusion of gynaecological conditions in the Women’s Health Strategy. Menstrual health was also included in the Relationships and Sexuality Education (RSE) and Personal, Social, Health and Economic (PSHE) curriculums but there was still a need to standardise provision across schools. The Director of Health and Wellbeing highlighted the work on a reproductive health strategy, working with partners including Healthwatch.

In response to a question about best practice globally, it was confirmed that the situation was challenging everywhere and there was no substantial treatment for the condition. 

RESOLVED –

THAT the contents of the report which can be found in Appendix A be noted and it be agreed to revisit women’s health at a future meeting.

ACTION: Director of Health and Wellbeing

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

This report focusses on the second quarter of the year (Q2) 2024/25 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:

·       A summary which highlights key responses from directorates and highlights particular cross-cutting themes; 

·       A detailed summary of individual service responses for Q2 2024/25 across each of our three Directorates.

Appendix A contains the data dashboard.

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

The Executive Director Adults and Health clarified that the residents held by the Adults Early Help pilot team would be supported by that team through the course of the pilot, including helping them navigate the wider local service landscape.

In response to questions about Camden having been identified as an “enhanced support” area by the Office of Health Improvement and Disparities (OHID), the Director of Health and Wellbeing explained each local area had been given a modelled target at the start of the three year drugs strategy. The council had been on target but, when the substance misuse treatment service had been recommissioned, a data cleansing exercise had identified and removed duplicate records. There had been challenges in finding enough people to undergo treatment, including through the courts and justice system. It was confirmed that the mobility of some more vulnerable residents, including the street homeless, was not taken into account in the development of modelled targets. Many vulnerable people needed multiple contacts before they engaged with substance misuse treatment.

The Executive Director Adults and Health commented that there had been no significant variations in social care data in Quarter 2. It was noted that there was still a low proportion of people receiving Direct Payments and work was underway to increase this through streamlining bureaucracy and ensuring the right support and services were available for purchase.

The Director of Health and Wellbeing highlighted substance misuse challenges and the continuing drive to increase childhood immunisation performance. Campaign materials, including social media, to support immunisation in the Somali community would be shared with the committee.

ACTION: Director of Health and Wellbeing

The committee were advised that in 2025 a chickenpox vaccine would be introduced.

It was clarified that 5% of those eligible for an NHS health check was invited to attend each quarter.

The Director of Health and Wellbeing confirmed that the decline in childhood immunisation had worsened since Covid-19. There had been much work on the reasons for this and a multi-pronged approach to tackling it. Ongoing community engagement was necessary to build trust.

RESOLVED –

THAT the report, including the most recent data and trends and the emerging challenges identified, be noted.

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 Adults and Health.

James Fox, Senior Policy and Projects Officer, informed the meeting that the Integrated Care Board had requested that the Community Pharmacies report be postponed to July. The final CQC Inspection report could be brought to the February meeting if it was published in time.

It was requested that the evaluation of the Cash Transfers in Pregnancy pilot be scheduled.

ACTION: Senior Policy and Projects Officer

It was agreed that the proposals for the Tavistock and Portman NHS Foundation Trust to merge be brought to committee. This could be a high level process paper in February or a more detailed paper at a later date.

ACTION: Senior Policy and Projects Officer

A further update on the Start Well consultation on proposals for maternity services was requested.

ACTION: Senior Policy and Projects Officer

The Chair proposed that a report on men’s health and their engagement with adult social care be scheduled. Officers suggested that this could be linked to the NHS Men’s Health Strategy that was being developed.

ACTION: Senior Policy and Projects Officer

RESOLVED –

(i)             THAT the work programme for 2024-25 (Appendix A) be noted and amendments proposed as summarised above; and

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

There was no urgent business.