Agenda and minutes

The Chair welcomed all. He introduced two advisors recently appointed to the committee following a recruitment campaign, Ms Emma Omijie and Ms Nila Patel who would bring the perspective of people who draw on health and social care services and their carers. 

Resolved that the minutes of the meeting held on 26^th October 2023 were approved and that the Actions Log was noted.

The Principal Scrutiny officer reported that she had been contacted by Chase Farm Hospital and informed that NHS England (NHSE) funding had been provided to remove the RAAC concrete from the hospital building, and that it would be removed by the end of the year.

Apologies received from Cllr Lucy Wakeley.

Ms Omijie declared an interest under Item 10.

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To follow

The minutes of the meeting held on 11 September 2023 were noted. Further to a question from a Member about representation from the different Boroughs on the JHOSC, the Chair agreed to circulate details following the meeting.

Action: Chair/Scrutiny Officer

The Chair introduced:

·         Mr Nicholas Ince, Deputy Director of Vaccination Transformation, North Central London Integrated Care Board (NCL ICB)

·         Dr Janet Djomba, Deputy Director, Public Health, LBB

·         Ms Khalida Aziz, Immunisation Commissioning Manager (North Central London), NHS England.

The Chair noted that measles is a topical issue, with many London Boroughs having some of the lowest Measles, Mumps and Rubella (MMR) vaccine uptake in the country. 

Dr Djomba spoke to the report which covers some of the roles and responsibilities for all immunisations across the lifespan of residents. She noted that the large migrant population and extensive areas of deprivation in London were some of the reasons for the lower take-up of vaccination compared to other parts of the country. Barnet’s figures were slightly better than NCL and London overall,  but vaccination take-up could be higher. 

Dr Djomba reported that there had been an increase in the number of measles cases in London over the past few weeks, but none so far in Barnet. A dedicated team is working on uptake of vaccines overall in Barnet but there are challenges due to the diverse population. In particular during the pandemic some groups had been identified has having reduced uptake. For example there is lower uptake and higher vaccine hesitance amongst eastern European communities and Somali groups. The Eastern European population in Barnet has been very hesitant towards childhood and Covid vaccinations.

Some useful information had been obtained in relation to these groups through the Community Vaccine Champions’ work which is presented in the report, for example that these groups would like to speak to health professionals with whom they can identify. Work with community leaders had helped to build trust and improve relationships with different groups, but behaviour change would take some time as it could be difficult to dispel myths around vaccination.

In addition overall it had been found that the population is suffering from ‘vaccine fatigue’ due to repeated messaging around vaccination, since the pandemic, so it was important to work with communities to continue to encourage vaccination.

Dr Djomba noted that increasing childhood immunisation is an ongoing task, with improvements seen following the pandemic, during which uptake had dropped. Access had also more difficult during the pandemic. The current focus is immunisation in school-age children, which so far is not improving. In particular the HPV vaccine uptake in boys is low across both Barnet and NCL. Adding to the problem was access to detailed, up-to-date data, which is needed to inform targeted interventions. Covid, ‘flu and childhood immunisation data were easy to access locally but school-age children’s data was more difficult, and the council is working with NHS England (NHSE) colleagues on how to tackle this.

Mr Ince reported that total uptake of seasonal booster vaccinations is included on page 9 of the report, showing a much higher uptake in the older population.

A Member enquired what actions are being taken in relation to measles and what improvements are expected in a year’s time. Dr Djomba responded  ...  view the full minutes text for item 9.

Ms Fiona Bateman, Chair, Barnet Safeguarding Adults Board (BSAB) spoke to the 2022-23 annual report. She noted that she would return in a few months’ time with the report for 2023-24. 

Ms Bateman noted that the increase in the number of safeguarding issues being reported partly reflects changes in reporting. There had been a push to engage productively with Black, Asian and Minority Ethnic (BAME) communities and VCFS colleagues to reach marginalised groups.

Ms Bateman reported that the rise in cases of abuse and neglect at home from 45-57% was a challenge and required a multi-agency response. The decrease in concerns from the care sectors signified that processes are robust and teams are working well with providers to minimise the risks of harm.

Ms Bateman reported that the Home Office had cited Barnet’s work recently in its ‘Safe at Home’ review, as a case study on financial abuse. She continued that Barnet’s ‘experts by experience’ had been invited to respond to government consultations, providing a solid voice on human rights reforms in the context of safeguarding adults.

A Member asked how challenging it is to uncover cases in residents’ own homes. Ms Bateman noted that the council has no additional powers to enter private homes so works in partnership with the police and health partners to gather information. She added that colleagues are being ‘professionally curious’ and reporting concerns, and  Barnet is one of the few places with an adult MASH. In addition MASH is engaging directly with the VCFS Safeguarding Leads who meet regularly with the adult MASH.

Ms Omijie declared an interest by virtue of the fact that she is employed by BOOST as a disability employment coordinator, that she has made safeguarding reports and works with vulnerable adults, and has a care package herself. Ms Omijie asked whether data sharing is being reviewed, as she finds that sometimes there is no way of sharing information between organisations on a resident being reported by social services as a potential safeguarding concern. Mr Mass, Operations Director, Adult Social Care, stated that there are agreements between partners on the Barnet Adults Safeguarding Board (BASB). If there are issues around a partner not having access to necessary information a meeting can be held to discuss the options for getting the right data sharing agreements in place.

The Executive Director, Communities, Adults and Health added that the BSAB has been working on how it feeds back to referrers. There are limits due to confidentiality but efforts are made to ensure referrers know that appropriate action is being taken. It is the individual’s decision whether information is shared proactively, so consent is needed and other agencies would not routinely be informed. Ms Bateman noted that there should be parity across all practitioners working with an individual, including The Barnet Group, and this can be discussed at the quarterly meetings of the safeguarding leads.

A Member requested clarification on the criteria for the different safeguarding concerns. Ms Bateman noted that of the 1395 concerns  ...  view the full minutes text for item 10.

The Executive Director, Communities, Adults and Health noted that report covers progress on implementation of the Dementia Strategy and Carers’ Strategy, and an update on new Care Quality Commission Assurance Process for councils, and the published 2022-23 data from National Adult Social Care Outcomes Framework.

Cllr Paul Edwards, Cabinet Member for Adult Social Care spoke to the report. He thanked officers for their work in providing adult social care services. He noted that it needs to be recognised that there is a funding crisis in social care and officers are working in difficult circumstances to maintain the council’s statutory responsibilities.

Cllr Edwards continued that the council has been working to refresh the council’s resident-facing policies and plans for adult social care over the past year, in co-production with 300 residents who draw on care, and their carers. ‘Our Plan for Adult Social Care’ is a statement of the council’s policy and ambition, embracing its core focus on improving the lives of thousands of Barnet residents every year, and has been co-produced with residents who have shared what works well and what needs to be improved. The Plan will be presented to Cabinet for approval in March – Cllr Edwards welcomed any suggestions from the committee.

Cllr Edwards added that he wanted to recognise the role of the fantastic voluntary sector in Barnet to support its vulnerable residents.

A Member noted that there is a reduction in admissions to care homes and that there are short-term services to help people stay in their own homes. He asked what impact the funding crisis has on what social care can achieve. Cllr Edwards responded that demand is outstretching supply and funding, so this is a challenge, but every local authority is facing this. There is a £1.5billion funding gap for the 2023-24 financial year which would increase annually unless additional resources are provided.

A Member asked about the £500million announced by the government today for all local authorities and the likely allocations of this. The Executive Director, Communities, Adults and Health responded that the Department for Levelling Up, Housing and Communities has not yet announced details but allocations will be made based on the Relative Needs Formula, via Social Care Grants. Officers would share this information as soon as they have been informed of the amount to be received for Barnet.

A Member asked what could be learnt from the people who use adult social care services, about improvements needed. The Executive Director, Communities, Adults and Health reported that Natalie Soffer, Engagement and Co-production Lead, had spoken to a lot of people who are being supported by adult social care staff and the document provides a snapshot of some of the feedback, particularly regarding consistent points being raised. This includes communication, being able to make contact by telephone, accessibility of communications including for residents with autism and sensory impairment, the need for interpreters, and the need to ensure contacts are timely and clear explanations are provided. Equality of access has been raised  ...  view the full minutes text for item 11.

The Chair presented a report with updates from the Central London Community Healthcare NHS Trust and North London Hospice at the mid-year point on the Quality Accounts 2021-22. The Chair would write to the Royal Free London NHS Foundation Trust to request their mid-year comments again.

Action: Scrutiny Officer

RESOLVED that the Committee noted the report.

The Head of Governance commented that if the recommendations of the Task and Finish Group are for Cabinet to accept or reject, they will be presented to the next meeting of Cabinet. They may also be for the ICB or a Trust, in which case it would be helpful if Cabinet endorses them first, but the recommendations would be sent to the relevant partners for their response.

Cllr Stock, Chair of the Task and Finish Group spoke to the report. She noted that a lot of work had gone into the project, and wanted to put on record Tracy Scollin’s excellent support in helping move the project forward. The Group has looked into the issues deeply and has one more meeting prior to bringing the report to the committee and to Cabinet. Cllr Stock added that she hoped that change could be achieved as this issue is distressing for many residents. It is unfortunate that there is a shortage of GPs and one of the recommendations would be to inform residents about how Primary Care has set out to manage the health needs of the population in the face of this.

A Member asked whether the true extent of the challenge of reducing digital exclusion is understood. The type of residents likely to be digitally excluded, such as some elderly residents, was recognised by the Group but was the scale of the challenge understood, given the growing elderly population? The Member noted that many of the means of communication likely to be used to inform residents of the services were digital so how could the council reach out to this group? Cllr Stock responded that the Group has to work within a defined scope, but had visited GP Practices within different PCNs which varied in quality according to the GP Patient Survey and other data. The report would recommend that best practice is shared across the Borough, and one of the Practices visited offered in-person lessons to residents to help them to communicate better with their Practice. Ms Omijie noted that Age UK and Barnet council offer support in this area.

Ms Patel noted that a lot of older people cannot use or do not know how to use a smartphone or do not have home broadband, so although classes may help some, GPs should not be reliant on this.

RESOLVED that the committee noted the report.

The Head of Governance reported that the purpose of presenting the Cabinet Forward Plan is to enable Members to have sight of issues about health and social care if they wish to, before decisions are made at Cabinet. They could inform the Chair of any issues they wish to receive further information on.

A Member noted that ‘Age Friendly Barnet’ would be launched on 6^th March at the Arts Depot.

RESOLVED that the Cabinet Forward Plan was noted.

·         Adults & Health OSC and Health and Wellbeing Board

The Chair introduced the Committee’s Forward Plan.

RESOLVED that the Forward Plan was noted.

Changes due to new legislation – to follow

The Chair noted that a change had been drafted for approval at Budget Council, on the Committee’s Terms of Reference. From 31 January 2024, new rules will come into force in respect of the aspect of health scrutiny that relates to reconfigurations of local health services. From this date scrutiny committees will no longer be able to formally refer matters relating to these reconfigurations to the Secretary of State, though the Secretary of State will be able to intervene and discuss matters with local partners.

RESOLVEd that the committee noted the report.

None.