Agenda and draft minutes

RESOLVED that the minutes of the meeting held on 24^th January 2024 be agreed as a correct record and that the Action Log be noted.

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The Legal Officer reminded Committee Members of the importance of declaring non-pecuniary interests.

Councillor Barnes and Alison Cornelius declared an  under item 10 (Commissioning Approach for Care Homes in Barnet) as Board Members of Eleanor Palmer Trust.

Councillor Stock declared an interest under item 10 (Commissioning Approach for Care Homes in Barnet) as her husband’s relative was in a Barnet care home.

Councillor Rose declared an interest under item 10 (Commissioning Approach for Care Homes in Barnet) as relative was in the Whittington Hospital.

Councillor Patel declared an interest under item 9 (Quarter 3 Adult Social Care Performance Report) as Board member on Age Friendly steering group.

Emma Omijie, Adviser, declared an interest under Item 9 (Quarter 3 Adult Social Care Performance Report) as a volunteer Age UK boost Disability Co-ordinator.

Councillor Sargent declared an interest under item 9 (Quarter 3 Adult Social Care Performance Report) as volunteer.

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The Chair reported that he attended the last meeting of the North Central London (NCL) Joint Health Overview & Scrutiny Committee, where the Start Well Consultation was discussed.

The minutes of the North Central London Joint Health Overview & Scrutiny Committee held on 30^th November 2023 were noted.

The Start Well Programme Director, Anna Stewart, gave an overview of the programme, reporting that this is part of a long-term change programme in the NHS, involving the reconfiguration of services and reducing the number of maternity units across North Central London from five to four. She advised the Committee that the changes are required due to a declining birth rate and an increasing level of complexity and need for specialist care in maternity services.

Two other options are under consideration which would merge the maternity units at either the Royal Free or the Whittington Hospitals. The current preferred option is to move services from the Royal Free to the Whittington.

The Programme Director asked the Committee for feedback on implications of the proposals highlighting that the aim is to improve quality of services.  It was emphasised that this is not a cost saving exercise and current staff would be redeployed. There would be investment in infrastructure in neonatal services in the NCL area. Both options will include investment in Barnet hospitals.

A final decision is still to be made and options would be published before Spring 2025.

The Programme Director said there is also a consultation on the potential closure of the Edgware Birthing Suite unit, as a only a small number of women give birth there and the numbers have been declining every year.

The Committee highlighted that there is conflicting information regarding projected birth rates. The Start Well consultation stated they were in decline whilst a Barnet report on school place planning predicted an increase. Also, the Jewish birth rate is higher than the non-religious community. The Programme Director said they were projecting a downward trend in births overall, but they would review the NHS modelling again.

The Committee raised concerns about decreases in hospital beds and resources for maternity services for Barnet residents. The Programme Director said the proposals did not include a net decrease in beds. The capacity in maternity wards would be in the right place, with the right skills to make the best use of resources. The proposals were not about reducing provision overall but changing where services are located.

The Programme Director said they had been considering the impact on the Jewish community and would look at birth rates in the next phase of the integrated impact assessment.

A Committee Member said the local community is concerned about the proposals for the closure of the Edgware Birthing Centre and asked if residents were aware of the current low usage. The Programme Director said they had been reaching out to residents with different types of consultation methods in Edgware.

The Committee asked how the consultation response would impact the outcome. The Programme Director said the consultation was not a vote, but they were gathering all the information.  She said that they would consider the evidence and decide upon the next steps. The status quo was not viable, and changes needed to be made.

A Committee Member asked whether it is possible to adjust  ...  view the full minutes text for item 8.

The Executive Director, Communities, Adults and Health presented the report.

A Committee Member asked about the proportion of adults in contact with secondary mental health services. The Executive Director reported that the council does not provide this service, nor does it relate to people who are directly supported by the council. However, the Committee could seek further information from the Mental Health Trust on the outcomes from this indicator, and on whether it is helping people to live independent lives.

In response to concerns about the decline in use of direct payments, the Executive Director said the team is asking for feedback about the advice offered by Social Workers to clients. The department also offered prepaid cards and is open to suggestions on how to make the process easier.

RESOLVED that the Committee note the report.  

The Executive Director for Communities, Adults and Health noted that the report had been requested by the Committee to help gain a better understanding of the council’s relationship with care homes. The Assistant Director of Community & Performance and Director of Integrated Commissioning were also in attendance to answer questions.

In response to questions, it was reported that;

·         Clients’ individual care needs are assessed, and a suitable care home placement is identified for them. If they want to be placed in a specific care of their choice this is possible but the council contribution to care home fees will be capped on their assessed need in a council commissioned placement. 

·         If a client’s care needs to change, this is assessed by the council. There is no statutory timeframe for the re-assessment, but the council aims to do this as quickly as possible.

·         The challenges with recruitment and retention of staff in the care sector was national and regional issue. Wages, conditions and training were important, but a whole range of measures are needed. There is a need for parity of esteem in social care career progression.

·         Barnet has invested additional money to ensure that clients’ cultural needs are met in care homes.

·         The council is working towards London living wage accreditation.

RESOLVED that the Committee note the report.  

To follow

The Director of Integrated Commissioning presented the report.  She reported that this work had improved the delivery of social care and led to discussions about language with people with lived experience. In light of concerns raised by this Committee, additional work could be undertaken to look at the uptake of direct payments.

In response to a question, the Executive Director, Communities, Adults & Health reported that the recent engagement exercise on the Enablement Service had led to improved outcomes, including helping people on the cusp of needing care leading to savings in the Medium Term Financial Strategy.

The Chair thanked officers for attending the meeting.

RESOLVED that the Committee note the report.  

To follow

The Clinical Business Unit Manager, Hubert Sakkariyas,Central London Community Healthcare NHS Trust, gave an overview of the services in place to support Long Covid, highlighting that there is a strong emphasis on self-management. The committee also received an overview of the study on Long Covid.

In response to a question, it was reported that some areas in Barnet are not accessing services, and more work is being done to reach communities, including raising awareness amongst GPs about the services available.

RESOLVED that the Committee note the report.  

Primary Care (GP) Access draft report – to follow

The Committee received a report on two Task and Finish Groups:

·         The Access to Primary Care report is being finalised and will be presented to the next committee meeting.

·         The Discharge to Assess Task and Finish Group has commenced and will undertake some visits to services shortly.

RESOLVED that the Committee note the report.  

RESOLVED that the Committee note the Cabinet Forward Plan.  

Health & Wellbeing Board Forward Plan – for information

RESOLVED that the Committee note the Forward Work Programmes for the Adults & Health Overview and Scrutiny Sub-Committee and the Health and Wellbeing Board.  

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