Agenda and minutes

The Chair welcomed all to the meeting, and both members and officers introduced themselves. Due to train strikes, a number of officers joined the meeting remotely.

There were apologies for absence from Cllr Mick Gilgunn

There was no declaration of substitute members

If you have a Disclosable Pecuniary Interest* in an item of business:

§  if it is not yet on the council’s register, you must declare both the existence and details of it at the start of the meeting or when it becomes apparent;

§  you may choose to declare a Disclosable Pecuniary Interest that is already in the register in the interests of openness and transparency. 

In both the above cases, you must leave the room without participating in discussion of the item.

If you have a personal interest in an item of business and you intend to speak or vote on the item you must declare both the existence and details of it at the start of the meeting or when it becomes apparent but you may participate in the discussion and vote on the item.

*(a)Employment, etc - Any employment, office, trade, profession or vocation carried on for profit or gain.

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  duties as a member, or of your election; including from a trade union.

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 in which one of you has a beneficial interest) and the council.

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 (g)Securities - Any beneficial interest in securities of a body which has a place of business or land in the council’s area, if the total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body or of any one class of its issued share capital. 

This applies to all members present at the meeting.

Cllr Fin Craig declared a personal interest that she had an honorary contract with Whittington Health NHS Trust.

In relation to the Chair’s Report, the Chair requested that Cllr Jeapes’ name was added to the list of those who had campaigned on matters relating to the GP contract renewal.

Referring to the section of the minutes concerning Healthwatch Islington, a member noted that they have seen increased publicity since the last meeting and had received a flyer from the organisation.

RESOLVED:

That the minutes of the previous meeting be agreed as a correct record, subject to the above amendment.

The Chair queried some of the performance information set out in the latest Budget Monitoring Report and asked officers to explain the overspend in Adult Social Care budgets.

Officers noted that the reported £4 million overspend recorded for Health & Social Care was mostly due to legacy and continual pressures arising from the COVID-19 Pandemic and the costs of supporting people with complex needs and those who are discharged from hospital. Officers explained to the Chair that the in-house transformation programme had been presented to the Executive about two years’ prior, and was centred on developing a community-focused model.

The Chair highlighted concerns regarding lengthy waiting times reported by residents when dialling the Islington Adult Social Services telephone number for support. The Committee were informed that responsibility for this phone line sits with the Fairer Together directorate as part of their front-of-house responsibilities, and a written explanation for the highlighted issue will be sought and presented to the Committee prior to the next scheduled meeting.

The Chair also thanked care workers who will be working over the holiday period for their commitment and hard work.

For members of the public to ask questions relating to any subject on the meeting agenda under Procedure Rule 70.5. Alternatively, the Chair may opt to accept questions from the public during the discussion on each agenda item.

None.

There was nothing to report to the Committee as there had not been a Health and Wellbeing Board meeting in the period since the previous Health and Care Scrutiny meeting of 15^th November 2022

None.

Sarah Wilding, Chief Nurse & Director of Allied Health Professionals, and Helen Taylor, Clinical Director, presented the committee with the quality accounts of 2021-22.

The Committee noted the organisation’s four key priorities (detailed in the agenda pack), against which broad progress had been made, however not all as desired. However, there was a recognition of COVID-19 related pressures on the organisation and NHS in general.

Over the next year Whittington Health would look to building on the progress and successes of the previous year. The organisation now had an opportunity to do some stakeholder engagement that they were unable to do during the COVID-19 pandemic. Whittington Health had worked with Healthwatch Islington and patients to form the key priorities for the year ahead.

In deploying the Zesty IT system, the Trust was still mindful to consider those affected by digital poverty and ensure that these residents are provided with alternate means of making appointments. The Trust will need to think about how they ask patients what their preferred means of contact is.

A member of the committee noted the staff morale indicators for 2021-22 were quite low and stands in stark contrast to the great work Whittington Health Trust is doing. Representatives from Whittington Health Trust remarked that this is an unprecedented time of pressure for the NHS, that they are committed to making improvements and continue to provide support, training and engagement with their staff.

It was also noted that Whittington Health Trust had not met the threshold for strike action for either UNISON or the Royal College of Nursing

A member questioned the Trust’s approach to transgender patients and referenced a case in which postal correspondence misgendered the recipient following transition.

The Chair asked whether handover time was included in the pay for Doctors and Nurses, to which the representatives from Whittington Health Trust confirmed that this should be the case.

The Committee thanked Whittington Health for their attendance and for their work in supporting the health and wellbeing of Islington residents.

The Director of Public Health informed the committee that while there are high infections of seasonal illnesses, it was expected for this time of year.

The Director also explained that they continued to deliver messaging encouraging childhood immunisations and vaccination uptake among the local community.

Messaging has also been delivered regarding the symptoms of scarlet fever, tonsilitis, and respiratory infections to parents in the borough.

In relation to recent national concerns about Strep A infections in children, a member of the committee asked whether there were any known issues in accessing antibiotics in Islington, to which the Director noted that this was not presently an issue within the borough.

In response to a member’s question regarding the isolation procedures for children infected with Strep A, the Director stressed that while infection rates could be adequately managed through good hygiene and thorough handwashing, any child confirmed to be infected should ideally stay home from school to avoid the risk of infecting others.

The Committee received a presentation on the reablement service, outlining the impact that an effective programme of reablement can have, in addition to explaining the basis of a new programme of reablement that will enable delivery to a wider range of residents, provide increased support and establish closer working with the NHS.

A key segment of improvement within reablement service is improving face to face contact time.

Work had taken place to rationalise the job descriptions of reablement workers and there had been significant success in recruiting to these posts. Recently, the appropriate number of senior enablers were appointed to – this was achieved both internally and externally through agencies – however, there were efforts to increase the internal proportion.

Members of the committee will be given the opportunity to speak to residents who have benefited from reablement and to ground some of the proposals in a bit more detail prior to the next meeting

The programme of reablement is primarily to assist those who have lost some form of capability to help regain life skills, things that a hospital stay, or serious illness can reduce. Studies have shown that a six-week programme of reablement has a proven positive impact in restoring the recovery of a patient’s life skills whereas more traditional care models are more centred on replacing those skills altogether.

In response to a member’s question regarding whether there are any of models of reablement in other boroughs that Islington should be mirroring, the presenting officer suggested that this would be considered at the next scrutiny meeting. The purpose of today’s presentation was generally to serve as an introduction.

At the Chair’s request, the presentation would be circulated to committee members following the meeting.

The annual report for 2021-22 was presented to the Committee by Fiona Bateman, Independent Chair of the Board.

The Committee was told that homelessness is one of many key areas which Islington are tackling head-on.

Ms Bateman also noted that some groups have been very vocal in feeding back to Government regarding proposed and enacted changes in the law that have been publicised recently, such as reforms to legislation concerning mental health and how this would impact their safety and human rights.

The Board’s annual report highlighted the purpose of the Board, key areas agencies achieved during the year, the agencies that make up the safeguarding board, and how statutory functions are met.

In response to a member’s concern regarding the safeguarding of those held in police cells, Ms Bateman noted that the board works with all statutory partners – the Integrated Care Board, Metropolitan Police and Islington Council make up the key partners – and that the representative from the Metropolitan Police feeds back learning to the organisation. They also provide regular data into the Board’s quality assurance subgroup. Every organisation is responsible for the safeguarding of people in their care, and while the safeguarding board isn’t responsible for safeguarding people in police custody, they ask for assurances of each partner. There were presently no concerns regarding those held in police custody in Islington.

The Safeguarding Board is a critical friend. Partners will report in any serious incidents that might have occurred in their setting, and that will be scrutinised by the Board to see if that meets the criteria for a serious case review.

The Board is in regular dialogue with the police via the London Safeguarding Board and Chairs Network. The London Police Commissioner recently talked of the effect of the time spent in custody by people in mental health crisis, as well as the impact on police resources, and openly stated their intention to liaise with partners about adopting a more collaborative approach that is in-use in other regions of England.

In response to a member’s concern regarding young people’s encounters with the police, the representative noted that the remit for the Adults’ Safeguarding Board technically begins with those aged 18 and above, however work is also overseen by the Board on the transition from adolescence. No issues have arisen regarding contact with the police in Islington specifically. However, London-wide there has been work to ensure there are adjustments made concerning those in police care who have autism, but it was not possible to say that this was applied in every instance.

The Safeguarding Adults Board are working closely with the Safeguarding Children’s Board to understand the risks around that transition to adolescence and adulthood. There’s a lot of work going on in Islington across different agencies, across housing and others regarding how to support young people going through that transition.

The Chair expressed concern about those who are lonely and suffering from financial abuse that do not know how to access support. The Board is  ...  view the full minutes text for item 57.

Nikki Ralph, Head of Strategic Commissioning, introduced the report. It was noted that home care plays a significant role in helping the adult social care service achieve its vision. Presently, the service is in the process of developing a new model of home care building on the previous recommendations of the scrutiny committee.

Progress against each recommendation was listed in the report, as well as future intentions. It was noted that home care transformation takes time, as there were so many factors in improving care for residents.

A member offered congratulations on meeting a goal in which the majority (77%) of Islington home care service users are supported by an agency that pays the London Living Wage. A discussion was had about the feasibility of bringing the service in-house. Officers advised that, under the Care Act, the council had to ensure residents had a choice of provider, and bringing the service in-house would require the recruitment of approximately 1000 workers in addition to a significant cost implication of £15 million. The current cost of delivering home care was about £21 million. By nature of the localness of the work, a lot of contracted providers are locally based.

A member noted that Low Traffic Neighbourhoods may have an impact on staff conducting home visits and suggested collaboration with Islington’s transport team to overcome any barriers this might pose. For example, secure bike storage was installed in Highbury after a district nurse made the point to a member in that ward.

RESOLVED:

That the progress made against the recommendations be noted.

Noted.