Agenda and minutes

Apologies were received from Councillors Nargund and Staff.

There were no declarations of substitute members.

There were no declarations of interest.

RESOLVED:

That the minutes of the previous meeting held on 16 September 2024 be agreed as a correct record and the Chair be authorised to sign them.

The Chair advised that the order of business would be revised to consider item B2, the Camden and Islington Mental Health Trust Annual Performance Update, as the first item of business.

There were no public questions.

Prosper Mafu, Managing Director, Islington Division, summarised the performance as detailed in the report which provided an update on the North London Mental Health Partnership (NLMHP) and overview on performance over the last 12 months.

The following main points were noted in the discussion:

• The Committee noted the updates on the Partnership’s operational and quality performance against national and local standards as outlined in the report.
• The Committee was informed that the progress towards the new Trust, to be called the North London NHS Foundation Trust, continued and the formal application had been submitted to the Secretary of State for Health and Social Care for final approval, which was expected to be signed off very soon.
• The key areas that the service was focusing on for improvement was on the number of women accessing the perinatal mental health service, with the target of a 10% increase by March 2025.
• In terms of update on borough partnership key programme update, it was noted that the mental health teams had adopted a new care planning approach called DIALOG+ which would co-produce a personalised care and support plan with service users and their carers.
• Mr Mafu provided an update on the St Pancras Transformation Programme and highlighted that a new NHS mental health inpatient building, The Highgate East, opened in March 2024. This new building was situated next to the Whittington Hospital. It was also noted that the Mental Health Crisis Assessment Service (MHCAS) opened in a new location at Highgate West. This was a 24/7 emergency mental health care across North London which offered an alternative to A&E for those in a mental health crisis.
• Following a question on talking therapies, it was noted that to achieve enhanced consistency of service delivery across the Partnership, all Talking Therapies services were being overseen by a single Managing Director. An Operations Manager was also recruited to support the approach and lead the transformational change required to deliver on the new access and outcomes requirements.
• A member stated that data from a representative at Whittington Hospital suggested that in Islington, around 56% of people with dementia had passed away at home, compared to 70% in the rest of England, meaning many spent their last days in hospital. The member raised concerns about this figure and asked whether suitability of housing was a contributing factor. In response, officers advised that they did not have any data to support this statement and would need to look further to collate data on this matter.
• In response to a follow up question, the Committee noted that the Memory Service worked in partnership with Age UK to provide support for carers of dementia patients.
• In terms of targets for talking therapies, it was noted that the target for recovery rate was 50% and this was a target set nationally.
• Following a question on Islington Clozapine and Depot Clinic, it was noted that during treatment, Clozapine would not be one of the first line anti-psychotic medication the doctors  ...  view the full minutes text for item 28.

Ian Swift, Director of Housing Operations, introduced the presentation as set out on pages 7-16 in the agenda pack.

The following main points were noted in the discussion:

• The Chair queried about accommodation available for the elderly, in response, officers advised that Islington Council did not have any sheltered accommodation for elderly people.  Sheltered accommodation provision was managed by a local Housing Association with around 900 properties. There were some challenges to allocate sheltered accommodation to elderly individuals as they often preferred independent living in general needs accommodation to maintain their independence as long as they can.
• In terms of the housing register, the number of pensioners on the register was very small compared to the vast majority of the register consisting of the younger population.
• Discussions with local housing associations had suggested that sheltered accommodation may be remodelled as the current model was not suitable for future generational needs. The Committee also noted that it would be very unlikely that Islington Council and partner housing associations would be building sheltered housing in the future. It was advised that the provision for new sheltered housing for elderly people was not at the forefront of priorities for Islington Council’s housing department due to increasing need for other forms of accommodation.
• The Committee noted that the Council had a right-size move approach which moved people from larger accommodation to a smaller accommodation. This approach had been successful with around 100 moves a year. This was also beneficial for the elderly population as it supported them to downsize and live independently.
• The Committee was informed that the Council had a Seaside and Country Homes Scheme which supported elderly people who wanted to move to a sheltered housing on the coast of Surrey, Sussex, Kent and Essex areas.
• It was noted that inflation, cost of building materials, land availability and demand were also some of the reasons for the lack of extra care sheltered units for elderly in the borough.
• It was also noted that the Council’s Housing department would most likely not be able to build more extra care accommodation for the elderly as the priorities were greater in other areas including homelessness and families living in overcrowded accommodation.
• The Committee noted that there was a 35% increase in homeless applications over the last 12 months. There were around 721 homeless single vulnerable adults living in temporary accommodation. However, vulnerable homeless households did not meet the threshold to access Adult Social Care services because they did not have needs identified within the Care Act.
• Officers highlighted that 1,143 tenants of Islington Council received support from Adult Social Care. This was one third of all care packages provided by Adult Social Care. The were 3,429 care packages in place from Adult Social Care. 16.80% General Fund budget spent on Adult Social Care in Islington. There were 25,357 Islington council tenants with 4% receiving Adult Social Care packages.
• A member queried on models of housing similar to Crowfield house, where there were specific blocks for  ...  view the full minutes text for item 29.

Johnathan O’Sullivan, Director of Public Health, introduced the report that sets out the quarter 4, 2023-2024 progress against targets for those performance indicators that fell within the Health and Social Care outcome area.

The following main points were noted in the discussion:

• Vaccination rates remained steady. There had been a 5% increase in the first dose of MMR vaccine (measles, mumps and rubella) uptake in the last year. It was also noted that there had been an outbreak of measles in North-West London.
• The community stop-smoking service, Breathe, continued to perform at a high standard. In 2023/24, a high percentage of people successfully quitting using stop smoking support in Islington accessed Breathe directly, with great success rates.
• It was noted that there was an expansion in the number of service users for drug and alcohol treatment. There was an increase of around 300 new service users over the last year. The Committee noted that there was a large number of service users that came in through prisons. The services collaborated closely with criminal justice partners to ensure effective pathways into treatment from prison, probation and police, which included co-locating of services and in-reach support. Officers added that the number of individuals successfully completing treatment was similar to that of the same period last year. This was due to lengthy periods of treatment, complexity of cases entering structured treatment and extended time needed for support.
• The Committee was informed that the most recent national data had shown that Islington had a high rate in uptake of Long-Acting Reversible Contraception, which was higher than the rate in London and England.
• The Committee queried about possible factors effecting completion of drug and/or alcohol treatment, including homelessness and the cost-of-living crisis. Officers advised that there had been a lot of focus prescribing outreach to people sleeping rough, or at risk of sleeping rough in Islington. It was also noted that partnership working had improved through dedicated efforts to build relationships and work together around the most vulnerable cohorts, with notable progress in work with the police and Community Safety and through outreach activities.
• Cllr Flora Williamson, Executive Member for Health & Social Care, added that there was also a lot of partnership work with Whittington Hospital and University College London Hospitals, where there were specialist nurses within the hospital enabling people to start their treatment immediately directly from A&E and other services within the hospital.
• In response to a question regarding staffing within Islington’s integrated drug and alcohol treatment service, it was noted that the service had recruited more staff and was also working closely with colleagues across the NHS and other local authorities across North Central London. It was also noted that staff were recruited into the criminal justice system and in prisons.
• The Committee was advised that Islington Public Health also commissioned a service called SWIM (Support When It Matters), which provided culturally competent, holistic support to men of Black African or Black Caribbean background, who were in contact with the criminal  ...  view the full minutes text for item 30.

RESOLVED:

That the Committee to note the report.