Issue - meetings

To consider appropriate conclusions and recommendations for the review.  An issues paper, outlining the key evidence received by the Panel to date, is attached to assist Members in this process.

The Panel was of the view that the Haringey Strategic Partnership, in making decisions on how funding within the areas based LAA grant is divided up between different blocks, should not look merely at the historical position in relation to funding and seek to replicate this within the new structure. It felt that a strategic approach should instead be adopted and that this should be based upon the key priorities identified within Haringey’s Community Strategy.  The introduction of the new funding regime, as well as a strategic approach, could help to facilitate longer term planning and hence a greater level of sustainability. 

It was noted that redundancy costs could not be funded from grants monies. The impact of the funding changes depended on what Haringey was allocated by central government.  If the settlement was better then expected, the likelihood of redundancies would be diminished.  Community safety had been extremely successful in brining in external grant funding for community safety purposes in recent years but, to some extent had become a victim of this.  The tacit assumption had been made that there was no need to put internal resources into the service as external grants could provide necessary funding.

The Panel expressed concern that relevant services might cease when grants expire and felt that all alternative sources of funding should be fully investigated.  The services provided were of high value to the local community.

It was noted that Camden had two Business Improvement Districts (BIDs) and that these had provided an opportunity to bring in additional resources.  BIDs were locally controlled partnerships for improving the environment and economic performance of a defined area. They were created by groups of businesses to oversee and fund environmental improvements and the provision of a limited number of additional or enhanced local services.  Consideration had been previously been given to setting a BID up for Wood Green but not pursued.  The Panel were of the view that this issue should now be revisited by the Haringey Strategic Partnership.

The Panel noted that the 7 Safer and Stronger Communities targets within the LAA were likely to focus on children, young people, volume crime, drugs, alcohol, terrorism, anti social behaviour and traffic accidents.  These would be equally rated in terms of their priority level.

The Panel noted that licensing and planning issues could impact considerably on the character of a specific area and felt that it was important that crime and disorder issues were given full consideration when relevant decisions were taken.  They noted that the Police Service in Camden had taken a particularly assertive and proactive role when the Council were dealing with such issues. 

The Panel felt that there was a need for crime and disorder to be given wider consideration across the Council so that it is considered explicitly when significant decisions were taken.  It should be a major consideration in relation to a range of issues, particularly planning and licensing.  The Panel was therefore of the view that there should be  ...  view the full minutes text for item 19

To receive evidence from the following:

·        Tom Brown – Service Manager, Older People, Adult, Culture and Community Services

·        Siobhan Harrington, The Whittington Hospital

·        The North Middlesex Hospital (to be confirmed).

·        Islington and Haringey Breathe Easy (to be confirmed)

The Panel received evidence from:

·        Norman Mattis from Islington and Haringey Breathe Easy

·        Dr. Anne Yardumian, Lee McPhail and Lisa Donegan from the North Middlesex Hospital     

·        Siobhan Harrington from the Whittington Hospital

·        Tom Brown from Adult, Culture and Community Services

Breathe Easy

Mr. Mattis stated that there were approximately 12 people who were actively involved in the local group.  The aim of the group was to make life as comfortable as possible for its members.  Its members suffered from a range of lung conditions such as COPD, asthma and asbestosis.  It met on a monthly basis.  He was referred to it by the Whittington Hospital, who provided some support for the group.   His condition was changeable in its severity – he could be fine some days and not so good on others.  However, there was a slow overall deterioration.  Exercise was of great benefit for people with lung problems.  He attended the gym on a regular basis.  In addition, the group was currently trying to set up a regular exercise session for its members and was trying to obtain suitable funding for this. 

Most people with lung disease had their own way of managing their condition and the ability to self manage was very important.  Ms Harrington stated that the group was integrated into the hospital’s rehabilitation programme.  The Respiratory Team at the hospital valued their relationship wit the group. 

Mr Mattis stated that his condition was related to his previous work as an engineer, which had involved him working with asbestos.  One particular aim for the group was to publicise lung conditions.  There was a lack of appreciation of their range and what they entailed.  He felt that this was leading him to having difficulty in obtaining compensation for industrial injury as well as a disabled badge. 

North Middlesex University Hospital

Dr. Anne Yardumian, Lee McPhail and Lisa Donegan from the North Middlesex Hospital reported on action that was undertaken at the hospital to reduce the level and duration of hospitalisation of people with long term conditions.  They had a First Response Team (FRT) who had proven to be effective in interventions to help avoid admissions and/or reduce their duration.  They worked by providing a highly visible, coordinated therapy and discharge service by means of effective early specialist assessment and intervention, internal/external networking and referrals , as well as fast track access to community services or other health/social environments.  There were now officers from Haringey’s Adult Services who were based on site.  The main benefit of the service was the provision of integrated services for patients, allowing a concentration and continuity of care from admission to the discharge of patients.  This incorporated promotion of care standards and the screening of medical and nursing interventions in order to assess for potential issues that might lead to a delayed discharge or readmission.

They were a multi disciplinary team and had links to other teams of professionals including the Rapid Response team at the hospital, the Intermediate Care Team, Community Matrons and  ...  view the full minutes text for item 14

To receive evidence from the following;

·        Councillor Nilgun Canver, Cabinet Member for Enforcement and Safer Communities

·        Helen Brown,  Acting Deputy Chief Executive, Haringey Teaching Primary Care Trust

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As Councillor Canver, the Cabinet Member for Enforcement and Safer Communities, was unable to attend the meeting, Jean Croot, the Head of Safer Communities, gave evidence to the meeting on her behalf. 

Councillor Canver felt that greater sustainability in the resourcing of actions to achieve Safer and Stronger

Communities targets could be achieved through a package of measures:

·        Improvements could be made in policy coordination so that opportunities for collaborative work were identified at an earlier stage and appropriate resources and commitment agreed.  The LAA grant would come to the Borough in a lump sum from 2008 and it was vital that the Haringey Strategic Partnership ensured that the key priorities in the Community Strategy as well as residents’ top concerns – which also included crime - were fairly and adequately prioritised.

·        Serious consideration needed to be given to core funding for areas of priority which were statutory and ongoing.  Examples of this were youth offending work, dealing with anti-social behaviour, reducing volume crime, reducing the harm caused by drug and alcohol misuse and addressing the fear of crime through consistent and professional communications work.

·        There were already some good examples of aligned funding and joint delivery of priorities.  The Supporting People Programme, for example, helped to deliver outcomes relating to drug and alcohol harm reduction, domestic violence and housing for vulnerable people.  This year, the Summer University was delivered as a joint programme by Neighbourhoods, Safer Communities and the Youth Service. There were also good examples of services and partners working together to deliver key priorities, such as partnership efforts to address worklessness and well being and the co-ordination of structured crime prevention work in schools.  Further opportunities should also be explored for joint delivery on LAA work.  These could include victim programmes, designing out crime and providing more effective services for ex-offenders.

The wording of section 17 of the Crime and Disorder Act 1998 had been strengthened recently and it was now a ‘duty’ both to prevent and reduce crime, disorder, anti social behaviour and substance misuse across all parts of the partnership.  There were some good examples of how crime prevention programmes and activity were being delivered by partners as additional to their ‘normal work’. Examples of this included the Fire Service led Prison Me No Way programme and the use of forensic nursing assessments in custody

suites.  Other work and programmes had become mainstream crime prevention work, such as Operation

Tailgate – a regular joint Police and Council enforcement operation involving a range of external partners –

and the embedding of programmes to address youth employment opportunities for those at most risk.

However, the mainstreaming of crime and disorder prevention work was not yet happening systematically in Haringey.  This requirement should ideally be part of standard business planning and policy making in a way that equalities considerations were. Some boroughs, such as Lambeth, had undertaken a fuller discussion amongst partners on how to meet their statutory responsibilities.

Councillor Canver felt that partners on the Safer Communities  ...  view the full minutes text for item 12

To receive the following from Gerry Taylor, Acting Director of Strategic Commissioning at Haringey Teaching Primary Care Trust:

·        An overview of strategic issues in addressing the issue of high intensity users

·        An outline of current support arrangements and their effectiveness

·        Details of any relevant development plans as well as an assessment of the likely implications of current changes to services, such as reconfigurations of acute care, the Haringey Primary Care Strategy and Professor Sir Are Darzi’s “Framework for Action”.

Gerry Taylor, Acting Director of Strategic Commissioning at Haringey TPCT, Delia Thomas, from the Integrated Care Team at the TPCT and Dr. Jyotindra Pandya MBE, a Tottenham GP and clinical director for the south east collaborative cluster of primary care practitioners provided an overview for the Panel on what was currently done to prevent the unnecessary hospitalisation of people with long terms and complex conditions.

Ms Taylor reported that Haringey practice was based on national guidance and strategy. This was generally based on the principle of helping people to support themselves.  Haringey was currently on track to meet the national target to reduce emergency bed days by 5% by 2008 through improved care planning in primary care and community settings. The Community Matrons (CMs) scheme had been recommended as a particularly effective approach.  Haringey’s target was to have 21 matrons by 2008 and there were currently 14 posts established, of which 11 were filled. 

One of their key roles was to identify very high intensity users and those most at risk from being admitted, as an emergency, to hospital. Some of the matrons were generic (4.25 posts) in their role whilst others specialised in a particular condition.  They were based within each collaborative cluster.  In identifying appropriate patients to work with, they liaised closely with local primary care practitioners.  Before relevant patients were taken on, CM’s had a discussion with the patient’s GP in order to be appraised on their history.  The patient was then visited.  The CMs had more time to work with the patient then GPs.  They undertook a range of functions, including reviewing medication and undertaking social and psychological assessments.  They worked separately from the District Nurses.  They worked intensively with patients at first and monitored them closely.  Following this, they could taper down their involvement, if appropriate. 

The CMs were employed directly by the TPCT.  The scheme was intended to follow an evidence based approach.  A pilot scheme had been set up initially using a telephone only contact with patients but this approach alone had been found not to be successful.    CMs currently worked with a caseload of approximately 50 patients as this was felt an appropriate amount for them to handle.  It was recognised that the level of service provided was not based on a complete picture of overall need/demand. 

The scheme was relatively new and had only been established locally in November 2006.  It was possible that caseloads could grow once the scheme had developed further.  The CMs had developed links with a wide range of organisations, including the Council’s Adult Services, the community alarm scheme and the ambulance service.  There was a specific CM network which allowed them to share expertise and knowledge.  As it was a new service, it was currently being evaluated to ensure that it was effective.  Current evidence was still unclear as to its overall effectiveness. 

Patients who might benefit from the service were identified either from them having been admitted and discharged a number of time or by  ...  view the full minutes text for item 6

To consider the key issues facing the Safer Communities Partnership in achieving the Safer and Stronger Communities targets within the LAA and meeting the challenges provided by the new sets of targets.  The Panel will receive evidence from Claire Kowalska, Community Safety Development Co-ordinator, Haringey Council and Simon O’Brien, Haringey Borough Commander, Police Service including:

·        An explanation of the LAA targets and their future development

·        Details of the funding for the specific initiatives that have been put in place to facilitate the meeting of the Safer and Stronger Communities targets

The Panel received evidence from Wayne Mawson, Deputy Police Commander for Haringey, Shaun Sweeney, Police Projects Officer and Claire Kowalska, Community Safety Strategic Manager. 

The Panel noted that community safety initiatives were funded with a high proportion of money from external time limited grants.  This had a number of disadvantages.  The delivery of initiatives often required considerably high levels of skill from staff and consequently high quality personnel were required.  The time limited nature of funding for posts did not assist recruitment and retention.  It could deter suitably qualified people from applying and inhibit the development of staff as the skills required to undertake the work were complex and took time to learn. Long term planning was difficult as funding decisions on changes to grant regimes were often taken at short notice and inconvenient times.  Reductions in the Safer Stronger Communities Fund (SSCF) had been announced in June and these had the potential to lead to redundancies for Haringey staff.  In addition, making applications for grants and monitoring them once they had been received was a very time consuming process.  If commissioning was undertaken over a longer period of time, economies of scale could be made. 

Many community safety initiatives and responsibilities were now statutory as well as covering areas of key concern for local residents.  The workload within specific teams had increased markedly.  The Youth Offending Service and the Anti Social Behaviour Action Team had seen a doubling in demand for their services.  In addition, the strategic planning function was also very important.  This involved working on the targets and national standards, analysing data and capacity building.  A new performance regime was soon to be introduced with the introduction of APACS (Assessment of Policing and Community Safety).  In addition, reporting of crime was being more actively encouraged and this was likely to increase workload further.  Police successes in apprehending young offenders was a factor in increasing pressure on the Youth Offending Service, who were required to undertake work with such young people in order to assist in their rehabilitation.

Staff in posts for which the funding was due to expire shortly were facing redundancy and it would be unsurprising if their performance suffered in such circumstances.  All of the Police officers who were involved in Safer Community Partnership work were supported by mainstream funding.  It was felt that consideration needed to be given to funding more of the Safer and Stronger Communities work though mainstream funding. 

Community safety was a partnership and there was a statutory responsibility for partners to actively participate and contribute.  The Police Service and Council currently tended to assume a large part of the responsibility but it could be argued that other partners should take a more active and equal role.  However, some of the other partners were constrained by limited resources. 

The main drivers for crime were linked closely linked to health, well being, education and housing and therefore mainstream activity by relevant partners in these areas was a considerable source of influence.  Section  ...  view the full minutes text for item 5