Agenda and minutes

It was noted the meeting would be webcast.

It was noted apologies for absence had been received from Councillor Adamou.

It was noted apologies for lateness had been received from Councillors Beacham, Bull and Stennett.

The Chair will consider the admission of any late items of urgent business (late items will be considered under the agenda item where they appear. New items will be dealt with at item 12 below).

There were no items of urgent business put forward.

A Member with a disclosable pecuniary interest or a prejudicial interest in a matter who attends a meeting of the authority at which the matter is considered:

(i) must disclose the interest at the start of the meeting or when the interest

becomes apparent, and

(ii) may not participate in any discussion or vote on the matter and must withdraw from the meeting room.

A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Members’ Register of Interests or the subject of a pending notification must notify the Monitoring Officer of the interest within 28 days of the disclosure.

Disclosable pecuniary interests, personal interests and prejudicial interest are

defined at Paragraphs 5-7 and Appendix A of the Members’ Code of Conduct.

Under item 7 of the agenda, Draft Primary Care Strategy – Summary, Councillor Connor informed the panel that her sister worked as a GP in Tottenham.

There were no disclosable pecuniary interests or prejudicial interests declared by members.

To consider any requests received in accordance with Part 4, Section B, Paragraph 29 of the Council’s Constitution.

The Chair informed the panel that two requests to speak in relation to the Budget Scrutiny Update, agenda item 6, had been received. 

Martin Hewitt, on behalf of Save Autism Services Haringey (SASH), addressed the panel and raised a number of points, including:

-       General concerns about how proposed budget changes would impact on social care across the borough.

-       Concerns about proposed changes to services for people with learning difficulties and autism.

-       Concerns about specific proposals to transfer care away from professionals to service users themselves, their family and carers.

-       Issues concerning data collection, and data gaps, especially in relation to carers.

-       The limited information that had been made available by the Council in relation to reablement and enablement.

-       The academic research, in relation to social care and home care reablement, that had been carried out by Gerald Pilkington and York University.

-       Concerns about alternative service provision should Day Care Centres and Residential Care Homes close.     

-       The need for the Council to be clearer about who would benefit from the proposals that had been put forward, in relation to reablement and learning disabilities, as part of the Medium Term Financial Strategy.

-       The need for the Council to be clearer about how high level proposals would work out in practice.

-       Ensuring opportunities for information sharing/comparison with other local authorities took place to ensure proposals for adult social services in Haringey were fit for purpose.

Jackie Goodwin, Chair of the Haringey Forum for Older People, addressed the panel and raised a number of points in relation to the Haven Day Centre, including:

-       Concerns about how proposed budget changes would impact on care standards.

-       The importance of addressing carers’ support needs.

-       The importance of reducing social isolation.

-       The value of the Haven Day Centre especially in relation to providing services for the most vulnerable.

-       The need for the Council to focus on people rather than statistics and budget figures.        

The Chair thanked the speakers for their contributions and informed the panel that these issues would be picked up under the Budget Scrutiny Update, item 6 of the agenda.

To approve the minutes of the meeting held on 11 December 2014.

RESOLVED: The minutes of the meeting held on 11 December 2014 were approved as a correct record.

The purpose of this report is to provide further information to support the Panel’s scrutiny of the Medium Term Financial Strategy in relation to Priority 2.

It was noted that the role of the panel was to scrutinise budget proposals in relation to Priority 2 – “Empower all adults to live healthy, long and fulfilling lives”  and to put forward recommendations for consideration by the Overview and Scrutiny Committee in January. The panel was informed finalised budget scrutiny recommendations would be presented to Cabinet in February 2015.

Beverley Tarka, in response to a question raised by the Chair, advised that in October 2014 a decision had been taken to undertake a desk top review of people using adult social services. The desk top review had not resulted in a formal report being published but the panel was informed that:   

-       A randomly selected sample, of the service user base, had been used for the exercise including older people, people with learning disabilities, people with mental health needs, and people with physical disabilities.

-       The information collated had helped to determine whether service users had reablement potential and whether current service levels were appropriate. 

-       The sample size for the review was 5%.

-       A multi disciplinary team, including social workers, occupational therapists, and a personal budgets manager, had undertaken the review.

-       The desk top review, in addition to other activities including a workshop facilitated by Gerald Pilkington Associates, had been used to inform high level proposals in relation to reablement.

-       Further work would be required in order to develop proposals for reablement once a decision, on how to proceed, had been made by Council.

There was a short discussion of the review.  

The Haven / Neighbourhoods Connects 

The following issues were discussed:

-       The aims and objectives of the Neighbourhood Connects project in terms of supporting timely discharge from hospital and contributing to reduced social isolation.

-       The evaluation of the Age UK Haringey Pilot, including suggestions/recommendations that had been put forward in relation to developing future proposals.

-       The methodology that had been used to evaluate the Age UK Haringey Pilot.

-       Concerns about replacing a valued day care service (The Haven) with a service (Neighbourhood Connects) that, in the opinion of the panel, had not been fully tested.

-       Concerns about whether the needs of clients using the Haven could be met by the Neighbourhood Connects model. These concerns were based on the information that had been provided to the panel in relation to the proposals.

-       Significant concerns about whether Neighbourhood Connects could meet the needs of the most vulnerable day care centre users. 

-       The budget for the Haven (noted in the report as £384,400 – excluding overheads and capital charges).

-       The impact of the proposed changes for people with learning disabilities.

-       The implications of the Care Act (2014) in relation to the proposals that had been put forward. 

-       Work that had been carried out by other local authorities, including community development work in Camden.

-       The service specification and tendering process for the Neighbourhood Connects project. It was noted the expected start date  ...  view the full minutes text for item 7.

This report provides a strategic overview of Primary Care in Haringey, highlighting the key national agendas and the proposed strategic direction in Haringey.

It also provides an update to the ongoing work of the Premises Task and Finish Group which has been developed to manage access to appointment issues in the east of the borough.

Cassie Williams, Assistant Director of Primary Care Quality and Development, Haringey Clinical Commissioning Group (CCG), provided the panel with an overview of Primary Care, highlighting the national agenda and the proposed strategic direction for Haringey.

In terms of the strategic direction for Primary Care in Haringey, the panel was informed Haringey CCG was committed to supporting General Practice. The following issues were discussed, with input from Dr. Helen Pelendrides, Vice Chair of Haringey CCG:

-       The importance of GPs working together

-       Making Primary Care more accessible

-       Coordinating care around the needs of patients

-       Making care more proactive

-       Working at scale

-       Premises development

-       Workforce development

-       Technology Development

-       The significant developments across Haringey in relation to data sharing  

Ms Williams concluded her presentation by providing an update on the ongoing work of the Premises Task and Finish Group which had been developed to manage access to appointment issues in the east of the borough. Information was provided on:

-       The aims and objectives of the group i.e. to address primary care provision in specific regeneration areas of Haringey and to look at ways of improving the quality of primary care access across the borough.

-       Progress to date. The panel was informed that in order to fully identify the level of need as well as possible short, medium and long term solutions an options appraisal / plan was being undertaken by GP Partnerships Ltd. It was noted the plan was due to be completed in April 2015. This would establish current and future needs, suggest options as solutions in the short, medium and long term, and assess and  prioritise options for the future.   

The panel was informed that in some areas practices had adequate numbers of GPs but needed support to improve their systems and processes in relation to making appointments available. It was noted that Haringey CCG had been working closely with individual practices to improve access and that a GP survey (published January 2015) highlighted some had made significant progress in this area. However, not all practices had yet been able to implement the necessary changes to improve access issues. It was noted that, where necessary, NHS England had the power, should a practice not meet expected standards in relation to access, to instigate contractual measures to bring about change.

During discussion, reference was made to the following:

-       The different types of primary care access available, including Saturday clinics

-       The number of GPs in Haringey compared to other boroughs

-       The importance of using resources appropriately to address local issues

-       Concerns in relation to GP provision in Tottenham Hale

-       The workshops that had been held in relation to the Doctor First appointment system

-       Standards of practice for confidentiality and patient consent to information sharing

The panel thanked Ms Williams and Dr. Pelendrides for attending and supported the ongoing work to explore short term solutions to immediate problems.

RESOLVED: That the report be noted.

RESOLVED: That item 10, Child to Adult Mental Health Transition Project – Verbal Update, be taken before item 8, Health and Wellbeing Strategy 2015/2018 – Consultation.  

To consider a verbal update from the Chair of the Adults and Health Scrutiny Panel.

Christian Scade, Interim Principal Scrutiny Officer, advised a draft report had been prepared in relation to the panel’s work on Child to Adult Mental Health Transition. It was noted that this had been circulated, via email, to panel members. It was proposed members of the panel should meet, outside the meeting, to consider the report before the panel meeting in March, 2015.

RESOLVED:

1.    That the verbal update on the Child to Adult Mental Health Transition Project be noted.

2.    That members of the panel meet the Interim Principal Scrutiny Officer outside of the meeting to discuss the draft project report.

3.    That the final report of the Child to Adult Mental Health Transition Project be considered by the Adults and Health Scrutiny Panel in March 2015.       

Prior to 10.00pm, during consideration of the Health and Wellbeing Strategy 2015/2018 – Consultation item, the panel considered whether to adjourn the meeting at 10.00pm or continue to enable further consideration of the case in hand.     

The panel RESOLVED to suspend standing orders (Part 4, Section B, Committee Procedure Rules 18) to continue the meeting beyond 10.00pm to enable the business in hand to be concluded.

To consider the draft Health and Wellbeing Strategy 2015-2018. The strategy was launched for a 3 month consultation at the Health and Wellbeing Board on 13^th January 2015.

Dr. Jeanelle de Gruchy, Director of Public Health, informed the panel that it was the statutory responsibility of the Health and Wellbeing Board (HWB) to publish a Health and Wellbeing Strategy and a Joint Strategy Needs Assessment (JSNA). 

Dr. de Gruchy advised that the HWB had launched a programme of activity to review and refresh Haringey’s Health and Wellbeing Strategy for 2015 to 2018. It was noted that an analysis of need in Haringey (the JSNA) had been undertaken in addition to a review of the current strategy through a series of meetings and workshops with key stakeholder groups, including focus groups of the voluntary sector and residents organised by HealthWatch and HAVCO.

The panel was informed the review had highlighted Haringey residents were becoming overweight and obese from an early age and were developing long term health conditions at a relatively young age. In addition, the panel noted there were significant numbers of people across the borough with mental health issues. Dr. de Grunchy advised that these issues contributed to significant health inequalities in the borough.

In response to questions, Dr. de Gruchy informed the panel that the review had informed the development of the draft strategy for 2015 to 2018. It was noted that the draft strategy had three priorities:

-       Reducing obesity

-       Increasing healthy life expectancy

o   Particular focus on people with a long term condition 

-       Improving mental health

o   Particular focus on enablement           

The panel was informed the purpose of the new strategy was to enable:

-       All parties to be clear about the HWB’s agreed priorities for 2015-2018

-       All members of the HWB to embed these priorities within their own organisations

-       Key agencies to develop joined-up or integrated commissioning and delivery plans

-       The HWB to hold member organisations to account for their actions towards achieving the priorities within the strategy

Dr. de Grunchy advised the panel that:

-       The new strategy would have a strong synergy with the council’s Corporate Plan.

-       The purpose of the consultation was to obtain views on: (i) the proposed priorities; (ii) the focus of the three priorities and ideas of how to deliver outcomes and (iii) how organisations and individuals could contribute to the delivery of the outcomes.

-       The consultation, launched in January 2015, would last for three months with the strategy/ delivery plans being considered by HWB in June/July 2015.  

-       The Council had recently appointed a Healthy Public Policy Officer to influence and assist policy development across all areas including licensing, planning, transport, housing and regeneration.

During discussion the panel considered how they could add value to the development of the Health and Wellbeing Strategy. It was agreed, with childhood obesity in Haringey being high in comparison to London and nationally, that input from scrutiny in terms of prevention, early intervention, and ensuring all stakeholders (not just those on HWB) were addressing issues relating to childhood obesity would be a useful scrutiny project for 2015/16. This was supported  ...  view the full minutes text for item 12.

This report is provided for information purposes and offers a brief overview of Part 1 of the Care Act 2014 which comes into force on 1^st April 2015 and describes the impact the Act and the approach Haringey is taking to its implementation. Consideration is also given to the role scrutiny may play with respect to Care Act Implementation with emphasis on the local authority’s adult safeguarding responsibilities.

RESOLVED: That consideration of this item be deferred.

To consider the ongoing Work Plan for the Adults & Health Scrutiny Panel.  

RESOLVED: That consideration of this item be deferred.

There were no new items of urgent business.

Tuesday 17^th March, 6.30pm

Tuesday 17 March 2015, 6.30pm (subject to change).

18:30 hrs to 22:12 hrs