Agenda and minutes

It was noted apologies for absence had been received from Cllr Pippa Connor, Chair of the Panel. As a result, it was AGREED that Cllr Peter Mitchell should preside as chairman for the meeting.

The Panel was informed that apologies for absence had also been received from:

-       Cllr Charles Adje (substituted by Cllr Gideon Bull);

-       Cllr Liz McShane; and 

-       Cllr Jason Arthur, Cabinet Member for Finance and Health.

Please note that this meeting may be filmed or recorded by the Council for live or subsequent broadcast via the Council’s internet site or by anyone attending the meeting using any communication method. Although we ask members of the public recording, filming or reporting on the meeting not to include the public seating areas, members of the public attending the meeting should be aware that we cannot guarantee that they will not be filmed or recorded by others attending the meeting. Members of the public participating in the meeting (e.g. making deputations, asking questions, making oral protests) should be aware that they are likely to be filmed, recorded or reported on. 

By entering the meeting room and using the public seating area, you are consenting to being filmed and to the possible use of those images and sound recordings.

The chair of the meeting has the discretion to terminate or suspend filming or recording, if in his or her opinion continuation of the filming, recording or reporting would disrupt or prejudice the proceedings, infringe the rights of any individual or may lead to the breach of a legal obligation by the Council.

The Chair referred Members present to agenda Item 1 as shown on the agenda in respect of filming at this meeting, and Members noted the information contained therein’.

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 as noted below.

None.

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.

None.

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

None.

To approve the minutes of the Adults and Health Scrutiny Panel meeting held on 11 July 2016.

AGREED: That the minutes of the meeting held on 11 July 2016 be approved as a correct record.  

The attached report, to be introduced by the Head of Strategic Commissioning, provides an update on work undertaken to ensure sufficiency of foot care provision in Haringey.

Charlotte Pomery, Assistant Director, Commissioning, provided an update on Haringey foot care services. It was noted that during 2015/16, the Panel’s work programme had focused on ensuring there was sufficient foot care provision in Haringey. It was noted the take up of foot care services by older people was an important measure in preventing falls and treating acute conditions such as poor circulation as a result of diabetes. 

During the discussion a variety of issues, highlighted in the report, were considered, including: 

-       Recent changes that had been made to foot care provision in Haringey, including the development of community-based preventative services following the closure of the Haven Day Centre, and progress that had been made to ensure continuity of service.

-       The locations, outlined in 6.4 of the report, where each year over 650 older adults received community-based services. In addition, it was noted that the Foot Care + service had started to visit new locations, previously visited by staff from the Haven Day Centre. In response to questions, Ms Pomery agreed to send Panel Members further information to explain why Larkspur Close had not been used by the Foot Care + service.   

-       The steps that had been taken to tackle performance issues with the Whittington Health Podiatry and Foot Health Service.  The Panel was informed that Haringey and Islington CCGs managed the performance of the service via regular contract performance monitoring meetings. The Panel was informed that both CCGs had identified the need to improve performance and that the service would be developing an action plan to deliver improvements to ensure the service met expected targets. 

-       The performance of the Podiatry and Foot Health Service at July 2016, outlined in section 7.2 of the report, was noted. Concerns were raised in relation to the number of patients waiting more than six weeks for their first appointment. However, it was suggested that additional monitoring was required in relation to the maintenance of the service (e.g. the time you wait for an appointment once you are in the system). The Panel asked Ms Pomery to circulate further information on the performance matrix that was used for the service.

-       The work, outlined in section 8 of the report, that was taking place to raise awareness of foot care services across the borough. It was noted  this was being done via a variety of channels, including: the nurse and health care assistant forum; the locality teams; the Haringey Advice Partnership; Patient Advice and Liaison Services; the Integrated Access Team; Haricare; and NHS Choices.

-       The information provided by Haricare. The Panel noted the correct information was not always available at the right time to enable citizens, service users and carers to help themselves effectively and to be aware of their own health so they could take steps to manage emerging or existing conditions.

-       Concerns in relation to the number of older people who may have problems carrying out basic foot care, such as nail cutting, by  ...  view the full minutes text for item 24.

This report, to be introduced by the Assistant Director, Adult Social Services, provides summary information to support a follow-up scrutiny discussion (following an all Members Learning and Development Session on 21^st September 2016) to contribute to the development of new ways of working, through an Integrated Target Operating Model that will; enable Adults in Haringey to live healthy, long and fulfilling lives by maximising their independence and support the future financial sustainability of health and care services in the borough.

Following discussion at a Members Learning and Development Session on 21 September, John Everson, Assistant Director of Adult Social Services, provided an update on developments concerning Haringey’s Integrated Target Operating Model (ITOM). The Panel was asked to note:

-       The significant funding and demand challenges facing Adult Social Services, Public Health and Health Services.

-       That the Council’s vision for adults in Haringey, and the guiding principles for service transformation (agreed by Cabinet on 16^th June 2015), placed an emphasis on values that promoted and maximized an individual’s independence, dignity, choice and control.

The Panel was informed that the Council’s approach, outlined by Priority 2 of the Corporate Plan, was based on a shift from institutional care towards community and home based solutions. 

Mr Everson explained that in order to deliver the Council’s vision of maximising independence and managing future demand pressures, whilst achieving financial sustainability, the Council had agreed a genuinely transformational approach between Adult Social Services, Public Health and Haringey CCG. 

In response to questions, the Panel was informed that the road-map for delivering a new sustainable model of health and care was set out in the ITOM. It was noted that as the model evolved it would support progressively greater integration between all services to deliver the significant change required.

Mr Everson advised, that in order to inform the development of the ITOM, work had been undertaken with service users, carers, staff and partners to ensure the Council was clear about its current service offer (the “As Is”), what people wanted for the future (the “I statements”), and how these may be delivered. It was noted that additional information, concerning service user, partner and carer engagement, had been provided as part of Appendix 1 to the report.

The Panel was informed objectives in Haringey’s Corporate Plan had a strong ‘whole population’ public health focus and would inform the future operating model. Dr de Gruchy, Director of Public Health, went on to provide information on the importance of prevention and various primary, secondary and tertiary prevention strategies. This included consideration of population, community and personal health issues. The Panel also considered the current service offer, outlined on a large process map, including entry and exit points for adult social care and the health and social care pathway.  

During the discussion, reference was made to the following:

-       The current budget position and the financial performance of Priority 2 Services (Adult Social Care, Commissioning and Public Health). It was agreed that further consideration needed to be given to these issues as part of the Panel’s planned Budget Monitoring session on 17 November. 

-       The importance of mental health services, day opportunities and the support provided by the Community Reablement Service.

-       The benefits and flexibility of using a Dynamic Purchasing System to streamline procurement for both suppliers and the Council. 

-       The schedule for developing the ITOM, as outlined in Appendix 1 to the report. 

-       Issue relating to the use of personal budgets and direct payments.

-  ...  view the full minutes text for item 25.

The Panel will receive an update, via PowerPoint presentation from the Assistant Director Commissioning, on issues arising in relation to promoting a sustainable and diverse market place following the Commissioning for Better Outcomes Peer Review undertaken in the borough.

Charlotte Pomery, Assistant Director Commissioning, provided an update on issues arising for the Council in relation to promoting a sustainable and diverse market place in light of the Care Act and following the Commissioning for Better Outcomes Peer Review that had been undertaken in Haringey during February 2015.   

To set the scene, Ms Pomery commenced her presentation by providing information on the Department for Health’s Care Markets Work Programme. The Panel was informed that a number of workstrands had been supported by the government in order to support local authorities to achieve the ambitions and statutory requirements for commissioning, market shaping and contingency planning and provider failure set out in the Care Act. Information was provided on the following:

-       The Government’s Market Shaping Review

-       A CIPFA project on adult social care finance, costs, fees and sustainability

-       Local contingency planning.    

Following discussion by the Panel in January 2015, it was noted that a key line of enquiry related to promoting a sustainable and diverse market place. With this in mind, the presentation from Ms Pomery, focused on both strengths identified by the Haringey peer review team and areas identified for consideration / action moving forwards.

The Panel was asked no note:

To receive a verbal update, from the Assistant Director Commissioning, on the Home Care Market across Haringey.

Charlotte Pomery, Assistant Director, Commissioning, provided an update on the home care market across Haringey. Ms Pomery outlined how the Council was working with providers to ensure the development of a diverse, effective and high quality local market.

The following issues were discussed:

-       The various pressures on local government finances and the need to make better use of resources.

-       The fragility of the home care market, including demand and capacity issues facing national providers, pressures on staffing and the impact of Brexit on the sector.

-       The role and responsibilities of the Care Quality Commission and the Haringey Safeguarding Adults Board. 

-       The work being carried out across London via the Care Act Commissioners Network.   

-       The fact the Council was focusing much more on outcomes. It was noted that this was highlighted by Haringey’s outcomes based framework for Home Care.

-       The benefits and flexibility of using a Dynamic Purchasing System to streamline procurement for both suppliers and the Council.   

-       Transfer of undertakings (TUPE) regulations in relation to the home care sector, including local issues relating to Sevacare.

Alternative, longer term, models for Home Care were also considered as part of this item.   

AGREED: That the update on the Home Care Market across Haringey be noted.

This report gives details of the proposed scrutiny work programme for the remainder of the municipal year.

Christian Scade, Principal Scrutiny Officer, provided an update on the proposed work programme for the remainder of the 2016/17 municipal year.

During the discussion, reference was made to: 

-       The fact the Panel had been invited to attend, and take part in, Enfield’s Health Scrutiny Committee on 5^th October. The Panel was informed that this was an opportunity to monitor developments at the North Middlesex University Hospital following a Care Quality Commission report, published in July, relating to urgent and emergency care services and concerns about standards of care.

-       The dates for budget scrutiny for 2016/17.  It was noted the Panel would meet on 20^th December to consider budget proposals relating to Corporate Plan Priority 2 (P2).  

-       The roles and responsibilities of scrutiny in relation to budget monitoring. It was noted that the Panel would hold a special meeting, on 17 November, to consider an update on the financial performance of P2 services (Adult Social Care, Commissioning and Public Health). The Panel requested information about performance against forecast savings.

-       The meeting schedule for the scrutiny review into Physical Activity for Older People.

In addition, it was noted that:

-       Under agenda item 7, the Panel had requested an update on Foot Care Services, for consideration during 2017/18.

-       Under agenda item 8, the Panel had agreed the Chair of the Panel would meet the Assistant Director, Adult Social Services, outside the meeting, to consider (formal and/or informal) options for scrutiny input before the scope and timeframes for each Business Critical Project were confirmed for the Integrated Target Operating Model.

AGREED:

(a)  That, subject to the additions, comments and amendments, referred to above, the items outlined in Appendix A of the Work Programme Update be approved and recommended for endorsement by the Overview and Scrutiny Committee on 17 October 2016.

(b)   That the scope and terms of reference, attached at Appendix B to the report, for the Panel’s review on Physical Activity for Older People be approved and recommended for endorsement by the Overview and Scrutiny Committee on 17 October 2016.

To consider any items admitted at item 3 above.

None.

The following dates are listed in the diary:

-       17 November 2016

-       1 December 2016

-       20 December 2016 (Budget Scrutiny)

-       6 March 2017

The Chair referred Members present to item 13 as shown on the agenda in respect of future meeting dates, and Members noted the information contained therein’.