Agenda and minutes

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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’.

Apologies for absence were received from Cllr Felicia Opoku and Cllr Mike Hakata.

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.

Cllr Pippa Connor declared an interest by virtue of her membership of the Royal College of Nursing.

Cllr Pippa Connor declared an interest by virtue of her sister working as a GP in Tottenham.

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 previous meeting.

Cllr Connor reported that following the agenda item at the previous meeting on St Ann’s hospital, she would be meeting with Sarah Mansuralli, Director of Strategic Commissioning at North Central London CCGs, later in the month to discuss this further. Feedback on St Ann’s hospital is also expected at the North Central London Joint Health Overview & Scrutiny Committee meeting due to take place at Haringey Civic Centre on 31^st January.

Cllr Connor referred to the agenda item at the previous meeting on safeguarding policies and noted that there was a new initiative to look at transitional safeguarding in conjunction with Children’s Services, so information on this should be available for next year’s report.

Cllr Connor also referred to a suggestion made by a member of the public at the last meeting that neighbourhood watch groups should be provided with a safeguarding guide of what to look for as they are well placed as the largest community group in Haringey to widen the scope of safeguarding. This had not previously been recorded as an action point but it was suggested that a response to this would be welcomed and so Beverley Tarka, Director of Adults and Health, agreed to look into this. (ACTION)

Other action points recorded in the minutes had either already been circulated or would be followed up shortly.

The accuracy of the minutes from the previous meeting was then agreed.

AGREED: That the minutes of the meeting held on 14^th November 2019 be approved as an accurate record.

To scrutinise progress on joint commissioning and integrated care.

Tim Miller, Joint Assistant Director for Vulnerable Adults & Children at Haringey Council & Haringey CCG and Paul Allen, Head of Integrated Commissioning (Integrated Care & Frailty) at Haringey CCG, presented slides to the Panel on joint commissioning and integrated care. The key points covered were:

• The Better Care Fund Plan funds three main elements of a “community-based system:

o   A community-based approach to commissioning and asset building.

o   Multi-agency anticipatory care solutions to manage people who could benefit from a coordinated approach.

o   Crisis and Recovery Pathways.

• A community-based approach to commissioning which is about mobilising all assets within a community to support individuals at an earlier stage with their health and care needs. This requires information, advice and guidance targeted at the right individuals and community navigation (such as Local Area Coordinators) and social prescribing to connect people to community solutions.
• The multi-agency anticipatory care solutions bring together professionals to discuss social and medical needs of people. Examples of this include:

o   Haringey Coordination & Prevention Team – this includes nurses, therapists, pharmacists, social care workers and community navigators which manage cases of people with complex needs.

o   Multi-disciplinary team (MDT) Tele-conferences for older people – these focus on individuals with multiple A&E or hospital admissions and enable the coordination of a care plan.

o   Frailty Care Closer to Home – this focuses on individuals with less complex needs but moderate frailty issues who may need community navigation or a comprehensive geriatric assessment.

• Crisis and Recovery Pathways refers to services that help people to recover their health and independence after an illness/crisis or to avoid a crisis/hospital episode. Examples include:

o   Nurse-led Rapid Response to help people avoid hospitalisation

o   Single Point of Access that triages people into the right solution

o   Home-based reablement to help recover daily living tasks

o   Bed-based rehabilitation to help people with more complex needs

• The jointly provided and commissioned care services for adults with severe mental health conditions or learning disabilities comprise of three main elements:

o   Care teams – such as Haringey Learning Disability Partnership and Mental Health Locality Teams which include doctors, nurses, therapists, social workers and some third sector staff working together as an integrated team to provide individuals with the care and support that they need.

o   Personalised assessment and planning – the team works together with individuals to develop a care plan and some people may have the right to a personal budget to meet any eligible care needs.

o   Care funding – community and preventative services are jointly commissioned by the Council and the CCG. Individual care packages are also jointly funded by the Council and the CCG.

Tim Miller and Paul Allen then responded to questions from the Panel:

• Asked how ‘crisis’ is defined, Paul Allen said that medically this is when an individual’s biophysical-social model of health has suddenly dropped to a low level. The rapid response service visits people in their homes in crisis situations which may be able to stabilise someone and prevent the need  ...  view the full minutes text for item 41.

To scrutinise the revenue and capital proposals relating to the 2020/21 Draft Budget and the Medium Term Financial Strategy for 2020/21 to 2024/25.

Beverley Tarka, Director for Adults and Health, introduced the report for the 2020/21 draft budget and the Medium Term Financial Strategy (MTFS) for 2020/21 to 2024/25. The MTFS agreed in Feb 2019 had identified a budget gap of £13.1m for 2020/21 that would need to be addressed through further budget reductions. The recent spending review confirmed the social care funding at 2019/20 levels plus an additional £5m. The overall budget gap for 2020/21 has been reduced from £13.1m to £5.5m. Brian Smith, Business Partner, gave further detail on this saying that there was £5m of pre-agreed savings in the 2020/21 budget along with some additional savings to agree this year. The Council budget also has growth of £11.6m, comprising of just over £6m for the London Living Wage and demographic growth of £5.5m, and £9m of additional funding from the social care precept and the external social care grant. Cllr Connor queried why in that case, Appendix B to the report showed the Adults part of the budget as being £83.5m in 2019/20 but £76.1m in the draft budget for 2020/21, a reduction of over £7m. Brian Smith responded that the £83.5m figure may be incorrect and so the finance team would look into this send a corrected figure to the Panel (ACTION).

In response to further questions, Brian Smith clarified that the Adults budget is £4.4m higher in 2020/21 than in the previous financial year. The savings for 2020/21 that had already been agreed in previous years total £4.039m and the new savings relating to Osborne Grove are £1.034m amounting to overall savings in 2020/21 of £5.073m. Asked about the progress on the previously agreed savings, John Everson said that these were currently running slightly behind track but that the likelihood of delivering the savings is high.

Cllr White commented that it would be easier to scrutinise the budget if all of these figures had been included in the report to the Panel and that this ought to be provided in future budget scrutiny reports.

The Panel than moved on to scrutinise the two MTFS budget reduction proposals included in the agenda papers.

PE01 Public Health Lifestyles

Will Maimaris, Director for Public Health, set the context for this item by stating that the public health grant received by the Council had been reducing for several consecutive years, leading to reductions in services, but was expected to rise next year. There is a budget of £700k used to fund an integrated lifestyles service in areas such as smoking cessation, exercise and NHS Health Checks. The budget reduction proposal aims to make an additional saving of £60k, representing a cut of nearly 10% to the budget which could potentially be partly mitigated by seeking alternative funding from partners such as the CCG. There are a number of options for reducing this budget. Existing services could be targeted at people who need them most and the NHS Health Check offer could be reviewed, as there has been a lack of long-term  ...  view the full minutes text for item 42.

To consider potential issues for inclusion within the work plan.

Cllr Connor drew the Panel’s attention to the latest work programme, noting that the commissioning project was continuing with dates for several evidence sessions currently held in the diary. The next full Panel meeting in February 2020 is due to receive reports on a review of service improvement within the Adults & Health directorate and an update on Canning Crescent.

Cllr Culverwell raised concerns around staffing issues at Osborne Grove Nursing Home. Cllr Connor suggested that he raise this directly with Beverley Tarka and to then bring this back to the Panel if he still had further concerns about this.

-       25^th February 2020 (6:30pm)

• 25^th February 2020