Agenda and draft minutes

Adults & Health Scrutiny Panel
Thursday, 9th September, 2021 6.30 pm

Venue: 40 Cumberland Road, Wood Green, London N22 7SG (2nd Floor, 1st Meeting Space)

Contact: Dominic O'Brien, Principal Scrutiny Officer, Email: dominic.obrien@haringey.gov.uk 

Note: To watch the meeting click the link on the agenda frontsheet 

Items
No. Item

12.

FILMING AT MEETINGS

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.

Minutes:

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’.

13.

Apologies for absence

Minutes:

Apologies for absence were received from Cllr Nick da Costa and Helena Kania.

 

14.

Items of Urgent Business

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).

Minutes:

A report was tabled regarding the possible relocation of the Grace Organisation from the Whitehall & Tenterden Centre on Whitehall Street to the disused Council-owned building previously used as the Irish Cultural and Community Centre. This followed a site visit to the Irish Cultural and Community Centre site by the Panel on 7th September 2021.

 

This report was discussed under the Cabinet Member Questions item.

15.

Declarations of Interest

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.

Minutes:

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.

 

Cllr Gideon Bull declared that he was currently employed by NHS England.

 

16.

Deputations/Petitions/ Presentations/ Questions

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

Minutes:

None.

 

17.

Minutes pdf icon PDF 235 KB

To approve the minutes of the previous meeting (28th June 2021) and the notes from a special briefing meeting (24th June 2021).

Additional documents:

Minutes:

The minutes of the previous full Panel meeting and the notes of the additional special meeting were approved as an accurate record.

 

RESOLVED – That the notes of the special meeting held on 24th June 2021 be approved as an accurate record.

 

RESOLVED – That the minutes of the meeting held on 28th June 2021 be approved as an accurate record.

 

18.

Haringey's Integrated Discharge Arrangements pdf icon PDF 399 KB

To provide details to the Panel on:

 

a)    The hospital discharge arrangements currently in place across North Central London to support Haringey residents to return home, including those who have additional care needs out of hospital.

b)    The NHS Continuing Health Care (CHC) arrangements in North Central London and how this is joined up with social care services.

Minutes:

Hospital Discharge Arrangements

 

Paul Allen, Head of Integrated Commissioning (Integrated Care & Frailty) at NCL CCG and Haringey Council, introduced the report stressing that there was a multi-agency effort to discharge people from hospital to help them to recover in a safe and timely way, ideally to their own home. Paul Allen added some brief comments on key points in the report:

 

  • There was a process called Discharge to Assess which involved discharging patients out-of-hospital to recover as much as possible and then assessing their long-term needs afterwards. The Covid-19 pandemic had both reinforced the importance of this approach and accelerated the plans for this model to be used.
  • Another important area was the establishment of acute-based and multi-agency Integrated Discharge Teams (IDT) including at Whittington Hospital and North Middlesex University Hospital.
  • Reporting requirements had changed following the suspension of statutory monitoring of delayed transfers of care in April 2020. Alternative measures on length of stay in hospital were now being used as set out in paragraph 3.8 of the report.
  • The report had been written just before the recent government announcement to extend the funding for the additional costs of out-of-hospital placements beyond September.

 

Alison Kett, Director of Operations for Adult Services at Whittington Health NHS Trust, added that pressures on services the previous winter had been unprecedented. While this had plateaued since then, the Trust was anticipating the coming winter to be challenging with Covid patients in the hospital in addition to the existing caseload, but were now in a much better place to deal with this. From a community perspective, additional funds had been provided to support the prevention of hospital admissions, including through the Rapid Response service.

 

NnennaOsuji, Chief Executive of the North Middlesex University Hospital NHS Trust, commended the intra-agency working that had developed during the pandemic and emphasised the importance of having the right discharge arrangements noting that this impacted all the way through to the emergency department. They chaired a joint A&E Delivery Board which looks at inflow, throughflow and outflow. She added that the funding announcement from the government had been welcome ahead of what was likely to be a difficult winter and recognised that a system-wide effort would be required to minimise admissions where possible, optimising patient time in hospital and maximising discharge.

 

 

Cllr Gideon Bull asked about the issue of delays in offloading patients from ambulances to A&E. Alison Kett acknowledged the pressures in this area and the knock-on effect on the rest of the system, noting that this was closely scrutinised. Nnenna Osuji added that the Trust aimed to offload 95% of ambulances within 15 minutes. Offload times that exceeded 30 minutes or 60 minutes were also closely monitored with the latter measure regarded as a significant breach. This was regionally and nationally monitored so there was an intense degree of scrutiny involved.

 

Cllr Bull asked about the assessments carried out on patients prior to discharge. Nnenna Osuji said that the Trust worked hard to  ...  view the full minutes text for item 18.

19.

Day Opportunities Scrutiny Review (Monitoring of Recommendations) pdf icon PDF 240 KB

To track progress against the recommendations of the Adult & Health Scrutiny Panel’s review report on Day Opportunities that was originally published in June 2019.

Additional documents:

Minutes:

Cllr Connor noted that the report provided updates on the recommendations from the Panel’s previous Scrutiny Review on Day Opportunities in Haringey.

 

Recommendation 1 related to Canning Crescent. Charlotte Pomery, AD for Commissioning, explained that Canning Crescent was previously a mental health clinic owned by Barnet, Enfield & Haringey Mental Health Trust (BEH-MHT) before the premises was purchased by the Council. It was being redeveloped with stakeholders as a new crisis café for people at risk of mental health crisis and a space for the relocated Clarendon Recovery College which was for people coming through mental illness. It was being delivered by BEH-MHT and the Council working with service users. A neighbourhood engagement event had recently been held.

 

Cllr Demir noted that the recommendation included a reference to the model adopted by Mosaic Clubhouse in Lambeth and said that this was a brilliant service, centred on service user involvement. Charlotte Pomery said that they had looked at best practice from various different models in responding to the recommendation made by the Panel. The model of the Clubhouse was a mixed model that responded to service user need, avoiding admission, supporting discharge and helping people to live in the community safely. Asked by Cllr Connor about co-production, Charlotte Pomery said that a group of service users were working with clinicians and practitioners to develop the model.

 

Cllr Peacock expressed concerns about the impact on people with mental health needs of the previous closure of mental health facilities at 684 High Road in Tottenham. Charlotte Pomery said that this underlined why such provisions were needed in local communities that are inclusive, accessible and provide meaningful occupations for people with mental health needs. Cllr Peacock highlighted the transport issues for people in Tottenham to get to these new services in Wood Green. Charlotte Pomery responded that the crisis café was an additional service in the borough which was centrally located and had good transport links. Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Well-being, noted that one of the relocated services was originally located in the west of the borough and that it would be useful to review what other provision was available in other parts of the borough. The Council was fully committed to continuing this new service and partnering with BEH-MHT should help with sustainability of the funding and prevent the kind of closures that Cllr Peacock had referred to in the future. She added that the building in Canning Crescent would provide a therapeutic space for people with a good amount of space and interaction between different services.

 

Cllr Bull raised the importance of preventative measures on mental health. Charlotte Pomery agreed that access to good quality education, employment, housing, and many other factors were clearly relevant to maintaining good mental well-being and so wider preventative measures were fundamentally important. Beverley Tarka concurred with this and added that the Council had recently been successful in a bid to the Great Mental Health fund which would provide over £300k  ...  view the full minutes text for item 19.

20.

Cabinet Member Questions

An opportunity to question the Cabinet Member for Health, Social Care and Well-being, Cllr Lucia das Neves, on developments within her portfolio.

Minutes:

Cllr das Neves, Cabinet Member for Health, Social Care and Well-being, introduced this item with an update on some key issues:

  • Mental wellbeing had been identified as a priority and some public health funding had recently been secured to support this, as had been discussed earlier in the meeting. World Suicide Prevention Day was taking place that week and partner agencies were hosting an event to promote this. Partnership working was needed so that services look at needs throughout the borough and bring together all the expertise and knowledge together.
  • There had recently been in increase in demand for care services since the pandemic, including an increase in more complex needs and cases involving ‘Long Covid’. The lack of stable funding and a strategic approach from the government was a challenge, particularly because of the need for investment in the workforce. The Council had committed to paying the London Living Wage to care staff and to ensuring that providers were doing the same.
  • Co-production had been an important priority in recent years and a lot had been learned in how to work with service users, people with lived experience and the wider community, to build projects including through the work on Osborne Grove. There was more to do to develop this approach in terms of commissioning, governance and management of services.
  • Violence Against Women and Girls (VAWG) was an important area and the Council was looking at ways to bring in more funds to resource this area, including through a bid to the Home Office on safety for women at night.
  • Discussions had been taking place recently on food poverty, including support for the Haringey Food Network and other projects in the borough.
  • There had been conversations about collaborative working, for example by coming together with mental health services and criminal justice to address substance misuse.
  • The Council’s ongoing pandemic response remained an important area of work including air quality monitoring for schools to reduce the transmission of Covid and different approaches to make the vaccine available in community settings.

 

Cllr das Neves and senior officers then responded to questions from the Panel:

  • Cllr Connor explained that the Panel had visited the site of Irish Centre in Tottenham earlier in the week as part of the Panel’s examination of proposals to relocate the Grace Organisation (a provider of day opportunity services) to part of the building. She noted that the building seemed to be in poor condition and asked about the source of the capital funding required for renovation work. Cllr das Neves confirmed that further details could be provided about this in writing. (ACTION) Cllr Peacock said that she had previously been vice-Chair of the Irish Centre and had been shocked to see the poor condition of the building and the wasted food found inside. Charlotte Pomery said that the building was currently a construction site and that investment was currently being made on the enhancement works to the building. The wasted food had been there when  ...  view the full minutes text for item 20.

21.

Work Programme Update pdf icon PDF 382 KB

To consider any additions or amendments to the Panel’s current work plan for 2021/22.

Minutes:

Cllr Connor reminded the Panel that evidence sessions would be taking place for the Review on Health and Care in Sheltered Housing on 29th September.

 

A site visit to see the localities work in north Tottenham was planned to take place prior to the next Panel meeting where there would be an agenda item on this issue.

 

22.

Dates of Future Meetings

·         15th November 2021

·         16th December 2021

·         3rd March 2022

 

Minutes:

·         15th November 2021

·         16th December 2021

·         3rd March 2022