Agenda and minutes

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’.

Apologies for absence were received from Cllr Thayahlan Iyngkaran.

It was noted that Cllr Mary Mason had joined the meeting and that she had expressed an interest in joining the Panel.

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 highlighted concerns that had expressed by the Panel about the format of the budget papers received at the previous meeting and suggested that the dialogue with finance officers about the budget papers for next year be commenced at an earlier stage. (ACTION)

The minutes of the previous meeting were approved as an accurate record.

RESOLVED – That the minutes of the meeting held on 8^th December 2022 be approved as an accurate record.

To provide an update on the work that Adult Social Care and the Integrated Care Board have undertaken to support hospital discharge in Haringey.

Rachel Lissaeur, Director of Integration for Haringey at the North Central London Integrated Care Board (NCL ICB), introduced the report on this item and highlighted the context heading into winter 2022/23. Within primary care, GPs were seeing more people than they had at the same time the previous year and the proportion of face-to-face appointments had also increased while the proportion of people being seen on the same day was around 50% of those presenting to primary care. There was also an increase in Emergency Department attendances, particularly at North Middlesex Hospital, but this was mainly for minor illnesses and there was not an increase in people being admitted to hospital. Staff sickness levels were also up across the country. Emergency Departments were therefore extraordinarily stretched and this was the context for the increased ambulance waiting times. The additional funding provided through the Winter Access fund has been focused on increasing the number of primary care appointments and increasing the primary care presence within the Emergency Department at North Middlesex Hospital.

Rachel Lissaeur went on to explain that the adult social discharge fund was distributed to both local authorities and ICBs with the aim of taking more people through the system, expediting discharges and reducing the length of hospital stays. Additional funding had been put in place to support GPs to see more children face-to-face, to add nursing capacity and acute respiratory infection hubs.

Another initiative was to put two GPs at the Emergency Department at North Middlesex from 8am to 8pm in recognition that there were high numbers of people attending with minor illnesses in need of medication or advice. Over 80% of the available appointment slots had been used, enabling around 200 additional patients to be seen each week.

Rachel Lissaeur, Vicky Murphy, Service Director for Adult Social Services and Cllr Lucia das Neves, Cabinet Member for Health, Social Care & Well-being, then responded to questions from the Panel:

• Asked by Helena Kania how the GP services at the Emergency Department was being publicised, Rachel Lissaeur explained that this wasn’t being advertised as such but that patients were triaged with nurses deciding whether someone was suitable to see a GP.
• Asked by Helena Kania about the situation at the Whittington Emergency Department, Rachel Lissaeur said that they also had seen increases in attendances, though not at the same levels as North Middlesex. There were GPs at the front door of the Whittington but they had not received the Winter Access funding. The mix of cases at North Middlesex leant itself better to seeing GPs with a higher proportion of working-age adults and young people. Helena Kania queried whether additional funding was required at the Whittington. Rachel Lissaeur responded that they had a very substantial ambulatory care service that worked efficiently and they didn’t have the same level of pressure on their Emergency Department as at North Middlesex, which is why the additional capacity had been added at the North Middlesex. However, the real challenge over the winter in the  ...  view the full minutes text for item 50.

To provide an update on the provision of aids and adaptations following the recommendations made by the Panel in September 2022. Minutes from the September 2022 meeting are available to view at: https://www.minutes.haringey.gov.uk/mgAi.aspx?ID=74001

Vicky Murphy noted that significant additional work had been carried out in the area of Aids & Adaptations/Disabled Facilities Grant (DFG) since the previous scrutiny item on this in September 2022. Janet Bradbury, new interim Head of Service covering aids and adaptations, noted that the issues raised by the Scrutiny Panel had largely concerned delays and communication issues. She then presented slides on the recent work which included the following key points:

• Standard letters had been developed and sent to service users at every stage of the process and the wording of these letters had been checked with Disability Action Haringey and they included information about expected timescales and contact details.
• Everyone on the waiting list as of October 2022 (approximately 800 people) received a personal phone call to check that they understood the process and the progress of their case.
• Delays had been reduced through additional capacity in surveying and assessment and the number of people waiting for an adaptation to be completed had reduced from 812 in August 2022 to 448 in February 2023 and it was expected that this would be reduced further through external contracting. Of the remaining 448 people:

o   66 had seen the work completed but the review stage was still underway;

o   in 125 cases, the work was in the process of taking place;

o   in 184 cases, surveyors were working to draw up specification, arrange for contractors or putting work out to tender;

o   73 cases were being allocated to an external surveyor. 

• In terms of communications, it had been found that officers did not always provide their contact details after a contact with residents and that some residents were unclear about which phone number they should call. This was a particular problem when there were long delays between stages of the work. Residents could now expect to be provided with officer contact details after every visit.
• Residents were also now proactively being provided with a copy of their support plan unless they specifically said that they didn’t want it. The support plans included details of what had been agreed with the resident, actions being taken and a list of conversations that had occurred.
• Residents waiting for an adaptation to be completed would be proactively contacted by phone every 4-6 weeks to check how they were doing and to update them on expected timescales.
• The next steps involved continuing the ongoing journey of culture change by carrying out a series of workshops involving staff and engaging with service users to improve their experience, deep diving into complaints and challenging inefficiencies in the system.
• Recruitment was currently being made to occupational therapy and surveyor vacancies, though this was challenging due to current workforce shortages in these areas, particularly for occupational therapists. 
• The team was moving to a new client record system which should allow better tracking of timescales. It was also necessary to improve prioritisation of new referrals according to government guidance.
• The team was looking at adding more detailed information to the Council  ...  view the full minutes text for item 51.

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

Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Well-being, began this item by setting out some recent developments in her portfolio area:

• Mental health was a key priority area and the public health team had recently held a workshop with mental health providers across the borough from the statutory and voluntary/community sectors to discuss existing services and possible gaps. She acknowledged that Councillors had been concerned about some of the casework that they had picked up around mental health issues and wanted to see more preventative action and the addressing of gaps in services.
• Gambling harms was also an important issue and, while the Council was limited in how it could prevent gambling establishments from opening in the High Streets, efforts had recently been made to look at support services. A summit had recently been held around gambling harms and a government White Paper was expected soon.
• On the issue of Violence Against Women & Girls (VAWG), Cllr das Neves had recently visited a secondary school in the Borough along with a worker from Solace Women’s Aid and had a good conversation with young women about what they experience in schools. This raised questions about ensuring that girls and boys in schools across the whole borough had access to those type of conversations. The Council would soon begin the process of commissioning VAWG services and this would involve Councillors and people with lived experience. The reach of services had been increased to include older women and LGBTQ+ women.

Cllr das Neves then responded to questions from the Panel:

• Cllr Connor noted that the Overview & Scrutiny Committee had recommended in 2022 that research be undertaken in Haringey to strengthen the evidence base on gambling harms, which could potentially be used as part of a decision to refuse applications for gambling licences. Cllr das Neves said that the Council had been waiting for some considerable time to hear about potential funding for this. She added that some useful conversations had emerged from the recent summit with people who were interested in being involved with this work so it was hoped that progress could be made on this soon. However, she was not persuaded that the research would necessarily enable the Council to refuse licensing applications due to the emphasis of national legislation on permitting applications and so the content of the Government’s forthcoming White Paper would have to be looked at closely. In response to a question from Cllr Opoku about what Councils can do collectively, Cllr das Neves said that she had been speaking to some of her NCL counterparts about this and one option could be a collective written response to the Government’s White Paper after it was published.
• Asked by Cllr Abela for further details on the support provided to residents dealing with gambling addiction, Cllr das Neves said that people could access a helpline but there were two workers who were going to come in to provide coaching and psychosocial support, including by having a  ...  view the full minutes text for item 52.

To discuss priorities for the Panel’s meetings in 2023/24. Dates for the 2023/24 meetings are expected to be confirmed shortly.

Dominic O'Brien, Scrutiny Officer, reported that the first meeting of 2023/24 would be on 22^nd June 2023 with further meetings to follow in September, November, December and February. An update to the Council’s response to the Living Through Lockdown report produced by the Joint Partnership Board was due to be considered at the September meeting. The November meeting would include updates on the Haringey Safeguarding Adults Board (HSAB) annual report, the CQC/quality assurance and on the responses to the Panel’s Scrutiny Review on co-production. In relation to the HSAB annual report, the Panel had asked for information about modern slavery to be included in the update. Updates on the Osborne Grove Nursing Home project and on the workforce strategy were also expected but were yet to have a date scheduled.

The Scrutiny Review being carried out by the Panel was on discharge from hospital (including barriers to discharge relating to sheltered housing) with another Review on digitalisation and communications with residents expected to take place later in the year.