Agenda item

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

Cllr das Neves responded to questions from the Panel on issues within her portfolio:

• Cllr O’Donovan raised the recent government announcement that Healthwatch would be abolished and queried what this would mean for local Healthwatch arrangements, given that these were commissioned by the local authority. Cllr das Neves said that this was currently unclear but clarified that the local Healthwatch was funded from the Council’s Public Health budget. She added that the Council relied on the local Healthwatch as an important part of holding health services to account and also noted that Healthwatch was a part of the Health and Wellbeing Board. There would be conversations with the local Healthwatch about their understanding of what the national picture would mean for them.
• Asked by Cllr O’Donovan about the NHS neighbourhood model and how this might fit with Haringey’s localities approach, Cllr das Neves said that this could potentially build on positive developments in the community, such as on early intervention and prevention, which could deliver better outcomes for people. However, it was not yet clear how this overall approach would be funded. She added that there were ongoing financial issues to work through, such as the lower levels of NHS spending on Continuing Healthcare in North Central London (NCL) when compared to other regions. Sara Sutton commented that the recent announcement that Integrated Care Boards (ICBs) would be required to reduce their budgets by 50% meant that there were ongoing discussions about the future landscape of ICBs including potential mergers. In addition, the NHS 10-year plan was expected to be published shortly and to strongly signal a shift towards neighbourhood health. She added that Haringey was well positioned to align to this with strong existing strategic partnerships with health and good foundations through the Borough Partnership and localities work.
• In relation to neighbourhood health, Cllr Mason highlighted the lack of a good space for people to gather in the more deprived areas of Bounds Green. Cllr das Neves agreed that it was important to have the necessary infrastructure in place to enable the voluntary and community sector but acknowledged the current financial pressures that created challenges in this area. Sara Sutton added that the NHS was looking at various ways of shifting care from acute settings to community settings and there was a consensus to include the voluntary and community sector in this. However, there was not yet the long-term stable investment in the way that was needed in the sector to support complex coordination so the Council was making this case to the government. 
• Cllr Brennan requested a progress update on Continuing Healthcare (CHC) funding in NCL. Cllr das Neves responded that there was Freedom of Information data available which showed that some sub-regions of London were receiving more than twice as much CHC funding as in NCL so this was a very significant issue. Jo Baty added that the Council had conducted work in this area, reviewing the cases of residents with complex needs. This had resulted in over £1m of achieved savings in one financial year. One of the historic issues had been a lack of expertise in challenging the health professionals that tended to dominate the discussions but capacity in this area had been developed in recent years to enable the Council to be more agile in negotiations. Sara Sutton highlighted that this was an area of increased risk as clarity was needed in three areas in the plans for ICB budget reductions – CHC, safeguarding and SEND. She added that, with the importance of partnership working with health colleagues, it would be better to avoid further ‘cost-shunting’ between the NHS and local authorities. ADASS (Association of Directors of Adult Social Services) was expected to publish a report on CHC in July or August which could be circulated to the Panel. (ACTION) There was then a brief discussion on the possibility of the Panel enabling further discussions on CHC at a future meeting. (ACTION)
• Cllr Iyngkaran asked about the latest understanding of what potential changes to the local ICB could look like. Cllr das Neves replied that there had been discussions at the most recent meeting of the Health and Wellbeing Board that there could be a merger of the NCL ICB with another ICB. She was concerned that there did not appear to be much time for community engagement on this. Sara Sutton commented that the scale of the ICB’s budget reductions were very significant and therefore there was recognition that a merger could be the only way to achieve this while continuing to deliver on their very significant responsibilities. She added that an ICB covering a larger area would make the future work on neighbourhoods and localities even more vital.