Agenda and minutes

Apologies for absence were received from Cllrs. Mona Ahmed, Stuart Graham, Sam Mackover and Portia Thaxter.

Any member of the Council who has a disclosable pecuniary interest in a matter to be considered at the meeting is reminded to disclose the interest to the meeting and to leave the Chamber while any discussion or vote on the matter takes place.

Members are also reminded that if they have any other significant interest in a matter to be considered at the meeting, which they feel should be declared in the public interest, such interests should be declared to the meeting. In such circumstances Members should consider whether their continued participation, in the matter relating to the interest, would be reasonable in the circumstances, particularly if the interest may give rise to a perception of a conflict of interests, or whether they should leave the Chamber while any discussion or vote on the matter takes place.

No declarations of interest were made.

The minutes of the meeting of Adult Social Care and Health Select Committee held on 29 June 2023 are submitted for confirmation.

The minutes of the meeting held on 29 June 2023 were confirmed as a correct record.

The purpose of this report is to:

1.    Update the Select Committee on the progress of the Homecare Transformation Programme.

2.    Invite the Select Committee’s comments and questions on the progress, model, and challenges described.

3.    Update the Select Committee on the timescales for the Homecare procurement.

The Chair invited the Lead Member for Adult Social Care and Public Health, Cllr. Rendall, supported by Gareth Wall to introduce the report and the following points were highlighted:

1.  Most users were impressed by the services, however, there had been some teething problems.

2.  The services helped people to get discharged from hospital and remain independent. Most of the time it was the preferred means of receiving care for users.

3.  On average, the Council provided services to 600 residents across the borough and 2,700 hours were commissioned.

4.  The programme had been ongoing for a few years, with some stops and starts due to the pandemic and staff changes, however, it was now back on track.

5.  The timeline included issuing the Procurement Strategy in December 2023 and going out for tender in February 2024, with contracts beginning in the middle of next year (2024).

6.  There had been a lot of time spent talking to residents, users and their families to understand what ‘good’ looks like to them and how they liked to access homecare.

7.  Some things would be decommissioned, such as the electronic call monitoring system, as it was littered with problems in practice.

8.  Regarding workforce, the risk had increased due to changes in the pattern of stable recruitment and the composition of the workforce. There had been a slight increase in the percentage of workforce coming from within the borough (32%), however, there had been a decrease in the recruitment of people from European Union (EU) countries. This had been partially offset by an increase of those coming from non-EU countries but there were issues around the cost of the legal process and retention of those workers. There was a Market Sustainability and Improvement Fund from the Government which would be utilised next year.

The Chair then invited questions from the Committee who:

1.  Asked whether there was more which could be done to address the workforce challenges around recruitment and retention and whether there were any learnings from the issues with the Care Quality Commission’s rating for MiHomecare. Gareth Wall noted that there were learnings which they could do more of and explained that pay was a key issue in the sector. The Council was a London Living Wage paying commissioning organisation and the overall rate with agencies was £21.21 per hour, which was competitive when benchmarked across London. The Council was looking at adjusting the size and shape of the geographical patches to reduce the need for travel time within patches and to build familiarity for staff and users. It was difficult to make time for staff to do other things, such as sharing experiences with colleagues, due to the way their time was costed. The Lead Member added that workforce was an issue in a lot of sectors and the borough was an expensive place to live. There were 300 key worker accommodation being built which would allow workers to live and work in the borough.

2.  Acknowledged that  ...  view the full minutes text for item 4.

This paper aims to:

·       Provide a comprehensive update on the progress made by the programme team since our last presentation to the Adult Social Care and Health Select Committee on 29 November 2022.

·       Seek the Committee’s support and gather the Committee’s opinions on the proposed new model of care before officially launching the engagement process.

At the Chair’s invitation, Jane Wheeler, Director, Local Care (NHS NWL), introduced the report assisted by Dr Andrew Steeden, Borough Clinical Lead (NHS NWL), James Benson, Chief Executive (CLCH), and Navneet Willoughby, Director of Operations (CLCH). The introduction included the following points:

1.  There had been a period of strong engagement across North West London (NWL) providing an opportunity to improve palliative care services for residents, including increasing the total number of community beds available across NWL.

2.  There was an unmet need for those that may not need specialist services but are unable to remain in home and do not need to be in hospital. It was particularly difficult for residents who live alone, and they need supportive wraparound services.

3.  Residents do not know where to go for advice and thus, the new model of care would introduce a 24/7 specialist palliative care advice line which residents and their carers could use. As well as introducing bereavement and counselling services.

4.  The model of care document does not include how services would be commissioned as this would form the next stage of the process, with formal consultation early next year (2024).

5.  A decision had not yet been made regarding the Pembridge Hospice (Pembridge); this would be included in the next stage which will look at placement of beds.

6.  Lockdown resulted in an increase of people who wanted to be supported within their own home and it transformed the way care as provided.

The Committee proceeded to discuss the report and the following points were made:

1.      Welcomed additional opening hours, adult community specialist teams and, hospice at home. Asked for a verbal update on the recent meetings with the community about Pembridge. Officers responded that the model of care group wanted to start discussing Pembridge and they expressed that the NHS had not been as open to ideas about reopening. Officers and the group discussed ideas, and outputs of the sessions would be published on their website. Officers confirmed that they did not have an agenda to open or close the Pembridge; they wanted to maximise services. At some stage, a decision needed to be made on how long to consider reopening it or to reallocate the funding and come to a resolution. The consultant workforce for Pembridge had proved difficult to find and a range of other health professionals would also be required.

2.      Expressed concern about how long it had been since the temporary closure of Pembridge and asked if all avenues were being explored in terms of recruitment. Officers explained that consultant recruitment was currently underway and two different job descriptions were to be advertised, with one being hybrid between inpatient and community work. Once approved by the Royal College, they would go out for recruitment, which would include looking abroad. The Committee noted that it would be hard to recruit if the future of Pembridge was unknown. In response, officers explained that this was a key challenge and the timeline was very  ...  view the full minutes text for item 5.

This report sets out the select committee’s proposal to establish a working group to carry out an in-depth review in the municipal year 2023/2024.

The Chair introduced the report, explaining that the Committee reviewed the Suicide Prevention Strategy in May 2023, and it was noted that there was a high rate of suicide among adult males. It was proposed for a Working Group to be established to look into this area.

The Committee RESOLVED to agree the Working Group membership and terms of reference.

This report is an update on the select committee’s development of the work programme for the municipal year 2023/24.

The Committee agreed that a briefing would be taken outside of the formal meetings on the progress of the Homecare Transformation Programme and they would report back to Committee with their findings and conclusions.

It was suggested to add palliative care to the future work programme. James Diamond suggested to keep a watching brief on it and that the NHS officers would come back at the Committee’s request to update them. It was also noted that the Committee could bring their findings to the attention of Full Council.

It was agreed by the Committee to receive a written update on Covid-19 from the Director of Public Health.

The Committee noted the actions and responses to recommendations.

[Each written report on the public part of the Agenda as detailed above:

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Note: Exclusion of the Press and Public

There are no matters scheduled to be discussed at this meeting that would appear to disclose confidential or exempt information under the provisions Schedule 12A of the Local Government (Access to Information) Act 1985.

There were none.