Agenda and minutes

To approve the minutes of the meeting held on 10 November 2020 as an accurate record.

The minutes of the meeting of the Health & Social Care Sub-Committee held on 10 November 2020 were agreed as a correct record.

In accordance with the Council’s Code of Conduct and the statutory provisions of the Localism Act, Members and co-opted Members of the Council are reminded that it is a requirement to register disclosable pecuniary interests (DPIs) and gifts and hospitality to the value of which exceeds £50 or multiple gifts and/or instances of hospitality with a cumulative value of £50 or more when received from a single donor within a rolling twelve month period. In addition, Members and co-opted Members are reminded that unless their disclosable pecuniary interest is registered on the register of interests or is the subject of a pending notification to the Monitoring Officer, they are required to disclose those disclosable pecuniary interests at the meeting. This should be done by completing the Disclosure of Interest form and handing it to the Democratic Services representative at the start of the meeting. The Chair will then invite Members to make their disclosure orally at the commencement of Agenda item 3. Completed disclosure forms will be provided to the Monitoring Officer for inclusion on the Register of Members’ Interests.

There were no disclosures of interest declared at the meeting.

To receive notice of any business not on the agenda which in the opinion of the Chair, by reason of special circumstances, be considered as a matter of urgency.

There were no items of urgent business.

The Sub-Committee will be provided with an update on the Croydon response to the Covid-19 pandemic. (To follow)

The Sub-Committee was provided with an update on the response in the borough to the covid-19 pandemic by the Director of Public Health, Rachel Flowers, along with an update on the vaccination programme from Matthew Kershaw, the Chief Executive and Place Based Lead for Croydon Health Service NHS Trust and Dr Agnelo Fernandes, the Croydon GP Borough Lead. Copies of these presentations can be found on the following link:-

https://democracy.croydon.gov.uk/ieListDocuments.aspx?CId=168&MId=2162&Ver=4

During the presentation, it was noted that the partnership working in response to the pandemic had been fantastic, with thanks given to the work of unpaid carers and the Public Health team. It was also noted that care providers in the borough were appreciative of the support provided by the Council to minimise the number of covid-19 cases in care homes.

Dr Fernandes advised that there had been a lot of energy expended by GPs in the borough to mobilise the six vaccination sites in Croydon and also gave thanks to the volunteers.  At present the vaccination programme was on track, providing the supply of the vaccines remained available. The 84 care homes for the elderly in Croydon had received vaccinations and work was progressing on providing vaccinations for the 43 homes for the learning disabled.  It was known that there was vaccine hesitancy amongst BME groups in the borough, with work underway to counter this by providing people with the correct information to make an informed decision.

Following the presentations, the Sub-Committee was provided with the opportunity to ask questions about the information provided. The first question highlighted the latest figures provided on covid related deaths in London, which indicated that the number of deaths in care homes had been lower than in the first wave. As such, it was questioned what had made the difference this time.

In response, it was highlighted that in the early stages of the first wave of the pandemic there was still many unknowns about covid-19. However, Public Health had advocated for testing in care homes at an early stage. During the first wave health and social care colleagues had worked with care providers on infection control and training, which had proven to be of benefit in the second wave. Croydon had some of the highest rates of testing in London, with care home staff and residents regularly tested.  The provision of additional funding had also helped to ensure that staff could be based at a single care home, rather than moving between different homes and increasing the risk of infection.

It was also questioned whether there was difference in the patients presenting at the Croydon University Hospital with covid-19 in the second wave. It was advised that although it was still predominately the elderly who required hospitalisation, more young people were being admitted requiring intensive care, than in the first wave. Underlying health conditions were still a major contributor to effects of covid.

This wave of the pandemic was also seeing a much greater part of the population catching covid,  ...  view the full minutes text for item 4/21

The Sub-Committee will be provided with an overview of the Adult Social Care budget proposals for 2021-22. (To follow)

The Sub-Committee considered a presentation from the Executive Director for Health, Wellbeing and Adults on the 2021-22 budget for Adult Social Care. The Sub-Committee was asked for to review the social care budget with a view to feeding any concerns into the consideration of the full budget by the Scrutiny & Overview Committee in February.

A copy of the presentation delivered by the Executive Director can be found at the following link:-

https://democracy.croydon.gov.uk/ieListDocuments.aspx?CId=168&MId=2162&Ver=4

Following the presentation the Sub-Committee was given the opportunity to ask questions about the information provided. The first question related to the cost for adult social care as part of the Council’s total budget and whether this was in keeping with other local authorities. It was advised that the adult social care budget in Croydon equated to approximately 31% of the total budget, which was lower than some authorities where it could be as high as 36%. It was suggested by a member of the Sub-Committee that the overall percentage in Croydon maybe lower due to the higher cost of children’s social care.

The next question concerned the take up of personal budgets, in particular why the take up in Croydon had been low and how was this being addressed. It was advised that there was a need to make personal budgets mainstream as part of the core practice. However, this would only work if the right services were available to purchase in the borough. Many people were already on direct payments, but these were managed by the Council, which was not the true form of personal budgets.

As a follow up, it was questioned what support was being provided to help people make the move to direct payments.  It was advised that direct payments were not seen as the answer to saving money, rather it gave people more choice and control over their care. There were good advocates in Croydon who had been supporting people opting for direct payment, but it was important to have a multi-faceted approach that was right for each individual case.

It was agreed that when increasing the take up of direct payments, it was important to have a balance between autonomy and supporting individuals to use the autonomy effectively. Assurance was sought that there would be effective communication on the implications for individuals thinking of moving to direct payments once the plans had been finalised. It was advised that the e-marketplace was a key priority, as it was important for people to be able to see what services were available. Communication was essential and the service constantly worked to get this right, with work underway to explore how best to capture the voice of residents.

In response to a question about transitioning some of the services provided to the voluntary sector, it was advised that discussions were currently ongoing. So far there had been a mixed response from the voluntary sector, particularly as the Council had in the process of reducing its costs, had less grants available for the sector.  ...  view the full minutes text for item 5/21

The Sub-Committee received an update from its Healthwatch Co-optee, Gordon Kay on the recent activities of Healthwatch Croydon. It was advised that Healthwatch had recently published three reports, two of which had been prepared before the pandemic.

The first report looked at the reasons for patients attending the Accident & Emergency (A&E) department at Croydon University Hospital, which found that severity of injury was the main reason for people attending. However, 20% of responders indicated they had used A&E because their GP was not available. It was likely that the outcomes from this report would have changed since the pandemic, but Healthwatch had recommended the realignment of the pathways and improving capacity with GPs.

The second pre-covid report was on signage. This review was conducted using a sample letter from Croydon University Hospital and asked a range of users to following the directions provided. The review had found that both the instructions and route planning needed to be clearer. Healthwatch had recommended that letters sent to patients and signage were improved, and support made available for patients who became lost.

The third report published by Healthwatch reviewed the shielding process during the pandemic to find out how well it had gone.  In conducting the review Healthwatch was constrained by the restrictions on who they could contact and it had taken a while to get the 70 responses received. The review had found that food shopping and medication services were the most used, and most needs had been met friends and family.

Most people found the shielding service to be good, but there had been a few issues with the food boxes received. It was found that there had been gaps in signposting residents to services such as those providing mental health support, but this could possibly had been because support had been focused during the first period of shielding on residents physical needs.

Healthwatch concluded the service had done well, but would encourage the service to expand and refine its approach to the different needs in the community. The outcome of the review had been reported back to Council before the second shielding had started and most of the recommendations made had been accepted.

The Sub-Committee thanked Mr Kay for the update provided and all the support Healthwatch Croydon provided to residents in the Croydon.

The following motion is to be moved and seconded where it is proposed to exclude the press and public from the remainder of a meeting:

“That, under Section 100A(4) of the Local Government Act, 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information falling within those paragraphs indicated in Part 1 of Schedule 12A of the Local Government Act 1972, as amended.”

This motion was not required.