Health Overview and Scrutiny Committee - Wednesday 17 September 2025, 7:30pm - Wandsworth Council Webcasting

Health Overview and Scrutiny Committee
Wednesday, 17th September 2025 at 7:30pm 

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  1. Webcast Finished

Thank you.
Hi, good evening everyone.
Welcome to Health Overview and Scrutiny Committee.
I'm Lucy J. Rose, I'm the chair.
We've got a couple of new members this evening, including Councillor De Vries, so just welcome
as well.
Thank you for being here.
I'll call the names of the members of the committee in alphabetical order, so if you
could just say that you're here and confirm your presence that would be
lovely so I've got Councillor Crivelli you just do it on the end I have to
speak into the mic and let it be recorded yes I'm here yeah this is my
first time ever speaking. Councillor de la Sejour. I'm here.
This is how he's done.
Thank you.
And we've got apologies from Councillor Gussain.
Councillor Jeffery.
Good evening.
And Councillor Marshall.
Yes, present.
And apologies from Councillor Macleod as well.
And Councillor Stutters.
Okay.
Also in attendance is the cabinet member for health, Councillor Graham Henderson.
Good evening.
We've got Councillor Lee joining online as she's had something go on.
So she won't be voting but she is joining us online.
Have we got?
Not here yet.
Not here yet.
Lovely.
And just before we start, I'd just like on behalf of the whole committee to express our
condolences about those affected by the fire at Fox House.
It's devastating and it's meant that families have been left without homes.
I wanted to say a huge thanks to the emergency services, to council officers for
working around the clock on this, to the voluntary sector for
offering all of the support in general, all of the work that they've done.
Reaching out to communities, supporting communities.
We've got a hub set up at York Gardens.
We've got a helpline that's been set up and individual support is now in place
For all of the households that require it
So I'm sure the committee will join me in expressing our sincere condolences for what's been happening
Sorry, my name's Jim and I didn't
Apologies for my colleagues Councillor Sutter's and Councillor Gossain
Thank you noted
I'd also like to welcome Stephen Hickey,
Chair of Health Watch.
I'll ask Stephen to comment on any item
he's indicated that he wishes to question
when we get to them.
And Stephen will also this time be introducing
Health Watch's annual report.
So really looking forward to that.
I'd like to welcome Kate Slemak, hi Kate,
Managing Director and Lucinda Uthridge,
Site Chief Medical Officer.
Thank you both for being here this evening and from St. George's Trust and they're attending to discuss
Agenda item three
We have a number of other officers present in person and online and they'll address themselves as and when we move through the items
Lovely so first agenda item is the minutes of the 13th 30th of June on the minutes of the previous meeting
agreed for the record

1 Minutes - 30th June 2025

2 Declarations of interests

And are there any declarations of either pecuniary or other registable or non -registable
interests that need to be declared?
Great.
Thank you very much.

3 St George's Trust Report on an Update on the Trust's Performance and Other Key Issues (Paper No. 25-306)

So our first item, St. George's Trust Report.
I'd like to welcome Kate and Lucinda to come and sit at the table and to give, I know the
level of data that has gone into this report as a result of the request of the last committee.
So thank you for that.
You can take the report as read but do give a brief introduction.
Thank you, Councillor Dobras.
I will just do a very brief introduction just to cover off some of the areas we have covered
in the report and obviously happy to take any questions.
We have updated on performance, trust performance and given some data in respect to that.
I would like to say overall we are performing relatively well in comparison with other organisations.
against our key operational metrics.
We do have some challenges around long waits,
which we can touch on later if needed.
Financially, we're under an enormous amount
of financial pressure, which I know you're aware of.
We have a 95 million pound savings programme,
which is a cash out savings programme,
the equivalent to just over 8%, which is significant.
And that's something some of the other items
we'll touch on today is linked to us needing to look
at how we deliver services more cost effectively
going forward.
We've got a section on Queen Mary's Hospital
and some of the discussions we're having
around services at Queen Mary's Hospital.
This I know there'll be some questioning on.
And that's obviously in the report,
happy to pick up on some of those.
And then also, finally, CQC.
We had CQC core service inspections in maternity,
urgent emergency care, in other words,
the emergency department and surgery.
Those actual inspections happened almost a year ago,
so October was maternity, it was a follow -up inspection.
The emergency department was November last year,
and surgery was January,
and we got the reports quite recently,
and we just provided a summary
of some of the key issues within those reports.
So happy to leave it there and take any questions.
Thanks, Kate.
Yeah, I think that was a lot of interest in the report.
We're very aware nationally and locally there are significant financial strains, so you're doing what you can within those environments.
So please do take those questions in that understanding.
But yeah, yeah.
Councillor Marshall, would you like to go first?
I just wonder whether you could comment a little bit further on the situation in maternity.
I know that's a matter of great concern and we've seen some, I'm glad that
St George's wasn't on the list of maternity services that were underperforming that was
published recently, but it is a matter of great concern.
The instability in the leadership seems to not be particularly recent to go back a couple
of years or more maybe.
And I wonder if you could just comment on that perception and what's being done about
it.
Yes, of course.
So maternity has obviously been an area of significant focus for us as an organisation.
I'd just like to reassure members,
we have very good outcomes at St. George's
and we have good patient experience,
but we did fall short around some of the safety measures
in terms of checking equipment,
some of our triage processes,
and a variety of things which we have,
that came up a year before in an inspection that we had,
and when we were re -inspected back in October last year,
we've worked very hard to address many of those issues.
I suppose one positive is movement adequate
to requires improvement.
So that shows there is performance improvement
in some of the CQC metrics that they particularly look at.
In terms of the leadership, you're absolutely right,
that has been an issue for us.
I'm delighted to say we've appointed
an excellent group chief midwifery officer.
I can't name her yet because all the paperwork
isn't finalised, but we're really confident
that she will help us turn some of this around
and provide a consistent leadership approach going forward.
We also are advertising for our site director
at Midmiffery at St. George's,
but we're working very close with Epsom St. Helier
in the interim period to lean into the support
that they have on their site.
So we can see a way forward to settle down
and address the leadership issues,
but getting consistent, capable leadership in place
is absolutely key to us driving the improvement plan.
We have an integrated improvement plan
because maternity is subject to so much regulation
and oversight from many different quarters.
And it can in itself become quite overwhelming
for the teams.
We pulled all of the actions from all the various plans
and reviews that we've had into an overarching action plan
and we're really driving forward improvement
in respect to all of those areas.
and we've dealt with the must dos and should dos
in the CQC plan as well.
We've got a really rigorous evidence assurance panel
that cheques progress against actions,
but more importantly, are those actions embedded?
Because that's the big change that we need to see.
We put actions in place, are they embedded
and does everybody following those practises?
So that's an area of focus as well,
and we've seen improvement in that area as well.
But we're absolutely on a journey.
It's a very high priority,
both for the site leadership team and for the board.
So we'll continue with that work.
Thank you, that's reassuring to hear about the trajectory
and the current measures to settle things in the leadership.
Thank you.
Thank you.
I have Councillor Jeffrey and then I'll come
to Councillor Crivelli next, thank you.
Thank you, Chair.
Good evening and welcome to the town hall.
So my question is around the Queen Mary's Hospital
and the enhanced primary care hub.
Now, I understand, I mean, there's really very limited information which has been provided
in the report.
It mentions it's under review.
Is it likely that it will close?
So just to roll back a little bit, you'll be where we used to have an urgent care centre
at Queen Mary's and then post -COVID that was recommissioned to become an enhanced primary
care hub.
There's two elements of the service that Queen Mary's.
There's a GP -led service that provides 111
and direct access to GPs on the site
for Wandsworth patients.
And then alongside that, we run a minor injury service
where we have advanced nurse practitioners
working alongside GPs, seeing patients
that make appointments to be seen there.
We are currently reviewing,
particularly the minor injury side of the service.
The reason being, it's a very well -resourced service
for the activity that goes through that unit.
And we also have high demands on St. George's site
around our urgent treatment centre
and a sort of government drive to run that 24 -7.
We are working with the ICB
about what other options might be.
Now, I'm pretty certain we won't,
I can say we won't be closing the service.
That is not our intention.
We know that that's a service that services and supports the local community and local
deprived community.
But I think we want to look at whether we can shape the service in a different way that
retains it but balances it across the St. George's site and the Queen Mary site and
has more rotation of staff between the sites.
So we've not even, we haven't even come up with, we're at the early stage of looking
at options.
Staff are aware we're looking at options,
which is why this, obviously you always have this,
when you're looking at anything,
this balance between letting staff know
so you're being open and transparent,
but then also creating some level of anxiety.
So we're working with stakeholders
and our communications team and the ICB
to putting some more communication hours about this,
hopefully to sort of calm things down
whilst we look at what the options might be going forward.
A sort of final thing I would say,
We know this is very valued service by local communities, so we absolutely bear that in mind.
Just following up, and yes it is a very valued service in the area,
and there has been petitions which have been signed, and
there's a petition ongoing at the moment with more than 8 ,000 signatures.
But how would it affect the St. George's Hospital in Tooting, and
What about, I mean, yeah, first of all, how would it affect that in terms of like how people are seen
and in terms of the waiting times?
And my second question is around, so you mentioned it's a minor injury ward,
so it's like the emergencies around minor injuries, not the GP -led from 111, is that correct?
Okay, so I mean it would be really difficult for them people who are living in the surrounding areas to I mean like
Use the services in tooting. I mean it's I mean if we talk about Richmond or
Hampton getting to tooting would be a struggle for them
So is there not an alternative we couldn't close the GP led side as opposed to the minor injury like
Is there no sort of a balance?
I suppose I want to say first of all we've made no decision yet at all so we're looking
at what the options will be, what potential options there are, working with our commissioners,
the ICB, and we will take stakeholder views into consideration and patient views into
consideration.
We're also conscious of the location of Queen Mary's being in a deprived part of the borough.
So all of that we will take into consideration.
Just going to go to Councillor Correlli now if you've been waiting a while.
Can I just say first and foremost, thank you for responding to the letter that I sent you
back at the beginning of September asking about this unit.
I wanted to ask you specifically that it's been said that the unit itself is underutilised
and costly to run, but isn't it a statement of fact that one of the reasons it's underutilised
is because it is an effect appointment only, whereas other minor injuries units, I know
or other hospitals in London,
there are actually sites where you don't have
to make an appointment.
You can actually walk in with a minor injury.
In some cases, you can phone up and seek advice
before you go in, and they'll say,
to my mind, having an appointment only, minor injury issue,
or for the matter, taking it away from Queen Mary's,
is counterintuitive.
NHS England estimate up to 2 5ths of A &E attendances
where people who could have been treated elsewhere,
urgent treatment centres, GP practises,
or consultations with pharmacists.
And there's been an emphasis on trying to take the weight
off of GPs by trying to divert people away from
A &E or GP surgeries.
So if it's the case that it's underutilised,
isn't it part of the overall, in effect,
consultation on this as to whether or not
it needs to be moved away from being an appointment only service to something
that is perhaps something that can that can be used the same way the other
minor injuries units are used at other hospitals is that is that something that
would be considered overall thanks councillor currently I meant that that's
absolutely something that can be considered it's currently not
commissioned to be a walk -in service it's commissioned to be of an
appointment only service.
Before, correct me if I'm wrong,
prior to December 2020, it was a minor injury unit
that you could walk into, wasn't it?
And then therefore, it wouldn't have been underutilised
if you can walk in.
I mean, the situation is there's no real difference
from going to see the minor injury unit as it stands now
and phoning up your doctor for an appointment, doesn't it?
I mean, I think there is part of the reason
for it being recommissioned in a different way.
Was the space that's available for people
just to walk into post -COVID, but I think everything, we'd need to look at all options
really and it is at the moment as I say currently commissioned like that. I think there are
differing views about you know would it be better if people could just walk in and would
it be better utilised if that was the case.
Can I just briefly cut, it would be really good to outline you know you talked about
the stakeholder input how you know the public and stakeholders might be able to feed into
this because obviously you know there's a range of the views in the committee I'm sure
there's a range of views in the communities.
Could you talk to us a little bit
about how that might happen?
Yes, so we're currently looking at sort of working
with both the ICB and the trust comms departments
about how we develop a stakeholder plan
and reach out in that sheet.
Because we know there's an enormous amount
of interest about this.
We're very conscious of that and very sensitive to it.
And so we will be reaching out both collectively
as an ICB and a trust to seek obviously views
of council members, but also the local population.
So we need to find a process for doing that.
Yeah, of course.
Can I ask a question about that?
Are you then gonna have a formal consultation on this,
which would be engaging healthcare professionals
in Wandsworth Health Service users and the general public?
The point that you seem to have already grasped quite well
is the fact that this is in a deprived area,
and it would potentially take away a facility
which is open to people in Roehampton,
but particularly so Roehampton.
So I don't know if I can answer the question
about the consultation.
We need to look at the parameters of it,
but let me take that away,
and we'll look at how we'll communicate
and how we'll work with stakeholders.
Thank you, and Councillor de Lesley,
did yourself have a question?
Yes, I do, on a different topic.
Just in terms of finances,
In the report you talk about the trust
being 14 million deficit,
which you describe as being on plan.
Can you let us know how you expect that deficit
to narrow over the coming months,
and what is the year end target, please?
So we have agreed with NHS England a deficit plan,
so we will be delivering, us being on plan
by the end of the year, we'll be delivering
a deficit position.
So I'm just trying to remember what that final position,
I think it's like 40 million deficit for St. George's,
because we are in a position where we are getting
financial support from NHS England to come in
at the end of the year on plan,
which is delivering a deficit position.
We're expected over the following year
to clear that deficit, but that is a mighty ask,
I have to say, because we will need to deliver
the 95 million cash -releasing savings,
and then go further, but we are doing everything we can
to look at what we can do differently
in order to deliver that.
I think it's also important to acknowledge
that Southwest London are undertaking a clinical review,
a strategic clinical review,
which we expect to look at how services
in Southwest London are delivered going forward,
because we know that Southwest London, as a system,
is in deficit, and that's not sustainable going forward.
Jeffrey.
Yes, I'm referring to page 21 of the report.
When there's a section about complaints, now it says that complaints are dealt with in
a good way with 100 % performance within 35 working days, but there is no indication of
how many complaints there are, what the complaints are about.
Is there some sort of indication you can give
of what numbers of how many complaints there's been?
I don't know off the top of my head.
We'll have to get back to you on that.
And we do thematic reviews on our complaints,
which the top ones tend to be around
administrative processes, how people are being treated
with care and respect, communication.
But we can get back with further information on complaints.
Thank you.
And just one more question surrounding on the same page.
On the same page, you mentioned the same ward twice, which is Trevor Howell.
And first we're talking about the falls prevention and then we're talking about the infection prevention within the same ward.
And I understand it's quite a sensitive ward.
It's like the oncology ward as well.
So I'm just wondering why, I mean, like what has been happening in this ward for
it to be coming up twice in the same report?
I mean, is there something which we'd be looking into further to make sure that there's no more problems within this ward?
There are no particular problems with this ward that I'm aware of.
I can't explain why it's coming up twice.
We obviously do have, we look at a number
of quality metrics across all our wards.
And there will be some wards that perform better
in some areas than others.
You've mentioned two of them, but there are numerous others
that we look at as well.
I'm not aware of that ward being a particular issue.
Actually, I only mentioned one ward,
which was a Trevor Howell ward.
Thank you, that's really helpful.
Councillor Correlli.
A different subject.
I wanted to ask you about the proposals on the St. George's
Carmen Bothings Centre.
And you've mentioned the fact that, in effect, you've
said here in it that no decision has been made yet.
You're obviously still considering our ideas
and engaging with users about it.
My concern about this is that potentially you may well be taking away a choice and a
service that is available to women giving birth.
I appreciate you do say that 97 percent are doing it in the giving birth and delivery
suite.
but the birthing centre, if you, in effect,
remove the birthing centre as a centre,
and you see here you're gonna move it
and provide it as a dedicated room, okay?
There's also space and capacity in the elderly suite
to provide a dedicated room for midwifery -led care.
What it sounds like on that,
I think somebody reading it might think
that you're closing the birthing centre,
and you're gonna have a bed in the corner.
It sounds like that at face value.
I'm sure you're going to dispute that, but that's what it sounds like at face value.
The second point that's made here is it says the Birthing Centre is significantly underused
with several other Birthing Centres nearby.
There may be more effective ways we can continue for choice to local people.
Correct me if I'm wrong in saying this, but the Birthing Centres nearby are in fact Kingston
and Chelsea and Westminster Hospital.
When you see that there may be other effective ways
we continue to offer to choice local people,
are you talking about engaging with them?
That maybe you would have pregnant women
going to these birthing centres
rather than using St. George's?
What is it that you're actually talking about overall?
Okay, so I think we need to frame this
in the environment that we're operating in,
that we're not all going to be able to deliver
every service and every organisation,
given the financial climate we're operating in.
So St. George's is the high -risk birth centre
in our system, and we see nearly all the high -risk mums
come to St. George's.
We have a birth centre.
There's a two -roomed birth centre
that's separate from the rest of the unit,
and it is really underutilised,
because the mums that come to birth at St. George's
tend not to be suitable for a birth centre.
There are birth centres at Epson St. Helier,
at Kingston, at Croydon, at Shell West,
which are better set up for managing mums
who want a midwifery -led birth.
That being said, we have a delivery suite
with a birthing pool, a delivery room
within the delivery suite with a birthing pool,
and we would be able to manage the activity
through that room, given the level of activity
that we have coming to St. George's that's birth -sent,
which would be free led birth centre suitable.
So again, the decision hasn't been made on this,
but we're looking at options of one of which would be
to close the current birth centre
as it's currently operating and to move that activity
to another bit of our organisation.
And we're looking at various options
and working those through.
But we are under enormous financial pressure
and we need to make sure we're using resources
productively and effectively.
that is incumbent on us to make sure we're using taxpayers' money effectively.
So that's why that's one of the services we're looking at.
Just ask about that, then.
I know you say it's still ongoing, but you're confident that, bearing in mind the low volume
of women using the birthing centre, that you think that you could maintain that same sort
of standard service within the delivery suite
if you meet this reorganisation.
Okay, thank you.
Thanks, and I'd just like Stephen Hickey
to invite Stephen Hickey to ask his questions.
Do you mind asking them in the round, if possible?
Sure, I mean, one of my questions was about
the public engagement with some of the changes,
and I think we probably talked about that,
so pass on over that.
My other question was a more specific one,
which is about corridor care,
which is obviously a big issue,
both nationally and locally.
And I declare an interest because I was on the corridor
twice last winter.
But I didn't see a lot of detail in this report.
And as I missed it, I didn't see numbers
about how many people are on corridors,
or treated on corridors, and how long they're there.
And I wonder if you are monitoring
in that sort of granular detail.
I did notice that you obviously had a number of changes
to try and improve the service in the ED,
which is very welcome.
But it'd be helpful to sort of have some visibility
about the numbers of people involved with corridor care
and the duration of their stays there.
And your projection, as far as you can,
for will the situation be better this winter
than it was last winter?
Thank you, and I wanted to start by saying
that none of us want to treat patients on the corridor
I'm sorry for your experiences.
That's not what any of us want.
I go regularly down to ED as does Lucy,
and it's not something that makes us happy,
but we make sure we provide the best care
that we can to patients on the corridor
and minimise the time they're there.
We don't actually nationally report on corridor care.
However, we do obviously collect our own data on it,
but the data includes everyone who's on the corridor
for five minutes whilst waiting for things
to be moved around to people who are actually on there
for a longer period of time.
Corridor care has come about as a result
of ambulance handover change times.
We, that some of those patients would have been
on the back of an ambulance for longer than they are.
So I think it's important to frame it in that respect
and that has seen a drive up in corridor care.
We're really focused on reducing it to a minimum
and we'd like to eliminate it all together.
We have a whole programme of work around care
without corridors and we monitor it very closely.
In terms of do I think it's gonna be worse this winter,
now I know people are aware we've reduced our bed base,
however we've done enormous amounts of work
to increase our same day emergency care.
We now have a frailty same day emergency care.
We've turned over some bed capacity to a frailty SDEC,
same day emergency care.
And in the three months it's been operating,
125 frail patients have been through that SDEC
and 50 % of them have been discharged back out
into their home or their nursing home.
From there, rather than being admitted,
all of those patients would have been admitted before
and would have built up a length of stay.
We know when frail patients are admitted,
they are very vulnerable to becoming institutionalised
and deconditioning.
So there's lots we're doing to minimise corridor care.
We also have a winter plan that's very focused
on reducing our length of stay and holding at 8 .4 days.
We've been quite successful at St. George's
of reducing our length of stay.
And we have seen no increase in corridor care
since we've closed the beds.
We're monitoring that very closely as well.
We've got a number of guardrails around bed closures
and how do we make sure that we're not
putting any patients at risk.
So happy, I mean we can share data on corridor care
because we do have it, but we need to look at
how we manage the data because anyone, as I say,
who touches the corridor for any period of time
gets measured.
Does that answer your question?
Yes, I think so.
I think obviously we're talking here about long stays,
not five minutes, but I think it would be helpful
to have some transparency about those long stays,
which is obviously what people are concerned about
in a regular way.
I appreciate it's not part of your national
reporting requirements, but I think having
some transparency would be really helpful.
Can I just add, we see six sit reps,
situational reports a day, corridor care is monitored,
we know when it's happening,
and we activate a set of actions to try and make sure
we're decompressing as quickly as possible.
So we're very active around reducing corridor care
when it's happening.
When there's sometimes a risk of build up
comes sometimes in the evening and overnight,
so it's making sure in the morning
we decompress as quickly as possible.
Thanks, we'll take a final round of questions
because mindful of colleagues' time who've come from the trust.
So go to Councillor Jeffrey and then Councillor Crivelli.
Thank you.
So just going back to the statistics,
I'm just looking at the steelbirths per thousand births.
I mean, it mentions the latest month of July 25.
But do we have an annual figure of how many steelbirths
or neonatal death that's been in the past year.
So we do report our figures.
We can include that in the next report
if that's helpful for context.
But those figures are monitored in a number of ways
and reported through the maternity services
data set nationally.
Thank you. Thank you.
Councillor Pravelli.
On the performance update,
you've talked about emergency care,
and you see that 13 ,400 people have visited
the emergency department and it's gone up slightly.
It's only about 10 patients compared to last year.
I might have asked this question before
on previous performance figures,
but I think NHS England estimated
that high intensity users were costing the NHS
about 2 .5 billion a year with repeated attendances at A &E.
A lot of these people are people
who get mental health issues.
First and foremost, I assume you're suffering
the same as all A &E units are in that respect.
And secondly, do you actually have any sort of plan
to try and address that sort of thing
and to try and divert people
who would otherwise not need A &E?
I'll start and then Lucy may want to comment on this as well.
So we have a high intensity users group.
We know who our high intensity users are.
And our ED colleagues work with other community partners
regarding, because often it's about social isolation as well.
I think going forward, this is gonna be a big part
of the neighbourhood work and how we work
with primary care, community teams, local services,
including voluntary sectors to support people
in their homes and give them better alternatives
than coming regularly to EDs
and having much more joined up care
across those boundaries.
So I do think this is a real opportunity
about sharing data and how we wrap some separate
and different support around some of these individuals
who are very dependent on coming to ED.
But Lucy may want to add to that.
Yeah, I think just to reiterate the point
of what we mean by mental health.
So in the broadest sense, that often means
psychosocial difficulties rather than mental health
under treatment with a community mental health team
or otherwise.
and so really involving all stakeholders in that is key,
but we are seeing a significant increase
in the number of patients
with a primary mental health condition
presenting recurrently to our ED.
And I think the committee would really welcome in November
an update on the CQC improvement plan
if you're able to share some of those steps
that you're taking.
And thank you so much both,
I know that you're very, very busy with your day jobs
and thank you for all you're doing at St. George's.
So, thank you.
Okay, is the report noted for information?
Thank you.

4 Annual Report of Healthwatch Wandsworth 2024-2025 (Paper No. 25-307)

We're moving on to our annual report from Health Watch.
I'd like to introduce Stephen Hickey and say thank you
for all the huge amount of work that's gone into this.
For your dedication and Health Watch's dedication
for incorporating the views of people
with lived experience, of patients in healthcare.
We're immensely grateful for that.
So would you like to introduce the report?
Sure, thank you very much.
And I'll ask Sarah Cook, if I may, to join me
in case there are questions to which I don't know the answer,
but she might.
So for new members, the Health Watch,
well you know the background to Health Watch,
statutory organisation with certain obligations,
but it's there essentially to give an independent voice
for patients and ensure that the patient voice is heard really across health services and
social services.
And one of our statutory obligations is to produce an annual report which comes to this
committee and this is the report.
I think the report itself I hope is fairly self -explanatory.
We try to write it deliberately in a way that is accessible and understandable.
Last year was, like all years, a busy year.
We were involved in a large number of projects
on a range of subjects, including dentistry, GP services.

3 St George's Trust Report on an Update on the Trust's Performance and Other Key Issues (Paper No. 25-306)

We did an entrant view on the stroke ward of St. George's.

4 Annual Report of Healthwatch Wandsworth 2024-2025 (Paper No. 25-307)

And you'll see in the report a lot of other activities
we've been involved with.
And I won't go into that in further detail,
but you may have questions about that.
The thing I do want to add, and it's
highlighted in the covering paper,
is that since this report was produced,
the government has made an important announcement
about the future of Health Watch, which
is following a report by Penny Dash, who is now, I think,
the chair of Health Watch England.
Health Watch is to be abolished, and the functions of Health
Watch are to be moved into the NHS itself.
and local authorities respectively
in relation to health and social services.
That came as quite a shock and a surprise, frankly,
I think, to most people involved,
including certainly Health Watch England and ourselves.
And so there is a real question mark now
about how that's going to proceed.
Health Watch is set up under statute
so the change is going to require primary legislation.
And obviously, nobody knows yet what the timetable for that will be, but the best guess, and
you can't go further than that, is that primary legislation is unlikely to be achieved before
next July.
That will be quite fast -going in some ways, but it's achievable—should be achievable,
which in turn would suggest the actual transfer should take place perhaps the following financial
year, 2027.
But that's speculation, and nobody knows the answer to that.
There is no real work being done yet,
either locally or nationally,
about what this would mean in practise.
What are these functions?
How would they be actually transferred to the NHS
and to local authorities?
What does that mean in terms of functions,
resources, people, et cetera, et cetera?
And I think the position at the moment,
as far as we understand,
and the council may want to comment on that,
is that we're waiting for some sort of
indicative guidance about both the process for how that's going to be discussed and for
timetable, but there's a vacuum there at the moment is my perception.
And the last point I'd make about it is that it will be quite a significant change in terms
of independence.
I mean, the thing about Health Watch is although it's set up under statute, it is required
to be independent.
And there has all, even before Health Watch existed, there were other organisations with
some of the functions going back decades, actually,
with that role to be independent.
And obviously, that disappears when
the functions move to the NHS itself and to local authorities.
So I suspect, this is pure personal speculation,
that there will be debate about this when the legislation comes
for parliament.
But frankly, none of us know, and we'll have to see.
But at the moment, our assumption
is that these functions do have to change.
And there is a bit of very important work
like to be done over the next few months with the council and with the NHS about what does this mean in practise.
So I'll stop there.
Take a first round of questions, Councillor Jeffery.
Thank you, and first of all I'd like to start with saying well done Wandsworth on the good result of the CQC.
And well done to Health Watch Wandsworth and to all the volunteers who've dedicated so
many hours in produce getting us to this level as well.
And you've made so much contributions to so many lives in Wandsworth.
Yeah, I've really enjoyed reading this report and it's been very user -friendly and accessible.
And yeah, it's just a comment, not a question actually.
Thank you.
Yeah, Councillor Cravelli.
Can I ask a question in relation to Health Watch and how well known you are because you
do a lot of good work by way of signposting and advice to people and you've got a very
good website I think that's very user friendly and gives a lot of good guidance to people.
What would you say if I said I don't think you're well known enough and that there's
a lot of things that you can do for people, there's a lot of advice that you can do and
a lot of assistance that clearly when people engage with you,
you do give them a lot of sound advice
and steer them in the right path.
What would you say if I thought
not enough people knew about you?
I wouldn't want to disagree particularly.
I think actually it's a general problem
with lots of the organisations in the health service.
I mean I used to be on the CCG
and we should play a really important role
in commissioning services.
I don't think most people knew what a CCG was
or anything about it frankly.
So it is a general problem.
to which I don't think there's a simple answer.
I do think that one of the, to some extent
we're an intermediary organisation as well,
but we do try to work and need to work
not just directly with individuals,
but actually with other organisations
who are themselves close to individuals.
One of the big difficulties that everyone faces
with engaging on these issues is about trust,
particularly with communities
who traditionally don't trust, frankly, white, middle class people like most of us here.
And we, like everyone else, therefore, do try to work as far as we can, not with and
through other organisers who are close to people and work collaboratively with them
as well as directly.
That's one way we try to do it.
But there is always more that could be done and really should be done.
So, any further questions for Health Watch,
apart from obviously the thanks that's gone into
preparing this report, and I echo Councillor Jeffery
that it's really user friendly, it's very accessible,
and obviously that's a testament to the work
that you've done with people.
Thank you very much.
Thanks, yes, hopefully it would be helpful
to hear from myself representing the administration.
Mr. Hickey and I had a very, I think,
useful conversation on the about sort of future
and what precisely is happening.
I think it's fair to say,
and Mr. Hickey obviously can disagree,
I thought we were pretty much on the same page.
One thing I would say about Penny Dash's report,
I do find it very thoughtful.
You may not necessarily agree with all her conclusions,
particularly in relation to Health Watch,
but she was actually charged with booking
a patient's safety and improving it.
And her first observation was,
considering that I'm only going to get into this,
but actually there hasn't been very much
significant improvement in terms of preventing
preventable deaths in particular.
And she looked at the work of six organisations,
all of which have got a finger in the pie
of patient safety, to which I must confess,
I've never heard of before.
And what she's actually charged with
is coming up with a system to promote patient safety,
and in particularly independent patient safety,
which was coherent and consistent and didn't have overlaps.
So she has made her own recommendations
that government has accepted.
As Steve and Hickey said, there's a lot more flesh
to be put on the bones and in the trial time,
old -fashioned silver sermons and people in the NHS
will be sent away and hopefully representatives
of local government will be involved in formulating
how this particular recommendation will exist in practise.
What I can say on behalf of the administration
is that we have always welcomed and supported
Health Watch, I think they do a very good job
in particular, it's not just 2 .6 full -time equivalent,
full -time staff, or either Steve himself
and previous Health Watch chairs who've actually come here,
but it's also the 15 or so volunteers
who really are the bedrock of Health Watch,
ones with friends, and ones with residences,
which I think is very, very important.
So I am very firmly of the view that whatever comes out
of this setting at the local level,
we do need to retain a very high level
of independent patient scrutiny,
quite how that is formulated, I think we do have
an opportunity given the legislation we'll have
to introduce and indeed as Stephen said,
this probably won't come into force I suspect
until sort of late 2026 or 2027.
And in fact at an eating of the London Chairs
of Health and Wellbeing books, which of course
as is cross -party organisation.
I did actually raise this, put it on the agenda,
any other business, actually asked for a presentation,
a discussion around Penny Clash's report,
and how we, as a London body representing
Chair's Health and Wellbeing boards,
who are in effect cabinet leads, et cetera,
or lead members in local authorities in London
we can best feed into this process
and in particular to influence the outcome.
But just to say that for as long as the legislation
remains extant, certainly this administration
is committed to continuing to support health
of Dr. Unsworth, they do a very good job in my opinion
and we will certainly be very much at the forefront
in trying to ensure that there is a truly independent
and patient voice in the healthcare and social system.
Thank you.
Thank you so much, and yeah, thanks again
for all of the work that's gone into this.
We really appreciate it, so thank you.
Is the report noted for information?
So now, before we get onto our meaty care technology report,

5 Verbal Update on the CQC's Local Authority Assessment of Adult Social Care

we've got a brief verbal update on our recent CQC inspection.
Just wanna echo what Councillor Jeffery said,
a huge, huge well done Wandsworth Council
social care department had its first CQC inspection,
the first of these kinds of inspections
and we were rated good, which is no mean feat
and it was a huge piece of work with staff,
the volunteers, lots of people interviewed,
lots of people preparing for this over a number of months.
So a huge thanks to the team and congratulations
and Claire, over to you to outline what we know.
Thank you very much.
My name is Claire Tew.
I'm the Assistant Director of Assurance and Innovation.
Thank you for that intro and I am very pleased to share this update on our Care Quality Commission's
assessment of adult social care.
As you will be aware, the CQC started its assessment back in December and completed
its onsite assessment between the 6th and 9th of May.
and on the 9th of September we received the CQC's report
of the assessment, awarding ones with a good score.
I'm sure, as you've already said,
that the committee will join me in thanking
the people with lived experience who were involved in
the process, our staff, our partners, and our providers
for all of their incredibly valuable contributions
on the assessment.
And we're also incredibly proud of our staff
who've achieved this really excellent result.
In my update, I was just going to provide a few highlights from the report.
In particular, they said that a preventative approach was evident at all levels in the
local authority, that assessments focused on people's strengths and abilities, that
people told the CDC that they felt safe, that there was really positive joint working internally
within teams and other partners externally, that there was really clear co -production
with people who use services and that the local authority worked really well with partners
and the voluntary and community sector.
Equality, diversity, and inclusion were embedded throughout practise.
A few quotations from the report that I thought were particularly impactful.
The secrecy said that we had kind, dedicated, and compassionate staff and that people told
us they could access services easily.
staff were focused on achieving positive outcomes
for people and staff told us they felt valued and motivated.
The report also notes that the local authority
was very aware of where there were gaps
and what improvements did need to be made.
There were a few areas identified for improvement
and those were that some waiting times
may be a bit longer than we would like.
There wasn't always sufficient care provision
for people living with more complex needs
that have been increasing since COVID.
And it wasn't always easy for unpaid carers
to access short -term care in an emergency.
We've already got strong plans in place
as part of our transforming social care programme
to mitigate these recommendations.
For example, we've talked before at the committee
about our use of AI to monitor our waiting list
for occupational therapy more closely.
And we've got significant work ongoing
in our commissioning area
to expand the options available for people locally.
As well as our plans to support unpaid carers
as best we can with improved respite and short breaks.
We are going to present a more formal report
at Cabinet in November which provide an update
on all of these activities in response
to the recommendations.
And we will be doing, bringing updates to this committee
in due course as we're delivering
on those activities as well.
Thank you very much.
Thank you Claire and I know a report's coming to cabinet in November
I don't know if timings will work
But it would be useful to have maybe the the more detailed report in the November committee just so you know committee members
Can kind of get under the skin of some of that detail and have maybe a more fuller discussion
But for now any questions on the verbal update cancer currently
Can I just say I would share your sentiment with congratulations to the officers for the
achievement of the good rating and the work that they have done.
It's particularly difficult climate, particularly so for adult social care.
It never gets easier only.
It seems to get more difficult on a perpetual basis, so getting a good rating is very encouraging.
I know the CQC would argue that their point behind these sort of evaluations is that they're
doing a meaningful evaluation that drives improvement.
And I know also that only two local authorities, Camden and Kensington and Chelsea, managed
to get outstanding.
So it is a particularly difficult target to hit.
But I'd be failing in my capacity as opposition spokesman if I didn't ask the question, do
Do you think that there is a possibility that that would be our target, that we can reach
outstanding?
Well, CQC are still – we're going to be hearing when we're going to be next assessed,
but I can say that we will certainly be – our ambition would certainly be to try and aim
for that outstanding score.
And also, as you are well aware, the whole process linked to the Penn Industrial Report
is being reviewed.
So there may well be changes in the mechanism of the framework itself as well, which may change and how it works next time as well
Thank you, but yeah, I think we all want to strive for that next level up don't worry
But you know still acknowledging how difficult it was to get the good rating as well
So so thanks for that and I think Graham wanted to say a few words. Yeah. Thanks. I'll
Leave the politics aside at this particular meeting
Can I thank you, Councillor Cravarri,
for the way that you engaged in this process.
Very much appreciated.
It's clearly in the best interest
of all Bournsworth residents
that we do have a good adult social care system.
In public, I would certainly also like
to add my sincere thanks to all the staff
in adult social care.
I know that they have worked incredibly hard,
particularly over the past three years.
And I think the actual culture and the total approach,
which they have adopted, I think is very much a credit.
In terms of achieving outstanding, I'm very clear.
One, we're not complacent, and secondly,
we are in the process of continuous improvement.
And so as far as I'm concerned,
that is the next stage to achieve outstanding.
Thank you.
Well, thanks again, Claire,
and please pass on all of our thanks to the team
and who've been involved,
and including yourself as well,
who was very helpful to me throughout the process.
So thank you very much.
Looking forward to hearing more.
Okay, is the, I don't know if we need to note this.
We don't, this is just for information.

6 Care Technology Service (Paper No. 25-308)

So the next one is our Care Technology Report.
I think, Claire, you're also giving an update on that.
It was great to see some of the innovations
that the council's doing to really focus on
person -centred care for people,
but would you like to give a brief outline of that report?
Yeah, thank you, I will give a very brief introduction
and then I'm very happy to take questions.
So yes, I am introducing our care technology strategy,
and the strategy's really a core part of our overall vision
to support people to live longer,
healthier, and fulfilling lives.
The strategy will mainstream care technology
with the view of increasing its reach
with more people with diverse needs
and across broader settings of care,
with the overall aim of supporting people
to live much more independently
and longer in their own communities.
We've done a lot of work to modernise the service already.
We've referenced the pilot that we've led.
However, most of the people receiving the service
are still older people.
So one of the key ambitions for the next steps
are providing more specialist pathways
for people with learning disabilities,
people with mental health needs, unpaid carers, and in the wider settings of care.
For example, at the point of hospital discharge or in care homes.
The way in which we deliver the service will be flexible, it will be person -centred, inclusive, and
strength -based in line with the way that we deliver social care.
There are also some operational drivers for change as we currently have multiple disparate services as we were seeking to innovate and transform.
We're now clear on the way forward,
and so we'd like to bring together these disparate services
which can be confusing for referrers and for the public.
So that was a very brief intro,
and I'm very happy to take any questions.
We have initial questions on the Counter -ology Report.
Councillor Marshall?
Yes, I wonder if you could speak a little bit
to what I think is probably a misconception,
but it'd be good to hear it from you,
that balancing compassion versus gadgets,
particularly escalation to a human being
if there's a problem or if the person
doesn't get on with gadgets
or not very familiar with them,
and an emphasis on measuring outcomes in human impact
rather than just monetary terms,
I think would be very helpful in this context.
I think there's probably two questions there, so I will answer the first one.
So I guess one of the core aims of our service is to deliver it in a compassionate way.
It goes hand in hand with our core operational services.
The technology doesn't take away the human at all.
Most of the people receiving CareTech,
it will be in addition to other services.
The technology and the overwhelming feedback
we get from people is that it supports
them to be more independent.
It supports their well -being.
It makes them feel safer.
So it really is a positive from people's point of view.
There are some people where there isn't
a good fit with the technology.
And those people might not be suitable for that technology.
And that's OK.
We also have a digital inclusion offer to support those that might be interested and want to use the offer but haven't felt able to in the past.
So we do have offers for all kinds of people that might want to access the service.
In terms of measuring outcomes, the overall principles of the service are around supporting people to be more independent,
As I said, helping people to feel safer, more secure.
So one of the key indicators in terms of our performance metrics that we'll be measuring
is customer satisfaction and feedback from people.
We've been very committed to gaining feedback from people through the process.
We've just run a piece of work around an outcomes framework to really understand what it means
to people so that we can measure those things as we go forward in the new service.
Thank you.
Thank you.
In regards to the digital work programme, I just want to know if there's any other borrowers
which are offering these kind of services, although obviously it's not a comparison between
other borrowers but just for information and how this service is going.
So I'd say expansion of care technology is very well established now nationally.
So most councils have either done something similar or are going to do something similar
and are transforming what was previously quite a traditional service. So many councils had a
traditional service that offered pendant alarms and most councils are looking at this sort of
Many have achieved very positive outcomes.
So our neighbours in Kingston are doing a lot of work,
and other boroughs in south -west London
are also doing work.
So there's lots of evidence nationally,
and the Telecare Services Association
publishes lots of case studies.
So happy to share a few more of those in my next updates.
I have a question on the budget.
And the question is, is a budget which is 550K,
is that based on the expected number of people
who could benefit from the care technology,
or is that your maximum budget?
And the reason for asking that question
is that the return on investment looks really good,
as you're saying, budget 550, efficiency benefits of 700.
So then that begs the question,
why not invest more in this?
So that budget investment is the additional investment over above some current investment
that we already have in the service.
So that is the investment needed to deliver the future strategy in terms of the step change.
So you'll see in the reference the increase in the number of people, about 450 people.
So that's what that figure refers to.
I'm sorry, what is the total budget then?
I haven't got the figures to handle the total budget because it includes some current budgets,
but I'm happy to follow that up with you.
Thanks.
I guess just to follow up on that as well for me, is this the start of where we might
see it continued expansion beyond this initial programme because I guess to
councillor de Zou's point if this continues to work really well when we do
roll this out to new cohorts like what will we be looking to to expand the
programme to more people or is this enough to meet the needs of everyone who might
need it and so the the strategy is for five years so it's it's a planning
period that we could plan reasonably with the time of the demand model that
we we have planning any further than that we felt was presumptive. But yes,
absolutely. This will be an ongoing transformation. There will be plenty
more to do beyond the five year period, and we probably won't reach a full
ambition within the five years. I have worked with other councils in previous
role around the country, and you know, it's more over the 7 to 10 period. 7 to
10 -year period that you would be maximising the full value
of a full care technology strategy.
Steven Hickey, would you like to ask your question?
I just wanted to ask whether this is in parallel with
or how integrated it is with what may be happening
in the NHS as well, and is there a risk of
individual families or residents or patients
receiving technology from you and from the NHS,
how much sharing is there, both of the technology itself
but also the information that you're finding
from this technology?
Because obviously it's a very rich scene.
And I imagine that GPs and community services
can really benefit.
So how does it all join together?
So firstly, one of the ambitions of the strategy
is to join up more with our NHS partners
across all the settings of care in the health sector.
so community, primary care, and in hospitals.
Funny enough, I was at a digital event yesterday
run by NHS England around exactly this topic.
Locally, the NHS is looking at similar technology,
but it is quite different technology in the health
sector.
It's called telehealth.
It is a different thing because it will
be looking at health indicators.
We are not looking at health elements,
but we might be looking at things like hydration.
and supporting people to remind them to drink,
which links to health.
And so we will be working very closely
with our NHS partners to ensure that the technology
we bring in is joined up with the technology
that our NHS community providers might be bringing in
and working in an integrated way.
And part of this investment is exactly to do that
because that requires bespoke pathways
that are joined up with the NHS
that requires that extra work
that we haven't currently got in place.
Thank you.
That's a great question.
I guess we are where we can use things that already exist
or we can share existing technologies.
It makes sense both for different things then.
We can't do that.
Okay, thanks everyone.
Is the report noted?
Okay, so our next report is our report on the work programme.

7 Work Programme (Paper No. 25-309)

It sets out some of the papers that will be coming up.
It's a constantly evolving draught,
obviously subject to when things get signed off,
when things are ready, but it gives an indication
of things that we'll expect to see coming up.
I just wanted to draw attention to our task finisher group.
This group has agreed to set up a task finisher group
on violence against women and girls,
of which Councillor de la Sejour, Councillor Hedges,
Councillor Davies, myself and Councillor Lee are members of.
The report is focusing on a review into how the council can improve prevention around violence against women and girls.
We know that violence against women and girls is a national epidemic.
There have been countless tragic instances in the news.
We had obviously the death of Sarah Revratt very close to our border.
We know that it's something that residents care about.
They want to see us on the front foot of.
We've done fantastic work in the council around improving our support offer to survivors and
victims of domestic abuse, but there is a lot more to do around prevention.
It's a constantly evolving landscape.
We've got the rise of toxic influences like the dreaded Andrew Tate and others that are
popping up all the time.
And it's something that as a council, we really want to prioritise.
We want to hear from the local communities on this, so we've got plans before we bring the paper.
In November to speak to some stakeholders to get some expert input.
We've got our VORG community forum that's meeting next week to start to get some of that input about where we want to prioritise.
And then we're working with children's offices to use some of their parent champions,
some of their existing forums as well to get feedback.
So we're in the stage of developing key lines of inquiry.
This is a huge area and we've got until February
to create a report and recommendations.
So we're trying to go through that stage
of prioritising where we really want to focus.
But of course we want to use that committee meeting
in November to really make sure that we have covered
all of those key areas and those key priorities
for committee members.
Because it's one of those topics that crosses so many different council departments.
And I think that's where we really want to use things like task and finisher groups to try and break down some of that silo working.
To get children's housing and health, community safety all coming together to really think about what we can do around violence against women and girls.
So that's just a slight intro and outline of that paper.
But I don't know if there are any questions on the work programme, on the task finisher group,
on how we're going to be moving forward with some of that work.
Councillor Jeffery?
Thank you, Chair.
So in terms of the women, I mean, in terms of the girls we're talking about,
what age group are we thinking about for the task and finish group?
That's a great question.
And I don't think at this stage we are going to limit it.
So we're looking at prevention around violence against women and girls.
So preventing the root causes of that might involve going to schools and talking to young men and boys about their behaviour,
rather than having all of the focus on the kind of people that experience it themselves.
So I guess it's more the causes that enable women to experience it rather than necessarily the cohort of women that do experience it.
But all women and girls are gonna be
in the scope of this review.
But obviously we've got until February,
so we're gonna get as many experiences
as we can across the borough.
I think it's a great idea, tackling young children,
young people, especially boys and girls,
and especially going to these schools
and providing this information,
because I think there is a lack of it at the moment
within schools as well.
So, well, as a parent of a young boy and a girl,
so I'd really appreciate this information
to be embedded in my child.
So, yeah, I look forward to hearing more about this.
Is the report noted for information?
Right, okay.
That concludes our business for the evening.
So thank you everyone for some really good
discussions, especially around St. George's
and the Care Tech report, and see you in November.