Health Committee - Wednesday 21 February 2024, 7:30pm - Wandsworth Council Webcasting

Health Committee
Wednesday, 21st February 2024 at 7:30pm 

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  1. Webcast Finished

so welcome everyone.
welcome to this meeting my name's Councillor, Lizzie de Brays, and I'm the new Chair of the Health Committee, I'm gonna first call on the names of the members of the Committee in alphabetical order. Please make sure to switch on your microphones to confirm your attendance and once you've confirmed please make sure that you switch off your microphones, thank you
Councillor Crowley.
I'm George Burley, the opposition spokespeople for health.
and Councillor Della Sagal may be joining us later, so it will come back to that Councillor Marshall.
good evening.
Councillor Rigby, hello.
Councillor Gareth, garage, did he think Chair?
and Councillor World grieving.
also in attendance is the Cabinet Member for Health, Graham Henderson, you'll be mild particularly to our Chair, who is celebrating her first meeting as chair on her birthday.
thank you everyone, so apologies for absence, we've got Councillor Hussain and Councillor Lawless for now, and we currently don't have Councillor Deller, Sir Joe.
so moving on to the welcome, so first of all I'd like to welcome members of the public gallery, thank you for joining us this evening, it's lovely to see there, and I'd also like to welcome Sarah Vice Chair of Healthwatch who is present at the meeting, allow Sarah to comment on any item she has indicated that she wishes to ask a question on when we get the item. I'd also like to welcome Kate
Richard from St George's Trust, who are attending virtually for the George's Trust,
spoken person lovely and we have a number of officers present, both in person and virtually he will introduce themselves when they address the Committee.

1 Minutes - 9th November 2023

so moving to the first item of business, the minutes are the minutes of the previous meeting, held on the 9th of November, agreed as correct.
great.

2 Declarations of interests

and declarations of interest are there any declarations of interest, either pecuniary or non registrable Councillor world, yes, and they nominated rep for the Council on St George's?
governance council of governors, as paper 1 and paper 12, involve St George's, even though no decisions are being made, are we'd be prisoners and involved in the discussion, but I wouldn't be and I won't be leaving the room.
thank you, and in relation to item 4 and item 5, I'm declaring an interest as the community safety champion and I work at women's a which is the national domestic abuse charity, I drive a pecuniary interest from the item, so I'll be present as well.

3 Report by St George's Trust on an update on the Trust's Performance and Other Key Issues (Paper No. 24-63)

I am moving on to our first main item report by St George's Trust, an update on the Trust's performance and other key issues I'd like to welcome Kate managing director and Richard from St George's and asked them to introduce the report.
Deputy and welcome. Thank you. Thank you Chair very much. I was just going to do on Kate, Slimane, managing director of St George's, really good to be here and to see everybody I was gonna. Do a very brief introductions are taking it mainly as read and then obviously we are happy to take any questions that people want to ask. So the start of the report to deliver about performance, just quick, high, high and low lights. We continue to be under quite a significant amount of pressure
and on non-emergency pathways, and we've had we are about to go into our 10th period of industrial action.
so that has put pressure on waiting lists as well, I have to say, we're doing relatively well with waiting lists and still managing to bring the waits down are 65 week waiters which we're hoping to eliminate by the end of March are much lower than they were, we still hope to get to 0 but the the latest announcement of industrial action commencing on Saturday may impact upon that.
so the performance is there to see a cancer is a bit more challenging, we're working on bringing that back on track that has also been impacted by industrial action.
we do relatively well in the for our performance standard, but we do have real challenges, around 12 hour trolley rates and flow generally, but we're doing lots of things working, collaboratively just just mentioned one in particular, we are developing an integrated transfer of care hub with Wandsworth and Merton.
to look at how we can work much more closely together on site planning. Patients discharged much earlier in their pathway, so there's lots of work going on in that space. Just another thing to pick out, as we have just recruited or just in the process of quitting a number of mental health support workers to give us a much more resilient workforce, to look after patients who have mental health needs in in the trust, particularly in an A&E, and we're working with sufferers on St George's around a number of mechanisms to try and reduce our unnecessary admissions of patients who could be averted and be cared for in the community or reduce their length of stay so well, and we're looking potentially at a
whether we can create some level of A&E for mental health patients to give them a better experience,
there's an update in the pack around the ce que c and obviously our CCSC report came out in August, which downgraded maternity services to inadequate, we have an enormous programme of work addressing the issues that were raised to the see QC report and we now are working with NHS England to look to we've had one.
a team come in and work with us about any other findings which has been really helpful around triangulation and some further recommendations that are in the report and again happy to take any questions on that. There's a section on infection prevention and control which obviously be focused very heavily on throughout the year. But winter is a time when that becomes quite a challenge and we've made good progress in a number of areas, but it's an area. We have to be very vigilant about consistently and obviously this being the sort of national incident or over measles that we've been sort of working working locally on as well in terms of campaigns and guidance, and then last, but by no means least, you all will know that the consultation for the children's cancer services that has completed and closed we've had a consultation report come out, which has been quite balanced, which has been helpful for St George's recognised the great practice and the length of service that we've been delivering
excellent children's cancer services, recognising that some of our estate is not quite where we want it to be, which we know already the decision of the final decision we are expecting any time from March, I think it's still not quite clear when exactly when that's gonna come through.
but just wanted to take the opportunity to thank everyone for their support, we had lots of contribution to the consultation, which is what we wanted to see from staff, patients, relatives and and local local people. So we were really grateful for that, so I'll stop there if that's OK, Chair and happy to take Richard and I are happy to take any questions. Thank you very much, so, yeah I'm gonna come to the committee first Cats, Laura
thank you Chair, and before I start, I just like to recognise the amount of work that takes place at St George's and congratulate the staff for working.
under really difficult conditions during winter and are now under tremendous pressure, so I'm a big heartfelt thank you to all the managers and the staff involved in running the hospital.
I suppose I just want to come back to one part of the report and that's the C QC aspect.
after the CQC visit, I know, Andrew, and it has been reported back to the this committee, that an action plan was agreed, and this is recommendations, but actually looks at what work was being put in place, I'm just wondering whether you could give more of an update as the progress against the action plan and the recommendations.
and in any key insights from the or learnings as you as we are progressing against the recommendations, the bud what you've got here is quite brief, and I think, following the the last presentation from St George's, I think we would all be interested to know what the progress is like.
OK, so we had never recommended to him. The CTC came back with a number of must, do and should do actions, and we've been through all the must do and they are now. They have been addressed to her in place. Some of the key areas around governance and processes around staffing. We've done a complete staffing review, we've looked at how we can put in additional ability to over-recruit consistently so that we are managing those transitions when staffing when staff leave and then we're waiting for new staff to arrive. We've looked at a whole risk assessment process
there were some issues around clinical equipment have been addressed and there was some environmental issues which have been addressed as well. We've looked at support for staff. We're looking at how we can communicate with staff to hear their issues right down from in at right through through the various layers within the service. Well, we would pretty visible anyway, but we continue to be very visible as a senior leadership team going regularly up to the unit, making sure we're talking to staff on the ground, so we've made really good progress with the must-dos and there should do, I think, with a lot of them they aren't this one of things that they're done and dusted. You have to continually review oversee, make sure that those are those are being maintained, so we've got sort of governance programme in place where well, where we have a number of people coming together every other week just to make sure we're keeping on track of those we're communicating clearly within the service and within the organisation, and then we've had this all add additional NHS E intervention, which has been helpful. It's triangulated a lot of what we've done already, come up with some sort of eye thoughts about how we strengthen clinical leadership, not least about giving people more time, particularly with some of the pressures. So it's a, we were sort of working those through as well. Richard, I don't know there's anything you want to add
thank you know, I think that's a good summary, I think, from a patient safety point of view, the see q see.
criticised as, as you can see in the secrecy report, the arrangements we have in place to triage mothers when they attended, and we changed that very quickly to make that much more robust, and they were also clear that we needed to improve in the way that we responded to instance where there have been complications in the birth as such as postpartum bleeding or tears both of which are recognised as complications of having a baby, but the CPU said that said that we should have a better oversight and governance of these complications and even if the care had not been at fault we should have a clear way of recording and recognising them and dealing with them.
and we very much addressed as one and or everybody in the Department has taken that on board.
thank you for the response, Councillor Rigby que, so right care right, persons being in place for a few months now, and so there was just a couple of questions around how is it impacting the A&E departments or low, so the people that would have been helped to get care with a police officer?
hey, but who's bringing them in now, are we still seeing police get involved and, just like generally, what's your observation on how that's how it's working?
sorry, yeah, actually so it has been in place, as you say, for for quite a while now it's been very softly launched and we'd still regularly have police coming in bringing patients in and often staying with those patients were there quite florid and and and and sometimes quite violent so.
the the issue around abstention. We've definitely is probably where we've noticed more of a change so depending on the risk factors of anyone who might've absconded because we do occasionally have absconded since we we've had to tighten up our processes about what we can do in the case of somebody excl absconding, because the police are less likely to get involved in this, they consider themselves at some high level of risk, but we haven't that it has been much more manageable. We were quite worried about it, and certainly the Eadie staff were particularly that concerned about police not staying with an individual if they're particularly florid and and are not being able to manage that, and they've been incredibly supportive and that the changes being minimal or if at all, I think probably the greatest changes, as mentioned, is around obscuration and just being just them, being less willing to follow up obstructions for low lower-risk patients, which they probably would have done before
thank you, Councillor Karney.
can I ask a question about the this, the work that you've been doing on the the A and E, and I, I think, the the the the stuff that you've produced about the triaging to to try and help the specialist team to try and interface to your people away who have or have mental health issues to resolve that although the accident maternity unit,
I wanted to to ask about A&E overall, I actually came across a report from it was from the Red Cross of all people who'd done investigation and to the number of people presenting themselves to A&E nationally, and they'd said that 1% of patients were actually responsible for 16% of admissions overall that in effect these were people who were coming back again and again and I appreciate if you do have.
vulnerable people, as you have pointed out, the mental health thing is it it makes perfect sense to triage them, but do you have people presenting themselves at A&E when it's not an emergency situation and that there could be dealt with medically somewhere else and was we're in interesting yeah, you know what sort of impact is not having on A&E and what are you doing about it now?
sorry, yeah, thank you, I think some very important questions, so so one of the main areas that we want to focus on and are focusing on is people who are very heavy users of unplanned and emergency care, and it's often not a simple issue, so these patients often do have very complex needs but often needs which are not best met through presenting to an emergency department, so I wouldn't want to give the impression that they simply don't need help but quite often the help that they need is in the community or from community services or from other kinds of input from primary care.
and so we have a big focus on looking at the small proportion of patients who who use a high proportion of the service, but I think the the other part of your question is, do people come to A&E who don't need any to the emergency department who don't need it and there are many patients who will come because they have an issue, but if the system as a whole worked better, it wouldn't have to be an emergency department that those people come to and we look after a lot of patients whose whose needs we wouldn't describe as emergencies but who do need help and where we can we help them, but it would be better for lots of people to be redirected.
and that's what we promote NHS 1 1 1 and pharmacies for and as a message that we send out particularly appearance when we're about to embark on industrial action and those quite challenging periods when we remind the the public that there are more sources of help available than emergency departments.
thank you just add 3 1 def just to say we do stream at the front, so we have an urgent treatment centre which is staffed by GPs and an advanced nurse practitioner. So, as Richard said, that when people come with different levels of need and we will stream people to the urgent care centre, it is more of a primary care need, and I think people often just choose to come because they will be seen, so there's no way, it's a, it's a sort of victim of its own success. If you know what I mean, but but at least we can make sure they're seen in the right setting by the right set of staff. Thank you. I come to Sarah from Healthwatch now, thank you Chair, I've got a couple of questions. One is again about the department and about people who are regularly being kept on trolleys in corridors, and I just wonder how much you monitor those length of stays and how the care for those people in terms of their privacy, and their dignity it is is managed.
we are not a situation that we're happy with, so I certainly wouldn't describe as those patients being regularly on trolleys, but it does happen, and our first priority is to make sure they're safe and all these patients are recorded on the system they're allocated on the system so that they can't be forgotten. They have a nurses are assigned to their care, or London ambulance staff who are managing their care and we do our best to maintain their privacy and dignity, and we use portable screens and other arrangements. But the plain fact is that if you're on a trolley in a corridor, your privacy and your dignity is not going to be what you or I would want for ourselves or for anybody else, and that's where the work that we're doing with patient flow, trying to tell the pressures of the emergency department, trying to triage versus, trying to look after our patients with mental health needs better is so important because it is certainly a compromise, touchable. Looked after and on trolleys in Ocado.
OK, thank you, my other question was back on the maternity see QC, report about and one of the recommendations was the users of the Vale using users, to help on the on the safety review, and I just wondered how that's being managed.
yeah thanks Sarah, it's a very really important question around user involvement and co creation, so we have a really active maternity voices group which she most Most maternity services are interlinked with maternity voices, partnerships and where we work with them in terms of being the maternity voice. So we've we've got Wokingham in the strategy that we're developing and they are linked into the changes that we're making around. See Q says that we tend to use that route in maternity through them on maternity voices because that's the route as well but that mums or birthing people choose to operate in it. To communicate with
thank you very much, and the report is for information, so I put all, of course, yeah go for sorry s, I just wanted to ask a question that you talked about vaccinations and you talked about your own Peter living, you talked about the flu and COVID vaccination campaigns against to predict and unless you've given us a statistic there for the uptake of vaccines, it is PE or that's it. That's for flu. Is that correct
that that's the flu uptake eventually the COVID updates COVID update has been much lower.
I was, there was going to ask you about that, a could, I appreciate it is not compulsory to have staff vaccinated with the the the COVID vaccine, but I'll make an assumption here that you're actively encouraging the take-up tick above it and in.
what are you doing to to ensure that people do to take the vaccine, yes, a wee sorry really actively encouraged people to take up the COVID vaccine, obviously promoting it across the organisation, making it as easy as possible for people to have it on sites we had non site set up where on on both the St George's and Queen Mary's site where people could go and have their vaccine,
in work time it's all done very quickly, it's not available now actually that that ran up to the end of the calendar year, I think.
but we tried to make it as easy as put it, it's not obviously a vaccine unlike flu that you can go out and about and rove with it, but it was made very accessible for staff and they could just turn up if they didn't actually get around to book and just wait and have their vaccine given to them.
can I check any other questions before me, so is the report noted for information letter, thank you, Kate and Richard for attending you're welcome to stay if you'd like to see, but also free to leave, thank you very much.

4 Wandsworth Community Safety Strategy 2024-2027 (Paper No. 24-64)

thank you so on to Wandsworth Community Safety Strategy paper 2 4 2 6 4 and we've got Kieran introducing that welcome, Karen and Davina from the Community Safety Team MBT
thank you Chair, so this report seeks the Council's endorsement of the Wandsworth Community Safety Strategy.
it's a three-year strategy running from 2024 to 2027, which also aligns with the VAWG strategy, which is the next agenda item just to highlight that it's overseen by the statutory community safety partnership board
and that's the statutory requirement for every local authority to have that it has a number of duties and one of those duties is to establish a community safety plan for the borough, just in terms of background, the strategies informed by an annual strategic crime needs assessment. That's also a statutory requirement, as well as community safety, consultation as well, and that's conducted annually as well. So annually it has a refresh as well, but this this particular strategy has been informed by all those moving parts. We've also looked at local and national policy, we've looked at changes regionally and nationally, and we've also considered good practice when we've developed the strategy as well. Just to highlight that the Community Safety Partnership is made up of criminal justice agencies that's probation police. It also has public health, it has individuals from across the Council, so it's very much a partnership approach as well, and we also ask the Chair for the Safer Neighbourhood boards to come on board to come along, as well as victim support services as well. So it's pretty well rounded in terms of partnerships, and it meets quarterly. The strategy has got a number of key priorities which are all set out within their so around. Keeping neighborhoods safe, just wanted to highlight that that focuses around a sb high volume crime and we've deliberately put that in because it's a three-year strategy. We want to make sure that we are responsive to our neighborhoods. So, for example, burglary would be the key priority for us now. Given the figures that we've got, it will also look at violence within the neighborhoods. It looks at preventing, reoffending and reducing reoffending vogue as well. Violence against women and girls. But one thing I'd like to highlight is that there's some high level information in the plan around VAWG and again the next agenda item. Given the importance of Bob, it has his own strategy to ensure that we are, we've got the breadth and depth that we need to respond to that,
there's a priority around standing together against hate crime and extremism and radicalisation, and the last priorities are on keeping children and young people safe as well, so it's pretty well worked round in terms of partnerships as well as cross council departments as well. The report does flag some areas around funding, so there's grant funding. It's a mixture of how we support the activities in that strategy. We've got the London crime prevention fund from the Mayor's Office for Policing and Crime, we've also got funding from the violence reduction unit as well for the London violence reduction unit, and we've also got core funding to
I appreciate the fact that in the report we've put that that funding is until for another two years.
and we've already was quite proactive and looking at those particular areas that we know we need resilience, and I'm sure if the Health Committee can recall back to previous meetings, we've already come here to ask for particular
gross and core funding to make sure that we can have a sort of sustainability in some of our core services, so the examples of that will be good for service that is grant-funded. So we're really grateful for the permanent funding that we've got for that, so it stabilisers that commission, we've got security. We've secured additional funding for the AFP officers as well, which have now been recruited by the way they started this week. Monday so Wandsworth is up from three officers to six officers in Wandsworth to help deliver some of that work, so we will continuously, as a partnership, look at where funding is needed to ensure that we've got exit plans and obviously take every opportunity we can to secure funding and grants as and when they come through as well. There's an ENO that's attached and we've given a summary around the consultation as well, and just to highlight the role of the council. Just to say that the community safety team, which sits within within my section and it oversees the coordination of the Partnership Board, it applies for the grant funding as well. It sense of the monitoring information it commissioned services and it will oversee the delivery of this strategy. So we very much play a key role in this, which is very common across all local authorities, in ensuring that we are statutory compliant as a council, but also to ensure that the partnership is in place as well and robust. And then
having that role to make sure that we do consider local need and what's prevalent locally, alongside what's needed across London
as well, so we tried to keep that neighborhood focus as well, so I'm happy to take any questions. Thank you, Kieran, I've got Councillor Wirral and then Councillor Marshall,
I thank you. First of all, I'd like second Grech, congratulations for this report. I recognise the amount of work has been going on behind the scenes that involved in here, and reports like this often don't riff don't reflect the hours spent, I'm involved in actually putting something together, so a big thank you and the other big thank you. So it's a nice and easy to read. It's great, it's unlike some of the reports, we see this as logically laid out and easy to follow and actually helps speak to both our philosophy and our manifesto commitments about
around community safety, so big heartfelt thank you for that and just to add two points, really just a clarification on page 47 of the report you speak, or the report speaks about agenda or informed approach as one of the as well as part of of one of our approaches and I suppose just some explanation whether it actually means in relation to that and the other one is just a comment on page 57 stuff around hate crime as for my experience,
working in another borough Tower Hamlets has a very good flow process in terms of the
the PR, the no place for hate pledge, that voluntary sector organisations and the Council signs up to, so it might be something to look at to help reinforce the excellent work that's that's actually recording here.
thank you, Councillor, so just in terms of the gender informed approaches, specifically around prison service, historically, in terms of that service, potentially it's very male-dominated, so you know there's government policy around this and there's recognised good practice. It's considering sort of the impact on, for example, women in the prison setting what's the impact around interventions or assessments. It could be around pregnancy, it could be around sort of just understanding what those needs are, so it's recognising that so, just within that, reducing reoffending framework, we're picking up that area of work. We obviously have ones with prison on our doorstep, so it's just understanding how does how does or being a female offender? What are those things that we need to consider as a partnership, but also as a prison service when that when women are going through the prison system and the criminal justice system, and just second point, absolutely noted, and we know we've got some development work to do around hate crime, we will go back and look at that good practice. Thank you, Councillor Marshall,
thank you very much, Lord Mayor.
can Councillor world's comments around speaking as a also sat as a magistrate and
all the more depressing parts of the legislative, seeing repeat, offenders coming up time and time again and contemplating the tragedy of their lives, the lives of the families and the impact on everybody that's affected by their repeated crimes, so I'm very glad to see that repeat offenders are a priority what I would like to ask about and what I'd like to see is some more data on.
the incidence of repeat offending are not just at the current point in time, but the trend, what proportion of crime is down to repeat offending, how many repeat offenders actually are there, what are we actually doing to that when you set out a paragraph which you described some of the in it from prison to housing initiatives types of things there was, there's what's the scale of those things, how many people are we rehousing?
and what is that doing, and I'd like to point to page 135, which is in the next report, but on on the violence against women and girls,
where you actually show, or the writer of that report actually shows the
incidents of of of of repeat offending, basically with a rather worrying trend to show that it's actually increasing as a proportion of all by autumn, all domestic abuse, so do you think we could see that in the next report and some more data on what's actually going on about repeat offending,
the answer to that is yes, there is a whole data suite that we're working on it at the moment, with probation, we take quarterly reports to the Community Safety Partnership Board and we have, I think, taken twice reports around defending where it's got all that cross sectional data that you know that you're talking about, and again you know, we're grateful for the analytical support, additional analytical support that we're going to get through the additional funding that we've got, which can do absolutely things like that for the partnership. I think the
a strategy also mentioned the governance structure, so you'll see, under each strategic objective, there's a strategic delivery board, so we will be developing that level of dashboard for those partners to look at those trends as a partnership as well.
thank you, I think, had Councillor Deller social first, just don't ask question, thank you, they've been to shootings in the ward ever present in the last few months, one of which was fatal, says he may be using that as a very unfortunate case, steady Q could you solve elaborate and how the strategy set out in this report?
is being applied to ensure residents and the local community that they are safe and also how houses strategy can reduce the likelihood of such an event happening again.
she also mentioned earlier around keeping neighbourhoods safe within that there is a sub priority around us responding to violence, and that's robbery, knife, crime, robbery, God enabled crime, as well as you've just referred to.
in terms of violence, we have got a separate violence, delivery plan and a strategic group that set up part of that is because we now have a statutory duty as a partnership, also as a local authority to respond to violence, and that's been published we had a deadline of the end of January to make sure we published that so in terms of how we work as a partnership it's making sure that we have got that coordinated approach and that we're monitoring that quite carefully and there is a strategic delivery board set up for that as well.
we are working very closely with our community, so in the strategy and the report, you'll see that we've got a bigger emphasis around the community and the community voice, whether it's the survivors' forum, but also we've re-establish Wandsworth communities against violence Forum, and we're currently building upon that to ensure that we are strengthening that community and providing that resilience and working alongside them. I think in terms of prevention, it's going to be around how we work as a partnership, so it's identifying those risks early and if you think about the interconnectivity with all the priorities we've set up, so reducing reoffending absolutely ties into that. So if you think about our integrated different vendor management scheme, which looks at the top sort of 50 or so offenders in the borough, we've made a decision that people who are high harm offenders will be referred into that scheme. We spoke earlier around, repeat offenders as well, so part of looking at those categories is have we got high harm offenders who are repeat offenders, so there's a huge amount of work. What I would encourage members to do is do have a look, we're happy to send the link around.
of the violence delivery plan that's been published in terms of reassuring communities, it is continuously building up that reassurance, listening to them, asking them how we can work on that. A great example is following one of the shootings. The community feedback was how we provide that bereavement support for families, but also how do we provide that emotional support for those members of the community that are first unseen and that's happened in a couple of instances as well, and how do we go back and convene with the community and speak to them about some of the trauma that they experienced as a community? So
we've found funding within our budget and we're piloting a bereavement service with Wandsworth bereavement service, I'm really happy that where we've launched that, and that is a direct outcome of that community feedback following that incident, so where you know we want to keep in touch with the community and what they have said and will continue to be flexible in our approach, thank you, and then Councillor Rigby yeah hi, so one of the main causes of deaths of young man is road violence and sometimes that gets put into the Transport Committee but,
I'd like to understand how it's dealt with here and the stats have just been released on numbers of hit and runs across London, ones were pretty high, we've got 324 hit and runs I witnessed one yesterday in Balham, a guy got run down and the driver just left him so it.
we wanna get that number down to 0, and sometimes well, quite often, the road violence is linked to drug taking two of the paper we've lost this year on the roads were because of drug driving, so does does this strategy touch toll road violence,
so there isn't a category around road violence because obviously, when we're looking at the crimes, we're looking at some of that data that comes through, but yes, road safety, I know that that's a bit of a grey area because you're absolutely right could sit in between both, so if you don't mind Councillor happy to take that away with the figures because this'll be around our close working with our colleagues with the place and Shannon has his hand up Shannon,
thank you, I just wanted to add that, specifically in relation to drugs, we work very closely with the Community Safety Partnership and the combating drugs partnership, which I co-chair, with the Met police that has the specific focus and remit around tackling drug supply, working again with three-year offenders if they've got substance misuse issues to try and support them with treatment and obviously part of
reducing any reoffending, so we work quite closely in that respect around those strategic priorities, thanks thank you for taking it away, because when we talk about road safety, that's very often it's telling residents how to look after themselves on the road and this this is about taking the danger away from residents so,
yobs. I'm isn't interested in it. Moving away from transport road safety and into has preventing the packages also mentioned within my team. One of the things that we do is we're all sort of parachuting into different boards and forums, so demeanour attends transport forms, so we're able to pick up various bits of community safety. Part of that is because the duty for the local authorities under section 17 of the Crime and Disorder Act, and that's where it says that we need to look at all parts of the Council on what we deliver and consider community safety and crime reduction across the board. So we do try to, I would say, parachute into the various different parts of business and the council as well, so I will certainly pick that up. Thank you. OK, 0 yeah, of course, go for
I, I wanted to ask a question you touched upon modern slavery on page 76, I appreciate you, you point out that there is no in effect metric available, there is no data available for this, but
since the introduction of the modern slavery Act in 2015
obviously a lot of people in the criminal justice system are more aware about modern slavery, particularly so things like the youth offending team, do you have a strategy to address modern slavery overall, such as identifying those who may be be vulnerable vulnerable to particularly, so when I was thinking I was thinking about the work that the Youth offending Team does with young offenders who who are deemed to be modern safe because they're dealing drugs and things like that,
so just to distinguish between the two, there's obviously grooming exploitation, and there's modern slavery, and with young people, as you've just said, that could fall under the remit around exploitation and grooming, which links very closely to our work around violence in terms of modern slavery, yes, although the date is not there, we know that,
you know, we've had a few cases in the borough which is predominantly it's women female, so in the Vogue strategy you'll see that modern slavery is mentioned there. I just wanted to say it's actually a really good example of work that we've done with adult social care and looking at safeguarding because safeguarding of children and of adults is a golden thread throughout the community safety plan, so we have worked in partnership with them. We have pulled together a flowchart in terms of how we will operate in response to a referral of modern slavery.
we've published it online, we've delivered training to officers so we do have an operational sort of approach in terms of that, and it's integrated into the work we're doing around VAWG.
and I think Councillor Henderson wanted to briefly come in.
thanks thanks to her.
gareth, please knowledge, or is the Cabinet Member the immense amount of work that has actually been put into this. I know Councillor but Oral commentary document, but it is admittance. This is a report across a whole number of different organisations, some of which Kieran actually mentioned the coordination of that in the agreement. That is extremely important and I do actually think that this strategy actually puts it in a fundamentally different and much more positive situation and although clearly we work with other partners which is reflected in the report, I would particularly like to draw
attention to the work that the Council has been doing, and in particular the Council Safety Team, which is set out in page 36. Etc etc from throbbing pages as well, and what I actually represents is an enormous investments in trying to tackle the root causes of of the type of problems which have been discuss elevate in community safety even though Wandsworth remains the safest inner London borough and effective, giving a shortness to our residents with a OS A for, we are looking after them. It is an immense piece of work clearly won't be delivered overnight or 3 years. I think it's good timetable. Thank you
thank you.
Jeremy did you want to come in?
well, yes, Cheryl is just gonna confirm that our Safeguarding adults Board, so are multi-agency partnerships, partnership, has included modern slavery as a priority for the coming year or and and, of course includes working very closely with the Community Safety Team OK, thank you any other questions before we move for a decision.

5 Refreshed Violence Against Women and Girls Strategy (Paper No. 24-65)

okay, so does the committee support recommendations in paragraph 2 and 3 a great key right moving on to the refreshed violence against women and girls strategy paper number 24 to 65 I'll go over to Karen again, sir, introduced this piece of work.
thank you Chair, so the last strategic needs assessment for Vogue was conducted in 2019, and since then there has been lots and lots of changes.
but I'm sure many Members would be aware of so, for example, cost of living we've seen the introduction of the domestic abuse Act we've had COVID, we've had the Casey review, we've had a new Met for London, et cetera, so there has been lots of changes since then, so we thought it's pertinent for us to refresh and look at the VAWG strategy so we conducted a needs assessment in 2023 that's in the Parkinson terms of some key findings are on page.
95 and the whole refresh is really to ensure that we've got a forward-looking strategy which is addressing the current needs of our community and fog.
the priorities that have been set out in the strategy are around changing attitude and behaviours early identification and help providing safety and support and hold perpetrators to account as well. Since the last strategy we've established over the last 12 months or so, a survivors' forum, a community walk forum and that's our commitment around ensuring that whatever we're doing around four, we've got a the broader community voice, but also we've got a continuous voice of the survivor as well, informing our approach, whether it's commissioning or the drafting of the strategy. We were really grateful for the input and support that everybody's given us in terms of developing this well rounded strategy
again, this is a partnership strategy and I think that's really important, given the multiple partners that would support this agenda, is overseen by the Community Safety Partnership that I've just explained what that what that is in the earlier report, there's clear governance structures not only for the community safety partnership but also around bog, so we have set out a more strategic delivery board. It's broad, it's got all the relevant partners that we need and there as well again it's a three-year strategy until 2027, running alongside the community safety partnership as well.
happy to take any questions fabulous, thank you, Karen Councillor Rigby.
so yeah, one of the pledges in Labour's manifesto, was that we'd make sure Wandsworth is a safer space for women and girls, and to do that we committed to doubling the support for domestic abuse services, could you outline what the key benefits to Wandsworth women and girls will be as a result of this investment?
she also one of the things is around doubling our advice support, so over the last 12 to 18 months, in terms of the increases we've had in our domestic violence, Multi Agency Risk Assessment Case conferences. That's where you got the high risk cases, we've obviously seen a trend of an increase in their, and I think one of the things to recognise is the more that we go out and raise awareness, which we have hopefully some of you who've seen that on the web. Some of you have participated in that in terms of the walkabouts that we've done, the White Ribbon accreditation that we've got you know. As we increase awareness across the community, the partnerships and the businesses, we would expect to see an increase in referrals and early identification and support. So we would expect to see a rise in some of our casework, so absolutely you know, doubling that resource pre-emptively, because we know that knock-on effect will be essential. It means that we are able to deliver that support swiftly
to to individuals experiencing domestic abuse, I think the second thing is around that proactivity, so by us securing the VAWG community safety officer going outside, you know going out to the community and our commitment around the public spaces where much much more proactive around that so it's broaden the approach not just to domestic abuse but how we're looking at public spaces with our partners and obviously safe spaces et cetera is evidence of that and some of the outreach stuff that we're doing.
and there's a whole list, I won't go through it, but in the previous Committee's you would have seen some detailed information around that, also in terms of commissioning, with the now security security of funding for our future commissions services around IDVA we're able to look a little bit more collaboratively around that to make sure that we've got a diverse sort of,
commissioning service and were provide, we we look forward to in terms of making sure that that service meets the needs of our community, so it's providing us with that stability.
to do that, and you know, I think finally I just there's lots of lets, lots of things that are there, but I think for us it's about having that survivors voice, really locking into the community and making them part of this conversation part of the development as we go forward.
thank you, Kieran, Councillor Wirral and then Councillor Arthur Lodge.
you go fast.
thank you, one of the strengths of the strategy is the way you've actually integrated, different areas of the Council together and bringing together resources, as you've said, and integrates integrating different themes which I really welcome, and it's one thing that we set out when we came to power to actually want to do more of and I'm glad seats reflected in this so thank you for that.
I just want them pick up on a point on page 96.
fifth point down, this is this, there's a section here about data recording and sharing responsibility is being made clearer across the partnerships and the service providers, do you just want to elaborate a bit more about that and what that actually means, because I think they could run counter to what you're trying to do if we're not careful,
sure, so I think, at a basic level it's just making sure that if we're going out and raising awareness that you know, the workforce across the partnership are able to recognise domestic abuse, violence against women and girls, that they are recording it, whether it you're going to a GP practice, whether you're going to A&E, whether you're going to housing or social care, were able to record it and identify it. Part of that is us ensuring that you know our officers and the workforce are able to then think about that risk assessment and that plan around the survivor, and it speaks to our commitment around early intervention. I think if you look at, I think it's page. There's a there's a page 1 0 9 and it's page 9 of the strategy. We've got some speech bubbles there of what
victims and survivors of survivors have told us that they want, and if you think about that it's a lot around, they don't want to keep telling the story twice, we need to share that information. You know it's about managing risk, it's about getting in there early, we've got a commitment around behaviour, change of perpetrators, so we need to work closely with our substance, misuse services, our housing services and pick up those things quite early to get the early planning in. We shouldn't have to wait for a case to go to the
while the MARAC the high risk conference, because that's when we know that things have escalated and actually, if we're getting high levels of referrals from the police for the Malak, you know in most cases please come in when things have really escalated and it's about getting in there much earlier and information sharing is central to that we've got the various data sharing agreements in place we are consistent with what is happening across London around that as well.
thank you similar.
thank you Chair, I welcome this new strategy and it's pleased to see that we are staying up to date with current needs, and I'm also very proud of, as an administration for investing in new strategies for violence against women's and girls', so in particularly we established a safe space as part of the night-time economy in Clapham Junction, so I'm just wondering if that can be expanded across the borough.
certainly so we're really pleased with that. It has been a real success, and it's the first time that we've delivered something like that in one's worth. We are working behind the scenes to sort of evaluate it, not a formal evaluation, but we're speaking to partners and colleagues to see how can we upscale this and I think one of the things that we want to link in is about empowering our communities, then working with us and bringing them along with us. As I've said, so we're thinking about things like you know, how can we increase volunteering around the safe spaces I know Tooting has been mentioned as a particular area that we'd like to launch it. What we don't want to do is launched something and then not stick to it, because people know that it's there, so we just want to make sure it's robust is resilient and think about creative ways that we can do it within our resources that we've got across the partnerships are getting that partnership buy-in, so we are looking at how we can upscale it, and I think this is about working really closely with our communities and getting partners involved, but also maybe volunteers, members of our community coming along and getting them engaged in that
thank you do I have any other questions from the Committee on this paper.
and I'd yeah, I was gonna, I think we're both him, I was just gonna, say, thank you so much to officers for all the work that's gone in this, I know that it has taken a lot of consultation as well from the community from the community vogue for and we've gone to a real effort to kind of represent survivor voice, so thank you to the team and I'll hand outs, Graham as well, yeah, thank you
the one-off hook, replete of alright annual agent of the community safety strategy, immense piece of the EPL working across a range of different organisations, absolutely fantastic work coordinated by the Community Safety Team, I would also hope I don't embarrass the Chair, but I do actually think that this is also an excellent example of what champions can actually achieve because the community safety team had been working incredibly closely with Councillor Dovers in her role as community safety champion and I think of success is down at obviously who ever came listening to to people vitally important.
I think it's excellent does fulfil a cut and Councillor Blake is statement about Alice Loughlin, the resource info much much-need it, the original Vogue strategy was pretty thin frankly, and I think we have now actually got something which is worth its name.
thanks, thank you.
lovely OK, if there are no more questions, then we will move for a decision, so does the committee support recommendations in paragraph 2.
great wonderful, thank you.
moving on to

6 Wandsworth Carers and Young Carers Charter (Paper No. 24-66)

paper 24 to 66 Wandsworth, carers and young carer charter, thank you so much, Kieran and.
the England
gonna have the overview by Richard once he's had a chance to sit at the table.
Richard over tea.
thank you.
now this, as you will, we will note from the report dates back from the discussion that this Committee had around carer issues in.
at January 2023, and I guess.
it has taken one bite comment 13 months, to produce a charter that is one page and 17 sentences, but I'm not going to apologise for that because this was a genuinely co produced charter, it was done by carers who, through the ones with carers Centre out through the
Young carers focus groups facilitated by our Children's Services and having spoken to some of the carers who were involved in that process.
I think they would say they feel much more while they do they, they said to me that they felt a real ownership of the charter in a way that I've never had when I've been working on more, more formal, more traditional strategies, so let's be it it has been an interesting and worthwhile exercise.
what I would say I mean no reviewing the points that they've come up with, I think they're, the common theme is that they're about.
please work with us as carers don't do to us and the if you read through time and again the points are about listening to carers.
informing carers and being responsive, especially what needs to change, and I think those are a messages we W we we we do have to take on board.
now the next stage is obviously having got a Charter, we don't want it just to be a nice shiny piece of paper that we produced.
we have to make things happen and.
the first stage of making things happen, which is is happening here for the Council but is happening with our colleagues in NHS bodies, is to make the the pledge which we were asked you to make tonight, and, following on from that pledge, there will be then a form of accountability in that each body making a pledge to the charter will through the carers Partnership Board.
produce an annual report showing what they have done to fulfil the
aims set out the the the ideals set out in the charter and that will then be subject to accountability and review by the Health and Wellbeing Board, it's a different way of doing strategies, I sincerely hope it will work and I have every confidence and certainly the process of developing it has been a very positive one.
thank you and so yeah we re we wrote in the manifesto these words, which I'm so pleased to say, we said we will listen to the lived experience of carers and give them a seat at the table to decide what services are right, so thank you for giving them the seat at the table and for bringing this, so this is a great star how do we make sure that every carer in Wandsworth knows that they have a charter and that they can hold us accountable if we don't deliver it in any way?
McIntyre average Joe Carlton Wadsworth, who in note knows is is a tall order. Frankly, I think we will certainly we work with our partners in the carer's centre who have actually a very, very large membership list of around 5,000. We work with our colleagues in the NHS and in the mental health throw in in St George's and the mental health trust, particularly on GPs. If there is a notification and in information about carers rights in all of those settings, it does mean that it I I it, it gets picked up, it's an ongoing process, though it is, it is not about a single splurge of publicity, it is about the continuing commitment. Thank you, and you know, yeah, Councillor Caravanning,
I can I just say I thought I thought the the the charter, as you know, is very good, and it's it gives I I I I. I think it identifies very clearly the very strong commitment that unpaid carers make to the social services overall overall and we're quite right to to to give that the required support. Can I just ask you about you've you've highlighted one of the the fundamental problems that a lot of the the young carers have, and that is the pressure that that puts on their academic life and the difficulties that they encounter, quite simply because they're trying to balance their caring roles with A or A academic life, obviously imposes or imposes heavily on those there to, for example, doing their A levels or college courses and things like can we just say or outline for us the sort of support that we will be able to to take it to give them overall, since there obviously are a key component within the the the the young carers that are we're talking about today
what I I can say is that the children's services are active partners in the the the the carers partnership, I think it would probably not be correct for me as a representative of adult services to respond on their behalf, but I can certainly ask them to pull together a note for you and for the committee on the particular actions that the the that they are taking because this is very much part of that.
roommate.
thank you, Councillor Oral.
yes, thank you.
first of all, congratulations on this and I think this is a great piece of work and really is a good example, as she said, of co-productions, and I look forward to more of this across the Council, I think this is a good example of co-production in action and as a good case study as well that we can use across the Council and also speak to the philosophy of that we have nothing for us without us.
which I think is ingrained in the in the the work that we want to do across the Council and work with service users just to pick up on just very slightly moving away from children and adults, and I note on page 1 7 SEN there was an issue of carers, representatives on on different boards and I'm just wondering what support can be provided for people to be able to take up those positions, especially as the boards can be quite onerous quote quite demanding in terms of paperwork and presentation and sometimes can be really boring for people as well.
yeah, I said I I think those are good questions is as you'll notice we did have a.
a fourth start, unfortunately, the are we, with the Health and Wellbeing Board, the carers Centre has now identified a or a new representative, so we we are hoping to go, go go forward with that.
the carers may very well need respite support to be able to attend boards one of the things that we we offer, and we have actually done this in in enrichment for a little while is.
an advance briefing for the the carer representative on the board so that they are.
aware understand that sometimes complex and lengthy papers, and I, I think.
they will also have the support of the carers centre in that one of the functions of the carer representative on the board.
which?
can be quite challenging, is quite quite quite a difficult one, the needs emotional support is the willingness to.
stop officers and say, Have you thought about the carer issue in this and
that is one of the things we are expecting the the the carer representative to do and will be supporting them with that.
do I have any other questions, yeah, OK for thank you, Chair, and I just wanted to say a huge thank you to everybody that was involved in producing this charter because it does so today for co produced, so thank you to the one-off carer centre, obviously the officers here at the council and the local NHS, so Councillor Corelli actually asked a question that I wanted to ask, but I do just want to mention that I am pleased to see that, as part of the young carers section that teachers and staff that are mentioned so that they do truly understand the needs of those young carers and we'll just wait to hear back from children's services on the question. Thank you
G yeah and I'll go to Sarah now from Healthwatch for her questions, thank you, Richard, for this I mean it is really nice to see something on one page, which sums up everything, and I think if you're trying to get user involvement in things that out of however many pages 250 pages is the way to go.
I just wanted to add to you've done a great job and obviously it takes a lot of time and effort to get this kind of user involvement, and I think just having one person on a strategic board is not, you know, it's just one part of that I would like to know how you're then going to evaluate this with carers as as as it gets rolled out really.
we were, I mean in, in addition to the the the the the Health and Wellbeing Board, of course there is the carers Partnership Board, which does have significant carer representation and also the carers centre, and that will be the
I
the driving force for delivery at the carer's centres care for the carers forum, which the carer centre coordinates, which is a carer led body, has agreed for the next year, it has four scheduled meetings and if you know there are four themes in the in the charter and one of each of those meetings is going to be looking at those themes and challenging the bodies concerned as to what we are doing about it so that that at least will be a start of of direct accountability and we'll see how it goes from there.
thank you, do you have any other questions from the committee?
I think yeah, Councillor Anderson wanted to make a brief comment, yeah, thanks thank you, Anna Herman, thanks for everyone who has worked on this.
I fully appreciate the co production, it's obviously much more complex and it's inevitable some things will take rather longer and perhaps a more traditional approach, I think, has been immensely important and certainly I think setts are very good.
seen for the future, just one thing that I would like to to mention which Mr what it was did actually refer to, is the new way of working.
I certainly believe in trying out different things, I think to actually agree something like a charter and to get our errors partners to sign up to reporting on that to be evaluated by the Health and Wellbeing Board.
it will have to see how it actually works out, I think that it is much more incisive and potentially much more rewarding than the more traditional approach receiving lengthy papers coming to this Committee or the Health and Wellbeing Board, thank you.
definitely thank you very much again I expected, so we'll move to a decision now, does the committee support recommendations in paragraph 2, great thank you, everyone.

7 Procurement of the Homecare Reablement Service (Paper No. 24-67)

so procurement of the Home Care Reablement Service paper 24 to 67 pages 1 8 1 2 0 8 and we've got Dr Rachel, who is gonna, come and present the report for us evening, Rachel Sony, I'm not a Dr told me that was coming out.
assistant Director of Commissioning yeah, got it.
so, yes, just to outlined to the Committee, we are aiming to commission a reablement service for our residents, which we are aiming to do over a 3 plus 2, so a five-year potential contractual period which will support people when they've had an illness or injury or adverse event in their life to support them for up to six weeks to regain as much or gain as much independence or back to a previous level of functioning is the aim.
we. The report sets out the service model, the service design we have. A growing, mostly reablement works with older adults, we do have a growing population, people needing that through hospital discharge, and we're wanting to grow the amount of hours and the provision that we provide extra reablement. More reablement for people is good for our residents and it's good for helping with our demand because, ideally it means less people go on to have long-term care because more people are regaining their independence and we're aiming to spend initially about 640,000 a year and we would aim for that to go up, because more reablement means a better outcomes for people
so we, ideally, the service will operate in localities in a hybrid model between internal and external provision, and that means that internal and external provision can compliment each other it can provide, can consistency, contingency, as well as very much being aligned to the health and social care team so that we can offer a more seamless care for people across their health and social care needs. And that's why we aim to run it in geography plus it helps provide us with providers, stability and ability to recruit and retain staff and operate logistically within a geographical space. And so that's the hybrid model that we are looking for. We set out the timetable in the report of how we're aiming to run the procurement and how we move into transition arrangements, am happy to take any questions Chair, thank you, ladle handshake, Councillor Cavalli. First
can I just say I, I think, overseeing or trying to expand the service and and
provide the service. The you you're talking about in the conclusion is obviously no completely laudable in effect. Is, is it it? It's 2 2 questions because I I note that you've I identified in paragraph 46 of the report that some of the people that you've you've discussed the potential contract with the the, they're not the sort of support services that you traditionally would be looking at. Are you confident that we will be able to engage a provider who can meet all of the stipulations that we are looking for? Is
this one is with Council, and I don't wish to be negative by asking you this question, but I'm just thinking of a fallback position, what happens if we can meet somebody who meets such standards that we're looking for?
thank you for the question, I think we are relatively confident we are, that we do have a market, we have an existing market and we have an established home care market, This is a home care re-ablement service where predominantly we will purchase these services from a more specialised home care market, which is really quite mature and Wandsworth has a number of providers that we already use and that we believe will be able and willing to apply for this service. It helps by us aiming to have one provider per locality, plus a complementary mix with our internal provision, so that we do have some contingency. You'll note in the recommendations that we're also aiming, as a contingency, to be able to call off from our Richmond home-care platform. Should we need to as contingency or should we have a capacity issue, particularly under time pressure where we, where we ask providers to provide services within two hours post to hospital stay, etc
so you know we of course, and having our own internal services would help if we did have a problem in the market, but my confidence levels are relatively high that that we will that we will succeed in finding providers, thank you and I have Councillor World.
I suppose it's just building on Councillor Cavill's question and the hybrid model, I'm just trying to get my head around it in terms of the the way that she functions, are you and especially the percentage, so is it almost like 70% of the works done by the private by the outside body in 30% stand by the council or how does actually work because on paper it sounds logical but I'm just trying to get my head around what it really looks like.
and I think that's partly why we set out that we'd quite like to have a developmental specification, so we'd really like to work with the market, as our in-house service goes through a developmental phase itself. The report sets out it has already been going through a bit of a developmental phase itself, so how the internal and external provision complement each other will develop over time and we'd like to leave space in the specification to allow that to develop so that they can be truly hybrid and truly complementary, whether that is working in different geographical areas or complimenting each other within a geographical area. That's that's our overall aim and obviously, to grow it where we can, and I did forget to say, Chair, that my two colleagues Hannah and I are online. Should we need them to answer any questions and I'll there they are and I'll call them in if, if so and or invite them, if they have got anything to add, if that's OK, Chair, thank you, please do. Thank you, yeah, follow up just to follow up to that. I suppose, as this is developmental, and I think the aspirations are great and I can understand the logic behind it, because this is a new way of working and needs to change over a period of time. I suppose what is the timeframe of the timelines to where you think you might get to the position of this is actually working in in the model is actually in place,
sorry, let me just refer to the timetable, but obviously it's post the you know in terms of developing its post, the actual award of the contract. Obviously we hope to have the contract in place by October and then we can have developmental parts in the specification, say, quarterly developmental parts in the specification where we can bring providers see how that's working, look at the development of how the in-house provision is working. Look at the pressure points, has it ha? We aim to increase the number of community referrals, for example, so not necessarily from people in hospital, but people that have had need a review of their care. Perhaps Baker it's helpful for them to go into a period of reablement
so that we can get them back to maximum independence or help them to do so, so I think we need we need to keep that under review, to see how how the market can respond, and that's why we want the specification to be developmental.
to answer a question posed by Nikki, any other questions from Committee members.
and Sarah, do you have any questions from Healthwatch, yes, I do. Thank you Chair two points. One is there's one line which says we seek to the input from some service users and carers and I'm just wondering at what point that starts happening in terms of the development of the specification, or indeed this sort of developmental kind of approach, and the other question is due envisage or see a problem when this short packages of care stop but long-term care might be required. Is gonna be a sort of a transition issue, sometimes for some of these people who are receiving this particular package?
thanks for the question, I'll start with the last question because I know my colleagues Hannah and Dial invite them in in a second who've been working on how we engage people during the procurement process and really trying to get feedback from people about the services, it's quite challenging often to ask people about their experience, particularly when they've gone through quite a significant period of change and they've had a hospital admission and gone through a six week re-ablement period so that we we must do that and we do have feedback mechanisms so I'll bring them in in a minute and they can take you through their plans for that.
and but in terms of the transition short to long term, re-ablement is not new, so having a period of rehabilitation and recovery and
reablement post a period of ill illness or injury.
we kind of have a deliberate separation of that care, so the person who provides all the provider that provides that interim short term quite goal-setting moving people through and helping people reach their goals and back to independence they do not then transition onto the same care provider should they need any long-term care so that transitions managed quite carefully and we support people should they need a change of care provider, it also aims to encourage people not to
do for PE, you know, do for people, but to really retrain people, and so I think we're quite adept at that transition. Obviously people do get attached to their carer, so you have to kind of manage that transition and that's really about communication from the Mino from us and the provider at the beginning that this is short term service, it's free at the point of delivery,
and that that service will transition to a long-term care provider should they need it, ideally the service will stop within six weeks because, ideally, they won't need that care long-term, Diane Hanna, do you want to come in on the first question around the procurement engagement?
yes, I'm happy to come in on this, thank you, so the question was around how we could involve service users and carers as part of the procurement exercise.
I'm sure the committee will be aware that it is our aim always to have Euston carers involved, so their voices are heard and as part of this processes we will be looking at.
using unpaid carers or service users to score some of the questions that come in in debates so ordinarily would ask them to score a couple of questions we may go to our older person, says, co-production group to find volunteers, or possibly members of our engagement register that we hold of interested residents.
potentially there's a reasonable commitment of time for any volunteers being engaged in this process because we need to do a short training session for volunteers and the evaluation of bids coming in will depend on the number of beds that coming into the Council and the questions to be evaluated, and then of course there's a moderation session once the bids have taken place, so we are doing a scoping exercise to just work out what the time commitment is volunteers, though we can be very clear and how we support those volunteers and and and remunerate or reward them for the time spent doing this work on our behalf, but we we've managed this process with users and carers for other exercises or tender exercises. We've done so we we think that's a really good use of people's time.
thank you, thank you any further questions me, Sarah okay, thanks everyone.
any final thoughts before we move to decision.
okay, so does the committee support the recommendations in paragraph 2?
great.
moving on.

8 Update on Public Mental Health in Wandsworth (Paper No. 24-68)

thank you very much for your time moving on to the update on public health in Wandsworth, so welcome officers to come to the table to discuss that am welcoming Natalie and Shannon.
MBT Natalie, thank you.
so at this report it provides an update on public mental health activities that have been taking place in one's work to improve mental health and wellbeing of the residents, and throughout this paper I'm going to give you some updates on specifically our mental health needs assessment, public mental health strategy, suicide prevention strategy and Wandsworth involvement in the south London lessons programme.
so, just starting with the mental health needs assessment, will put a governance structure in place.
that is responsible for the prioritisation and implementation of the recommendations that came out of that, and that is that's the responsibility of the local mental health partnerships that chaired by Dr Tom Coffey.
and we've got over 30 recommendations, and they've been grouped into categories which are health inequalities, prevention and early intervention care pathways indicates integrated care and crisis care and suicide prevention.
and I'm just going to give you some brief highlights of some of those recommendations.
so we are developing a public mental health strategy, and I'll talk about that in a little bit more detail later, another recommendation was ensuring that mental health support teams cover all schools and colleges, so there is good progress being made on that.
and funding was identified for a third mental health support team starting from September 2024 and focusing on schools in Putney and Roehampton.
we then have a recommendation around improving crisis care, self-harm and suicide prevention pathways, so again I'll be talking in a bit more detail about self-harm and suicide prevention pathway and toolkit that we have launched.
from that, so those were relevant to children from an adult's perspective, the public mental health strategy will also cover them and there was also a recommendation around reducing ethnic inequalities in mental healthcare by improving access, experience and outcomes through the expansion of co-produce community mental health programmes and the M hip programme that our colleagues will have heard of is progressing well and we're currently seeking an evaluation partner.
to look at the outcomes and the impact of that programme.
regarding the public mental health strategy.
so the purpose of the strategy really is to prevent mental health disorders and improve community resilience through recognise that services are under a significant amount of pressure at the moment. So it was agreed that it was important for this strategy to incorporate interventions across the the whole council, because we recognise that factors such as poverty, debt, poor housing, educational outcomes, environment re-ablement, community safety, they all have an impact on people's mental health, so it's really important this across council strategy. We're also engaging with our wider partners and outside of the Council as well, and now we're in the process of identifying a mental health champions across the directorate
and the the purpose of the champions is really to
help us to identify the right programmes which that are feeding into this public mental health strategy and then support us with the monitoring of those programmes, what are the outcomes will be outputs that we're achieving, and so we can see what kind of impact the strategy is having.
moving on now to south London listen, so that's a collaboration across south-west London, including the integrated care boards 3, mental health trusts, local authorities and over 150 community organisations now, following some listening events that were held in the borough the council has committed to.
focusing on five key areas during 2024, along with the ICB, the mental health trust and the community and voluntary sector.
and these are around work and wages, children, young people's mental health, housing, mental health and social isolation, and race and migration.
now regarding suicide prevention, so we have a strategy for the borough around suicide and self-harm prevention, which takes an evidence-based approach now we're looking at our rates, we've got some numbers here and the good data was actually just very recently updated, they've changed the metrics very slightly,
so if we look at the updated data, we are looking at a downward trend from 2072, then thousand 19 up to their latest data, which is 2020 to 2022, so things are heading in the right direction, which is fantastic.
I am just highlighting a couple of areas within the strategy and just some of the the achievements.
so we worked closely with the R N Ali and H M coastguards to prevent suicide attempts at Wandsworth bridges when Wandsworth Bridge was closed to traffic, so generally they, on average dated the data says that they have one suicide attempt a week from Thames bridges that intersect with Wandsworth.
we put mitigation measures in place which are are noted in the paper and over the 10 week period that the that the bridge was closed, there were no suicide attempts from the bridge.
they say there were reported some in the surrounding areas and were continuing to work with partners
2 to further mitigate that.
and then I also just wanted to mention the suicide or self-harm and suicide prevention pathway and toolkit for children, young people called Porter's, which is now active, and the purpose of that is to improve the experience of children, young people and their families as well as provide support for frontline staff so that they can feel more confident in their responses to self-harm and suicide and this uses a needs-based evidence-based approach.
and we have launched it in a number of schools and will be carrying out an evaluation to understand the impact.
and the intention is to develop that resource even further and also.
create a version for children, young people with special educational needs and disabilities,
so I will stop there and take any questions, and my colleague Graham is online to help with any questions, thank you for that very comprehensive update, but Councillor Rigby first yes I mean gosh, when we were talking about closing the bridge, had no idea of the link to suicide is is that because when those traffic on its A drivers stop if they see somebody wanting to harm themselves,
yeah, so it is is easier for people when there are people crossing the bridge to to be able to.
there is attempt suicide, so with a busy bridge year that's mitigated to a certain extent.
do it if there was any possibility of.
maybe if, if there is sort of Peppa Pig wake sooner, like in January, if we could.
trial having marshals on so, even though the bridge is open to traffic, whether we could try during those weeks because it seemed to have been really successful in saving lives.
we can certainly and have a look at that possibility and take that away, thank you for bringing that to our attention, Councillor Wirral, and then I'll go to Councillor Corelli, thank you.
I suppose I just to recognise it once again the amounts of work that goes into this area of work and how this paper, just so as postures, validates the work that's being done and our commitments towards mental health in the borough.
in the paper you also mention the mental health community champions or mental health champions or local community and myself this sounds really exciting as an area of work, and I've I have experience of champions in other areas of work I'm just wondering in relation to this how does it work or if you could provide a bit more information?
yeah, so am I. I will pass over to my colleague Graham in a moment leading on this, but this is essentially identifying people across the council within the directorate, so they can it's really to help that engagement with our public mental health strategy and support that ownership of the strategy and across the whole Council because we really recognise the importance of the different.
I think the impact that different directorates have on on mental health, but I'll hand over to Graham to expand a bit more who's online.
and to Natalie thanks, Councillor Warren, for that question and as Natalie has alluded to, the public mental health strategy really is looking at the wider determinants of health, and so the social influences, the environmental influences and access to services, and we recognised that to improve the wellbeing of our residents. We needed to look at the broad range of services that the Council provides, and I think those broad range of services puts us in a good position to really positively influence the mental health and wellbeing of residents. So whether it's mitigating the impacts of poverty through the cost of living commission, giving every child the best start in life, improving our physical environment by improving air quality and access to green spaces, improving community safety, as we've had earlier tonight, all of these contribute and we recognise quite early on that a public health department on its own is not able to influence that, but will need to rely on support from from fellow officers across the Council. So we've developed the process. Essentially we we spoke to the chief officers of the Council, to share our vision for happy and thriving communities and we agreed a cross council approach would provide the best opportunity to achieve the vision
and so we've gone away and developed a toolkit which will provide.
support for other Council officers to really champion public mental health across the broad range of directorates, and we will be bringing the strategy to the Health Committee for endorsement later on this year in June.
did Al Shannon, do you want to comment briefly? Yes, chair or mayor also add that, in terms of looking at the opportunities for scaling up some of the preventative work around public mental health in the Council, we've also developed a making every contact count training module which helps people to recognise stress triggers and be able to support those people early enough or signpost them to other services that can support them and in those training modules are not only available to council staff but to some of our partner organisations across the Council, including the voluntary and community sector.
and Sarah, did you have any questions he likes?
although some of it's been answered already, which is this is very much a preventative strategy and obviously measuring the outcome and impact of prevention is quite difficult thing I imagine Graham was talking about just are bringing a strategy into the next meeting, but it would be good to know what kind of
impact measures. You think are possible with this kind of broad ranging work yeah saying thank you, so at this stage we haven't we're not at a place where we can measure outcomes because we're quite early in the journey, but I think from our suicide prevention strategy, for example, our suicide prevention and self harm toolkit as well. We'll be able to measure the impact that those are having
on an our vulnerable groups of children, young people.
and so within a later date, we can certainly bring those back to this committee.
thank you, yeah, go ahead Shannon, in addition to that, in the Joint Local Health and Wellbeing Strategy that we've recently been published, obviously mental health has been recognised as one of the issues and we've got a range of outcomes indicators that we will monitor through the Joint Local Health and Wellbeing Strategy, and I think if you start to see, for example, the indicator we talked about around, you know the rate of suicides if we see some of those heading in the wrong direction, then again maybe that's a signal that we either need to do something differently or we need to do something more, but obviously noting that you know with that particular indicator, there's the signs of progress as something must be happening within the wider system.
yeah, I just gonna think about joining that up with some of the pressures we've seen on Eddie at St George's and.
both across young people's mental health and older people's mental health.
so it's think it's a, it's a massive issue, but I'm in thinking about how the impact might be on people turning up or the demand for services, particularly when you're looking at the children's 1 and the demand for CAMHS services and things I think Councillor I'll go go for a year have a quick one, thank you and just to say as part of the public mental health strategy will be engaging with St George's hospital as well, so we would definitely making that link.
thank you, and I think Councillor Henderson wanted to make a brief comment register liked him.
yeah thanks.
mental health was and is one of this administration's key priorities, we will know what's actually happening in society, a demand for social services amongst children and adults in relation to mental health, and also other social services is really going through the roof, though mental health is one particular area where we felt we needed to put considerably more.
our resource and effort in this is just simply an update of what has happened so far, I say simply an update, it will, of course, be part of a whole series of future papers which detail what we are actually doing tangible to improve the mental health of our residents and to help the system, so I'm suddenly extremely so pleased with the progress and thank you for everyone involved.
there is, I think, all were, or are clearly to be done, the mental health needs assessment was potentially a hostage to fortune in terms of looking at all the urgent mental health needs across all ages, and it certainly produced, I think, a very hard-hitting list of things of a considerable number of things I'm particularly pleased that in our work our traditional partners on page 211 212 those partners have agreed to take the lead on certain of the issues identified, and I think that demonstrates a very clear and coaching partnership, working with all the various people who have involvement.
in mental health there is a
however, as I said, I had considerably more to-do and.
I would particularly like to acknowledge the tremendous work that there is done by them here.
of ethnic minority health improvement plan project and a note Alec I'd always is here, I'm not saying this because, for that reason, sending the whole issue of ethnic minority have has been a key concern, a key focus of this administration and indeed,
last year's public health report by the Director produced an extremely hard-hitting report, enough is enough.
there is a lot more to do that in relation to youth at area, as indeed a number of other key areas thanks.
thank you again go ahead, Councillor can I just ask a question building on the
a suicide and A or A or A and self-harm prevention work that you've you've been doing, and unless you've outlined the strategy with the six key or objectors about it, one of the consistent trends within the figures about suicide rates is that this suicide rate for men is much higher than it is for.
women and I was just wondering if there's anything specifically any specific approach or action that you are intending to take to sort of address it from that point of view.
thank you, so again I will hand over to Graham in a moment and because he leads on this area of work, but we do recognise that the the rates of suicide are higher amongst men compared with women about three times higher and so they have been identified as a vulnerable group we do have a mental health interventions to support men, specifically so, for example, we have the med men's sheds projects in the borough so yeah, that is very much identified, but I will I will hand over to Graham to elaborate a bit further
thank you, and thank you for the question, yes, absolutely, we have men's sheds within the borough which we support through grant funding, and that's really to ensure that we address social isolation, which is one of the biggest drivers for for suicidality amongst men, we also work closely with the NHS with the ICB and they have community suicide prevention.
workers who I have been engaging in areas that we have put forward, so, for example, Barbara shops and sports clubs in other areas within the borough, where we would expect to see the particular profile that you've just mentioned Councillor, and we recognise that the most important thing is also equipping people to feel comfortable to talk about it as well, so we commission, mental health, first, aid, training and also suicide prevention and awareness training and we really want people to feel like they are able to talk about.
feeling suicidal and feeling that there's no hope so that we can direct them to the services that are available within the borough, thank you.
thank you, did you want to just add something yeah yeah, sorry, thank you, I just wanted to add that we've been working with prisons as well in to reduce rates of suicide amongst them.

9 2022-23 Adult Social Care Outcomes Framework Annual Report (Paper No. 24-69)

thank you all, and so is the report noted for information, yeah fabulous thanks everyone moving on to adult social care outcomes framework, and thank you for the update very comprehensive.
I look for social care outcomes framework, annual report paper 24 to 69 and we've got Claire, I believe, introducing that over cheaper.
hi everyone, my name's Clare, to you, on the associate Director for assurance and innovation. This is the social care outcomes framework annual report. It consists of 19 indicators and it has two parts to it. Really one is a service user survey and the second part is a set of national performance indicators, and these are all benchmarked across London, which are the results that you can see in the report. Wandsworth performance is very good, we've got 15 of the 19 indicators in the top two quartiles and most indicators. Nearly all have improved this year, so it really is a really great outcome.
and I'll stop there so very happy to take any questions, thank you any questions on this paper.
think we're all questioned out.
but I mean, it's it's clear that there's a really positive outlook on the report and I think that speaks for itself Claire, so thank you and the team for all the hard work, thank you, thank you.
you do want to make a quick yeah over to Grant.
the Rosso.
I think we should actually celebrate good news, I know where the committee had because I was at the committee meeting itself, we ask searching questions.
trying to find fault, not done on a point about the purpose of scoring political points, but I think we should actually celebrate this as a tremendous positive outcome, I mean, I suppose the fundamental question which we all ask ourselves is whether what we are actually putting in place is actually achieve positive things, particularly for our residents and this particular survey. You cannot actually get more granular, it's actually based upon service users' opinions and experiences as some seven key performance indicates. It is also a comparison across the whole of London.
unfortunately, this ovaries inspire.
was a delay coming after the Department of Health in producing this information?
I think for AB it is going to be challenging, not only for ourselves, but for all local authorities in London to maintain their performance, given the pressures particularly financial pressures they are under, but it is absolutely clear this outcome was certainly a
spoken to a number of officers, they're never actually seen a set of results, as it is these, and I do think this shows us is representative of investment we have actually put into social care, but also the support that we have given to individual officers to actually fulfil their potential as professionals developing and delivering excellent services, thank you.
thank you very much, Claire so.
I don't think a decision is required on this and say the report is for information, only is the report noted.
to me.

10 New Adult Social Care Statutory Complaints Policy (Paper No. 24-70)

and moving on to the new adult social care statutory complaints policy paper 24 to 70, welcoming Nancy, to give a very brief update on that one, every tenancy
thank you Chair. So this policy sets out how the Council applies the Local Authority, social services and the National Health Service's complaint regulations and a description of the statutory all of the discretionary elements of the Adult statutory complaints procedure, whilst the complaints pages that we have on the website already provide comprehensive and accessible information on how to complain this policy formalises what we're already doing and provides greater transparency to complainants, and I will be happy to answer any questions. Thank you fantastic do I have any questions for any members of the committee
Councillor Warrell, and then Councillor Rigby.
minus not a question for the at moments are just to say we'll be writing to out of or outside of this meeting just for a couple of issues around the advocacy and support section, there's quite a lot of detail.
I am looking for some feedback on and I think it'd be take-up, probably half the evening, so I'll be right just to let you know, I'll be writing to you separately, thank you, Councillor Mowat, thank you that I'll write yeah absolutely I look forward to hearing from you thank you.
Councillor Wrigley yeah, thank you, so this will be appearing on all our website. What measures are we taking to make sure it's fully accessible? So I'm thinking for neuro diverse issue so that people don't because it's it's quite
yeah, I mean quite long and you could get confused with it, so why are we doing anything particular to make to help people understand how to get through it, we that isn't something we've considered and I'd be really happy to take that back and discuss that and I can come back to you.
yeah, we've we've just in my workplace we've started to bring in sort of neuro Davos specialists that help us to break down information in ways that make it easy so yeah, that'd be quite thank you, yeah, if you could send an update to Councillor Rigby and that'd be fantastic.

11 Annual Review of Charges (Paper No. 24-71)

thank you, you, and does the committee then support recommendations in paragraph 2, agreed fantastic, moving on to the annual review of charges paper, we're welcoming Sarah and to give an introduction this paper, it's paper 24 to 71 over to Sara, thank you I'm Sarah Evans Assistant Director for business resources this is a a short paper, an outline in the annual fees and charges and proposed increases to those in in line with the Council's charging policy.
most adult social care service users make a contribution towards the cost of their care and support based on or on an individual financial assessment, so service users in the main pay, a contribution based on, or or follow affordability to pay, and the financial assessment will take into account specific costs housing costs such as council tax and rent etc
appendix A sets out those specific charges where the proposed increases 6.7, which reflects CPI at September or and that's the proposed increase across all Council services.
there are small number of charges you'll see from Appendix A that fall into that category and there are a small number of service users that are paying the full charge.
but just to highlight there's always discretion within the financial assessment process to take into account all costs the individuals are required.
to the individuals are facing. I think I'll stop them happy to take any questions. Thank you, I'll go to Councillor Kellaway first, can you say you said there's a small number of service users? Can you tell me those roughly how many it is the small number yeah I can do I am in terms of the self under arrangement fee, there were 64 service users that are paying that currently does change over time, in terms of the day centre for Gwynus Morgan, the number paying that full charges 7 and for deferred
payment fees that's 12, and my supplementary question to those fair to say that the total amount raised is negligible.
it says yes, it's a small amount in terms of those three specific charges.
thank you, Councillor Karney, did you have any okay?
and Councillor Rigby, did you have a question or do that now, okay, does anybody else have a question for Sarah?
lovely fantastic.
OK, we're moving on to the final agenda item, which is just 0 no sorry apologies and you would make one mistake, so does the committee support recommendations in paragraph 2?
don't support it, OK.
so we will move to about do you support any of the
OK.
so can I ask for a show of hands in favour?
and against.
5 and 2, so that note that paper is still carried, thank you.

12 Verbal Update on the South West London and Surrey Joint Health OSC

thank you, Sarah, and so moving on to the final item, which is an update from me on the south-west London and Surrey Joint Area C, so a sub-committee was formed at the meeting of the joint sc on the 7th of June, the purpose of the Sub-Committee was to formally respond to NHS England's consultation on the proposals for the future location of a very specialist cancer service for children living in south London and much of the south of England and to submit a report to J Sock upon receipt of the final consultation.
the Sub-Committee met on the 22 of November and received representations from anxious England Evelina St George's and a patient representative regarding a mid-point review of the consultation, these representations provided an evidence base for the sub-committee which then formulated its response to NHS England's consultation document. The formal response of the sub-committee on behalf of J Sock and its constituent authorities was then submitted on the 14th of December. My response made it clear of the unanimous view of the sub-committee that the service should that if the services required to move then St George's was a clear and obvious choice for the NI Centre. The sub-committee submitted their response to NHS England's consultations on the future of the location and the Sub-Committee are clear of the unanimous opinion that this year, but if this should move, it should be at St George's and the independent consultation summary report has not swayed the Sub-Committee's reviews and has reiterated the issues of strong feelings from patients, families, conditions with regard to any move.
the final report of the Sub-Committee was submitted to NHS England, alongside a covering letter from the Chair of J Sub-Committee on the 12th of January, and these reports will then be ratified and discussed on the 7th of March at the next jostle committee, and this isn't for a decision just for information.
thank you, everyone in the meetings now closed, thanks for your contributions.
very impressive.
Webcast Finished - 1:51:04
I was expecting a long briefly.