Health Overview and Scrutiny Committee - Wednesday 18 September 2024, 7:30pm - Wandsworth Council Webcasting

Health Overview and Scrutiny Committee
Wednesday, 18th September 2024 at 7:30pm 

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  1. Webcast Finished

good evening, everyone welcome to the meeting, my name is Councillor Steve role of Deputy Chair of the Health LCC, unfortunately, Councillor debris is unable to attend the meeting tonight and it is proposed that I chaired the meeting in her absence is this agreed?
thank you.
I would also like to welcome our two new members to the Committee Councillor Kim caddy and Councillor Sarah Davies welcomed the committee and thank you for attending.
I would like now to go and ask each member of the Committee to please switch on a microphone and confirm that their attendance, I won't call them mathematics, exclude anxious, go around the table.
if we can start with Councillor Henderson.
yeah present, thank you.
presence, if you can, if you can add your name and also Surrey, Sarah David's sculptures.
Councillor Joe Rigby.
Councillor Lisa Millar afterwards.
Councillor Kim caddy, good evening, Councillor Daniel cousin good evening, Councillor George gravelly get it, thank you very much, do we have any apologies for absence?
yes, there's a councillor, Caroline De La Seu gel, she said absolutely not agree, and we have Councillor Marshall as well as given his apologies.
OK so.
I would also like to welcome Sarah Foster, Vice Chair of Healthwatch, whose present at the meeting today, and I'll ask Sarah to comments on items as we go along in terms of in terms of the papers, I would also like to welcome Kate
Islamic apologies for Mr. Panayiotiou, name from and Lucy Etheridge from St George's Trust, who will be in attendance for the trusts update report, and I would like to welcome Tom Coffey and Prius Samuel from south-west London and St George's mental health trust, who will be joining us online tonight.
we also have a number of officers, present in-person and online, and I'll ask them to introduce themselves when they speak to different papers.
item number 1 minutes

1 Minutes - 21st February 2024

are the minutes of the previous meeting, held on the 25th of February 2004 agreed as a correct record?
great thank you very much.

2 Declarations of interests

declarations of interest are there any declarations, either pecuniary or registrable and knowledgeable non-returnable interests, please declared an interest quoting the item and the paper number in which you have interests and describing the nature of interest, including whether or not she'll be taking part in the item.
I would like to declare I am the Council appointed representative of St George's Trust, as the item is for information only and there are no decisions being made, I will remain in the room and be chairing the meeting.

3 Report by St George's Trust on an Update on the Trust's Performance and Other Key Issues (Paper No. 24-230)

item number 1 report from St George's trust and an update on the trust, performance and other key issues as before, I'd like to welcome Kate and Lucy from St George's trust and asked them to briefly report on the and introduced the report.
thank you, Chair, mining kits Lennox, as he got my name right, and on the managing director of St George's, and I'm here with Lucy Etheridge, who St George's Chief medical Officer, and thank you for inviting us this evening, so I'm going to be very brief just introducing the paper very happy to take any questions anybody has been we both on so we've got a performance update in the paper in very brief we are performing well with regards to long waited for our t t.
we hope to have a minimum or maximum, rather of 20 over 65 week, waiters by the end of September, the government intention is 0, but we are well ahead of many other organisations and we're bringing of 52 week waiter numbers down as well.
we are just short of compliance around cancer standards and I can go into a bit more detail on questions with regard to that, but we are compliant with regards to the sector requirement for 62 days referral to treatment
Eddie continues to be a challenge. I think, as we all know, we've put in a number of different measures over the summer with a view to a more robust winter, and we can talk a little bit more about letter. That's helpful. As you know, we are in a very challenged, I mean the NHS and and probably the UK. There are very challenge financial environment. This is a point yeah I it's receiving a high level of focus by the organisation, and there are a number of things were put in place to deliver a five and a half percent cost improvement programme, we've made really good progress with our CQC actions in maternity, and we're proud to have excellent outcomes in maternity and be second in the country around patient experience and we are undertaking a sort of workforce.
developing a new workforce plan. We've got a new chief people officer who started about a month ago and she is very focused on. We're looking at all our standard of having a more empowered and engaged staff, so the whole piece of work going on around that area and and we've just L are lastly but very importantly that children's cancer services, as you know, the plan is for those services to move the Evelina and we're very much in the thick of transition planning with the Evelina and g s t t, happy to talk about that as well. I was going to leave it at that for an introduction and we're happy to take any questions
great, thank you.
any questions from councillors McKay, first of all, Councillor Keogh.
so first of all, Councillor Crivelli.
can I can I thank you for your report, I just wanted to touch upon the the last point that you made about the transfer of the the Councillor Services to the Evelina, I appreciate that you, you'll be aware what Wandsworth council's position as of if that were supportive of a few in respect of the fact that we don't want to see the transfer to the to to the Evelina and we're still got until 2026 to fight that corner.
but I just wanted you to know from a long-term point of view.
if it is the case that this transfer does go off ahead, what impact do you think it could potentially have an other cancer treatment services that are being offered by St George's right now, and by that I mean, is it the case that perhaps that there may be a reduction in other council services that you're francas surely if it is the case that there's a transfer from St George's to the Evelina, that's gonna blow quite a bit of a hold your budget, not to mention the fact that,
you don't have the existing level of council services that you you have at this moment in time.
so I'll make a start and then that bring LeasCheann, who is also a paediatrician, clinically so.
we don't anticipate this going beyond children's cancer. We are a large cancer provider in south-west London and there's no indication that this will go beyond children's cancer. We are working very hard to look at the impacts if we do lose the service and thank you to Wandsworth are for your support. We really do appreciate it but were absolutely everything needing to engage in the transition programme and alongside that we're working with NHS E regarding if the service does move, how do we recompense what we're losing, make sure we're not dealing with stranded costs, and how do we build other elements of our of of children's cancer services? For instance, some post-EU services? There are things that we can. We can deliver high level post-coup services than we currently do
and there are other things that we can replace some other cancer work with, but it's very much live work to see how that will work its way through pathology also could be quite significantly impacted and we're working through whether we can keep a lot of that work regardless of a service moving, so it is a risk, we're very aware of it and we're working very proactively and openly with NHSE, and they've been quite open with us about how they're going to support us with the transition, but also to build on some of the excellent alternative services that we provide. But Lucy you may want to add to that.
I thank God I don't think there's much more to add to that that the risk radius to to children's services and particularly to the sort of tertiary level children's services that we provide across south-west London and into Surrey but as Kate says we're we're very actively working with NHS England to look at building where we have strengths and then managing our networks, including in children's cancer through the provision of enhanced possibly services for the children of south-west London.
great, thank you of the I've got Councillor Davies and then Councillor caddy next and then Councillor Whitby.
thank you for this report, I'm interested in the section about maternity services.
and
it's here, it talks about the challenges, and particularly for peo, people with protected characteristics and the vulnerable groups, and I just wondered if you could give a little bit more detail here, it talks about you know there were 11 outcomes and so yeah if you could talk about that a little bit, so it's on page 10 is the second bullet points there with a new Equality delivery system?
and so we recognise across the country that there are differential outcomes for women with protected characteristics, particularly women from black and minority ethnic backgrounds, and obviously within this area of London we do have a high population.
who have English as a second language and a high deprived population in the area, so you know, I think this is a focus for maternity services generally, and it's very much part of our focus at St George's, not not necessarily linked to our CQC report for example, it is just part of our our development work.
and we, the improvements that we've made recently include, particularly in access to translation, and this has been identified locally through review of incidents, for example, as an area that we need to focus on, which is why we've given its our attention.
Mayor of supplement to, so, thank you.
so reasonably possible, to have a report at some point to say that we would be able to benchmark you note the progress, therefore those different cohorts.
yes, absolutely, we do collect that data, I don't have the stats to hand, but I can tell you that we actually benchmark very well Avenue at St George's but were happy to share that data, thank you very much.
great, thank you, Councillor Kelly.
thank you very much Chair.
what I've got three questions is that OK to just rocket through them directly, get one to whom I got okay.
OK, I'll come by one and.
the. I guess overall, thank you very much, really interesting reports. The one thing I was going to ask for probably relates to what Councillor Davis said to some extent, because lots of this is great news and things that we can potentially share for our residents. So you know the the lowest 65 week, where it's obviously great news. I wondered if there was some simple metrics or there was a sort of you know, a dashboard of key metrics that we could perhaps look at as part of this report so that we can then maybe even interrogate you on some of the other sort of issues because it's difficult to know, for example, talking about the 50 million deficit, what we know where that stands in terms of the total budget, what that is compared to last year, why you know whether that's important, whether that's gonna be an issue, I'm not sure about the implications of a 50.1 million pounds deficit that's referred to be. It would be sort of interesting interesting to be able to interrogate that a bit further, and then the second question with
on the maternity services, it said that there were 15 must-do actions.
I wondered how many of them had been addressed and then I was just slightly concerned that it talked about the group evidence and assurance panel, which was implemented in July 2024, and I think the CQC report was a year before and it just seemed like a really long time before that is implemented.
I can pick all of those up, so we can certainly perhaps talk outside will know about the what, what would be helpful in terms of metrics to see in this report we have, as you can, imagine, enormous number of metrics.
and we, we measure our performance and lots of different ways, so really happy to help and support for anything that would embellished and support this report further in terms of the deficit, and we we are, I mean we're one of the few sectors in London that posted a deficit and negotiated a deficit really because we did not feel we could break even this year and we didn't break even nastier either so we've been really open and transparent about that right from the beginning.
we have to deliver all of our proper performance standards and key metrics and take the savings into account, so it shouldn't get in the way of as delivering what we we should be delivering because we've actually worked at through to a level that we think is deliverable rather than being asked to deliver something that's impossible, so we've got a whole programme of work around savings and transforming the way we do things. Improving productivity is a big part of it and you'll see that in terms of government messaging, we've made a lot of inroads into improving theatre productivity for instance outpatient productivity, all of which brings in more income as well. So it's both sides of it.
so but yes, certainly we can look at other metrics that would be helpful.
in terms of the maternity service. In terms of the must do is we have dealt with all of the mass do actions and we did that very quickly and that was required of us. The the reason there's a delay in a lag in terms of the evidence assurance panels the way we've been overseeing this became quite onerous and if you really look at how we're going to embed and assure ourselves that the evidence exists, staff know what's happening, that we've got an overarching group now set up across the group cross Epsom, St Helier and St George's, to look at that, but it's replacing what went before rather than than nothing being in placed faucets and providing more from a governance to deliver this going forward, anything you want to add Lucy.
great Councillor Rigby.
yeah, so I was going to ask about the deficit, but just as a follow up point on that is everything going to be covered for the coming winter flu season, can you reassure residents on that?
yeah, absolutely, we for cancer, we've got our flu vaccine planning being rolled out now, we, we do an enormous amount of winter planning because we know that we'll see COVID obviously coming in and going out during winter.
there are other infectious IPC issues as well, that you see a little bit more of in the winter and general pressure, so we will account we have accounted for that I mean.
that that is accounted for in our planning and our financial allowance, I suppose, put it better way, we've obviously got to look all the time about how we do things more efficiently and more effectively.
but we have a, as would the were finalising our winter plan at the moment, but absolutely it will be allowing for all of those those scenarios and making sure we're undertaking a winter flu campaign.
I've got another go for Councillor Kelly, you indicated that and then okay and Councillor Davis also indicates that wants to speak and then nothing last quick question from Councillor goes on and then I'll go to Healthwatch.
yeah, I just wonder if you could help iron something out for me, which I'm possibly not reading something correctly, but you know we know about the the report and the rating of inadequate a year ago.
for not being safe, but then further down the page 10, it says we continue to be a safe environment for childbirth and you know, obviously I am meeting a contradiction there, but can yeah can you explain that for me please?
so as to the CQC are regulator and they undertook a number of on through their inspection, they picked up a number of issues around staffing triage, etc that we have had to improve the Abbot safety common is linked to our outcomes, we have really excellent outcomes at St George's.
in terms of our maternity unit and which were really proud of, we have very good relationships between midwives and obstetricians, which I have to say, isn't doesn't exist in every unit and we have excellent patient experience, I suppose for us it's just that.
the risk abusive of having an inadequate CQC inspection create anxiety with people who might be planning to have their baby at St George's, and certainly initially we felt quite a bit of that we've addressed all of the issues that the CQC raised, but we wanted to emphasise the great outcomes that we do have at St George's and that has continued without throughout and I suppose the judgement of safety from the CQC isn't they have a number of key lines of enquiry that they follow around safety but it doesn't necessarily align does not having good outcomes.
so I hope those symptoms for cancer.
final question from Councillor Gasson before I switched to Healthwatch.
thank you Chair awkward question about children's cancer services moving.
I was wondering if you could give a bit more information about the support that will be available to families during transition, and I'm I'm sure that support will be yeah much appreciated, and it's extremely welcome, but is the fact that you are?
providing support in a way an admission that you know there is no hope for children, cancer services remain that St George's is at the end of the campaign, so to speak, or are there any other possible alternatives going forward?
so I think in answering the second part and then I'll go back to the first part, I think we're so we we know that there's been a referral that's been put, in which obviously we thank on Council for supporting that, but we do have to absolutely engaged with the transition process. We were not able not to engage with that and, of course, if the referrals not successful, it's really important for us, for our staff to be fully involved in planning water. A unit at the Evelina will look to have a set of expertise they just don't have raised, so the Marsden and ourselves are both working collectively with the Evelina ISIS, on a steering group with seizure Francis, whose one of our clinical chairs, new, you've, probably met seizure before when we've been discussing this topic
and I have to say we Evelina, we're working really really effectively and transparently with us, have been very open, they're working with families, so they are very much leading that discussion, but we're supporting at St George's because clearly we have families who have children have quite complex needs and can I have to come to St George's for their care and don't just have their carer at the Marsden, so our families have slightly different perspective, the price or perhaps families coming from Marsden, so they've been very open to involving our families. We've been encouraging our families to get involved in the discussion, so it's it's an interesting and slightly uncomfortable place, because we know that we, we all, agree that it would be better if it stayed at St George's, but if we don't engage in and get involved, then there's a risk both to our patients and our staff, that we're doing them both of the service
thank you, Sarah, if I could ask you some questions for, can ask you to some, please, thank you Chair. My first question is, is it relates, I think, to Councillor caddy and that the metrics in the paper because I think it's quite difficult sometimes to because we get different metrics from different times and it's quite difficult, and one of the things we'd like to do in Healthwatch, particularly in light of some of the report and the Darzi report, is actually reassure the local community about where St George's sits in that saying and the others that might follow up question would be about the cancer waiting times. Are there any particular clinical areas that you have worries about in terms of cancer care and what's being done in those particular clinical areas that are perhaps performing more poorly than others?
so in terms that, I think we can probably think about how we present the metrics, I must admit, their sort of embedded, aren't they, as you go through the report and I actually some of them a bit out of date and here by the time that when the reports written arrives and,
and certainly for elective care, we are top quartile in London in terms of the weights electively Wandsworth has really good weight, so it's something we should be really proud of.
we know we've got a long way to go still to become 18 week compliant, but we are on our journey towards that and we're eliminating 65 week waiters, and we're now working on a 52 week wait it, so I think that will come down cancer.
we were almost there with all of our metrics and cancer as well, but we do have some tumour sites that really struggled to maintain performance and Lucy may want to comment I'll bring Lucy in in a minute, but we and those tumour sites are breast.
skin skin really suffers from really high referrals in the summer, and us then recovering, we're seeing high river was coming from GPs.
the they're going up and up and up, so it's how we make sure we've got one stop clinics to be able to capture those patients do everything they need done in order to move into the pathway as quickly as possible, and the third area where we're quite challenge is Guiney. So there were three. We've put quite a big investment into into breast cancer, but we're just needing to land the additional investment with recruitment of the right people into the roles and again the referrals have gone up exponentially, and it's making sure we've always got the capacity available to meet the demand that's coming through the door and were able to flex at, and that's sometimes quite difficult
and particularly with breast and skin and breast and skin, a high volume, special high volume cancer referral of specialties, so you really do need to be performing in those specialties in order to be cancelled, compliant aggregate level Lucy did you want to add to that?
so I think as Kate says, it's breast guardians, Skinner are are three areas where we're really focusing in all of those areas. The conversion rate of a referral as a possible cancer to a diagnosis of cancer is very low. So our priority really is making sure that for patients that do have cancer were able to make that diagnosis quickly and were able to move people onto the right treatment pathway, so they get the ongoing care they need. So we really do need to think about the models of provision for that rapid access to diagnostics. One Stop shops, as as Kate has described, so that we can very quickly make that diagnosis and and then we actually performed relatively well in terms of getting people onto their kind of ongoing treatment pathway.
we also do need to focus on the workforce, getting the workforce model right for this one, and you know that that is a challenge and is part of our workforce improvement plan.
and also making use of novel technologies, so, for example, telly Dermatology which is being rolled out across London so that we're more rapidly able to to make a quick sort of diagnosis, of yes, needs to be seen or no is fine and and all of these are projects that are being rolled out.
thank you.
as this paper requires no decision and the report is for information, can I ask Councillors is this report noted?
thank you very much.
thanks Kate and Lucy for attending and updating the Committee to really appreciated, please feel free to stay if he wants to see the rest of the the committee meeting and.
listened to other items, but I fully understand it figure that you would like to if you want to leave the meeting tonight, thank you.
I don't know if it's the recording, but it feels it sounds like this I can radio on very, very low, is at the the sound recording.
I can just hear like her.
thank you.
thank you.

4 Mental Health Specific Place Programmes Planning and Delivery Across Wandsworth (Paper No. 24-231)

OK, we're gonna move on to the next paper paper 2 3 1 I just want to check that Tom Coffey and Prius Samuel online yeah, we're here, thank you great OK, I'd like to welcome to Tom Coffey and prior Samuel from South with London mental health trust and awesome to introduce the report. Thank you sorry, I'll start and visceral, actually
Money, trompe coffee, I'm a GP, and so I don't work for the mental health trust I work as a GP at a Brocklebank Health Centre in Wandsworth on the GP, mental health lead for Wandsworth and I worked for the integrated care board in this role and prayer works that mental health trusts and we'll keep you very much the trust perspective
one thing I would like to say I think St George's might have disappeared by now, but they are very engaged with general practice as well, I've beer GP since 1993 in Wandsworth, I was born in Tooting so very much like people here I've lived my whole life in Wandsworth and Lee lived and breathed the the health service.
within my present either pick up some of the points that Councillor Woro raise in advance, so I can try to answer those questions that you pose to us try to this meeting and I'd well, I suppose I wanted to start by thanking Shannon, I think that the most Shannon, the public health team, because a lot of what we do is based on the public health support and public Health, joint strategic needs assessment that is done on mental health quite regularly to allow us to plan our services accordingly and Grandma. Well, wannabe Shannon's consultants yeah works very closely and phenomenally effectively, and also made the services that we now provide for. Our residents are, in fact, are provided by yourselves by the local authority, so we've got very much a mixed economy, but services are provided by the NHS but also in mental health also provided by the local authority. What I'll try and do is
talked about children first, then adults just give you a flavour of what with what we're doing at the moment, so children's services for mental health divided tier 1, which in essence are elvers at a school nurses in general practice and then and also social social care, social workers,
tier two, and they are very much we look at the next level up of mental health provision is very much based around schools at the moment, so what we've tried to do is make sure all schools in Wandsworth have a mental health presence.
it is a mixture of the mental health trailblazers which cover about half the schools in Wandsworth.
mental healthcare professionals in West Wandsworth from the mental Health Trust.
and so we worked with some charities significantly and all of that as a good place to be which are based on a number of primary schools and also offer services for all our secondary schools.
also, we do work with South Thames College as well, and they have got a mental health team based at the South Thames College to work with our younger adults. The Local Authority provide an excellent service called family consulting. This has led by your ED site Team, which provides services for children who are referred into the mental health trust and then to get their actual treatment. The ED slight team, offered an excellent service. We also work with a new organisation called a well Centre again in the community, and that's a summary of our tier. Two services tier 3. I thought I, young people don't more unwell, they won the tree, our service, they've got of general and specialist services like eating disorders, narrow diversity, yeah, children in crisis and self-harming, and that's how we cover our our children's services. One area which I think Councillor were or wanted to ask him about was our asd service. The Harriet's operate hitting the mental Health Trust runs a service for over eight year, roads are under a notch a, it's a combined service by the local authority and by St George's, and that's where biggest challenges, there are long waiting lists in this service, as the number of children who have been referred into the service has grown over the last four or five years, but a capacity in the service hasn't matched that also the service about four years ago by your previous.
Council good at some significant changes to try to make some cost savings, or that has resulted in a service now which is perhaps underfunded and doesn't really have the capacity to provide a service for the children and Young people that is needed, it does more on post diagnostic support which the Local Authority runs very effectively but waiting to get a diagnosis can often be up to 18 months, which is unacceptable for children and their parents were looking at a new service designed to try to address that concerns.
we've St George's taken a greater lead and the local authority having a lesser lead to try to address this issue, but that will come with a cost which we will just will be discussing with the ICB at a later date for adults again very much Connor as a 3 tier service we have services from an adult services for in general practice which is very much GPs but also we have a new service and it's done by it's called a a r s service additional role service government gave some investment in the general practice.
to try to increase the capacity within general practice, and one of the new roles was a mental health worker, so the GPs, I think, that six out of the 9 primary care networks have got an assistant psychologist faced in our practices working with our patients and then the third service within general practice is called Primary Care plus that's for our patients who've got a severe and enduring mental illness like schizophrenia or serious depression and that group were very,
in need of great care, get input accordingly in a community we've got a whole host of services, including our community mental health teams, are talking therapy service, Rosa, a new programme called them hip.
and again this is a question I think asked by Councillor borrow with the ethnicity, mental health improvement project which we are now developing, trying to develop some new hubs in Wandsworth to try to make sure we address the stark inequalities highlighted in in Shannon's report amongst that BME community for mental health access experience and outcomes we're trying to do some family support work to get families involved in supporting.
adults with mental health admissions, but trying to make sure we reduce the control and restraint in the hospitals were trying to make sure as greater cultural capability, training within the hospitals and the hubs dimension 1 we've got at the moment on Beechcroft Road or one in Rushcliffe Hassan near Tooting Broadway I were looking for two new hubs, one in Battersea and one of West Wandsworth to make sure all of one's office is covered and these hubs will be the centre of many of our community programmes over the next few years.
and then the third level, of course, is the hospitals system very much for our inpatient care for the wards, which are principally based on the news, Springfield sites and some patients also on Tamworth, so that tries to summarise how our system works and where our challenges are, and that has been quite a lot of governance change. As the ICB try to address some financial challenges and reorganise is and reduces by 30% its management spend there has a consequence of, therefore, it does mean that we've got less management support to deliver these programmes and transformation, and it does mean some of the committees are undergoing continual review, which is having in a moment will be completed. I would imagine by December, so that hopefully gives you an idea of how we operate within Wandsworth in a services for children and adults. Thank you and try and probably talk about the mental health trust itself. From the Trust perspective
thank you Tom, if I can do that now, Councillor world.
thank you, so, as Tom has shared with the Committee, there are a range of organisations that are delivering mental health activities and programmes to support local residents, and this report really illustrates that.
the mental Health Trust will at the November health and Committee provide a trust, specific update on services, so I just wanted to reassure the Health Committee of that and and the timings we always welcome support from partners, and particularly the council, who have a great reach to residents and a direct reached to residents and it would be great if we could cope, promote our mental health initiatives, using the Council's communication channels and networks to help support increase the awareness of the initiatives that taking place the support that's taking place, for example the end hip hubs that Tom has mentioned and to be able to know of local network groups.
and contacts at the Council has so that we can make direct contact from. Whilst the the following initiatives are being led by the mental Health Trust, I would like to say that these will have a positive impact to residents across the borough, so we are working with the Council's Arts and culture team to deliver the London Borough of culture activities planned for next year using Springfield village as one of the sites, and we are also working with Wandsworth Chamber of Commerce to deliver business breakfast event at Trinity in Springfield village. On the 17th of October. We are also planning the opening of the youth shelter in the Park in the autumn again to to help provide a place for young people to go and also use the park facilities, and also, once a date is confirmed. We will invite the Health Committee to the opening of the new park here at Springfield.
we are planning a toe or a series of talking listening benches project on World mental Health Day, which is on the 10th of October, which will have plaques featuring our offers of support featured on the benches, and I will be sharing all those details with the local authority and with other partners.
I think there's there is something that I would like to talk about, which is the patient and carer Race Equality Framework, it's the NHS, its first ever anti racism and accountability framework, to tackle and eliminate the unacceptable racial equalities in access, experience and outcomes face by racialised an ethnically and culturally diverse communities and to significantly improve the trust and confidence in mental health services.
there are three core Kampl per cow excuse me, core components,
the first is legislative regulatory.
obligations, which is leadership, governance, the second is national organisational competencies, and the third is the patient and carer feedback mechanisms the implementation of peak ref will build upon the Emmett programmes, work which Thomas mentioned earlier, to tackle health inequalities across Wandsworth in access outcomes and experience of mental health services for black and brown people in our community.
this will be a really significant component of our work to become an anti-racist, an organisation, and to tackle health inequalities moving forward in terms of the implementation of peak ref, the mental Health Trust has set up a task and finish group which will input from internal stakeholders, including patients, carers, service line and corporate representatives.
with assistance from NHS England their role was to advise how we implement P CREF, completing a self assessment and establishing an internal advanced in race equality steering group the group has already completed this tasks, the next step in terms of our advancing racial equality steering group will involve voluntary and community organisations focusing on organisational competencies such as anti-racist partnership workforce and cultural awareness such as the unhip cultural capability and multicultural organ orientation and psychological safety.
sorry, peak ref will be, it will be used to as part of our planning and accountability and partnership framework for all future advanced and racial equality initiatives, as part of this specific Data Strategy Group has been set up to address data requirements based on health inequalities, duties and data gaps and we have as part of that member's from the public Health team to to co-produce and ensured that we are using existing data that that's available.
in terms of what's been done to involve local communities within the Peak ref framework, we're using an inside-out approach, combine an internal competencies with external insights to develop more innovative solutions aligned with our local priorities, such as a community to based in community led racial Equality interventions.
we're involving patients, carers and staff, who represent the local community in the implementation and and focusing on different aspects of peak ref at any one time there are also involved in are other groups, such as the workforce, racial equalities strategy, externally we started collaborating with the voluntary sector through the hip funding in a limited capacity on our plan is to establish a wider system advanced Race Equality Group.
involving and embedded in the voluntary and community sector, the goal is to build an alliance of black and ethnic minority organisations with the capacity to run community based cultural reform services, the trust chief strategy officer and the ICB colleagues are also leading on integrated.
ICS White's data collaboration initiative, aimed at improving quantitative and qualitative data, and this work will also involve voluntary and community sector representatives. I think what I will end on is to say that, in November's report, from the Trust will include more information about the ongoing work for pre-crash and where we are. Thank you.
great, thank you, Tania prior.
there's a lot of information has been given to us the already there's a lot of information in the paper.
in the interests of time, because we have a number of items on the agenda, if I could ask Councillors to keep their questions focused and any responses focused as well, so well, OK number So consecrating first.
OK, I'll try and keep this is focused at of Du Cann.
I wanted to go to your clearly doing a tremendous amount of work on trying to address the issues with their mental health in in schools and young people, and that's that's fantastic, the Y really getting a grip on this I wanted to just go to paragraphs like 11 and 12 in your report which focuses on,
schools and you've talked about the fact that you, the mental health support for schools, you've got 40% coverage of of CAMHS for skills, you trying to push that up to 80%, can I just ask if I've got this correct you're looking at having in the long term you're hoping to have 100% coverage of mental health support teams for schools, if I understand that correctly correct me if I am wrong and seeing that and if that is the case,
do you have a sort of target frame for when you think that would be are achievable? 2 2 2 2 ha to have 100% coverage? The second point was you make reference to his children's wellbeing practitioner, that seems to be somebody who takes a very prominent role within trying to address the issues that you're talking about. Could you just tell us a little bit more about what the children's wellbeing practitioner does and what their qualification is to fulfil that role? Earlier on, you make reference to a clinical psychologists lead, but if you could just tell us a little bit more about the children's wellbeing practitioner, and they're all, I'd be very grateful
okay.
very quickly set out a thou, so we've got three mental health support teams in Wandsworth, we're gonna get a fourth one, which hopefully will start in December this year and that will bring us up to towards about 70%, and we'll get a fifth one, we hope in 2026 which will bring us up to 100%.
the children's well-being. Practitioner is a junior psychologists supported by a senior psychologist and because we were identified that West Wandsworth the HRA, the Roehampton happening area particularly had will high need but it hadn't been allocated when we put a bid in for a mental health school trip trailblazer supporting we decided to use our own money to say let's replicate that model in as West once of schools, so that's why, although we got 40% coverage adding in CW pies that were juniors ecologists, that brings it up to 50%
J, going to sounds, very briefly, I, sir, so that they are all they are all, then junior psychologists, the chilling children's wellbeing practitioners.
they they are, but there are always supported by senior psychologists, okay and the so they're, in fact more qualified than the the trailblazer to any other schools, okay, greatness, thank thank you for anything.
I've got Councillor Rigby Councillor Keddie and then Councillor Hussain in that order, he so quick one you mentioned about wanting our help to push out this information, would it be possible to get light some e-mail content that you could send and we can book market further right moment and also if we could think about getting posters to put up in the estates in libraries but you might already be on that thanks.
yes.
absolutely yes, I will liaise with I'm guessing, the comes team with that from the council, but I'll double check with the with Council officers.
Councillor Kelly,
thank you very much again, the reports full of interesting information which I think residents would be yeah delighted to know, so definitely support support, sharing that more widely, I wondered whether there was also the possibility to have some more data in there, it would be great to understand, for example, if I'm the mum of a teenage daughter how quickly a child with an eating disorder would be seen what the outcomes would be, like just some of that sort of solid data, what the demand has done just to be able to sort of, tell people where, once with sits, in comparison with other boroughs or previous years, it would be great to have some of that solid data and also to support some of the equalities work as well. It would be great to see that thank you, and what we won't be able to do is in the November report, which prayer alluded to. We can make sure about waiting time data because is no no no used to have a fantastic service that you wait 19 months for. So we need to have a good service that people can access in the appropriate time, as it happens, the children's eating disorder services access in a few weeks, but we can get the exact data which career can share. Review in November presentation. Thank you very much. Councillor Hussain, thank you, Chair, I've got 2 questionnaire, as the first are a similar to that covered by Councillor Cavalli, but I just want to dig a little bit deeper when you say junior psychologist, do you mean an assistant psychologist, or do you mean a fully qualified clinical psychologist under a consultant clinical psychologist?
so what I, so they're not Assistant psychologists, so what I don't want to do is give, because this isn't psychologists tend to be working in adult mainly.
o on what I'll do it, can I get back to you the exact qualifications because that that is led by the mental Health Trust, and unless prayer has got that information I don't have that to hand, I'm afraid I haven't got rid exact qualifications. Yeah yeah, if you could come back to us without information, is pretty important information. I mean I I work in this field myself and to somebody who isn't part of Isfield and doesn't understand the difference between different types of practitioner. There is a very significant difference in terms of the sort of quality of provision that can be provided, so it is. It is a pretty important thing and it will enable us to
to to to to determine the effectiveness of these mental health teams know if we know that a certain level of professional it is are contained within these teams.
I'm also curious as to why it's up to three high level clinicians and why can't be more specific about the number?
can I come in on that one Kanye, this conversation possibly be taken offline is quite a technical question around criteria and it would be useful if they were able to send him the information to us and then we can pick it up on that I'll I'll asking him happy to do that you can ask a different question about the autism social communication disorder pathway.
and the waiting lists mean this is something that we've been living with.
a good amount of time, the the autism and a de HD search has been happening for quite some time.
and I'm just wondering why, because I used to work in the ones with access service do neurodevelopmental Sir assessments, this is getting on eight years ago and you know it was a significant problem then and it seemed to the problems getting worse, I'm just wondering why it still a significant problem and why enough people aren't being seen as quickly as they need to be seen against. Sorry, I try and answer that said in fact, so for the
so how we divide our services in Wandsworth is sorry for the for asd under the age of eight, their diagnosis is done by the community paediatrics at St George's, in liaison with the Local Authority over the age of eight for asd is done by the mental Health Trust 4 8 D H D the cut of his age 11
and therefore under a 111 goes to St George's over 11, it goes to the mental Health Trust.
one were Councillor Hussain, was talking very much by the older age group and in fact the performance for that age group actually is much much better than the performance for the younger age group. The numbers, as it happens, are much greater in the under under 8 because, as you can imagine, most parents and teachers, they start having their concerns about their children when they start entering nursery and early years educational settings, and that's when the referrals tend to come in. There are many less referrals for 9 10 11 12 year olds, and so the mental Health Trust does actually quite well
but the under aids the issue was and the it's a bit of a history very quickly, we used to have something called a Garrett Park, autism advisory service is run by the local authority and they did all the autism, data assessments and collections going to observe the children in their homes in their schools that get it and how an information pack and there'll be an MDC meeting led by paediatricians to work out does the Charter of autism or not changed five years ago when that team was disbanded and it was suggested then, from now on day, two, the information will be collected by the individual schools and by the parents, and what's happening at the same time as a new service came in, so an increase in number of referrals to happen at the same time, and so many parents and many schools struggle to complete the information that is required to have the MDC assessments. What's happened now you've got off many, many hundreds of children who are still in that data collection pathway and have been for a year because they're trying to get the five or six different forms or completed, and eventually they brought together to the to St George's, and when that happens, the actual process goes quite quickly. So by making a change which at the time was meant to be well-intentioned, has resulted in a issue whereby we've got a massive backlog in children and are being haven't having the information collected in a very slow, inefficient way.
OK.
America. Truth questions to a close go, Chris, who's Sarah Healthwatch, and if you could ask a question, please, thank you, actually I was going to ask about P CREF, which I think praise covered for that's the advantages sending in the question in advance. I think that because we've got very comprehensive answer, thank you and Sarah just to confirm we will, through the mental health performance update report, provide further information about pre-crash sorry. The Health Committee will be expecting that at its November meeting
I recognise this purpose probably generate a lot more other questions that were in clarification, if you could send your questions through, we can pass on through and seek answers and then get responses back and pass them on to Councillor members, so thank you for that.
this paper, there's no decision required for information, only, so can I ask, is the report noted?
great and thank you Tom and prior for a very comprehensive presentation, lots of detail there which, where has been re, really useful and has so far, has generated more questions for us that will be following through, but thank you and please feel free to stay online and watch the is the session should you feel that you wish to.

5 Verbal Update on Supported Housing Acquisition for People at Risk - Springfield Site

great mixed one is a verbal update on the supported housing acquisition acquisition for people at risk at the spring few on the Springfield site.
whose
if I could ask remind officers if they could be just J introduce themselves before they presents the papers or give any feedback for the viewing public, thank you.
good evening I am Rachel Sony, I'm Director of Commissioning for the council an adult social care and public health just this paper is to provide Committee Members with a verbal update for a paper approved our Finance Committee in July to enter into an agreement with London Square for an exciting opportunity for us to acquire and enter into a lease for London Square to develop the 56 units of supported housing for us, so really the verbal update that we wanted to add to in terms of the paper and ensure the Health Committee.
has sight of that is, in particular around the delivery model, things are progressing, we are entering into the agreement, it's part of a wider developments are works have already commenced.
and the delivery model in particular, is a mixed use site where we will be able to meet the needs of a range of people who we have a high need for supported housing in the borough.
a lot of people are placed away from their local area, so people with learning disabilities, enduring mental health needs and care leavers in particular means that this exciting opportunity we can bring the partnerships that we have and establish relationships that we have, we can bring our provider in to support that mixed use on the site.
that supports are wider commissioning intentions to bring more people closer to home and have a wider supply of accommodation in the borough and with the right care and support providers, so we just wanted to update Committee and let people know again, we've provided a briefing that gives assurance around the viability of the scheme and monitoring of the works et cetera.
and I'm happy to take questions from the Committee if you have any, thank you, thanks to Rachel any questions from councillors on this.
Councillor saying.
thank you for I, I think this was, this is a really promising initiative and I think there's lots that people across the Council Chamber will support the other sort of query that I have really is the that the focus on one bedroom properties.
given that there are obviously plenty of people with significant mental health, difficulties that are part of families and live with their families and may have significant housing needs are why they aren't catered for under these plans.
thank you for the question, yes, majority of are demand for supported housing is predominantly for single people, people who are in housing, need and in need of getting support with that housing, so having one bedroom flats will be a significant.
benefit to us to be able to house that population, and that is the demand that we see where someone with a learning disability may want their carer all perhaps live in a community with other people with learning disabilities there will be the flexibility in the development of the scheme and the arrangements within the
within the building, were working with the specialist occupational therapy housing lead, who will help and is designing that's special, the specification to meet those needs, so there is the ability to have flexibility.
but obviously we're trying to maximise the number of units that we can make available for residents.
great thank you any further questions.

6 Response to the Balham Petitions received by the Council (Paper No. 24-232)

no okay, as no decisions required, and the verbal update is for information only is noted for thank you, next item is paper 2 3 to our response to the bellum petitions received by the Council.
there are a number of people will be speaking in relation to this.
Councillor Henderson, this has asked to make a comment first and then we will go to the the presentation from the officers in relation to the paper.
thank you, thank you Chair, it might vote voice sounds a bit crocus because is still recovering from a minor throat procedure I have a few weeks ago also, hopefully, will hold up.
I just simply wanted to set this within the correct context, despite the title of report, this isn't actually a specific response to the for petition signed by 120 people, but are much broader description of what we have been doing to address issues in Balham and that's set out very clearly in part of 6 Karen Vogel, who is the head of community safety, and I had discussions on Bolam and a number of other wards in early 2023, which was showing relatively high status in relation to anti-social behaviour and crime. As a consequence, we agree to establish a multi agency task and finish group in March 23, which causes, before the petitions were actually launched, and that set out in paragraph 7. Now we also agreed that the multi agency task and finish group in Balham should very much be a pilot to be rolled out elsewhere and indeed that his body is actually subsequently happened. So ban was very much the first trial
more generally, I should remind the Committee that the current administration has to both the resources and community safety from the previous administration.
doubling the number of Community Safety officers and also employing an analyst who has been a very good at enabling us to target our approach and much of what has been done in Bolton, frankly, we wouldn't have been able to do without that additional resource and family there's no resource he was set out in a paper to this committee in September 23 a year ago it's called the Community Safety growth report.
and that's set out a whole range of different initiatives which we have been engaged in, some of which are actually referred to specifically in this Balham report.
can I just say this is, I mean a personal observation, I mean, I do have some serious doubts as to whether petitions of this nature, particularly once more thought petition signed 120 people. Here is the best way of actually raising this issue. They'd actually seriously run the risk of creating unnecessary concern and perceptions about anti-social behaviour and crime and, frankly, you if you know there are other routes to deal with these things, particularly if the Safer Neighbourhood Teams and the ward panels, et cetera, I manufacturer, remains now, once was is and remains the safest in the London city, Barra in terms of anti-social behaviour and crime, despite last year as crime statistics, national crime statistics,
under the previous government which were the worst ever recorded in history, thank you
thank you, Councillor Henderson, I just want to check that Kieran and Zoe actually online. It's my staff Cathaoir, OK, thank you. If you like to present the papers, please show so. Councillor Henderson has covered. Sorry the key points, what I'd like to just draw Members' attention to is in table 2 of the report. We've set out each area of concern for the Ballon ward from burglary to vehicle crime, etc and we provided details on the actions taken for those specific areas as well. We've also provided data. As part of this, we reviewed the data for the period of February 2023 to January 2024, covering either side of the petitions as well. So we sort of set out what the crime figures look like for that ward, and section 7 of the report sets out some ongoing work that we've got as well. We've had a huge amount of positive community feedback about the work that we've done. We've managed to get the lighting resolved as well, under the walkway near the station.
and generally we've had really positive feedback from the local community, Councillor Henderson mentioned the extra resource where we doubled the Community Safety officers from three officers to six officers, and just to say that the Balham ward is covered by one of those three new offices that have come into post so we have recruited all three officers and indeed the analyst as well happy to take any questions Councillor or,
great thank you third point is Councillor hedges has requested to speak to the Committee, is the committee an agreement for Councillor hedges to speak on the for petitions?
great thank you very much.
Councillor hijras, you have up to five minutes to address the Committee.
thank you, Chair for letting me say a few words. Firstly, I'd like to thank the council's community safety team for all their hard work in tackling and preventing crime. I very much welcome the focus on on Balham ward and appreciate all who inputted into this report before I was elected as Councillor in Balham in May 2022 Councillor Hamilton I spent some time supporting the previous Balham and Nightingale ward councillors, surveying residents about specific concerns, we had many responses about crime and the fear of crime in the Balham and Clapham South area.
of the thousands of residents we spoke to, women's safety came up time and time again, especially when walking after dark, some of the examples we were given by residents include feeling harassed, followed uncomfortable or threatened as a result of strange behaviour.
petrified about walking in the dark early morning and evening concerns about lighting on Clapham and Tooting Commons and residential areas such as those close to balance station in near bus stops. I raised these concerns back in April when 2022 to Sergeant Annika Jones and her team at my very first Balham Ward Panel meeting with former Balham Councillor Lewzey Mowat. We asked for improved lighting, then more CCTV better education on personal safety strategies and the provision of safety alarms. I'm very pleased that the Met police have delivered on their promise to conduct a walk and talk for women in Balham, which I have attended twice now.
over the past two years we have seen an increase in anti-social behaviour linked to rough sleeping on Balham High Road behind Sainsbury's in the car park and more recently, on Ramsden Road and outside Balham Library.
women still feel vulnerable.
and indeed men.
when using the cash dispenser close to where rough sleepers are Andrew, whether drinking alcohol, catcalling and asking for money.
we carried out these petitions Councillor Henderson, because we wanted residents to know that we were listening to them and that we would partner with the police and the Council to lobby for improved safety in Balham.
whilst there is still a lot more to do, I am pleased that the Council and the police listened and they have taken action here in this report is also my birthday today, and the best present the Council and the Met police could give is to tackle the rough sleeping in Balham and the anti-social behaviour that is linked to it.
so if you can help us make people feel safe again in Balham and Clapham South area as well, that would be much appreciated, thank you for letting me speak.
thank you, Councillor hitches before I go to general questions from councillors, ask current, are there any responses to the issues raised?
sorry, if I just focus on the rough sleeping, because
that had quite extensive multi-agency work taking place, because we recognise that the police were aware of some of the rough sleepers are rough-sleeping team.
this spirit outreach team, they were aware of rough sleepers as well as we collected quite a lot of information around the rustling paper we identified 10 individuals and there was some close working to look at some of the casework, but those individuals, one example was an individual who is actually from another borough was begging and rough sleeping in our area and in fact,
they did have a property in another borough and they were subject to a community protection notice is just one example of how the information sharing was intensified, we've kept a regular check on the rough sleeping in the air, I think we're down to maybe one or two, but we do regularly monitor the area as well.
great thank you very much before, just as a reminder to councillors, there's a lot of information already in the paper by responses from the Council, so I refer you back to the this paper as well.
any questions from councillors, police.
Councillor caddy and then Councillor Whitby very quickly. This is just an appeal to help and support the person who is living under Banbridge, because I see him nearly every day he he's not being moved, Donal helped or supported, and it is deeply frustrating because I went through this process with I don't know if it's the same rough sleeper, but with someone under Alan Bridge two years ago, and it does take a lot of work and effort, but they they can be helped and they can be supported in its it's not just the ASP, it's actually fit for their own good one, for you know, for their support, their mental health, so I would really make a plea because it was there today twice when I went down there so
yeah, I know thank you.
thank you.
Councillor Rigby yeah, an so I thought it might be helpful, I don't know, Councillor headaches reviewed Aggrey if the officers could take this paper out of the big pack and create a link, and then Councillor hedges, you could e-mail it to the 120 pupils that you've GAL.
the data capture for be so that they can see what the council are doing, that that might be helpful.
would you Bill?
yeah happy to send that across, thank you.
great thank you for the suggestion, any further questions.
no okay.
this there is one item for decision in relation to this paper, does the committee support the recommendations in paragraph 2 of the paper?
thank you very much, the recommendations paragraph 2 are therefore supported by the Committee.

7 Review on the Council's Approach to Implementing the Community Trigger (Anti-social, Behaviour, Crime and Policing Act 2014) (Paper No. 24-233)

moving on to the next paper paper 2 3 3 which is the implementation of the Community trigger once again Karen across you.
thank you Chair, so in the anti-social behaviour Act 2014 it provided for a Community Safety Partnership to set a process in place called the Community trigger in most local authorities is process is managed by the Community Safety team led by the Council and supported by the Partnership,
we in 2020 23 started to review our process, it was pretty outdated, we had feedback from officers across the council from partners, there was an ombudsman complaint and we had some feedback from some of the individual residents who were involved and we took all that feedback on board and reviewed the process so the paper sets out what the community trigger is and in appendix 1 it lists all the key changes that we've made.
in in terms of the changes that we've made, members will note that we have changed some of the timescales of our responses, and part of that is around understanding the process of what the Community trigger is. So if a resident raises a concern and says we'd like our case reviewed on many occasions, my team won't be involved in that case, so part of the process of assessing whether it meets the threshold or not is to collect and collate that information from partners that could include the police. It could include NHS, it could be include other Council departments like social services, housing, and we need to allow time in order for us to collect that information. What my officers look at is what the response has been to that ASP complaints. We've been really clear on what that qualifying complaint is so three complaints in the last
6 months, separate complaints of Owersby the emphasis of the Community trigger is to enable a review. It's not a complaints process, so people still need to follow the complaints process for an organisation. It's basically a sort of peer review to understand whether the right steps have been taken to address the anti-social behaviour, support the victims and their families. As a result, we do hold, we collect the information we decide if it meets the threshold
if it does, we hold a Panel meeting, we make sure that the victims' voices throughout that whole process. In that Panel meeting, we decide whether there could be further steps taken to address the Owersby and also just to reassure Members. It doesn't mean that the support stops whilst this process has taken place is just like any other complaint where the individual will continue to get the support they need. If the case doesn't meet the threshold, we would still have conversations with other colleagues and partners. We would also ensure that there's some form of risk assessment that takes place as well, so are not in, or the process is much more clearer. The document that you see in the report is quite detailed, because that's if you think about this whole process, sitting across a number of different partners, we have been very prescriptive on the roles and responsibilities of each of the partners. What we will hold them accountable to, we have ASP leaflets across the borough. There'll be a link around the Community, trigger or the ASP reviews, information will be made available online, summarised as well, in terms of how it works. There's an online form that we've put together as well, and we've sought from fresh that form as well, but in all we have looked to improve bat process and I think finally one of the key improvements we've made is that the case remains open with us.
once the Panel have met and we go back and check with, the complainant, was a victim around the outcomes, if things had been put in place and obviously follow up with other agencies just to make sure that there is that whole total sort of feedback to the victim or the community and then we close the case so happy to take any questions.
thank you very much any questions from Committee members Councillor Cathy first.
thanks very much I I do have some concerns about the impact this will have on victims, and I speak as someone who has had to report ASP in the past and I this just essentially puts the onus entirely back on the victim, to have to get all the data together to have to fill in the forms, and I just predict strongly that many victims won't be bothered, and I wonder whether there was an opportunity for a third-party agency such as the Council, to effectively sort of Paul. We SSB, Community trigger on behalf of the victim, because the victim is just gonna be going through this Kafkaesque nightmare of having to explain all of the things that they've already explained to pop, possibly three or four other agencies. Often the problems with that would trigger a community or that would start of a Community trigger are things like you know somebody losing the details and not doing anything at not getting pass to the right person, so the victim has probably had to go through this, getting getting the data three four five times and have to do it all again. I'd you know, I just find it unbelievable that they would ever do it,
and certainly you know I I I don't think I would the other issue is that obviously the Council and the Community Safety team will be more aware of other complaints, a victim will only be aware of their particular complaints so for example, if it's a neighbour making noise or yes on in the street causing problems yeah there might have been only one complaint from one person in six months, but there might have been 25 complaints from other neighbours, but it's impossible for the victim to have that kind of overarching be, whereas the Community Safety Team will obviously potentially have that overarching view.
sorry, I guess my concern is, is it possible to do it without having all of these kind of detailed questions and the victim having to go through it all again and then, very specifically on page 62, one of the questions is, can you confirm that, as far as you know, no action has been taken, and it's very often not the case that no action has been taken. Often there some action that's been taken, but it hasn't worked or there's some action that's been taken. It hasn't been done quickly enough and I just think that question will really put people off because if if I was filling in, for example, for my case, while I I can't say that no action has been taken, but I don't feel satisfied that the right action has been taken or in a in the appropriate time
so I felt that that question really needs to be lit tax, I think that people would not answer, that would find it difficult to answer that. Thank you,
thank you, and I was wondering, are you in the position to actually directly answered that at the moment, or do you need to take it away and come and come back with a response I can answer the question Councillor well will suggest in terms of the council raising the Community trigger, my team needs to stay independent.
of that because we're obviously looking at it quite independently, the request that we've had, I mean we, we will you know, there's not too much of an onus on the person to raise the trigger, they can give us as much information or as little information as they have, and the additional time that we've put in is for us to collect all that data so Thursday to us they have reported it to the police that sufficient or they have reported it to the their landlord or housing that's sufficient. It's for my officers to
collect and collate a lot of that data around reports, and that would also pick up, for example, if we've had reports elsewhere in the system so that a whole 3 16 terms of collecting data we will do that, but you know the is the victim that needs to apply for the trigger, but also they can go to another agency, so an agency can raise a Community trigger as well, so, for example, the police could raise a Community trigger if they feel they are dealing with a case that hasn't been dealt with sufficiently
housing potentially could so another part of the Council could raise it as well. We've had them to, so there are various opportunities. Councillors can raise it on behalf of their constituents as well, to give them the support and help. So that's the answer to the first bit. In terms of the question itself point noted in terms of, is there any action that's been taken? Potentially we can look at rephrasing that to they are they aware of because I appreciate the fact that there may not be aware of any action that's being taken, but we need to ask that in case, for example, they have been notified that I don't know there has been a in eviction or an arrest or something like that, so we asked for as much information to be filled as possible once it comes in our officers, liaise with the individual who has raised it as ward by them with that support
that is hugely reassuring, really appreciate that thank you.
Councillor of birthright sorry, thank you for this report, it's great to see the changes that are coming to the protocol and the procedures as a result of this, and my only question you kind of touched upon it is that how will these new procedures and processes kind of be put forward to victims and to the public because at the moment it's quite a chunky document and you know that approve victims don't wanna be reading through pages and pages so just wondering how that this will translate easy to read to victims and the public.
show, I think, for the purpose of this committee we've been quite detailed in the changes that we've made, so we've got that element of transparency in terms of how it improving in the information will be available online and it will be basically what the offer is IE, you know this is the threshold and hear some of the service pledges that you would get. We will get back to you in 28 days, et cetera, et cetera, I don't think many, they'll be obviously that bit around
we will be sharing information with agencies that we cover the whole information sharing piece, and that's why the victim has to.
confirm or authorise and agree to the Community trigger being initiated, because we are going to be going off and asking other agencies, maybe other than the Council, for information sensitive another about third parties, including the victim themselves. So we obviously need the authorisation to do that, so it will be quite simplified in terms of the leaflets that we put out we already have some
leaflets on the Community trigger and, if anything, what we've provided you as the protocol, it's more to ensure that there's really good process across the partnership, because there are different partners involved and we need partners to work with us so that we can provide the best service possible when the trigger was raised.
great thank you, Councillor goes on.
thank you.
there's a lot of what sort about collaboration between different agencies are, on the one hand, that can be seen as responding comprehensively to any complaint, but it is also the potential, I imagine, for increased layers of bureaucracy there, so there's not much in this paper about the sort of the process and the mechanisms by which collaboration happens and how that process will be streamlined.
so I'm wondering whether you could say a little bit more about that to ensure that, as Councillor caddie said that people don't get lost in this Cafcass nightmare with multiple agencies, all sorts of working on different levels show just related to the earlier report by Berlin we mentioned this sort of a patron multi-agency response, so we've got a well oiled process around sharing information across partners and colleagues, so you know sharing of information is pretty, I would say, when I say smooth, I'm saying that we know who to contact which organisations to contact there's a whole layer of partnership work for me my team, it's business as usual working with colleagues across the Council and across the partnership including the place
so there are really good strong partnership networks already in place. A lot of the partners I mean Community trigger has been around for some time, so they are all familiar with it as well, so they do buy into the process, so I would say that there is a very tight process already in place. If anything, the improvements that we've made ensures that we do a whole wrap around around the individual that initiates a trigger and we take ownership of going back to the individual to say OK, you know, it's been to three months, how is it going? Is there still a SB, have the agency's delivered, what they haven't we also checking with agencies to ensure that they have as well
before we move to decision any further questions.
OK what I'd like to say, as well as a big thank you, and to recognise the amount of work that goes into preparing, not only this paper but behind the scenes, revising this pulling things together, it's often not recognised by the public and by ourselves the amount of work and time and effort and the coordination that's involved, so I'd just like to say a big thank you for myself in relation to the work that's been done on this.

8 Contain Outbreak Management Fund (COMF) (Paper No. 24-234)

there is a decision that's been made that needs to be made does the committee support the recommended recommendations in paragraph 2 okay, therefore the recommendations paragraph two others was supported by the Committee and thank you moving on to paper 2 3 4 contained outbreak management fund I believe this is being presented by Uzma Khan is that correct.
thank you Chair, so Usman Khan, considering public Health for health protection, work with Shannon.
I'll introduced the people so that contain outbreak management fund was allocated in 2020 21 to local authorities in response to the impact of COVID-19 on population, health and wellbeing and to support local authority public health initiatives, including alleviating COVID-19 included health inequalities, this report focuses on and provides a detailed overview of Gombe funded projects.
and activities undertaken in Washwood during 2022 23 and 23 24, summarising the key outcomes and next steps, and the details are in the paper just to highlight that, for our future preparedness we have got a robust multi agency Walsworth, where resilience Forum pandemic plan which was recently updated and is based on the London resilience interim pandemic response Framework published by a CSA.
United Kingdom kingdom Health security Agency in 2023, this plan details escalation triggers, strategic leadership, responsibilities from a communication framework and potential pressure points during a pandemic in incorporating lessons learned from COVID-19, this generic plan is available applicable to any pandemic and is being regularly tested through doubled-up exercises, so I'll stop here for any questions thank you.
great thank you, and before we move to any questions.
I think it's important to recognise that this was a really difficult period for for all, for the communities and for the Council, and to recognise the response that members of the public, as well as council officials, achieve made in making sure that we got through the COVID period and work together and support our local communities so moving on to questions from,
the Committee any questions.
Councillor Davies,
hello, I'm I just had a question about the different projects that were funds it and whether, possibly at elsewhere, there's an impact reports available on the successes and the outcomes.
so I think, be provided some outcomes and outputs of the projects that were undertaken, there are different stages because some have been funded quite recently before the fund comes to an end by the end of this month. Some some details are in the paper, but I have got some more details. If you are interested, I can share with you some outcomes and outputs are available, we are eligible.
thank you.
any further questions.
no à la I'd like to pass across the Councillor Henderson yeah, thank you, thank you Chair, and I would like to find newsman for all the work that he's done this fielders duty very important, and I think the report sets out and he very many achievements which,
grant being obtained as a consequence of the work and the investment and
certainly, Councillor warning absolutely correct, you know we can only achieve this by working in partnership with residents and a whole range of other people, but in particular.
one of the reasons for thank him as well is that this will be his last meeting, he is sadly leaving us after three years having worked for Wandsworth.
Richman, but I'm very pleased that Saudi and with Salman pleased to say that congratulations to as well, because he's actually living as on promotion, which is always the best way to leave, so thank you Wiseman, on behalf of also the Council and I'm sure the rest of the Members thank you.
thank you very much, Chair Gaza, and it's an indignity.
there is no decision required on this paper, the reported for in is for information only is report noted.

9 Annual Report of Healthwatch Wandsworth 2023-2024 (Paper No. 24-235)

thank you next paper is paper 2 3 5, which is the annual report of Healthwatch Wandsworth and if I can ask Sarah to speak to us, thank you very much and I'll keep it quite break times getting on this is the annual report of Healthwatch Wandsworth and it's the first year of a new contract although we Wandsworth Care Alliance who holds the contract for this work had it previously.
I hope we've read the
some of the wide ranging things that we've achieved in Healthwatch, which is basically
a couple while two and a whole full-time equivalent people and a lot of volunteers who've managed to raise the profile of user involvement in health and social care, a couple of change, well a couple of Conor tweaks this year in this year was an increased collaboration with the Health what she's across the ICS.
which has been really helpful in sharing practice and sharing the load in terms of what how we'd like to influence services while we maintain a keen focus on Wandsworth and Wandsworth residents needs, but that has been a great great advantage as the ICS has developed and got more mature and its approach, the other collaboration which I think we worked on a bit more is with the other aspects of Wandsworth Care Alliance which is obviously got a lot of links with voluntary agency work and has other health type.
and health and wellbeing projects within it, and we're maximising the amount of way we can work across with our voluntary sector, particularly in getting the views of more,
people who are not always heard and maintaining the relationship with some of those agencies.
big thanks to the staff who work very hard and
to the volunteers we do as volunteers, we do a range of things, but we do have key representation on I myself were are on the governing body of St George's. We have people in the mental Health Trust we have people across the ICS boards, which is why, when we come to meetings like this, we can make informed comments as well, because we've got a lot of people with quite a lot of expertise across the health and social care context.
the other challenge, I think for us is always to work on how our work impacts change, and that's I think, something that we all grapple with sometimes.
but we continually looking for how we can assess whether what we're doing is making a difference on behalf of the community, and I think there are some examples in the project in the paper of where we have managed to do that very effectively.
so happy to take questions and Sarah who know who wrote the report is actually here to help there's anything very technical.
any questions from Committee members, Councillor Kelly, thank you very much, it's not really actually a question, it was just to say that.
as a new member of the Committee, I learned a lot, I mean, I thought it was a fantastic report, it really.
brought to life what you do and I personally think that the value of you know getting service users input and feedback is absolutely enormous, so I thought it was a fantastic report really useful to read and I guess maybe as a question is there anything else that the Council can be doing to support you and your work because I think it's great
thank you for that. Well, yes, I mean, I think we have very good relations with a lot of organisations across, and the fact that were involved in these meetings and a high level and a lower level, so some of the, for example, some of the things have been discussed today, like for the mental Health Trust, the autism work you know we get involved with that, so I think there is a
a feeling of great support for us.
and and the organisation when we sit within.
any further questions.
OK and we've.
Councillor Henderson
very built very briefly, combined those muscles said about Mon Tues because they do an absolutely tremendous job, and I think when you item, so something of a gratitude, says Sarah, if you could pass on our thanks to the want, is thanks.
so while day we have a little celebration of as some of our volunteers or volunteer week, but will certainly pass that down. Thank you very much, and and and from my and for me as well, just to say a big thank you. Healthwatch is often not recognised in terms of the amount of work that they do behind the scenes. Challenging services, improving quality and supporting people using services. So a big thank you for that. I just will pick up on Councillor Kelly's points. However, is that sometimes it's very difficult to know the for people to know Healthwatch actually exists or anything that we can do to help you please tell us how we can promote it as the Council, as Councillors, through different contexts we actually have. We need see sometimes be led by you to tell us how to timber to promoted. Thank you. Thank you very much. We will do

10 2024/25 Quarter 1 Budget Monitoring (Paper No. 24-236)

thank you, there's no decision required and this is for information, only so can I ask, is the report noted great thank everyone next paper paper, 1 3 6 which is the quarter 1 budget monitoring paper, I believe, is a Sarah you presenting his
thank you, Councillor Lamb feel like there's lots of service here tonight, but I must say that I was there for heaven's and direct for business resources in adult social care and public health, and this report provides an overview of the forecast revenue position for the remit I think the Committee which includes adult social care and public health and community safety as at Quarter 1 for the financial year 24 25 the forecast position is an overspend of 2.2 million compared to a revised budget of 97.3 million which is just over 2%.
there are significant budget challenges within adult social care and public health, and it's the budgets for our care services that are most challenged across all our client groups which have experienced increased demand and rising care needs, both complexity of need, a market conditions are leading to increase prices within the market and also significant pressure within the NHS is impact impacting adult social care with patients being discharged more quickly into the care system.
the report sets out mitigating actions the directorate is taking continuing to where we're continuing to focus on our strengths, based approach to keep residents healthy and independent, thus preventing, reducing or delaying the need for long-term care services.
the Director as a transformation programme transfer the transforming social care and its implementing a range of initiatives to help manage future demand for services and improve efficiency, which includes the use of digital technology, integrated health and care services.
and a more strategic approach to mental health commissioning.
however, as set out in the report, there are key financial risks and challenges that remain not just for once, with Council but nationally, as evidenced by the recent ADASS survey which highlighted nationally, the financials position for directors of social social Services had significantly worsened.
I'll stop there and I'm very happy to take any questions along with my colleagues.
great thanks, very much Christians.
Councillor Curley,
can I thank you for your report, the the the you've you've talked about the the the fact that there's the overspent overspend on the budget, and I think we're all aware of the increased costs, the pressures on costs overall.
well, one or a I wanted to know, is it in the over the forthcoming year, there's this isn't mentioned in the report, but are we looking at having a large increase, the significant increase in see, for example, costs for non-residential and residential services by way of home home care cuts or other costs for service users is is that something that you envisage?
and Ted and yeah, we've.
home care, we've we have seen a significant increase, says in the number of home care users and the number of our hours that have been provided that are being provided, and so we've started to see a slight drop off in in residential care home places in our home care staff in a home care increasing,
and what we are seeing within those home care packages, as it is there much more intensive. So if we look at home care packages, 10 hours plus there has been significant increases in that area. So, yes, to answer your question, we are expecting that to continue to increase and what we'd like to see is that that those home care packages increased with a corresponding decrease in residential care vary packages and the talk about in the report
use of Reablement and, in particular, part of our demand management is around.
increase in the use of Community Reablement, with the aim again of then reduce the enlarge away in the need for care packages going forward, and that would include home care,
sorry, can I just come back on that is, is there actually gonna be an increase service charge for the Care User than if they're using it?
as a result of the overall budget changes we, we wouldn't charge, that would be the charges that the Council paid to the provider horror, so you know you, you don't see any significant change within that, OK, thank you.
thank you any further questions, Councillor Kenny, thank you very much Chair, it's just on the savings, I just wondered whether there are any sort of specific numbers and by each of those projects, because in my experience, if there's no,
specific, hard plan for creating savings in getting savings and a sort of detailed method of doing that it, it tends not happen, and it might be that that's something that's happening in the background, but I just wanted to check that the savings programme is sort of being looked at in that in that kind of detailed way. Yeah, as part of the transforming social care programme that a talked about, we monitor our savings than there are specific targets
attached to or a range of savings. So yes, we do monitor that in the background and can can include that in future reports to that that would be really useful. Thank you and I guess just a plea that obviously 97 million is a huge budget and I appreciate that we're talking about sort of. You know an increase of 2 million, but there is a whole 97 million that potentially we can look at for for for savings, and I just want to make sure that we're sort of thinking around and all those stones
Councillor Hussain and
thank you Chair.
though there will be a lot or a lot of pressures, financial pressures, and it's difficult to predict what those are, but I'm I'm curious about the potential impact of the cessation of winter fuel payments which could lead to an increase in demand in terms of you know for social Sir social care services, emergency support plus increased costs with home adaptation and in our mental health services and wondering if if if the Council will be considering the potential effect on those areas of this.
changes in national policy and the are what might be in place to mitigate those impacts.
thank you thanks for that question and I doubt our plans to that.
currently I think it will be cross directorate in terms of any response that's that's done to that, so that work will be will be ongoing, but we haven't done anything specific within adult social care and public health at this stage and see Jonathan
thank you, so, although they may not be any new initiatives on the horizon, the Council does have an ongoing Winter warmth programme that helps people with a range of different offers, whether it's adaptations within their households, to try and improve energy efficiency or linking them into other existing funds, because they are some regional based funds as well as some local ones that can support people with their fuel bills during winter so all that work will be ongoing and those budgets were increased recently in the last couple of years.
before we sorry Jeremy, you wanted to come in on that one.
yes, and just adding to to what Shannon said, so the Council has a comprehensive programme looking at the impacts of the cost of living crisis, so a lot of the actions being taken there will positively impact on this group, but particularly in relation to the winter fuel payment we're looking making sure everyone who is entitled to pension credit.
it is then claiming that and and receiving that, because that's a key factor that will then ensure they're receiving the that the people that need the winter fuel payments so where we already do do targeted work on that, so, for example, when people have a financial assessment our our officers on our on they can identify whether people are missing out on pension credit and then can proactively help them or refer them to we've got a special service we commissioned with CIB to help people but we're looking at.
how we can step up that work as we approach this winter.
thank you.
Councillor Henderson
any comments in relation to paper
no, thank you O very briefly,
the first thing I'd like to say is that this is the first time a paper like this has actually come to a Scrutiny Committee.
you have to Scrutiny, Committees were left pretty much in the dark in terms of how their departments are they supposed to monitor, we're actually spending their money unless they delved into 700 pages of the Finance resource Scrutiny Committee, et cetera, so this is very much part of the administration's commitments to transparency and openness and really putting the
owners upon Scrutiny Committees to actually monitor what is actually happening, and you know the scrutiny and committed as a frequently asked to approve procurements running into millions of pounds, and I certainly right that they should actually see what the outcome of that is.
specifically in relation to the changing the winter fuel, at the sorry certainly endorse what is that we could hear what Mr J as soon as those actually said, the cabinet are actually looking at this very closely, we had a good discussion about that at a week ago.
this is a work in progress and you will hear more in the future, thank you.
thank you, Councillor Anderson, in relation to the paper, there's no decision required and the report is for information only, so he's report noted thank you, fellow Councillors.

11 Richmond and Wandsworth Safeguarding Adults Board's Annual Report 2023/24 (Paper No. 24-237)

the last paper of the evening paper 2 3 7, which is the what Richmond and wants for Safeguarding adults Board annual report, if I can ask certain Sousa to respond.
I thank you Chair, so I'm introducing the annual report of the Richmond and once worth Safeguarding adults Board on behalf of the Safeguarding adults Board Executive and the the Safeguarding adults Board, is a multi-agency partnership which, once we've Councillors established with its statutory partners the police and south-west London ICB but also jointly with Richmond council so it's it's the Richmond and Wandsworth Safeguarding adults Board.
during so I'm just going to highlight a few key points from the reports for members during the last year and the governance arrangements of all Safeguarding adults Board were reviewed, so a new Strategic Safeguarding once worth partnership meeting has been established, so so within our joint Board arrangements there is a very specific focus on the local priorities.
and working with partners about issues affecting the Borough and keeping our residents safe.
I just wanted the confirming reassured the Committee that can to needs to be very close collaboration with the Children's Safeguarding Partnership.
and also the Community Safety Partnership say we're making sure that we're all working together in alignment to keep our residents safe, so the report sets out actions that there'd been taken during the year by the Council and and our local partners to safeguard residents, and that includes work on raising public awareness including issues such as self neglect and hate crime.
the report area focuses highlights areas of focus work that took place during the last year and that includes multi agency work on homelessness and rough sleeping and work on developing a modern slavery pathway.
one of the key things that bore does is it focuses on ensuring that we adopt learning in bed learning from any serious.
KC, so they're called Safeguarding Adult reviews or domestic homicide reviews or coroner's reports.
so during the year there weren't any Safeguarding adults reviews for Wandsworth, but of course the focus remains on embedding learning from previous reviews and just improving practice and sharing best practice across the wider partnership.
on pages 166 and the 167 of the agenda pack, there's a focus on on the borrower's key safeguarding data, so you, you'll note, there's 3,300 there were 3,300 safeguarding concerns in the past year and then that has led to a thousand safeguarding enquiries.
being undertaken, both those figures have shown quite a big increase from the previous year and that's as set out in the report, the main types of abuse remain as being self neglect and neglect, and then financial abuse.
the reports are set out, some data on the quality of the bar was regulated care services.
and actually those are generally very good, so you'll note 87% of all care homes are rated as either good or outstanding, and 79% of our home care providers are good or outstanding.
and where a can't providers do require improvement.
or rated inadequate, we worked very proactive, lies our quality assurance team work, with the Care Quality Commission on supporting those providers to improve that their standards.
finally, I want to just note, so are our aim is about focusing on the outcomes for people in the safeguarding process, so to improve the quality of life and improve.
well, that is how we promote wellbeing and safety, so we aim to do this in a person led outcomes focused way.
and supporting choice and control for our residents.
so it's worth 19 95% of outcomes for our residents were fully or partially met.
in safeguarding cases, and that does show we are doing well in our approach.
it's to make safeguarding personal that's the game that we have, and also in 96% of cases risks will removed or reduced and that does indicate that all safeguarding multi-agency arrangements are working effectively to keep our residents safe, so I'm happy to take.
questions along with varying the Bassey's, our Head of Safeguarding adults whose available online, thank you great, thank you any questions.
Councillor Davis,
thank you for your fault, yeah, which went really interesting meeting I noticed somewhere near to for rough sleepers.
you know this yeah, good good outcomes, by bunded what room there is for sort of ensuring continuity, of progress and from good units.
I'm going to ask you if answering the to.
so to answer that question might come at anything if needed and actually are an alcoholic Ali Smith, whose all Safeguarding Board partnership managers also am available, thank you, thank you, Jeremy, I think to some extent, carrots from Community Safety has also kind of covered that and we linked very closely Wiseman outreach teams around rough sleeping and and spares so it's something that we generally would monitor it each year kind of get feedback in terms of outcomes for individuals.
and co, look at that partnership, working across ensuring that people that have quite complex needs.
are being supported correctly, so, and I think it is about having just those links across partners and understanding who to contact when there is quite a complex situation.
thank you.
Councillor Henderson
for example, friendship, just a lot.
officers have recently, in conjunction with even see boom, other interests completed and a survey of the health needs and issues affecting homeless people for the first time, a survey has been done in ones with since 2013, that report is due to go to the Health who have been order later well actually some October often referred to its next meeting it does actually contain a lot of very interesting information.
and I'm quite certain that once the Health and Wellbeing Board has discussed it and it is most appropriate together initially, because it does involve along different agencies and that if the Scrutiny Committee or interest saying that report, but I'm sure it could be made available to thank you,
yeah, thanks to Councillor Henderson, and I think all of us around the topic here would really like to see that report and the recommendations in such shown in it, so thank you for your sharing with us and we look forward to it any further questions from Committee members.
no okay.
this papers, there is no decision required, the report is for information, only so can I ask, is the report noted?
thank you for that brings us to the end of tonight's meeting, I'd like to thank my fellow Councillors for insightful questions asked this evening and also a big thank you to all the officers concerned and preparing the papers for us and sending them through and are and answering the questions that were there were raised this evening so big thank you for myself and on that note that's the end of the meeting, thank you for attending and a safe journey home for everybody.