Agenda and minutes

Health and Social Care Scrutiny Commission - Tuesday 22 March 2022 7.00 pm

Venue: Ground Floor Meeting Room G02A - 160 Tooley Street, London SE1 2QH. View directions

Contact: Julie Timbrell  Email: Julie.Timbrell@southwark.gov.uk

Items
No. Item

1.

Disclosure of Interests and Dispensations

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    Members to declare any interests and dispensations in respect of any item of business to be considered at this meeting.

    Minutes:

    There were none.

2.

Apologies

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    To receive any apologies for absence.

    Minutes:

    Apologies for absence were received from Cllr Victoria Olisa and Cllr Bill Williams . Cllr Martin Seaton attended as a substitute for Cllr Bill Williams.

     

3.

Notification of any items of business which the chair deems urgent

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    In special circumstances, an item of business may be added to an agenda within five clear working days of the meeting.

    Minutes:

    There were none.

4.

Minutes

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    To approve as a correct record the Minutes of the meeting on held on 2 February 2022.

    Supporting documents:

    Minutes:

    The minutes were agreed as an accurate record with the following amendments: Cllr Maria-Linforth Hall’s name will be corrected in the section where she gave evidence on Domestic Abuse in the Latin American community and her evidence will be corrected to state that language barriers and a macho man culture contribute to Domestic Violence, rather than conflict in the country of origin.

     

5.

Interview with the Cabinet Member for Children, Young People and Education

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    Councillor Jasmine Ali, Deputy Leader and Cabinet Member for Children, Young People and Education, portfolio is enclosed. The commission will interview Cllr Jasmine Ali on children and young people.

    Supporting documents:

    Minutes:

     

    Councillor Jasmine Ali, Deputy Leader and Cabinet Member for Children, Young People and Education, was interviewed on children and young people.

     

    The following themes were covered:

     

    ·  Social care workforce, including impact of pandemic and loss of four social care staff to COVID 19

     

    ·  Priorities

     

    ·  Children in our care and care leavers (including asylum seekers) - including Youth New Deal, which is particularly focused on Care Leavers.

     

    ·  Residential children’s care homes being built by council

     

    ·  Youth offending workforce & delivery

     

    ·  NEST appointments and outreach

     

    ·  Substance misuse gaps in service for young people

     

    ·  COVID 19 , air filtration  and PIMS in children

     

    ·  Emotional & mental health 100%  support target and continuation of delivery and funding

     

    ·  Peckham Rye ward and community safety following murder

     

     

     

6.

Long COVID

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    A report is enclosed on Long COVID from Guy’s and St Thomas’ Foundation Trust, and partners. KCH have also provided a report.

    Supporting documents:

    Minutes:

    The chair drew member’s attention to a papers from Guys and St Thomas’ Trust (GSTT) in the agenda pack, and a paper from King College Hospital, to note.

     

    The following people presented from GSTT:

     

      Paran Govender (Director of Operations and Partnerships) 

      Jacky Jones (Deputy Chief Therapist)

      Andrea Carney (Head of Patient and Public Engagement)

     

    Following the presentation the chair invited questions and the following points were made:

     

    ·  It is unclear at the moment if the virus stays in the system, there is not enough information yet.

     

    ·  Members asked if the higher morbidity and mortality amongst certain ethnicities is mirrored in the Long Covid cohort. GSTT staff responded that there are some trends to ethnicity and age, but again not sufficient robust data to draw conclusions. GSTT are linking with Public Health here on epidemiology. Presently it is mostly white people coming through to services. GSTT is conducting a lot of outreach, as had been described, as there are concerns that there is a long standing reluctance and lack of confidence in some ethnicities to access services.

     

    ·  Members offered to assist with linking GSTT to local communities and putting people in touch - including constituents who want support. GSTT said that they would welcome this offer. 

     

    ·  GSTT staff were asked to outline the symptoms of Long Covid and the clinicians said that fatigue and tiredness is a key symptom – with people reporting really low energy. The top three symptoms are fatigue, breathlessness and brain fog, but there are 250 symptoms identified with Long Covid. People seeking help are emphasising that they want to be believed and have some support.

     

    ·  Long Covid is receiving investment because this is a long term condition that people will want support over time. This is similar to other long term conditions that the NHS support people with.

     

    ·  Commission members said that their constituents are telling them that they are not receiving adequate care for Long Covid, or referrals to secondary care and instead are being told to go on holiday, etc. GSTT acknowledged these concerns that said there is outreach to GPs to improve take up of secondary services and diagnostic care. Members asked if people can self-refer and GSTT said that given the primacy of GPs as a frontline service they do want referrals to come from GPs, however this issue is being considered more and GSTT are considering the potential for self-referral.  Presently GSTT think that going via GPs is right as the NHS want people to be referred to the right place – and this can mean a referral to a cardiologist or neurologist. GSTT went on to emphasise that a holistic approach and links between mind and body and affirming the experience of patients is a key aspect of their approach.

     

    ·  Commission members referred to a recent report on the BBC that COVID 19 infection can lead to brain shrinkage and lung damage. The GSTT clinician said there is an iterative approach to respond to emerging symptoms and  ...  view the full minutes text for item 6.

7.

Update on CAMHS race equality work

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    A presentation is enclosed on CAMHS to update the commission on race equality work.

     

    A presentation on the impact of substance misuse, particularly Skunk, on Mental Health is also enclosed.  

    Supporting documents:

    Minutes:

    The chair introduced this item by explaining this is a to follow up on work SLaM are doing to improve equity for Black, Asian and Minority Ethnic young people and the CAMHS service,  arising from work done on a previous review on mental health and specifically a discussion about CAMHS with SLaM in March 2021.  The chaired referred to SLaM’s evidence in the scrutiny review report, finalised August 2021. This included a recommendation on follow up:

     

    Recommendation Seven

    The commission is keen to see the work by SLaM develop and to deliver on the outcome of increasing uptake of CAMHS services and improvement in meeting the unmet mental health needs of Black, Asian and Minority Ethnic young people. The commission would like to see a particular focus on the last approach; CAMHS working with partners, including Black, Asian and Minority Ethnic community groups (including Latin American and European immigrant communities) to develop new ways of working in prevention and early help approaches across our communities. A report back on progress is requested in 6 month’s time.

     

    The chair explained that there is also a presentation on Skunk (cannabis) and the impact on the mental health of young people included under this item as this was a topic of concern during last year’s review, but the commission did not get a chance to explore this in depth.

     

    The following SLaM staff presented the update report on CAMHS work to improve race equity and the report on Skunk / Cannabis:

     

    • Claude Jousselin

    Interim Deputy Service Director CAMHS

     

    • Saurabh (Sam) Dhingra

    Southwark CAMHS Service Manager

     

    • Bob Pritchard

    Southwark CAMHS Team Leader

     

    Dr Sue Goode, Lead Clinician Southwark CAMHS, sent her apologies due to Covid.

     

    Following the presentation the chair invited questions and the following points were made:

     

    ·  Members commented that some of the acronyms are not explained in the presentation. SLaM staff undertook to address this and provide a glossary.

     

    ·  Members asked SLaM more about reporting on improving the equality and diversity of staff and the aim. SLaM staff explained that the aim is for the staff to team to reflect the people we serve  and in order to do this they had diversified their approach, including identifying some front line roles which would be good to do targeted  recruitment. SLaM undertook to provide more data.

     

    ·  SLaM’s community engagement has been with young people. Commission members suggested also engaging with community leaders.

     

    ·  Performance data is provided to the CCG monthly and this can also be provide to the commission.

     

    ·  Members queried the 25% target and if this reflected the local population, or was more complex. SLaM explained that this is target for the four boroughs that SLaM’s CAMHS service serve. It is a 5 year target that SLaM is aiming to achieve by March 2023. SLaM added that they are reviewing their data and demographics as it is a complex picture, plus there has been an overall increase in referrals and provision.

     

    ·  SLaM said that most referrals from GPs and schools. There is  ...  view the full minutes text for item 7.

8.

Elective Care Recovery

9.

Scrutiny review: Health & Social Care Workforce

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    Minutes:

    The Commission discussed the purpose of the review  and work to date. The original aim of the review was to look at the impact of Brexit on the workforce, and later this was expanded to include the impact of mandatory vaccination and burnout / wellbeing stemming from the pandemic. So far evidence received indicated that Brexit is not a significant issue at the moment, but may impact in the medium term,  and the government has changed its policy on mandatory vaccinations. The commission did not have time to consider evidence from unions or Human Resources but this something a future iteration of the Commission could cover.

     

    RESOLVED

     

    The Commission recommended this review was carried over into the following year to examine evidence from unions and Human Resources on the impact of the pandemic, particularly burnout. In addition an update on Brexit would be timely.

     

10.

Scrutiny review: Domestic Abuse in families

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    The draft report is enclosed.

    Supporting documents:

    Minutes:

    The scrutiny review report on Domestic Abuse in Families was agreed with the following amendments:

     

    ·  Cllr Maria-Linforth Hall’s name will be corrected in the section where she gave evidence on Domestic Abuse in the Latin American community and her evidence will be amended to state that language barriers and a macho man culture contribute to Domestic Violence, rather than conflict in the country of origin.

     

    ·  The introductory section, which refers to evidence received during the previous review into the Mental Health of Black and minority ethnic young people, will be edited to make clear that evidence on increases in family conflict and domestic abuse during the pandemic referred to the whole population, rather than specific ethnicities.

     

    ·  The report will clarify that perpetrators of Domestic Abuse are not always men.

     

    Once the report has been to cabinet and a response received the Commission recommended that the lead cabinet member is invited back to the Commission to discuss this report, as well as follow up on previous reviews, and specifically the review completed in June 2019 by the Community Safety Scrutiny Commission on Violence Against Women and Girls.