Agenda and minutes

Health and Social Care Scrutiny Commission - Tuesday 16 May 2023 7.00 pm

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

Contact: Julie Timbrell, Project Manager (scrutiny) 

No. Item



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    To receive any apologies for absence.


    Apologies were received from Councillors Charlie Smith and Naima Ali.


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.


    There were none.


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.


    There were none.



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    To approve as a correct record the Minutes of the open section of the meeting on **  ******** 2021.


    The minutes of the 18 April will be approved by email.


Queen's Oak nursing home and Annual Care Homes report

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    Supporting documents:


    Genette Laws, Director of Commissioning ,  presented the report and the chair then invited members to ask  questions.


    The following points were made:


    ·  The Annual Care Home report will now go to the October cabinet and include an expanded remit to look at ethical care more broadly and quality challenges.


    ·  Lay Inspector remit has changed to a visiting service for residents without loved ones to advocate on their behalf.


    ·  The Director of Commissioning said that officers have regular meetings with the  CQC where the lack of candour over Queen’s Oak nursing home was raised. 


    ·  The visiting regime by council officers for local spot purchased care homes was discussed .  The Director of Commissioning said that there are quarterly visits



    ·  The Director of Commissioning said that officers wrote to all providers reminding them of their Duty of Candour. There are clauses in the contract regarding partnership. She said that some providers have concerns that there would be a punitive stance from the council.  She explained that the  new team is taking an approach of constructive support and then moving to more challenge.


    ·  Members said that they would like to see a pre-emptive rather than reactive approach, for example providing extra resource Tower Bridge.


    ·  Members asked about NHS visiting homes to access the quality of care and the Director of Commissioning said that there  is a new officer leading on this agenda . The needs of people in homes are now increasing with  higher dependency - often needing nursing care.


    ·  A member highlighted the mid stage dementia can be more challenging- with people being  mobile rather than on stretchers, but needing support on medication and wandering .  The Director of Commissioning said that they are  focusing on Extra Care for people with high needs with dementia , with the aim of enabling people to be able to age in place . This was welcomed.  



Immunisation update

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    Supporting documents:




    Denise McLeggan presented the immunisation briefing. She is the Public Health Improvement Programme Manager –a joint post between the SEL ICB and the Council PH Division. She was accompanied by the following:


      Sangeeta Leahy, Director of Public Health

      Kate Kavanagh, Associate Director – Healthy Populations and Community Based Care Team (Interim), SEL ICB

      Sarah Robinson, Head of Programmes: Health Protection & Screening, Public Health, Children & Adults Services


    The chair invited questions and the in response to the commission was told that there are  targets to increase vaccination by 5% by working with communities to understand barriers to take up.



Care Contributions update briefing


Scrutiny mini review: Care Contributions

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    Supporting documents:


    The Commission discussed the draft report and agreed to amend the recommendations as below:




    Recommendation one

    Raise the Minimum Income Guarantee by increasing the government mandated buffer of 25% with an additional local buffer of 25%, to make a total of 50%. In addition it is recommended that officers produce an impact assessment to understand the cost to the council and benefit to disabled people and carers.


    Recommendation two

    To explore, as part of this year’s budget process, the removal of disabled adults from the assessment for Care Contributions.


    Recommendation three

    Provide better information, advice and support to enable disabled people and carers to understand care contributions generally, and their right to have adequate Disability Related Expenditure taken into account in financial assessments. This ought to include a variety of engagement approaches including outreach, information on websites, and leaflets.


    Recommendation four

    Take steps to reduce the adverse impact of Care Contributions on the incomes of people reaching pension age, both disabled people and their carers. In particular take action to mitigate the steep increases that can be incurred once a) a disabled person reaches pension age and their employment related pension becomes assessed b) carers facing reductions in income as they reach pension age and lose Care Allowances and income from paid work.


    Recommendation five

    Cabinet revisit the Fairer Contributions Policy Cabinet agreed in 2015, and revised in 2020,and report back to the Commission on the outcome.





Scrutiny review: Access to Medical Appointments

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    The draft scrutiny review report on Access to Medical Appointments is enclosed.

    Supporting documents:


    The Commission discussed the draft report on Access to Medical appointments.


    A member commented that a couple of constituents had raised concerns that about prescriptions being made that did not reflect contraindications in their GP practices notes.


    There was a discussion on the particular vulnerability of young people to isolation and loneliness and that the last recommendation ought to be strengthened to reflect the focus on this cohort.




    The following recommendation was added:


    Recommendation eight


    Note the importance of maximising GP continuity and ensuing adequate appointment time in order to carefully prescribe, identify contraindications and avoid mistakes.


    The following recommendations were amended as below:


    Recommendation nine


    Seek to recruit and retain more GPs to Southwark and to the new Primary  roles by:

      Suggest this is included as an objective within SEL workforce programme if not already.

      Undertake work with local GPs and local Primary Care to understand more on  how to improve retention, with particular regard to housing and addressing the national problem with burnout and low morale,  and if there are opportunities within Partnership Southwark and SEL to retain more local GPs for longer


      Redirect more resources to Primary Care, where possible


    As part of the above the Commission recommends that the Cabinet Member for Council Homes and Homelessness works with the Cabinet Member for Health and Wellbeing to link the council ambition to build 500 homes for key workers to the housing needs of GPs and other local Primary Care practitioners, and also calls for the council’s commitment on the number of new key worker homes to be increased in future years.



    Recommendation eleven


    The Commission recommend that Partnership Southwark initiate a project with local surgeries working with the local voluntary and community sector  to develop a more proactive and holistic  model of good health and wellbeing, with a particular focus on increasing social connection. 


    It is recommended that a pilot scheme is developed in a neighbourhood with higher levels of deprivation, and that this focuses on groups at particular risk of ill health and poor well-being, such as older people, people with mental health needs, and young people, noting that is a group suffering from some of the highest levels of unhappiness and isolation. This is with a view to promoting good health and overcoming loneliness and isolation.


    This could build on the model and research that came out of the Peckham Experiment on activities that promote good health, building upon existing NHS preventative work, such as health checks and social prescribers,  as well as working more proactively with the local community.


      In doing so it is suggested that Partnership Southwark identify one or two GP practices in clusters/ neighbourhood multidisciplinary teams (such as Walworth Triangle, Peckham)  and locally based community projects ( such a Blackfriars Settlement, Copleston Centre or Walworth Living Room) that might be interested, as well as linking with initiatives that work across the borough with communities of interest that work with older people (such as Golden Oldies , Southwark  ...  view the full minutes text for item 9.


Scrutiny topic: Partnership Southwark

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    A revised Trigger Template checklist is enclosed following consultation with Partnership Southwark leads.

    Supporting documents:


    This was noted.


Work Programme

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    The Commission proposed the following as items for next year’s work programme:


    ·  A review on Adult Safeguarding and how can this be defined to better protect vulnerable adults, carers and paid staff.   This could look at definitions of abuse in elder care to consider what is or is not abuse. Unfounded allegations can cause distress to staff and  providers might welcome more clarity.  


    ·  Blue page application process and criteria for award.


    ·  The use of cooperatives in the delivery of care.


    ·  Looking at closers and relocation of GP surgeries,  with reference to two large practices in Lambeth with patient lists that include Southwark  residents.