Agenda and minutes

Health and Social Care Scrutiny Commission - Thursday 2 February 2023 7.00 pm

Venue: Ground Floor Meeting Room GO1 ABC - 160 Tooley Street, London SE1 2QH

Contact: Julie Timbrell, Project Manager (scrutiny) 

No. Item



    • Share this item

    To receive any apologies for absence.


    Councillors Maria Linforth-Hall and Naima Ali gave apologies.


Notification of any items of business which the chair deems urgent

    • Share this item

    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

    • Share this item

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


    There were none.



    • Share this item

    To approve as a correct record the Minutes of the meeting on 15 December 2022.

    Supporting documents:


    The minutes of the meeting held on 15 December 2022 were agreed as an accurate record.


Care Charges

    • Share this item

    This item will look at Care Charges and the impact on people with Learning & Physical Disabilities and their families.


    The following will attend:


    ·  Adult social care officers

    ·  Carers

    ·  Southwark Disablement Association – David Stock


    The following is provided:


    ·  A report of meeting between carers and councillors convened by Bede House.

    ·  A briefing on Care Charges provided by Bede House for councillors

    ·  An officer briefing / presentation

    ·  An email from Southwark Disablement Association (SDA)


    Supporting documents:


    The chair introduced the Care Charges item by explaining the intention was to particularly look at the impact on people with Learning & Physical Disabilities and their families. 


    The background to this item was a meeting between carers and councillors convened by Bede House, and paperwork relating to this event is provided as back ground information


    The chair explained that the following will contribute:


    ·  Pauline O’Hare , Director Adult Social Care


    ·  Carers, who have received moral support from Mencap to tell their stories.  Alan Burnham will present. He is the brother of a client that has attended Bede House for some years.  Mary Kumar has provided a written statement, which was tabled. She is full-time carer for her adult daughter.


    ·  Southwark Disablement Association – David Stock, CEO


    Pauline O’Hare, Director Adult Social Care


    A presentation on Care Charges, provided in advance, was given.


    The chair invited questions and the following points were made: 



    ·  Certain disability related expenditure can be considered, examples of this are  heating if additional warmth needed, scooter charging, extra laundry costs to cover incontinence etc. 


    ·  Southwark Council adopted a Fairer Contributions Policy in 2015, which outlines the way the Council financially assess recipients of social care services. This was amended by cabinet in early 2020. 


    ·  Minimum Income Guarantee (MIG) was set prior to the present cost of living crisis and members queried if this is sufficient now.


    ·  The council spends close to £130m on Adult Social Care of which the budgeted income from charging for service is £8.4m. Members asked if the £8.4 million figure can be broken down to look at the proportion that goes to people of working age and pension age. This officer advised  that she had not been able to do this in preparation for this meeting and she did not know if it was possible but would look into it.


    ·  Many disabled people are not able to work throughout their adult lives, and therefore do not accrue assets or savings.


    ·  Some older people have been able to acquire assets, although not all. In some cases income is low, despite assets accumulated. Some people have worked in jobs with no or inadequate pensions. Wealth and income among pensioners is very variable.


    ·  In response to a question on why some people are charged and others are not the officer clarified this can be a combination of factors including income, if a placement is educational and if the threshold of care is high enough to be funded under the NHS Continuing Care. Social workers do not undertake the financial assessments, this is done by officers tasked with financial assessments.  People can discuss charging with the social worker when being assessed for services, for more detailed information the client affairs finance team will be able to help.


    ·  There has been a recent increase in resident concerns about Care Charges but it is unclear why this may be so since charges track back to 2015 and later changes made in 2020.  Individuals can be unexpectedly impacted by charges  ...  view the full minutes text for item 5.


Mental Health Transformation

    • Share this item

    This item is to support the scrutiny review on Access to Medical Appointments.

    Supporting documents:



    The chair introduced the item  by explaining this will  contribute to the scrutiny review on Access to Medical Appointments.


    The  report and presentation circulated in advance was presented by the following : 


    • Carol Yates – Partnership Southwark Project Manager
    • Sumeeta Dhir – GP, Live Well Mental Health Clinical & Care Professional Lead, CCPL Advisory Group Co-Chair
    • David Mirfin – Consultant Psychiatrist, Associate Medical Director (SLaM), Live Well Mental Health Clinical & Care Professional Lead



    The chair then invited questions and the following points were made:


    ·  There is linked patient and carer race equality framework  to deliver a more equitable service to Black and Minority Ethnic people . The service will know that is delivering improvements when indicators of inequality such as the over representation of disadvantaged communities in forensic services start to reduce, there is more early treatment and more equal outcomes.


    ·  There is engagement work led by  Black Thrive , alongside looking at both service delivery and Mental Health Transformation through the race equality lens – this means looking at issues such as  addressing cultural barriers , racism and systematic bias.


    ·  There is work with GP Federations / Primary Care Networks. An example is the mental health practitioner in the Lister Service , as GP practice.


    ·  There is an emphasis on supporting people in the community to prevent crisis , and to reduce the need for A & E. There is recently launched mental health crisis team in Lambeth. The problems for people visiting A & E in mental health crisis were acknowledged .


    ·  A sanctuary service has been added to the Wellbeing Hub to meet the needs of people in crisis.  


    ·  There is digital option that has opened up access in Primary Care for mental health appointments which has shortened wait times . NHS staff said that that many patients are getting more comfortable with online  appointments , however they did acknowledged problems for some people. They said there are  not enough resources, or the money that it would take to expand the workforce, in order to deliver all the appointments face to face , or to meet all the demand. There is a reduction in GP’s , and resultant lack of capacity, with the NHS direction of travel being to recruit a broader range of  roles to deliver Primary Care,  such as Physician Associates, and Health and Wellbeing Coaches.  


    ·  The Wellbeing Hub is for people with  low to moderate mental health needs, and has a physical location and a mobile service working in the north and south of the borough .


    ·  The Wellbeing Hub  has been around for a couple of years so has a profile in the community , and there are presently outreach support roles being recruited to enable people to be seen in the community .


    ·  There is communication strategy for the Mental Health Transformation project.


    ·  There will be more work with Partnership Southwark to have an ear to ground.


    ·  Members commented that the  pandemic has impacted on  older people with increased social isolation and loneliness.  They added  ...  view the full minutes text for item 6.


Patient use of urgent and emergency services

    • Share this item

    This item is to support the scrutiny review on Access to Medical Appointments.


    A report on patient use of urgent, emergency, 111, and ambulance service including numbers, waiting times and demographics is enclosed.

    Supporting documents:



    The chair explained this item is to support the scrutiny review on Access to Medical Appointments.


    Martin Wilkinson, NHS full time chief operating officer, provided a presentation on patient use of urgent, emergency, 111, and ambulance service including numbers, waiting times and demographics.







Work Programme

    • Share this item

    Supporting documents:


    The chair asked the the scrutiny Project Manager, Julie Timbrell, to give an update the workplan:


    Queen’s Oak nursing home


    An informal officer briefing has been circulated by email about the closure of the home and impact in residents – as well as information on a forthcoming report to cabinet on care homes.


    Community engagement and outreach for the  Access to Medical Appointments review


    Sessions with older people at the Copleston Centre and the wider community at Walworth Living Room  have been provisionally scheduled for lunchtime / afternoon  of either Tuesday 21 Feb, Thursday 23 February, Tuesday 28 February and 2 March. The dates and times are to be confirmed and all members will be invited to attend.


    Next and final meeting is now scheduled for the 18 April


    The additional meeting on 30 March will now not be going ahead because of diary clashes and instead an informal meeting will be arranged late March or early April to report back on the outreach and discuss headline recommendations for the Access to Medical Appointments review.




    The nursing care home report will be circulated with the next agenda.