Members are reminded to consider the categories of interest in the Code of Conduct for Members to determine whether they have an interest in any agenda item and any action they should take. For further details, please see the attached note from the Monitoring Officer.

Members are reminded to declare the nature of the interest and the agenda item it relates to. Please note that ultimately it’s the Members’ responsibility to declare any interests and to update their register of interest form as required by the Code.

If in doubt as to the nature of your interest, you are advised to seek advice prior to the meeting by contacting the Monitoring Officer or Democratic Services

No declarations of interest were received at the meeting.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Panel held on 1^st December, 2020

The Sub-Committee confirmed as a correct record the minutes of the last meeting of the Health Scrutiny Sub-Committee held on 23rd July 2020.  The Chair was authorised to sign.

The Sub-Committee received a report on the Adults Learning Disability Health Scrutiny Challenge Session and welcomed Councillor Kahar Chowdhury the former Chair to the meeting.  As a result of questioning the Committee:

v  Noted that the challenge session had taken place on the 10th of March 2020 which had reviewed “How health and social care is supporting adults with a learning disability to live independent lives in Tower Hamlets”.

v  Noted that the session had focused on three main areas of the Learning Disability Strategy: Health, Accommodation and Employment.

v  Was informed that the report had been compiled providing documentation of the sessions and including recommendations to be actioned upon, however sign-off of the report had been delayed due to the outbreak of the pandemic.  Accordingly, the report has been updated against the March position and included an impact assessment of the pandemic for the learning disability population.

v  Noted that people with learning disabilities do not learn certain skills as quickly as other people and may therefore need extra help in certain aspects of their lives. The specific skills in question will depend upon the type of disability. People with mild learning disabilities may live alone, travel independently, and work. They may not require any support from their local authority or may just need support in managing their finances.

v  Commented that with the right support people can live full and meaningful lives. However, if this support is not provided, they may face problems in gaining independence or a home of their own, in accessing leisure and recreation activities, and/or in developing friendships and relationships.

v  Was advised that with regard to the progress on the four-year programme to reduce the number of residents in out of Borough placements this has been slower than anticipated because of the infection control restrictions and the challenges with moving people after long periods of time in a placement outside of Tower Hamlets.

v  Commented that consideration should be given to how the pandemic was impacting on mental health and wellbeing among these residents as it was felt that they are more likely to have lower levels of happiness, life satisfaction and sense of purpose e.g. due to mortality concerns, fears about the virus, grief for the loss of normality, restricted access to health services and restricted access to activities that protect wellbeing.

v  Noted that it is acknowledged that whist whilst it is acknowledged that the Covid-19 pandemic has affected many people’s mental health and wellbeing people. That those with mental health needs, a learning disability or autism who had contracted Covid-19 may require reasonable adjustments. As it is recognised that adults with a learning disability may be particularly at risk of a poor health outcome if they  contract Covid-19.

v  Noted that health services will continue to have due regard to their obligation to advance equality under the Equality Act 2010; which includes recognising and factoring-in the vulnerability of different groups of people with protected characteristics; and inequalities in access,  ...  view the full minutes text for item 3.1

The Sub-Committee received a report that outlined what support has been provided to older people’s care homes in Tower Hamlets, throughout the duration of the Covid-19 pandemic and the actions that have been taken to date and priority areas for the future the main points arising from the discussions maybe summarised as follows:

The Committee noted that:

v  The purpose of this report is to provide a summary of the support that has been provided to older people’s care homes in Tower Hamlets, throughout the duration of the Covid-19 pandemic.

v  When the global pandemic had been declared in mid-March 2020 it had resulted in a high level of infections and mortality across the globe.  One of the key trends that emerged both in the UK and internationally was the number of deaths occurring in care homes, particularly at the onset of the pandemic. 

v  The Borough led the support efforts to the five older people’s care homes commissioned in the borough during this challenging time:

v  Throughout the duration of the pandemic, Tower Hamlets has experienced infection outbreaks (classed as two or more cases reported within a 14-day period), at various points in time, in all five of the older people’s care homes.  As of 31st December 2021, the care homes have reported 38 deaths related to Covid-19.  Whilst 30 of those residents having died in their care home and 8 in hospital. 

v  The age-specific mortality rate was higher for care home residents aged 85 and over than for non-care home residents for deaths involving Covid and for all deaths. Which it was noted was to be expected among care home residents than non-care home residents, even taking age into account, since poor health or frailty being a common reason for needing residential care.

v  The latest report from the Office for National Statistics (ONS) had indicated that there has been a total of 25 Covid-19 related deaths in care homes in Newham, 26 in Tower Hamlets and 18 in Waltham Forest.  However, it was important to note that the ONS dataset differs to the Tower Hamlets figures as the ONS dataset commences from 10th April 2020, whereas the Tower Hamlets dataset begins from 28th March 2020

v  Whilst data that related to for all deaths in care homes from the ONS it was recognised that the data does not capture the numbers of care home residents that had died in hospital, both of which it was noted are reflected in the Tower Hamlets dataset

v  It was important to capture the lessons learnt about the symptoms, progression, and management of this viral infection in the older population.  Therefore, the Council had initiated and completed a learning review.  This review had identified the following areas of good practice (1) the Council has led a proactive response, frequently going beyond national guidance and anticipating future guidance bulletins; (2) positive partnership working at both the strategic and operational levels; (3) a strong commitment to multi-disciplinary and multi-agency learning; the lead  ...  view the full minutes text for item 3.2

The Sub-Committee received an update on the developing the medium-term financial strategy (MTFS) to bring together all known factors affecting Health, Adults and Communities savings the main points arising from the questioning on the presentation maybe summarised as follows:

The Committee:

v  Commented that the financial position for the Borough at this time is subject to significant uncertainty. Which makes financial planning even more challenging than normal and when taken alongside the huge uncertainty surrounding financial forecasts at the time of a global pandemic.

v  Asked if the Borough was satisfied that all the contributions to the local pooled budget had been done correctly to deal with the growing health and social care pressures. In response it was noted that the final report by Grant Thornton into the pooled budget was awaited and would be circulated to the Sub-Committee once it is published.

v  Noted that the local pooled budget had a particularly good spread of joint initiatives and projects and robust processes around continuing healthcare

v  Agreed that these joint funding arrangements of the Integrated Care Fund should be the subject to further scrutiny by the Sub-Committee.

v  Noted that Adults and Children’s passenger transport has been the subject of a strategic review by Grant Thornton with a number of recommendations arising from it around better utilisation of the internal transport fleet, route optimisation and savings achieved through more cost-effective external transport routes delivered via a dynamic purchasing system (DPS). However, more work will need to be done to ascertain the savings already identified to ensure there is no double counting. Also, it was noted that the Grant Thornton review is not the only way in which transport savings are being modelled in the Borough and there is a working group that cuts across Children's and Adults to consider a full range of options.

v  Agreed that this and other similar reviews should be the subject of further detailed scrutiny.

v  Agreed that consideration should be given to the Sub-Committee looking at (i) how savings can be delivered in the Reablement, Hostels and Substances misuse services without adversely affect residents; (ii) how  to unlock funding and share ideas across services to create a better functioning social care system that meets people’s needs more effectively. 

The Chair then Moved, and it was resolved that the Chair in consultation with Divisional Director, Strategy, Policy and Performance consider how to progress further scrutiny affecting Health, Adults and Communities savings.

Nil items