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 Sub-Committee held on 08/06/2021

The Sub-Committee formally confirmed as a correct record the minutes of the last meeting of the Health Scrutiny Sub-Committee held on 8^th June, 2021.  The Chair was authorised to sign.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Sub-Committee held on 16/09/2021

The Sub-Committee formally confirmed as a correct record the minutes of the last meeting of the Health Scrutiny Sub-Committee held on 16th September, 2021.  The Chair was authorised to sign.

1.    Item 7.3 Health & Adults Scrutiny Sub-Committee - Tuesday, 8th June 2021. Operation Oak - Departmental and voluntary agency support for asylum seekers.

v  The Committee was reminded that there had been discussions on the Home Office housing recovery programme, known as Operation Oak, which is intended to accelerate the movement of asylum seekers out of contingency accommodation into dispersed accommodation across the United Kingdom, in both new and existing dispersal areas.

2.    Item 3.1 Health & Adults Scrutiny Sub-Committee Thursday 16th September 2021 Food Poverty in older people and low-income families.

v  The Sub-Committee had considered a report which had summarised what food poverty is and who is affected by it in the London Borough of Tower Hamlets (LBTH). In particular that the food poverty needs of older people and low-income families and the food provision that is in place for these vulnerable groups.

It was agreed that these matters would be kept on the action log and the Sub-Committees would receive regular updates.

The Chair:

v  Commented that as one of the Councils representatives on the Inner Northeast London Joint Health Overview and Scrutiny Committee (INEL JHOSC) at the last meeting on Monday 13^th of September 2021 there had been a discussion on the Integrated care system (ICS) a substantial change in the way to improve population health and reduces inequalities between diverse groups. The ICS would also be the subject of discussion at the that the Tower Hamlets Health and Wellbeing Board on 2^nd of November 2021. Members of the Sub-Committee will be sent copies of the agenda pack for that Board meeting and have an opportunity to raise formally comments for consideration by the Board.

v  Commented that (i) she is a Member of the Local Covid  Engagement Board that leads on engagement with the public regarding Covid-19 risks and prevention; (ii) she has seen this week an increase in the reported cases of Covid-19; and (iii) she is very happy to take questions from the Sub-Committee on the Board’s work.

v  Welcomed to the meeting Katie O'Driscoll the newly appointed Director of Adult Social Care

v  Reminded the Sub-Committee that it had been Adult and Social Care Practice week on the 21st of September 2021 and together with a number of other members had undertaken shadowing of Telecare across Adult Social Care.

The Sub-Committee received a presentation from Eugene Jones and Waleed Fawzi East London NHS Foundation Trust (ELFT) and supported by other colleagues who had asked to attend this meeting to outline their proposal to permanently locate the inpatient dementia assessment services at East Ham Care Centre. This was originally moved to free up space in Mile End Hospital to make it more Covid secure and to provide existing dementia residents with a step-up offer. The main points of the discussion on the questions raised by the presentation summarised as follows:

The Sub-Committee:

v  Noted that before the public consultation is launched on the proposals ELFT wanted to check in with Members around their plans and the questions that ELFT were intending to frame around these plans, so as to allow the opportunity to change and reconfigure those as needed before the public consultation commences.

v  Noted that once this consultation is completed ELFT intend to report back to the Sub-Committee.

v  Was advised that the Unit is an in-patient dementia assessment unit for older people living in the boroughs of Tower Hamlets, Newham, Hackney and The City of London.

v  Understood following questions that the Unit provides dementia assessment in the City of London, Hackney, Tower Hamlets and Newham. It is a short-term assessment unit with an average length of stay of six weeks. It provides assessment and treatment for people experiencing complex mental health problems associated with degenerative brain disorders such as dementia.

v  Was informed that each patient receives a thorough assessment of their needs from a wide range of health professionals. Along with input from families the aim is to provide person centred care by building an understanding of a person's life history in order to meet their individual needs.

v  Was pleased to note that in terms of the staff moves to East Ham Care Centre all of the staff that were previously providing the services at Columbia Ward Mile End Hospital would be moved with the patients to the Cazaubon Dementia Assessment Unit.

v  Felt that the passion of the staff around this care group provides is essential in ensuring a continuity of care given their knowledge of the individuals within this group.

v  Observed that in terms of the impact on families, ELFT have had positive feedback from service users and the families and ELFT have also put in place a carers questionnaire to identify specific feedback around the nature of travel and any issues that people have experienced.

v  Was told in response to enquiries that recommended local taxi companies receive vetting in terms of their ability to provide care and support for patients and their families and that ELFT will continue to monitor and to date they have had no negative feedback.

v  Noted that if service users and carers require support in terms of the journey by their own vehicle ELFT can provide support with that and therefore ELFT has a multi-pronged approach which is not just about taxis but about  ...  view the full minutes text for item 6.1

The Sub-Committee received a presentation which highlighted (i) the overall budget for adult social care; (ii) the position at month 6 of the 2021/22 financial year; (iii) delivery of savings; and (iv) pressures/risks going forward and the approach to managing these.  A summary of the questions raised by the Sub-Committee and feedback given is summarised below:

The Sub-Committee

v  Agreed that the quality, reliability, and effectiveness of our adult social care system depends on a workforce that feels valued, supported, and encouraged to be the best. 

v  Commented that this support will need to be focused on levelling up the knowledge, skills, and experience of care colleagues across the sector through the establishment of a new knowledge and skills framework, promoting varied careers pathways, and making the most of any investment in learning and development.

v  Noted the impacts of Covid on people's physical and mental well-being which can manifest through an impact on their needs for care and support.

v  Noted that the P5 category identifies a patient as having requested to remain on the waiting list but to defer treatment because of their concerns about COVID-19 and should only be used if this is the reason treatment is being deferred. Accordingly, members agreed that they wished to receive details of the number of patients who have asked to defer treatment due to Covid.

v  Acknowledged that carers have also been adversely impacted during the pandemic in several ways and therefore the support that they may have been offered may not been available during significant periods of time through the period of the pandemic and therefore for several reasons people’s needs have become more complex because of that.  In addition, the Borough must work out a whole range of financial implications that are going to start to have an impact and that work has only just started as the Government is due to make further announcements that will provide more details.

v  Noted that from October 2023 the (i) Government will introduce a new £86,000 cap on the amount anyone in England will need to spend on their personal care over their lifetime, (ii) upper capital limit (UCL), the point at which people become eligible to receive some financial support from their local authority, will rise to £100,000 from the current £23,250, and (iii) lower capital limit (LCL), the threshold below which people will not have to pay anything for their care from their assets will increase to £20,000 from £14,250.

v  Observed that adult social care covers a wide range of activities to help people who are older or living with disability or physical or mental illness live independently and stay well and safe. It can include ‘personal care,’ such as support for washing, dressing, and getting out of bed in the morning, as well as wider support to help people stay active and engaged in their communities.

v  Noted that social care includes support in people’s own homes (home care or ‘domiciliary care’); support in day centres;  ...  view the full minutes text for item 6.2

The Sub-Committee noted that the Contain Outbreak Management Fund (COMF) provides local authorities with financial support to reduce the spread of coronavirus through test, trace and contain activity. Accordingly, the Chair had invited Somen Banerjee, Director of Public Health in Tower Hamlets to set out the use of this fund in the context of the strategic aims of the Local Outbreak Management Plan and help the Sub-Committee explore the wider learning from the approaches that have been taken. The main points arising from consideration of the presentation may be summarised as follows:

The Sub-Committee:

v  Noted that LBTH is working on the assumption that the Government will ‘clawback’ the Coronavirus (Covid-19) emergency funding given to local government and that LBTH will need to allocate that funding received before the end of March 2022.

v  Noted that LBTH is also mindful (i) that there are "early signs" that Covid infection levels are increasing; (ii) whether there is going to be additional restrictions; and (iii) whether funding can be carried over.

v  Noted that LBTH have in this year has received £11m.

v  Noted that with the funding there has been a real focus on inequalities and have identified which communities have been particularly at risk so as to develop the outreach that has been commissioned and informed  investment in the Community Clinics (CC) and have seen a kind of reversal of inequality.

v  Requested that the outcome of this activity and good practice developed be shared with the committee.

v  Noted that the role of the Covid-19 community champions established to empower and support Tower Hamlets residents to stay up to date with the latest advice about Covid-19 is providing information about testing and rapid testing.

v  Noted LBTH has a real focus on vaccination as whilst over two-thirds of the Boroughs population have been vaccinated there is a challenge around (i) uptake of vaccination in the 12- to 15-year-olds; and (ii) the Booster Programme which is a major new program that LBTH needs to focus on given the Government’s announcement that they wanting to accelerate the booster and the 12- to 15-year-olds vaccination programmes because of the increase in the numbers of Covid cases.

v  Noted that the improvements around infection control measures in schools; care homes and workplaces which are really critically important for the control of all infectious diseases.

v  Noted that the vaccination programme for Covid will in the future be the same way as there is for influenza.

v  Noted that LBTH will continue to support communities addressing inequalities and the impacts of coronavirus which can cause symptoms that last weeks or months after the infection has gone e.g. post-Covid syndrome or "long Covid".

v  Noted that since April 2021 the Council “Call Centre” have had about 28,000 calls of which 90% are vaccine related (e.g. booking vaccines for residents).

v  Acknowledged that whilst the success of the vaccination rollout has paved the way for a gradual lifting of restrictions no vaccine is 100%  ...  view the full minutes text for item 6.3

The Chair:

v  Informed the Sub-Committee that subject to consultation with Divisional Director Legal, Governance and Monitoring Officer the next meeting would be held on the 30^{th of} November 2021.

v  Reminded Members that the Tower Hamlets Health and Wellbeing Board on 2nd of November 2021 will be considering a report on the Northeast London Integrated Care System (NEL ICS) and that report would be sent to all Sub-Committee Members and they would have the opportunity to raise formally comments for consideration by the Board.

v  That the Sub-Committee Work Plan would be circulated for Member’s information and comment.

v  That officers would be asked to ensure that Members would be informed of all future scrutiny training sessions.

Finally, with no other business to discuss, the Chair called this meeting to a close and thanked the Sub-Committee members, for their attendance and participation.