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

There were no declarations of disclosable pecuniary interest.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Panel held on 13 February 2023.

The minutes of the Sub-committee meeting held on 13 February 2023 were approved as a correct record of proceedings.

The Chair;

-      Informed the Sub-committee members that the latest Covid update was circulated for review.

-      Requested  the Action log which included outstanding items be circulated to the sub-committee members outside of the meeting.

-      Introduced the sub-committee members to Nicola Lawrence and Assan Ali who will be appointed  Healthwatch representative co-optee and resident co-optee respectively, once officially confirmed at the Overview and Scrutiny Committee meeting scheduled for 16 May 2023, which was postponed on 24 April 2023.

Somen Banerjee, Director of Public Health, Katy Scammell,  Associate Director of Public Health and Denise De-Goze, Schools and Families Team Manager,  gave an overview of the current strategy and corporate comms on tackling obesity and what measures can be taken. This included child excess weight patterns over time, health outcomes, the causes of unhealthy weight and the priorities included  for the healthy child action plan.

Further to questions from the Sub-Committee, Somen Banerjee, Katy Scammell and Denise De-Goze;

·       Clarified that the Healthy Families scheme is available to all child guardians and alternative courses are held in children’s centres, schools, and community centres. Foster carers can also attend a Ministry of Food (MOF) healthy cooking course held twice a year.

[Clerk's Note – course details available here: Healthy families programme (towerhamlets.gov.uk)]

·       Explained that the GP Care Group commissioned BY Public Health to deliver the 0-19 service, a directory for primary care and other professionals to support healthy weight.

·       Noted that through the Public Health Commission they are also training those working in the community to support a healthy weight.

·       Conceded that the borough will most likely achieve healthy weight levels if there is good air quality that encourages active travel.

·       Clarified that challenges in tackling obesity include; the number of  unhealthy foods available, the lack of alternative options, green  and  play spaces and overcrowded homes in some parts of the borough. The Local Plan’s strategy will help create an environment that is more supportive of being a healthy weight.

·       Explained that data from the National Child Measurement Programme 2015 to 2021 showed that year 6 aged boys of South Asian ethnicity have the highest rates of obesity. Continual work with parents and schools takes place to identify unhealthy weight levels and there are plans to train Youth Workers as well as offer training to those working with children in care.

·       Indicated that consideration will be given to work alongside Influencers to promote child health. A proposal to introduce a healthy advertising policy will be submitted to Cabinet and work is also taking place to support fast-food owners to provide healthier options to their customers..

·       Confirmed that a Play Manager post has been created to take forward work to increase play opportunities for Tower Hamlets children. Although Mile End Play Pavilion Park is a dedicated space, officers will discuss specific areas that do require play spaces with Sub-Committee members outside of this meeting.

[Clerk's Note – park details available here Playgrounds and Inclusive Play (towerhamlets.gov.uk) ]

·       Clarified that ongoing workstreams will have sustainable long-term effects, such as the ‘School Food Improvement Programme’, the training  schemes  and changes to the borough’s leisure services to benefit children. The range of initiatives are across the borough and the cost cannot be apportioned to one department.

Following comments from Officers, the sub-committee;

·       Thanked the Officers for the presentation and all efforts made to date in tackling the issue of child obesity within the borough.

·       Requested officers update sub-committee members at a future meeting in the  ...  view the full minutes text for item 4.1

Councillor Gulam Kibria Choudhury, Cabinet Member  for Health, Wellbeing and Social Care, introduced Katie O’Driscoll, Director of Adult Social Care who gave an overview of the Adult Social Care (ASC) Preparation for Inspection Report which details the service activity in readiness for regulation by the Care Quality Commission (CQC). This relates to how local authorities will be assessed against how it meets its duties under s1 Care Act 2014. The report outlines the CQC assessment framework, which is divided into four themes; how we work with people, how we support people, safety within the system and leadership.

Further to questions from the Sub-Committee, Katie O’Driscoll and Warwick Tomsett, Acting Corporate Director, Health Adults and Community;

·       Clarified that both the permanent workforce and retention rate is good. A written brief on the current number of ASC locums will be forwarded to sub-committee members for review.

·       Explained that as many residents are technically skilled, they may prefer to complete online self-assessments and as part of the Care Act want to provide other opportunities to adults to access assessments, once the system is operational.  The completed details will be sent directly to ASC for review, so information, advice and eligibility can be considered.

·       Confirmed that as part of an annual review process, residents are also asked about the quality of the care provision they receive, to ensure appropriate support is being provided. There are plans for the quality monitoring team in the Integrated Commissioning service who currently visit residents in domiciliary care to also visit residential and nursing care residents.

·       Explained that residents are assessed for eligibility as per the Care Act 2014. Those that do not meet the criteria are still supported with advice, information and signposted to appropriate services which meet their needs or provided relevant preventative service. This may include a Reablement intervention, equipment or home adaptations. If an adult is assessed as eligible for care support,  this is subject to the charging policy and financial assessments are undertaken. The move to free home care is scheduled to commence in April 2024.

·       Confirmed that interpreters or advocates are presents at assessments or review meetings if required  to ensure their needs are expressed.

·       Conceded that the rate of those eligible for care and support using Direct Payments is low. A review is ongoing to resolve issues and make direct payments more easily accessible. Further details on a workstream, part of the transformation programme can be brought back to the sub-committee for review if required.

·       Indicated that further work is required to support residents who are discharged from hospital to improve outcomes in supporting them.

·       Clarified that a good partnership exists between a range of council ASC services and NHS in commissioning those services. Full details on these including the quality and performance can be forwarded to the sub-committee for review.

Following comments from Officers, the sub-committee;

·       Thanked the officers for the presentation and work undertaken for the CQC inspection and the support given to  residents requiring care.

·       Requested officers update the  ...  view the full minutes text for item 4.2

TO FOLLOW

The Chair gave an overview of the report which set out the findings and recommendations from the Scrutiny Review on Workforce Shortages Across the Health and Care Sector in the borough.

Three review sessions where undertaken to examine the staff social care and health shortages. A further session took place which included stakeholders from BARTS, NHS, ICB, Primary Care Commissioners, Adult Social Care and ELFT to name a few.

After consideration the sub-committee APPROVED the nine recommendations;

Collaborative Approach

-      Recommendation 1:

The Integrated Care Board (ICB) is recommended to collaborate with Tower Hamlets Together (THT) Board to develop robust and dynamic workforce intelligence for the health and care sector.

-      Recommendation 2:

The ICB is recommended to collaborate with the THT Board (System) and the local authority’s Health and Wellbeing Board (Place), to undertake investment in developing shared communications and ongoing engagement with the borough’s residents.

Planning in Design

-      Recommendation 3:

The ICB and LBTH is recommended to incorporate integration when planning, developing and implementing its health and care workforce strategy such as service, financial and workforce plans.

-      Recommendation 4:

The ICB and THT Board to partner with the borough’s wider Health and Care employer stakeholders to review and co-design job roles required to support the demand for health and care services.

-      Recommendation 5:

The ICB and THT Board is recommended to partner up with LBTH’s Education and Careers Service, Adult Social Care service, Primary Care commissioning and BARTS NHS to develop experiential learning opportunities for young people in secondary education.

Cost of Living Impact

-      Recommendation 6:

London Borough of Tower Hamlets (LBTH) is recommended to incentivise key worker accommodation status, council tax reductions and parking provision for health and care professionals.

-      Recommendation 7:

The ICB is recommended to work with the local Higher Education Institutions and develop grant top up funding streams that can support medicine students in the last two years of their study.

Developing Capacity

-      Recommendation 8:

The ICB is recommended to collaborate with local FE and HE education institutions with a view to supporting investment for piloting Degree Apprenticeships, and T- level placements to help increase much needed capacity.

-      Recommendation 9:

The ICB and LBTH is recommended to draw on international recruitment options to meet the immediate shortfall for health and care demand whilst developing its growth model from local labour for future demand

RESOLVED that

1.    The Health and Adult Scrutiny Sub-Committee report recommendations be approved and noted.

None.

The Chair called the meeting to a close and thanked the sub-committee members and stakeholders, for their attendance and participation for all the meetings during municipal year 2022/23.