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

Further Advice contact: Linda Walker, Interim Director of Legal and Monitoring Officer, Tel: 0207 364 4348

There were no declarations of disclosable pecuniary interest.

To confirm as a correct record the minutes of the meeting of the Health and Adults Scrutiny Sub-Committee held on 03 September 2024.

The minutes of the Health and Adults Scrutiny Sub-committee meeting held on 04 June 2024 were approved and signed by the Chair as a correct record of proceedings.

The Health and Adults Sub-Committee RESOLVED;

1.    That the Action log be noted.

The order of business on the agenda was changed at the meeting. This item was discussed after item 4.2.

Councillor Gulam Kibria Choudhury, Cabinet Member for Health, Wellbeing and Social Care, presented a brief introduction on  current commissioned services

for residents over 55, through Tower Hamlets Connect and Linkage Plus. Details on the plans for additional care homes in the borough, additional investment in community support and the major public health campaigns to raise awareness on these initiatives were also included.

Dr Somen Banerjee, Director of Public Health, informed Members that the borough has a lower number of residents aged 65 and over than other local authorities and is expected to rise in 5 to 10 years, at a predicted rate of 31% within the 50 - 64 year age range. This will increase the pressure on Adult Social Care (ASC) services, as this age group has the highest levels of income deprivation and health disparities.

Members were informed on the health trends and census data for over 55 year old residents and noted that self-reported health concerns in over 60 is worse than the rest of the country. 50% of over 65’s are the most health deprived than the most affluent boroughs. Details of inequalities for Bangladeshi and Black adults in the age range were also noted, including higher levels of stroke, diabetes and heart disease.

Warwick Tomsett, Joint Director of Integrated Commissioning, noted that ASC services are more likely used by older residents with long term health conditions, are or have been smokers and live alone. Larrisa Howells, the Director of Services, Age UK, then outlined the organisation, who are one of the lead providers for Tower Hamlets Connect.

Age UK supports older people to maintain their independence and promote health and wellbeing whilst tackling loneliness. Tower Hamlets Connect facilitates all referrals for initial assessments via a telephone hotline. The service assists residents to access the help and support required within the community. Ms Howells outlined the work of Information Officers, who advise residents on various issues such as receiving benefits, consumer concerns and general advocacy work. Although Age UK supports adults over 18, around 86% of calls received are from residents over the age of 55.

Members were informed that 73% of those who initially requested or had been referred for intervention by ASC assessments were able to receive assistance in a timely manner with assistance via the telephone hotline. The UK National average is 58% across all other adult social care services. The service assists in addressing all safeguarding concerns before initial assessments are conducted and support over 66% of those referrals in the Community. Ms Howell noted that Information Officers have identified around £3.3 million of unidentified entitlements for residents when assisting in welfare benefit concerns.

Emily Bird, Community Partnerships Manager at Linkage Plus, Toynbee Hall, outlined the service to the sub-committee. Like Age UK, this service aims to improve well-being, enhance social networks and tackle isolation, to improve health and well-being outcomes for older  ...  view the full minutes text for item 4.1

The order of business on the agenda was changed at the meeting. This item was discussed before item 4.1.

Councillor Gulam Kibria Choudhury, Cabinet Member for Health, Wellbeing and Social Care, presented a brief overview of the new charging system for free community care. The policy will commence in April 2025 and allow residents free home care who have long-term disabilities and health conditions.

Georgia Chimbani, Corporate Director for Adult Social Care, noted that following the Council’s Strategic Plan, residents will no longer have to be assessed for a contribution towards the cost of their care, however, this does not apply for those in residential or nursing care, who will still be financially assessed.

Further to questions from the sub-committee, Georgia Chimbani, Corporate Director, Health and Adults Social Care and Margaret Young;

·       Acknowledged that financial risk of an increased demand for services is difficult to quantify. Work is ongoing to determine the new demand of residents who will receive free community care. Once the calculations are completed, details can be brought to the sub-committee for review.

·       Confirmed that the funds have been allocated to implement this policy. Officers will contact the Section 151 Officer for additional details and update the sub-committee Members.

·       Explained that financial assessments for ASC are based on Government legislation. Residents who feel their assessment is inaccurate, can be reassessed, although there is no formal appeal process.

The Chair thanked the Officers and noted that community care is essential, particularly for elderly and vulnerable residents. Access to care should be fair and not depend on the someone ability to pay. Equity is crucial in relation to this revised policy and the Council has a duty to protect its most vulnerable residents.

Members discussed the sub-committee having more of a role in the recommissioning of Linkage Plus when the contract expires. Members suggested  performance data for Tower Hamlets Connect and Linkage Plus and be shared to the sub-committee. Gateway Housing's performance data, particularly regarding tenants of sheltered accommodation, should also be reviewed.

Members also encouraged further discussion by the Council on the issue of home care charging historic debt collection.

The Health and Adults Sub-Committee RESOLVED;

1.    That details on the funding for the Free Community Charging policy will be provided to the sub-committee for review, via the Section 151 Officer.

2.    Tower Hamlets Connect and Linkage Plus performance data be brought to the sub-committee for review.

3.    The presentation be noted.

Julie Dublin, Senior Transformation Manager, presented the last item, which outlined the Winter Plan for 2024 to 2025. Members were informed that NHS England published their winter letter to the Integrated Care Boards (ICB) Chairs and Chief executives on 16 September this year, with the aim to improve the Urgent and Emergency  Care (UEC) recovery by:

-      Improving A&E performance with 78% of patients being admitted, transferred or discharged within 4 hours by March 2025.

-      Improving Category 2 ambulance response times relative to 2023/24, to an average of 30 minutes across 2024/25.

-      Reducing 12 hour waits from time of arrival in Emergency Departments.

Ms Dublin noted the key areas considered in preparing residents for winter including; the vaccination campaign, discharging patients back into the community with health colleagues and social care services, and also assessing the High Impact Interventions for UEC. It was noted that there is no additional winter funding made available from NHS England for this year.

Details of the Physical Capacity Funding allocation of £30 million for General and Acute beds and £723K for out of hospital support.  The money will be allocated across a number of schemes to support admission avoidance, discharge and reducing hospital length of stay. The schemes, currently in draft will be submitted to both the Tower Hamlets together board and Urgent Care Working group for sign off. Details of the ICB’s Triple Lock process and the High Interventions to improve areas within same day emergency care, frailty, intermediate care and inpatient flow.

Members heard details of how both the NHS and social care are working together over winter. These schemes incorporate both regular business arrangements within the borough, commissioned services and newly drafted schemes, which will be provided through the Physical Capacity funding and the Adult Social Care discharge grant. These included:

Proactive population health management:

-      Flu/COVID vaccination campaigns.

-      The LBTH Education Offer for advice and support for families with young children.

-      Tower Hamlets Connect

-      Idea store / Mosques.

-      Transfer of Care Hub.

-      Homelessness Support

-      Community Spaces

Optimising hospital flow through Acute, Mental Health and Community trust sites;

-      Additional ‘Step Down’ provision .

-      Improving current discharge levels.

Provision and access of alternative pathways to reduce UEC footfall and attendance:

-      Rapid Response service.

-      Mental Health Crisis Response/Crisis Café/Crisis line.

-      Advance care planning.

-      Pharmacies.

Further to  questions from the sub-committee Juliet Alilionwu and Julie Dublin;

·       Clarified that the High Intensity User Service, is provided by East London Foundation Trust’s Mental Health team. The service assists residents with complex concerns, including mental health, social care needs and substance misuse issues.

·       Acknowledged  that the details in the presentation were amended to a more accessible format and sent to Members after publication of the agenda. The Winter scheme is still in development and the final version will be brought back to sub-committee once finalised.

·       Confirmed that some of the schemes have yet to receive funding. Providers will be notified regarding commencement,  ...  view the full minutes text for item 4.3