Agenda and minutes

Apologies for absence had been received from Councillor Adam Bennett (Councillor Peter Smallwood was present as his substitute).

There were no declarations of interest in matters coming before this meeting.

RESOLVED:  That the minutes of the meeting held on 10 October 2023 be agreed as a correct record. 

RESOLVED:  That all items of business be considered in public. 

The Chairman welcomed those present to the meeting.  Mr Gary Collier advised that the report provided the Committee with an annual update and preceded a report which would be considered by Cabinet.  The report had included the draft strategy which aligned with the outcomes in the delivery plan for 2023/24.  The strategy reflected the vision and mission statements considered by the Committee in the update report in 2022.  The report also included case studies.  Some information from the previous year's report had been included in this report to provide Members with a fuller picture and, as it was now available, data from the 2021 census had also been included.  The latter showed a reduction in the number of those identifying themselves as carers compared to the 2011 census and feedback from the Office of National Statistics (ONS) suggested that this could be related to the census being conducted under Covid lockdown conditions.

Mr Collier advised that, in addition to the 2021 census, the key sources of comparative data about carers were the annual national short and long term (SALT) services return (completed by all local authorities with adult social services responsibilities) and the Adult Social Care Outcomes Framework measures for carers tested through the biennial National Carer Survey, which was currently in progress.  The meeting was informed that there were limitations with the SALT data as strict criteria meant that carers who had not gone through a carer’s assessment were not counted.  As a result, adult carers being supported by the Carer Support Service who had not had a carers assessment had not been included in this data.  Mr Collier advised the Committee that the Carer Support Service contract was between the Council and Carers Trust Hillingdon, who acted as lead provider on behalf of a consortium known as the Hillingdon Carers Partnership.  The contract represented the main Council support offer to young carers and an important part of the offer to adult carers.

Mr Collier advised that SALT was being replaced with new reporting requirements called Client Level Data (CLD) that would start to be collected from 1 April 2023.  This had less strict inclusion criteria in relation to which carers were included and would provide more information about types and levels of care provided.  Comparative information from this data was unlikely to be available until October or November 2024.  This would enable Hillingdon to benchmark against comparable local authorities.

It was noted that there had been a reduction in the number of carers who had declined a carers assessment (81% of carers who were offered an assessment declined in 2021/22 and 77% in 2022/23).  Although the reasons for refusal were not recorded, the reasons given anecdotally included: the services offered through the Carer Support Service already met their needs; and the service offer available following an assessment did not justify the time taken to complete it.  The Committee was informed that feedback from the Carers Forum identified that some carers were concerned about what would be expected from  ...  view the full minutes text for item 35.

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised Members that the Better Care Fund (BCF) was a national initiative with two objectives:

1.    Enable people to stay well, safe and independent at home for longer; and

2.    Provide the right care in the right place at the right time.

The first BCF plan had been put in place in 2015/16 and the latest iteration covered a two-year period from April 2023 to March 2025.  The Section 75 (s75) agreement gave legal effect to the financial and partnership arrangements that had been put in place to deliver the BCF objectives.  Cabinet had approved the first year (2023/24) with a one year extension.  

The report had included the national metrics and the Q2 position.  The BCF metrics had an adult focus but work in relation to child related schemes continued to take place.  The Committee was advised that the North West London Integrated Care Board (NWL ICB) had been doing a review of the BCF schemes being undertaken across all NWL boroughs to identify any duplication in service provision.  It was anticipated that there would be a resultant revision in Q4. 

Mr Collier advised that capacity in relation to mental health discharges had been strengthened this year and there had been examples of the delegation of functions between the NHS and social care.  Many features of the legal agreement had remained the same as the previous year.  Monitoring requirements for this last year had been considerable and it was anticipated that this would continue going forward. 

Mr Richard Ellis, the Joint Lead Borough Director at the NWL ICB, advised that there had been an overlap with the previous report on this agenda as some of the BCF funding was used for carer support.  He noted that there was limited local flexibility in terms of how the BCF money was spent but that every effort was made to maximise this flexibility.  Mr Collier advised that the BCF contained different funding schemes and that the local authority had less agency over the ICB additional voluntary contributions.  Some voluntary contributions had been taken out of the BCF but the services that these related to had continued to be provided.  The Council did have some say over the use of the NHS minimum contribution as well as the Improved Better Care Fund and local authority discharge fund and had been very transparent about their use, all of which had positive benefits for Hillingdon’s health and care system.  

Members were advised that £905k core funding for voluntary and community organisations had been removed from the BCF Pooled Budget.  However, the funding was still available for the same services.  This reflected a move to commissioned services rather than providing various organisations with annual grants to deliver services.  Public procurement regulations necessitated that the Council would have to go out to tender for these services but the approach offered a longer-term certainty and stability for the service providers as the Council would be offering contracts  ...  view the full minutes text for item 36.

RESOLVED:  That the Cabinet Forward Plan be noted. 

Consideration was given to the Committee's Work Programme.  It was agreed that, as there were no items of business scheduled, the meeting on Monday 18 December 2023 be cancelled. 

The draft recommendations from the Select Committee’s recent review of the CAMHS referral pathway had been circulated to those stakeholders who had attended the various witness sessions.  The feedback that they had provided had been collated and would be incorporated where appropriate.  The draft final report would be considered by the Select Committee at its meeting on 23 January 2024. 

Members discussed the new commissioning model that was being introduced for the delivery of health and social care services that had previously been provided by the voluntary sector through annual grants.  It was agreed that the impact of this change be considered at the meeting on 23 April 2024.  This would need to include a list of those services that were currently provided by the voluntary sector under grant arrangements, with notes against them as to which organisation then provided the service under procurement arrangements.  Thought would also need to be given to what support would be provided to those smaller voluntary organisations that were perfectly capable of providing the contracted services but which did not necessarily have in-house bid writing expertise. 

With regard to the review that had been undertaken in relation to assisted living technologies, it was noted that Mr Matthew Wallbridge, the Council’s Chief Digital and Information Officer, had been asked to provide the Committee with an update.  Once this information had been received, consideration could be given to any further action that was required. 

RESOLVED:  That:

1.    the meeting scheduled for 18 December 2023 be cancelled;

2.    the draft final report on the CAMHS referral pathway be considered by the Select Committee at its meeting on 23 January 2024; 

3.    information on the impact of the new procurement arrangements on small charities be considered by the Committee at its meeting on 23 April 2024; and

4.    the Work Programme, as amended, be noted.