Agenda and minutes

Apologies for absence had been received from Councillor Reeta Chamdal (Councillor Adam Bennett was present as her substitute).  It was noted that Councillor Philip Corthorne would be arriving a little late.

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

RESOLVED:  That the minutes of the meeting held on 12 November 2024 be agreed as a correct record. 

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

Consideration was given to the Committee’s updated remit.

RESOLVED:  That the Committee’s updated remit be noted.

Consideration was given to the Cabinet Forward Plan.

RESOVLED:  That the Cabinet Forward Plan be noted. 

Consideration was given to the Committee’s Work Programme.  It was agreed that the Autism Strategy consultation report and update on the implementation of recommendations from the Making the Council more autism friendly review be moved from the meeting on 25 February 2025 to 19 March 2025.

RESOLVED:  That the Work Programme, as amended, be agreed.

The Chair welcomed Ms Lesley Watts, Chief Executive at both The Hillingdon Hospitals NHS Foundation Trust (THH) and Chelsea and Westminster NHS Foundation Trust (Chelwest), to the meeting.  She had been at Chelwest for about ten years and had joined at the same time as the organisation had come together with West Middlesex.  Ms Watts had previously been working with Hillingdon Hospital as a maternity advisor.  She reassured Members that her responsibility to patients at THH would be equal to that of those at Chelwest – both were equally important.

It was noted that Hillingdon Hospital had a number of challenges, including those relating to infrastructure and had some real strengths and fragilities which would be better supported through joined up working with Chelwest.  The Government had announced that Hillingdon would be getting a new hospital.  This had given staff a boost and infrastructure changes had already been made, including the move to using the Cerner system.  It was noted that the new hospital development was now in phase one of acceptance but that work on the design was still needed.  There would be a financial gap that would need to be bridged and the Trust would need to be as efficient as possible. 

Consideration was currently being given to the planning and structure of the proposed new hospital building.  Ms Watts assured Members that there would not be any huge changes and that this was more about the interior design and layout.  There had been an acceptance that the design was the right one but that the hospital needed to be made as efficient as possible.  She suggested that Mr Jason Seez, THH’s Deputy Chief Executive, be invited to attend a future meeting to talk to the Committee about the hospital redevelopment. 

Ms Watts noted that hospitals received more money from their elective work.  THH needed to get a better balance between its emergency and elective work.  Consideration would also need to be given to the Trust’s governance arrangements and back office functions to identify economies of scale and ensure that they were as efficient as possible. 

Members noted that, in the past, the Committee had expressed concern about a number of performance issues at THH but these had never really improved.  It was queried how improvements would be made at THH and whether the current set up would be part of a more permanent merger of the Trusts.  Ms Watts advised that there were no plans around a merger at the moment as this could be a distraction as there was more to do.  From a Chelwest perspective, action would need to be taken to address the quality of care, funding and performance at THH before this would be considered, otherwise it could result in further instability.  Ms Watts stated that she would ensure that the quality of care at THH was as good as it should be.  Whilst operational performance at THH was good in some areas, this needed to be addressed in the Emergency Department. 

Ms  ...  view the full minutes text for item 52.

Councillor Jane Palmer, the Cabinet Member for Health and Social Care, thanked the Committee for inviting her and Ms Sandra Taylor, the Council’s Director of Adult Social Care and Health, to the meeting.  Ms Taylor noted that this provided them with a good opportunity to talk to Members about the recent CQC inspection of Adult Social Care.  New regulations had been introduced which had seen Hillingdon as one of the first twelve local authorities to have an inspection of its adult social care services.  It was noted that all of the local authorities in North West London had been inspected, although some reports had not yet been published. 

Hillingdon had been advised in 2023 that it would be inspected by the CQC in 2024.  The Council received the templates and started to develop an action plan for improvements and develop a self assessment document.  The CQC contacted the Council on 19 February 2024 to request that a range of information be provided within the following two weeks.  As progress had already been made, the self assessment had to be rewritten, identifying the service’s strengths and weaknesses and included evidence to support the detail that had been included therein.  199 pieces of evidence were submitted to the CQC at the beginning of March 2024.  Ms Taylor praised the diligent and focussed team that had pulled the information together to be submitted to the CQC within a very short time period. 

On 14 June 2024, a three and a half hour leadership meeting was held with the inspectors to tell them what the Council thought was important.  This meeting had been attended by Mr Dan Kennedy, Mr Keith Spencer, Ms Taylor and others to demonstrate leadership across the piste.  An onsite inspection was also held. 

The Council had had to provide the CQC with the names of individuals that they wanted to interview including residents, representatives from the Select Committee, Cabinet Member, Chief Executive, partners such as Healthwatch Hillingdon and the third sector.  The Council team had briefed each of these individuals face-to-face before their interviews.  In July 2024, eight CQC inspectors came to Hillingdon and worked closely with staff who highlighted what Hillingdon did well for residents and the areas that were being worked on.  In all, 133 meetings and conversations took place.  The inspectors were also encouraged to go out and meet staff working in the community. 

Ms Taylor advised that the Council had received the first draft of the CQC report in September 2024.  Whilst the content of the report was good, the style had needed some work and factual inaccuracies had needed to be corrected.  The CQC took on the Council’s feedback and the updated report was sent to the Council in November 2024.  The changes were then accepted by the Council and the final version of the report was published on 13 December 2024. 

Ms Taylor was proud of the work that had been undertaken and the Council’s achievements.  Although she was disappointed with the score of  ...  view the full minutes text for item 53.

Mr Richard Ennis, the Council’s Corporate Director of Finance, advised that these were challenging times for local government and that the London Borough of Hillingdon was no exception.  The cost of providing Adult Social Care had increased as a result of an ageing population and more complex needs. 

Members were advised that there had also been significant spend on things such as temporary accommodation and homelessness.  The Government had set a target to build 1.5m new homes in the next five years.

The proposed budget had been considered by Cabinet on 6 December 2024 and had subsequently been out for consultation.  The final budget would be considered by Cabinet on 13 February 2025 and Council on 27 February 2025. 

It had been announced that local government would be getting a three year settlement but that the amounts would not be known until the summer of 2026.  A three year settlement would provide more stability for local government than the current one year settlements.  Mr Ennis advised that it was still unclear whether the settlement would take account of the change to the National Insurance threshold and the impact that this would also have on the private sector contractors commissioned by the Council (the contractors might want to pass the additional costs on to the Council but the authority would need to “hold the line”). 

There were also pressures in the economy with inflation being a bit “sticky”.  As it was unlikely that Government would invest a significant amount of money into local government, it would be up to the Council to come up with its own solutions. 

Mr Ennis noted that Hillingdon residents were getting very good value for their Council Tax money.  Of the fourteen outer London boroughs, Hillingdon had the lowest Council Tax.  Furthermore, one of the neighbouring boroughs charged £400 more than Hillingdon for a Band D property. 

Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health, advised that since the pandemic there had been a 7% increase in demand for Adult Social Care services each year.  Increasingly, the demand had been for more complex, higher needs that required more support which meant that contractors were needing more money to provide the services to meet residents’ needs.  The cost of living crisis and the increase in the minimum wage had also impacted providers and their staff and there was a risk in relation to retention.  As such, it was important that the Council work with providers to get through these challenges together. 

The Adult Social Care placement budget was under significant pressure.  This had been impacted by elective operations being delayed by years which had a negative impact on residents’ ongoing health.  It would be important to ensure that the whole system became more efficient, leaner and more agile.  If the hospital performed well, demand would reduce.

Members were advised that residents were sometimes placed out of Borough due to a lack of local placements.  Ms Taylor advised that Hillingdon would like to  ...  view the full minutes text for item 54.