Agenda and minutes

Apologies for absence had been received from Councillor Labina Basit (Councillor Sital Punja was present as her substitute) and Councillor Philip Corthorne (Councillor Ekta Gohil 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 12 May 2022 be agreed as a correct record. 

RESOLVED:  That Agenda Items 1 to 9 be considered in public and Agenda Item 10 be considered in private. 

The Chairman welcomed those present to the meeting.  Mr Mark Braddock, the Council’s Statutory Scrutiny Officer and Senior Democratic Services Manager, presented the report to the Committee.  The report set out the role of select committees and overview and scrutiny in Hillingdon as well as how select committees operated and scrutiny roles, support and guidance. 

Mr Braddock took Members through the remit of the Health and Social Care Select Committee and advised that this Committee held the statutory responsibility for health scrutiny as conferred by the Local Authority (Public Health, Health and Wellbeing Board and Health Scrutiny) Regulations 2013.  It would also act as Hillingdon’s lead select committee on the monitoring and review of domestic abuse services and support which was a cross-cutting topic. 

Select committees in Hillingdon were able to: assist in the development of Council policy; evaluate and question actions taken by Cabinet before or after decisions were made; and report to Cabinet with recommendations. 

Insofar as the call-in procedure was concerned, Members were advised that an app had been developed for them to propose a call-in.  Once a Member of the relevant select committee had initiated a call-in proposal, the other Members of the committee would be alerted and could either respond (in support / opposition) or could ignore the alert.  Four Members would need to support the call-in request within the five day period after the Executive decision had been made for it to be carried forwards. 

The Chairman stated that the scope and workload of the Health and Social Care Select Committee was huge so it would be important for Members to focus their energy on the issues that mattered most or for which they could make a difference.  The External Services Select Committee previously held the statutory health scrutiny powers and had been regularly frustrated that it was unable to scrutinise social care services that worked with external health partners.  The new format would mean that the Committee would be able to look at how these services worked together to provide joined up health and social care services in the Borough. 

Whilst information requests were a perfectly legitimate part of the Committee’s work, the Chairman asked Members, where possible, to raise them at the Committee’s meetings so that they could be discussed openly and to ensure that the requests were relevant. 

RESOLVED:  That the discussion be noted. 

The Chairman advised that External Services Select Committee (ESSC) had previously heard from partners at its meeting on 22 February 2022 about the pressures being faced when dealing with mental health attendances at Hillingdon’s Accident and Emergency (A&E) department.  Members had heard about the huge amount of time that the police had spent in A&E waiting for action to be taken in relation to a patient that had been detained by them under Section 136 (s136) of the Mental Health Act 1983. 

DCI Saj Hussain, Public Protection in the West Area Basic Command Unit (BCU) - Metropolitan Police Service (MPS), advised that Sergeant Jason Wright ran the Mental Health Team for the West Area BCU and PC Brooke Dunlop was an operational officer within the Mental Health Team (which had been established in 2018). 

Mr Richard Ellis, Joint Lead Borough Director at North West London Clinical Commissioning Group (NWL CCG), advised that this was a partnership issue which provided partners with a collaborative opportunity.  Since the ESSC had met in February 2022, progress had been made. 

Mr Ellis praised the work of those services involved in dealing with mental health crisis including the police, London Ambulance Service and Hillingdon Hospital.  He noted that there had been a 25% increase in demand for mental health beds in 2021/2022 and that the West Area BCU was the busiest area in London with 20% of their calls relating to mental health (1,500-2,000 calls per annum - about 475 of these were s136s, with the remainder being voluntary attendances at hospital).  Since the start of the pandemic, there had also been a 40% increase in the number of s136 detentions undertaken by the police where the individual had to be taken to a Health Based Place of Safety (HBPOS).  It was noted that around 60% of people presenting in mental health crisis were previously unknown to partners – this caused partners a significant challenge. 

DCI Hussain advised that, although there had been a year-on-year reduction in the number of s136 detentions between 2018 and 2020, the pandemic had then prompted a significant increase in 2021.  This had since reduced back to 2018 levels.  Although no definitive reason for the increase had been identified, it was thought to be linked to issues such as the rising cost of living and isolation. 

Members were advised that around 43% of those who were detained under s136 were subsequently discharged.  Effort was being made to focus on this group to then reduce the number of hours that the police spent in A&E as well as reduce the number of people detained on a s136 who did not require inpatient mental health care.  On average, each s136 took 12 hours and 16 minutes of police officer time (around 4,000 police officer hours per year equating to about £80k-£120k).  Although approximately 30% of s136s used a HBPOS and 70% went to A&E, DCI Hussain advised that not everyone in mental health crisis needed to go along  ...  view the full minutes text for item 8.

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that the report was being considered by the Select Committee prior to being considered by the Executive.  Members would therefore have the opportunity for their comments to be included in the version that was sent to Cabinet.  As well as the structure of the new Strategy, information had been included in the report to provide Members with a broader understanding.  The Committee was assured that future reports would be shorter. 

It was noted that, as the Carers’ Strategy was a joint strategy for Hillingdon which covered carers of all ages, there was a cross over with the Children, Families and Education Select Committee.  The draft new strategy would be considered by both Select Committees before going to Cabinet.  The Committee was advised that this would be in Q4.  [NOTE: Since the meeting, the Office of National Statistics (ONS) announced that carer-related data from the 2021 census would not be published until December 2022 and officers have advised that sign-off of the new strategy would be deferred until Q1 2023/24].

Mr Collier advised that the main support offer for carers was provided via the Carer Support Services contract between the Council and Carers Trust Hillingdon (CTH).  CTH was the lead organisation for the Hillingdon Carers’ Partnership (HCP was a consortium of local third sector organisations which also included the Alzheimer’s Society, Harlington Hospice and Hillingdon Mind). 

The Committee was advised that the development and delivery of the Joint Carers’ Strategy was overseen by the multi-agency Carers’ Strategy Group (CSG).  Efforts were being made to get carer representatives to attend the CSG, but it would be important that these carers approached the development and delivery task objectively.  It was noted that a carer representative on the group had recently decided to leave due to changes in their personal circumstances.

Members were advised that a guide for carers had been co-produced between the Council and Carers’ Trust and was available on the Council’s website.  Hard copies of this leaflet (“Are you a carer?”) were circulated to Members at the meeting.  The Committee noted the intention that this would be used by partners across the health and care system to support people who may not realise that they were carers.  It was emphasised that the key message for carers was to contact the Carers’ Trust to access a full range of information and advice.

The Chairman advised that the Committee was likely to be more focussed on the future draft strategy where the Members’ input could be most valuable going forward.  The report stated that new staff starting with Hillingdon Health and Care Partners were provided with an hour’s introductory training about the role of carers in supporting the health and care system and the importance of identifying them and addressing their needs.  It was agreed that this training would be made available to Members of the Health and Social Care Select Committee. 

In response to a question  ...  view the full minutes text for item 9.

Consideration was given to the Cabinet’s latest Forward Plan.  Whilst there were a large number of reports which fell within the Committee’s remit, it would be important to only request additional information in relation to reports where there was a compelling reason to do so.  It was agreed that a request be made for the Older People’s Plan update to be brought to the Committee prior to it being agreed by Cabinet in 2023 if timings allowed.

RESOLVED:  That:

1.    officers be asked to present the Older People’s Plan update to the Health and Social Care Select Committee prior to it being considered by Cabinet in 2023; and

2.    the Cabinet Forward Plan be noted. 

Consideration was given to the Committee’s Work Programme.  The Chairman noted that the Committee had a large and important remit and it was agreed that, as such, the Committee’s next two meetings be used to learn more about the work of social care and public health (July) and health partners (September). 

An update on Child and Adolescent Mental Health Services (CAMHS) had been scheduled for the October meeting.  Members would be in a better place to make a decision about the review topic that they would like to pursue at the end of the meeting on 12 October 2022.  As well as CAMHS, other possible review topics included the procurement and monitoring of health and social care services. 

It was agreed that the Cabinet Member for Health and Social Care would be invited to attend the meeting on 21 March 2023 or 26 April 2023 to talk about her plans for services within her portfolio.

RESOLVED:  That:

1.    the meeting on 19 July 2022 focus on social care and public health;

2.    the meeting on 14 September 2022 focus on partner health services;

3.    the meeting on 12 October 2022 focus on CAMHS;

4.    the Cabinet Member for Health and Social Care be invited to attend the meeting in either March or April 2023; and

5.    the Work Programme be agreed. 

Consideration was given to the Council’s general procurement processes and it was queried if there were any controls over how much of any contract was sub-contracted and whether it was possible to assess the necessity sub-contracting (to ensure such practices do not diminish the amount of investment that actually went into whatever it was that was being procured).  When sub-contracting was undertaken, it would be important to monitor the deliverables and adjust who delivered what rather than becoming complacent. 

RESOLVED:  That the discussion be noted.