Agenda and minutes

Health and Social Care Select Committee - Tuesday, 21st March, 2023 6.30 pm

Venue: Committee Room 5 - Civic Centre. View directions

Contact: Nikki O'Halloran  Email: nohalloran@hillingdon.gov.uk

Media

Items
No. Item

70.

Apologies for absence

Minutes:

Apologies for absence had been received from Councillor Alan Chapman (Councillor Darran Davies was present as his substitute).

71.

Declarations of Interest in matters coming before this meeting

Minutes:

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

72.

Minutes of the meeting held on 21 February 2023 pdf icon PDF 266 KB

Minutes:

RESOLVED:  That the minutes of the meeting held on 21 February 2023 be agreed as a correct record. 

73.

Exclusion of press and public

Minutes:

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

74.

CAMHS Referral Pathway - Second Witness Session pdf icon PDF 167 KB

Minutes:

The Chairman welcomed those present to the meeting.  Ms Amanda Erasmus, Special Educational Needs Coordinator (SENCO) at Uxbridge High School (UHS), noted that 5.9% of children at UHS were on the special educational needs register and that most of these were in relation to mental health issues.  She advised that the school had started to refer children to Child and Adolescent Mental Health Services (CAMHS) during the Covid pandemic and that, over time, good relations had been built with the staff and therapists there.  UHS had referred 28 children to CAMHS over the last two years, five of which had been accepted.  Where the children were not accepted, the school had received a letter detailing possible alternative pathways, such as SEND Advisory Service which had been helpful but which was not always that straight forward.  The letter would be quite brief in terms of the availability of alternative support and schools would often not know the full range of services that were available to help young people so would just use the ones that they did know about.  Schools provided the support that they could to young people but they were not mental health specialists. 

 

Members were advised that exclusion was avoided where possible and measures were put in place in schools to support the child.  Mental ill health would not lead to an exclusion but would instead prompt interventions such as a personalised timetable.  For ADHD, UHS worked with Screening, Assessment and Support Services (SASS) and the Behaviour Support Team to support the child so that the situation rarely ever resulted in exclusion. 

 

Ms Erasmus stated that, when the school contacted CAMHS, they did receive a response and that UHS attended meetings with the child, their parent and the psychotherapist.  She also noted that the school had been chosen as one of two pilots in the Borough to work with the Mental Health Support Team whereby three mental health support workers came to the school for two days each week to work with 50 young people on issues of worry, low mood, anxiety, etc.  Supporting this low level mental health need through early intervention meant that it was much easier to manage. 

 

Ms Summer Wessels, Deputy Designated Safeguarding Lead and Senior Mental Health Lead at Douay Martyrs School (DMS), advised that the school had had a positive experience with CAMHS but that, as an educational establishment, it did not expect to have to make referrals to CAMHS.  Where a mental health issue had been suspected, the school had asked the parents to take the young person to see their GP who would then be able to make a referral to CAMHS.  If the GP refused to make a referral to CAMHS and school believed that there was enough evidence, the school would make the referral itself (DMS had made five referrals to CAMHS in the last two years and all of them had been accepted). 

 

Where the referrals made by the GP were refused by CAMHS, DMS might ask  ...  view the full minutes text for item 74.

75.

Cabinet Member for Health and Social Care Update

Minutes:

Councillor Jane Palmer, Cabinet Member for Health and Social Care, advised that early intervention to deal with social care issues that arose in childhood reduced the impact on their lives into adulthood. 

 

Councillor Palmer praised the social workers who had worked tirelessly during the pandemic to support residents during a very difficult period.  There had been a range of initiatives delivered and work undertaken over the last year included: Hillingdon Shared Lives Scheme, reablement and hospital discharge.  In addition, the Hillingdon Suicide Strategy had been developed with links to health, British Transport and Hayes station.  There had been no strategy in place to prevent to suicide in the Borough when Councillor Palmer had taken on her Cabinet portfolio so she was very proud of the partnership working that had resulted in this accomplishment. 

 

It was recognised that social care took up approximately 60% of the Council's entire budget and that this supported a relatively small number of residents.  However, it was also noted that social care was a statutory service that had never been sufficiently funded to enable preventative work to be undertaken which would ultimately reduce the overall costs of the service provision.  To ensure that the quality of service was maintained, proper procurement and monitoring measures had been put in place to ensure that poor performance in contracts was addressed and to ensure value for money.  However, inflation had meant that everything was now more expensive than it had been previously (including the workforce) but the Council continued to maintain its sound financial management. 

 

Ms Sandra Taylor, the Council's Executive Director of Adult Services and Health, advised that social care would always be a high spend area of the local authority and would therefore always be a talking point.  However, Hillingdon had demonstrated a good and effective use of resources based on early intervention.  A strong hospital discharge process had been put in place resulting in 70% of people coming out of the reablement process with no ongoing care needs.  It was important not to create dependencies and to keep people living in their own homes for as long as possible. 

 

Further work was needed to create resilience in young people and, to this end, Ms Taylor would be speaking to the Interim Director of Public Health to see what action could be taken to further develop good general health.  There were gaps that had emerged and it would be important to fill these with voluntary sector providers. 

 

Councillor Palmer noted that social care in Hillingdon was a good place to work, with dedicated staff.  The Council promoted social care apprenticeships to enable the authority to develop its own staff and allowed them to move between departments.  Supportive working relationships were in place with proper supervision and support for social workers and caseloads were well managed. 

 

Ms Taylor stated that staff retention in social care in Hillingdon was very good and that the leadership team had a breadth of experience to support the service area.  Social workers were  ...  view the full minutes text for item 75.

76.

Cabinet Forward Plan Monthly Monitoring pdf icon PDF 241 KB

Additional documents:

Minutes:

Consideration was given to the Cabinet Forward Plan. 

 

RESOLVED:  That the Cabinet Forward Plan be noted. 

77.

Work Programme pdf icon PDF 143 KB

Additional documents:

Minutes:

Consideration was given to the Committee's Work Programme.  It was noted that the Committee's next meeting on Wednesday 26 April 2023 would receive updates from health partners.  Members requested that each of the health partners be asked to provide, in advance of the meeting and to be included on the published agenda, a written account of the work that they had undertaken over the last year and to provide an indication of their performance against targets during that period. 

 

RESOLVED:  That the Work Programme be noted.