Agenda and minutes

Apologies for absence were received from Councillors Barrett, Mrs Elizabeth Turpin and Wildey.

To approve the record of the meeting held on 10 March 2022 and the record of the Joint Meeting of Committees held on 18 May 2022.

The record of the meeting of the Committee held on 10 March 2022 and the Joint Meeting of Committees held on 18 May 2022 were agreed and signed by the Chairman as correct.

There were none.

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct.  Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

There were none.

This paper summarises the Children and Young People’s Mental Health transition arrangements currently in place as well as planned development areas.

Discussion:

Members considered a paper which summarised the Children and Young People’s Mental Health transition arrangements currently in place as well as planned development areas.

As the Committee was the lead on scrutiny of health in cases of the transition between childhood and adulthood, representatives of the Children and Young People Overview and Scrutiny Committee were present to participate in this item. In addition, the Committee considered written representations from the Medway Parents and Carers Forum representative on the Children and Young People Overview and Scrutiny Committee, who made the following points:

·         many parents/carers found that support was good until the transition point and very often the young person did not meet the adult criteria, leaving them with nothing.

·         parents then became frustrated and the young person’s mental health quickly deteriorated, needing more support than perhaps they would have.

·         mental ill health was higher in ages 16-24 because transition was so poor.

·         it could be difficult to differentiate the CCG plans for Medway and Kent

·         Kent being the larger area received more support than Medway

·         It was good that the LTP mapping of services had been completed but whether there were companies duplicating work was queried.

·         the need to signpost parents and young people to service was critical.

·         the Forum was about to launch a Health Survey which would include learning disability health checks and opinions on all health services in Medway. An offer was made to analyse the 18-25 age group and report back to the Committee.

In discussing the paper, several Members expressed their concern that transition services had not improved in spite of long standing, severe problems in children’s mental health services. 82% of the young people spoken to in Medway had said they had experienced difficulties with emotional wellbeing or mental health in the past and had sought help from or accessed help. In total 1 in 3 young people from Medway were currently accessing mental health support from a service. There was a very confused landscape of providers, a recruitment crisis and demand was at an unprecedented high.

The lack of a plan to improve services with milestones and data was criticised, as was whether there would be any progress under the new Integrated Care System and how this would be monitored.

The point was made that there was a constant cycle of intensive treatment, help from community services and then patients having to describe from the beginning their problems at the next crisis.

The lack of a robust service at the acute hospital for mental health patients who had gone there having found nowhere else to get help was referred to.

An assurance was sought on how the period before, during and after transition would be managed with a plea for this to be seen not as separate sections.

A point was made that intervention did not happen until a person’s condition had significantly worsened. If early intervention took place this would minimise people facing a lifelong recurring need for social care.  Members were  ...  view the full minutes text for item 53.

This paper provides an update on the following areas:

·       The transformation of the wider mental health services, in particular the transformation of community mental health services and urgent and emergency care mental health services.

·       The transformation of dementia services, including the redesign of dementia services for people with complex needs

Discussion:

Members considered a paper which provided an update on the transformation of the wider mental health services, in particular the transformation of community mental health services and urgent and emergency care mental health services. It also provided an update on the transformation of dementia services, including the redesign of dementia services for people with complex needs.

The following issues were discussed:

·         Mental Health Together model being rolled out across Kent and Medway – the locations of these sites in Medway would be provided to Members.

·         Data Harmonisation - how quickly the coding issue would be fixed which was resulting in some cases of a dementia diagnosis not appearing on a GP practice’s dementia register was queried. Members were advised the coding needed to happen in the GP practice in order to be entered on the dementia register. The CCG was identifying those GP practices where there was a significant variation and supporting them to review their lists.

·         GPs with an Enhanced Role – whether GPs would have sufficient time to carry out this role, how advanced the programme was and whether this would be affected by GP shortages were queried. Members were advised that this was a pilot based in Rochester, Medway South and Chatham. If successful, it would transform how community mental health services worked.  GPs would be able to diagnose medium levels of dementia and this would also free up capacity with partners.

·         Crisis Team – in response to a comment that support was not always available immediately after diagnosis and before entering crisis, Members were advised that a new service was currently being evaluated which enabled Dementia Coordinators in each Primary Care Network to provide support for people as they progressed on the dementia pathway. A point was also made that the crisis team was not as effective as it should be. There needed to be a focus on ethnic minority families who often did not ask for help until the last minute.  Members were advised that the CCG was working with partners to find a solution for Medway.

·         Safe Haven – in terms of the opening hours for this service, the CCG advised these were not open all day. The current contract had expired, which presented an opportunity to review this service.

·         Talking therapies – reference was made to long waiting lists. An undertaking was given to provide Members with an update on this.

·         Medway Primary Care Mental Health team – a point was made that this team was finding it difficult to find a location to work from and needed to be co-located to be effective. The CCG advised that they were discussing with local GPs to understand what room space and capacity was available. Concerns about the team not being co-located would be fed back to relevant CCG colleagues.

·         Admiral Nursing – in response to a comment that this service was overloaded and what was being done to support them, the CCG assured Members this was a valued service. The review would  ...  view the full minutes text for item 54.

This report highlights the findings and recommendations following the Local Government Association (LGA) Safeguarding Peer review carried out between 31^st January and 2^nd February 2022.

Discussion:

Members considered a report on the findings and recommendations following the Local Government Association (LGA) Safeguarding Peer review carried out between 31 January and 2 February 2022.

In discussing the report, Members commented that the report was critical but fair. Whether officers were confident the service would improve as a result was queried as well as why some of the actions with an August deadline had not been started.

The Assistant Director – Adult Social Care commented that the approach was that of a critical friend and there had been some positive comments from the review team. She felt that the three-hub approach now should probably change to a one hub approach, but the data on this was still being looked at.  There were valid reasons why work on some actions had not started, mainly due to difficulties in recruiting. But in the last few weeks progress had been made in some areas.

With regard to the suggested supervision audit, caseloads in adult social care were higher than in children’s services. The aim was to bring the numbers down and move to an allocated social worker model.

In response to a comment that the use of “localities” was not well understood by the public, the Assistant Director undertook to reflect on this.

Decision:

The Committee agreed to note the findings of the report and the action plan and timescales.

Medway’s Council Plan 2021/22 sets out the Council’s three priorities. This report and appendices summarise how we performed in Q4 2021/22 on the delivery of the priority relevant for this committee: People.

This report also presents the Q4 2021/22 review of strategic risks.

Discussion:

Members considered a report on performance in Quarter 4 2021/22 on the delivery of the Council Plan priority relevant for this committee: People.

A point was made that the Directorate was performing well in spite of the pressures it was facing. The rise in fuel prices could have a significant impact on domiciliary workers.

Members queried why the strategic risk SR52 (A new severe pandemic, e.g., flu, Covid-xx, MERS or other, more serious than Covid-19) had been removed from the register and it was suggested this should remain on the register.

The Director of Public Health commented the Council recognised there may be another pandemic. There had been a change in emphasis to reflect the fact the Council was more likely to be prepared having learned from the Covid pandemic. In response, a point was made that this rationale could be applied to many of the other strategic risks.

The Director of Public Health assured Members he had the tools and the ability to direct resources in the event of another pandemic. The Council was still responding to Covid but it was not sustainable to maintain the same state of readiness as before.

Decision:

The Committee agreed to note the Quarter 4 2021/22 performance against the measures used to monitor progress against the Council’s priorities.

Discussion:

Members considered a report regarding the Committee’s work programme.

With regard to the item on women’s health due to come to the October meeting, a request was made for the statistics in the Government’s call for evidence report to be included.

Decision:

The Committee agreed to approve the proposed work programme, as set out at Appendix 1 to the report.