Agenda and minutes

An apology for absence was received from Councillor Perfect. 

To approve the record of the meeting held on 20 August 2025.

The record of the meeting held on 20 August 2025 was agreed by the Committee and signed by the Chairperson as correct. 

The Chairperson explained that it was the end of Baby Loss Awareness Week and as a symbol to honour all babies who had sadly passed and to raise the importance of compassion and open conversations to support families, he lit a candle.

The Chairperson will announce any late items which do not appear on the main agenda but which he/she has agreed should be considered by reason of special circumstances to be specified in the report. 

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

Councillor Campbell confirmed that although she was the office manager for the Gillingham and Rainham MP, she had had no involvement in the matter relating to item 8 (Update on pharmacy provision in Rainham) as this was being dealt with by case workers, she would therefore stay for the debate and decision on that item.

This annual report provides an account of the role of the Deputy Leader of the Council, who has responsibility for Adult Social Care and Public Health. It details their ambitions for their areas of responsibility, how they have and will undertake political challenge and leadership and what their priorities and ambitions are for the year ahead.

Discussion:

The Deputy Leader of the Council introduced her report which set out the ambitions, achievements and challenges relating to the services that fell within her portfolio, particularly highlighting the Adult Social Care (ASC) workforce rightsizing, Public Health research collaboration, Marmot Place status and the James Williams Healthy Living Centre.

Members then raised a number of questions and comments, which included:

·       Pharmacy provision – in response to a question about pharmacy provision and the Pharmaceutical Needs Assessment (PNA), the Deputy Leader explained that the development of a PNA was a statutory function of Health and Wellbeing Boards, of which she was the Chairperson and the standards and framework in which the PNA operated was nationally set.  She shared the frustrations relating to provision in Rainham but explained that due to current legislation, the PNA was very limited in what it could and could not take into account.  She added that the MP for Gillingham and Rainham was sighted on the issue and would be lobbying the Department for Health and the Health Secretary to update the regulations to ensure that PNAs could take into account the day to day accessibility of provision, particularly for those with protected characteristics.

·       Mental Health – reference was made to the increase in demand for mental health services and the increase in funding that this rise in scale and complexity of need had required.  Officers undertook to provide a briefing note to demonstrate detailed data regarding the increase in demand.  The Deputy Leader explained that the increase in expenditure was still not sufficient to meet need and that ASC had seen an increase in people being deemed medically fit for discharge whose needs were in fact very significant and complex. Therefore, there was a need to be robust and push back to partners where ASC were unable to meet an individual’s needs.

·       Direct payments (DPs) – in response to a question regarding the uptake of DPs, the Deputy Leader explained that the Council was still below its target but there were often good reasons for people to choose not to accept DPs and so although the option would continue to be promoted, it would never be forced onto clients.

·       Impact of winter fuel changes – in response to a question about how pensioners in Medway had been impacted by the Government’s decision the previous year in relation to the winter fuel allowance, the Deputy Leader explained that following its announcement, the Council provided substantial support to raise awareness for those eligible to claim pension credit and provided a £200 grant to those poorest households that did not qualify for pension credit through the Household Support Fund.

·       ASC Rightsizing – in response to a question about the impact of the rightsizing of the ASC workforce the Deputy Leader explained that the increase in staffing had restored levels back to where they had been before previous structural changes, but that demand would continue to rise as would the need for staff. However, the addition of over 80  ...  view the full minutes text for item 349.

This report provides an update on the outcome of an independent culture review at Medway NHS Foundation Trust, and an update on delayed referrals to the Ear Nose and Throat service.

Discussion:

Representatives from the Medway NHS Foundation Trust (MFT) introduced the report which set out the outcome of an independent culture review at the trust and provided an update on the delayed referrals to the Ear, Nose and Throat (ENT) service. They expressed their disappointment and concern of the culture review findings and set out how they were working to address the issues.  In relation to the ENT issue, it was explained that the majority of patients impacted were from the Dartford, Greenwich and Bexley areas and no urgent or cancer patients had been affected by the issue. The investigation into the issue was ongoing but with support from the Integrated Care Board (ICB), capacity had been doubled to address the backlog.

Members then raised a number of questions and comments, which included:

·       Action plan – in response to a question the Interim Deputy Chief Executive of MFT confirmed that the Culture Transformation Programme was one of ten priorities within MFT’s Stabilisation Plan. She explained that the recommendations from the culture review were embedded in the whole organisation and staff were being given the space to be able to contribute and to share their own experiences. The Committee requested to see the action plan.

·       Diversity training for the Board – it was confirmed that Executive and non-Executive members of the Board had undertaken training in diversity and inclusion.

·       How behaviour had been able to occur – in response to a question about how the environment had enabled bullying, racism and other unacceptable behaviour to occur, the Chair of MFT explained that there were a combination of factors, such as the previous leadership not taking the issues seriously enough and a lack of support and training for middle management to ensure they had the necessary skills to manage such issues effectively.

·       Metrics – The Chair of MFT confirmed that there were a number of different metrics used to gather data, such as the annual staff survey, the quarterly pulse survey and through staff embedded within equality, diversity and inclusion networks.

·       Monitoring progress – the Committee was clear that they would be requesting regular updates from MFT on the situation.  In addition the Chair of MFT highlighted that the MFT Board meeting papers were publicly available and the meetings were livestreamed. Members could therefore use this information for additional insight, to supplement the updates to HASC, as an update on the culture issue was being reported to the Board every other month.

·       Addressing the issue within a challenging environment – comment was made to the challenge in addressing the issues outlined within the culture review, whilst also dealing with the constant high pressure and demand within the NHS. In response the Interim Deputy CE explained that they listening to staff around what works best for them to address the issues. They continued to host listening events, wellbeing events as well as raising awareness to ensure teams prioritised time to enable staff to take part in these events, access training and were supported  ...  view the full minutes text for item 350.

The purpose of this report is to:

·         update the Health and Adult Social Care Overview and Scrutiny Committee (HASC) on the Kent and Medway Integrated Care Board (KMICB) Community Services procurement (value c.£1.8bn) including service mobilisation ahead of service commencement

·         outline the next steps to service transformation planning to ensure we fully engage throughout the lifetime of the contract to achieve the best for our populations.

·         outline key risks and associated mitigations.

Discussion:

The Chief Strategy and Partnerships Officer and Interim Delivery Officer from the Integrated Care Board (ICB) introduced the report and was accompanied by the Deputy Chief Executive Officer (CEO) and Chief Operating Officer from Kent Community Healthcare NHS Foundation Trust (KCHFT), the lead provider of the new contract. It was explained that the new contract was on track to mobilise on 27 October 2025, and it was anticipated that the plan for transformation would be ready by March 2026.

Members then raised a number of questions and comments, which included:

·       Changes to ICB – reference was made to the forthcoming transformation of the ICB and it was confirmed that regardless of the changes to the ICB structure, community services would remain a core part of the future of the health service and keeping people well in the community.

·       Length of contract – The ICB explained that the contract was five years, with the option of extending for a further three years, which provided stability for the provider and the services.

·       NHS Ten Year Plan – reference was made to the synergy between the contract and the ambitions around the transformation of community services, with those set out in the Ten Year Plan, promoting neighbourhood health and addressing health inequalities.

·       Mobilisation of contract and TUPE of staff – it was confirmed that the new contract was on track and was expected to go live on 27 October 2025, with staff being transferred over from that date.

·       Responsibility to deliver the contract – it was confirmed that as the lead, KCHFT would hold responsibility to deliver the contract and meet expectations and any failure to deliver would be the ultimate responsibility of KCHFT, who would in turn hold to account providers who have been sub-contracted to provide services.

Decision:

The Committee noted the report.

This report provides an update on the provision of pharmaceutical services within the Rainham area of Medway.

Discussion:

The Director of Primary and Community Care from the ICB introduced the report which updated the Committee on issues relating to pharmacy provision in Rainham. He explained that the way in which ICBs managed contractual arrangements with pharmacies was set by national regulations which opened up opportunities for resolution where there were disputes and provided space for a contractor to respond. If following the process, a decision was made to remove a pharmacy from the pharmaceutical list, then the Health and Wellbeing Board would be informed so that it could decide whether or not to submit a Supplementary Statement to its own Pharmaceutical Needs Assessment (PNA).

Members then raised a number of questions and comments, which included:

·       Wider company issues – reference was made to the fact that the pharmacy currently shut in Rainham was part of a wider chain which was experiencing difficulties.  The ICB confirmed that the way pharmacy provision was commissioned was highly regulated and each individual site had to be treated individually. The pharmacy in Rainham was not the only one from that particular chain that fell within the Kent and Medway boundary and the ICB was following the procedures directed by national regulations.

·       Ageing population of Rainham – reference was made to the ageing population of Rainham and the impact the lack of provision caused by the now closed pharmacy had on them.

·       Delay in action – reference was made to the perceived delay in action by the ICB.  In response the ICB confirmed to the Committee that they had been working with the pharmacy to support them through an informal resolution process for them to meet their contractual obligations which followed the performance management framework for community pharmacy. This was part of the required process which had been unsuccessful, and a case had therefore been taken to the Pharmaceutical Services Regulations Committee.

·       Limitations of the regulations – frustration was expressed by Members that other providers had requested to open a pharmacy in Rainham but had been rejected. The ICB explained that there was an extensive process to remove a pharmacy from the pharmaceutical list and until the full process was completed, a pharmacy remained on the list. The PNA had to include all pharmacies on the pharmaceutical list, regardless of their performance, a requirement set by the regulations with no flexibility. The ICB emphasised that they also wanted communities to be well served and have easy access to medicine and other pharmacy service provisions. Reference was made by the Committee to the local MP who had also been looking into the issue and had indicated they would take the matter forward to Government.

• Letter to Government – it was suggested that the Committee write to the Department for Health and Social Care, with support from Public Health and the ICB, to raise the opportunity for population health in a more flexible approach to pharmacy commissioning and its concerns of the limitations caused by the current regulations and the impact this was having on  ...  view the full minutes text for item 352.

This annual report sets out the position on complaints, comments, and compliments for Adult Social Care for the year, and where possible provides comparisons against previous years. It also highlights some examples of the positive things people have said about the provision of adult social care in Medway over the same period.

Discussion:

The Complaints Manager for Social Care introduced the report which set out details of complaints and compliments received in relation to adult social care (ASC) between 1 April 2024 and 31 March 2025.

Members then raised a number of questions and comments, which included:

·       Hard to reach – in response to a question about how the service was ensuring there were no barriers for those harder to reach groups, officers explained that every correspondence sent from ASC included a QR code asking for feedback. In addition, part of the rightsizing of ASC including the introduction of an engagement team to ensure the service hears the voices of all the communities and service users it serves, whether that is through complaints or general commentary. The were also working with Healthwatch Medway to assist with gathering information and feedback from vulnerable and harder to reach groups. Officers undertook to explore with the performance team the possibility of recording the number of potential gaps in feedback from harder to reach communities.

·       Compliment comparison data – in response to a request to have comparison data for compliments received year on year, the Customer Relations Manager explained that staff were becoming more proactive at recording compliments as there was as much to learn from compliments as there were complaints and therefore officers would look to provide more comparative data in relation to this within future reports.

·       Levels of complaints – in response to a comment that the complaints relating toDeprivation of Liberty (DoL) and Approved Mental Health Professional (AMHP) teams seemed lower than expected , the Assistant Director, ASC explained that these teams were often complimented by how well the staff advocate for users and ensured robustness of the process.

·       Rise in complaints – in response to a question about why there had been a rise in complaints, it was believed that this related to the rightsizing which enabled staff to be more aware to invite feedback.

·       Number of users – in response to a request for the number of services users to help give context to the figures, it was explained that ASC worked with approximately 3600 receiving care and support, plus another approximately 4000 receiving support.

·       Ethnicity – officers undertook to look at the recorded figures for this and check their accuracy.

·       Expectations of service users – in relation to how expectations of service users were captured, it was explained that for safeguarding it was captured as part of the assessment but not within other areas of ASC and this was something that Heads of Service and the Engagement Team would be working on to gather this information.

Decision:

The Committee noted the report

The report asks Members to consider the draft final report of the in-depth Air Quality, Public Transport and Active Travel Task Group. The Committee is asked to consider the findings and recommendations of the Task Group. This report is due to be considered at the Regeneration, Culture and Environment Overview and Scrutiny Committee meeting on 9 October 2025 and by Cabinet for approval on 18 November 2025.

Discussion:

The Chairman of the Task Group introduced the report which set out the findings and recommendations of the review into air quality, public transport and active travel.

Concern was raised about the rise in particulate matter pollution.  The Senior Public Health Manager confirmed that this was reducing in Medway and explained the emphasis Medway was putting on the importance of individuals to reduce their own personal exposure to air quality, particularly indoor air quality.

The Chairperson commented that there had been lessons learned from the review in relation to process, for example, the scope had been too broad and had impacted on the Task Group’s ability to effectively scrutinise the issues. The Principal Democratic Services Officer confirmed that since the review had begun, the Council had approved a Scrutiny Review Protocol as part of the Council’s constitution which also recommended review scopes to be narrow and deep. The Chairperson added that the review would have benefitted from a member of the Corporate Management Team being nominated to lead or sponsor the review.

Decision:

a)    The Committee approved the content and recommendations of the report that fell within the remit of the Committee and referred it for consideration by Cabinet on 18 November 2025.

b)    The Committee also recommended Cabinet to agree that for all future scrutiny reviews, a member of the Corporate Management Team
is identified to lead or sponsor the project.

The One Medway Council Plan (OMCP) 2024/28 sets out the Council’s priorities and the performance indicators used to monitor performance. This report and appendices summarise how we performed in Quarter 1 2025/26 on the delivery of these priorities. This report also presents the Quarter 1 2025/26 review of strategic risks.

This item was deferred to the following meeting due to it missing some of the data due to an administrative error.

Discussion:

The Principal Democratic Services Officer introduced the report which provided the Committee with information of its work programme. Reference was made to the next meeting which was already heavy, and a suggestion was made for the following items to also be potentially added:

·       The Gateway 3 Contract Award: Residential and Nursing Care Services (as pre-decision scrutiny)

·       Kent and Medway Mental Health Trust and its recent CQC inspection

·       South East Coast Ambulance NHS Trust and its response to the recent dispatches programme which had been broadcast earlier that week

It was therefore suggested that officers explore the options for an additional meeting or to relook at the work programme to see what could be moved.

Decision:

The Committee noted the report and agreed the work programme as set out at Appendix 1 to the report, subject to accepting the proposed changes outcome in italic text on Appendix 1, plus the additions mentioned and requested the Principal Democratic Services Officer to explore the option or an additional meeting in December.