Agenda and minutes

Health & Adult Social Care Scrutiny Panel - Wednesday, 20th September, 2023 7.00 pm

Venue: Conference Room, Civic Centre, Silver Street, Enfield, EN1 3XA. View directions

Contact: Email: 

No. Item




Cllr James Hockney, Chair, welcomed all attendees.


Apologies for absence were received from Cllr Doris Jiagge and Cllr Elif Erbil.


Apologies for absence had also been received from Dudu Sher-Arami, Director of Public Health, Deborah McBeal, Director of Integration, NHS North Central London ICB and Dr Riyad Karim, Assistant Director of Primary Care, Enfield.



Members of the Council are invited to identify any disclosable pecuniary, other pecuniary or non-pecuniary interests relevant to the items on the agenda.


There were no declarations of interest registered in respect of any items on the agenda.



To approve the minutes of the meeting held on 8 March 2023.


The minutes of the previous meeting held on 8 March 2023 were AGREED.



To receive the report of Tony Theodoulou, Executive Director – People.

Additional documents:


Cllr Alev Cazimoglu, Cabinet Member for Health and Social Care, introduced the report of the Executive Director – People, in respect of the draft 5-year Safeguarding Adults Strategy for consultation. The priority areas and key projects were highlighted.


Elspeth Smith, Team Manager – Safeguarding Adults, confirmed that publishing a strategic plan was one of the duties of the Safeguarding Adults Board (SAB). Learning from previous reviews, and trends in safeguarding data were included.


Questions were invited from Members.


In response to queries around self-neglect, it was advised that this had been counted as a form of adult abuse since 2014, and that awareness had risen during the Covid-19 pandemic. High numbers of over-65 year olds lived alone and self-neglect could reach an advanced stage as no-one was aware and able to intervene. Visits from loved ones had been prevented during lockdown and this had exacerbated the problem. Hospitalisations during the pandemic also provided evidence of people not having contact with professionals, living alone and self-neglecting. The numbers of adult safeguarding concerns raised went up in 2021 and had not gone down subsequently. Hoarding was also advised to be particularly difficult to tackle. The Council had established a hoarding database. They also worked alongside London Fire Brigade. There would be recommendations on voluntary sector contracts to help with response. Trusted people and voluntary and community service (VCS) colleagues were key to better approaches to delivering assistance and communication. Longevity and continuity of the relationship was also important. Officers also commented on solutions when adults rejected intervention in their best interests.


In response to questions about support for older people for whom English was not their first language, it was confirmed that the consultation exercise would be inclusive. There had also been learning from the pandemic that people responded better to trusted voices in their communities, and these should be tapped into during this process to that those who may miss out had the opportunity to have their say. Links had been developed to all ethnic communities and there were plans to reach as many people as possible. Other communication issues in respect of literacy were discussed, and that there was liaison with colleagues in the learning disability service in respect of documentation. ‘Silo’ working was reduced during the Covid-19 pandemic. Partnership working was the way forward. A multi-disciplinary high risk advisory panel was being convened.


The Chair thanked the officers for the report and their attendance at the Panel.


The Panel AGREED:

I.  To note the consultation and promote across the Council.

II.  That updates on progress on the 2023-28 Strategy for the Enfield Safeguarding Adults Board be received by the Panel in due course.



To receive the Annual report of the Safeguarding Adults Board.

Additional documents:


Cllr Alev Cazimoglu, Cabinet Member for Health and Social Care, introduced the report of the Executive Director – People, in respect of the Safeguarding Adults Board Annual Report for noting by the Panel. The report highlighted the work undertaken to protect adults at risk in 2022-23 and achievements throughout the year. She wished to record thanks to all professionals working to safeguard adults at risk in Enfield.


Bharat Ayer, Head of Safeguarding Partnerships, highlighted the broadly positive external review by RedQuadrant, and the focus on partnership working. Recent work by the infection control team was also brought to the Panel’s attention.


Questions were invited from Members.


In response to queries around assistive technology, feedback was provided regarding the trial of PainCheck, and the preventative value of SMART devices to support people.


In response to questions about the Learning Disability Learning from Lives and Deaths Programme (LeDeR) reviews, it was confirmed that notification was of deaths of all ages and regardless of circumstances and the requirement for review was brought in some years ago.


Further details were provided to Members of the support and training to care homes in respect of infection control, not just for Covid-19, and ensuring that care home residents were the priority. Further details were also given in respect of actions in extreme temperatures during summer and winter and pre-preparation.


In respect of the table of types of abuse reported, set out on page 59 of the agenda pack, it was confirmed that they showed what was reported, but there was probably under-reporting. Work needed to continue to raise awareness of how to disclose abuse, and that something can be done.


Learning from cases such as Mr K and those declining support was discussed, including the importance of professional curiosity and appropriate challenge, and assessment of mental capacity.


In response to Members’ queries, it was confirmed that the Partner Updates in Appendix A of the Annual Report were expected and were produced by each partner. The Independent Chair of SAB would oversee if any action was needed on a strategic basis. In respect of the update from the National Probation Service, it was advised that people coming out of prison homeless would be provided with more than a rucksack containing a sleeping bag, and that more details could be obtained from the Service: the Panel requested a letter be sent to clarify those details.

ACTION:  Elspeth Smith


In response to Members’ queries regarding Deprivation of Liberty Safeguards (DoLS), further detail was provided on applications and authorisation and due diligence through the process.


The Chair thanked the officers and recorded congratulations on the team’s nomination for the 2023 Local Government Chronicle Awards in recognition of modern slavery work.


The Panel AGREED:

I.  To note the Annual Report. Noting the report at Cabinet, Scrutiny and Council enables Enfield Council to demonstrate its commitment to safeguarding adults at risk throughout the organisation. The report is a partnership document and as such is agreed  ...  view the full minutes text for item 5.



To receive the report of Dudu Sher-Arami, Director of Public Health.


Glenn Stewart, Consultant in Public Health, introduced the report of the Executive Director – People / Director of Public Health, in respect of the uptake of maternity and childhood immunisations in Enfield and partnership work with the local authority and NHS being undertaken to improve the uptake.


The target uptake for immunisations worldwide was 95%. There was a lower uptake of maternity and childhood immunisations across the UK and especially in London, including Enfield. There were numerous reasons behind the lower vaccination uptake in Enfield, not all of them fully understood. A lot of work was being undertaken to raise the uptake and to rectify the high variation in uptake across Enfield. Future activity would include special focus on increasing uptake of MMR, and winter planning including for flu.


Questions were invited from Members.


In response to queries around engagement and linking with the voluntary and community sector in Enfield, it was confirmed that engagement was done at community events all the time. There had been work with schools and with faith centres, and the process was continuous. Dr Chowdhury advised that Angel Surgery had Turkish and Polish speakers, and employed a staff member just to call parents about childhood immunisations. In conjunction with North Middlesex University Hospital, ten schools had been identified for prioritisation and proactive offers for MMR alongside flu vaccinations. Work was being done involving midwives at University College London Hospital, who played a primary role in respect of messaging and immunisation support.


In response to questions about the HPV vaccinations, it was confirmed the in-school offer was now eligible for boys and girls and that from the autumn this would require one dose rather than two. For those girls who missed out on vaccination at age 12 / 13 there would be a catch up project in the new year and this vaccination was available from the NHS up to the age of 25.


Post Meeting Note:  All information is detailed on the NHS website – see link below.


The good vaccination uptake during the Covid-19 pandemic was referenced, with the concerted effort and national messaging and support, and the effect of the immediate threat felt by people. NHS colleagues considered that a national effort was needed again now. They were experiencing more vaccine hesitancy and circulation of misinformation. In preparedness for the winter and anticipation of a potential measles outbreak, increased capacity for delivery of vaccinations was being planned.


Further details were provided to Members in respect of the low vaccination uptake by Gypsy / Irish Traveller ethnicity. It was difficult to put together accurate data for this group who often did not register with GPs, but an anti-vax sentiment was noted during the Covid-19 pandemic. There was some settled community in Enfield, but interaction was limited.


The Chair thanked everyone for the information, and the forthcoming communications should also be shown on the Council’s social media.


The Panel AGREED to support the following actions:


· Write to central government to request that increased access  ...  view the full minutes text for item 6.


WORK PROGRAMME 2023/24 pdf icon PDF 85 KB

To note the Health and Adult Social Care Work Programme for 2023/24 will be discussed at the first meeting of the new municipal year.


NOTED the Health and Adult Social Care Scrutiny Panel Work Programme for 2023/24.


The Integrated Care Systems topic would be submitted to Overview and Scrutiny Committee, and it would come off the Health and Adult Social Care Scrutiny Panel work programme, in order to avoid duplication.


The topics of CQC Inspections Update and the Borough Partnership Plan for consideration at the 28 November 2023 meeting were separate topics.

   ACTION: Governance



To note the dates of future meetings as follows:


Tuesday 28 November 2023

Wednesday 28 February 2024

And 1 additional date to be confirmed.


All meetings will commence at 7:00pm and will be held in the Conference Room at the Civic Centre.


NOTED that the next meeting of the Health and Adult Social Care Scrutiny Panel would be on Tuesday 28 November 2023 at 7:00pm in the Conference Room, Civic Centre.