The Scrutiny Panel will hear from the Cabinet Member and Officers outlining priorities and areas of challenge.
Cabinet Members and Officers will be asked to leave the meeting at this point.
Minutes:
Cllr Nesil Caliskan, Leader of the Council, gave details of the areas of focus for the coming year.
1. External parties – the NHS who were a major stakeholder.
2. Services – integrated care systems, the North Central London (NCL) Clinical Commissioning Group (CCG) and how to get the most out of the changes.
3. Primary care services – this was an ongoing issue, particularly GP provision and Chase Farm out of hours service.
4. Mental health transformation – young people.
5. Adult Social Care – reforms, cabinet report.
6. Public health – reducing obesity and its links to poverty, smoking, preventing bad health by increasing screening.
Doug Wilson, Head of Strategy & Service Development, added that Integrated Care Systems (ICS) were to promote partnerships, however there were concerns about a lack of focus on Enfield. He also mentioned the transformation work across mental health services and identifying new investment.
Vicky Main, Head of Integrated Learning Disabilities, stated that working groups had been established to look at the risks of the reforms. The most significant risk identified was around staff resources to implement the reforms. It’s estimated a 25% increase was required. It was difficult to attract qualified staff.
Dudu Sher-Arami, Director of Public Health, voiced concerns around drug treatment services as the current contract was ending in March 2023. She suggested the Scrutiny Panel look at this to help inform the commissioning process.
Bindi Nagra, Director of Health & Adult Social Care, felt there were three elements for the panel to focus on;
i. The legal responsibly to scrutinise the NHS and any changes
ii. The development of ICS and mental health services
iii. Challenges across primary care.
Alongside this, the following topics were mentioned:
i. Internal adult social care and public health, as well as the care cap and how the department plans to implement this.
ii. Care Quality Commission inspection of adult social care – the area had not been inspected for 15 years so lots of preparation was taking place and working with partners.
iii. Annual Safeguarding report – a standing item each year.
In response, the Chair congratulated the department for receiving an award and then the following comments and questions were received from panel members:
1. Cllr Anolue had concerns about dental care for children. It was thought there had been a previous report on children’s oral health, however this could be looked at more widely, for example around access to care.
2. The Leader stated that mental health was a risk for NCL as the care in Enfield was not as good as neighbouring boroughs, such as Camden. The provision must be good, not just expanded. The borough had an issue with adolescent mental health and services within the community required improvements.
3. Cllr Supple raised concerns about women’s health and family planning. Cllr Milne added cervical cancer to this.
4. Cllr Islam asked about mental health wellbeing centres in the borough. Officers advised there were services available and plans to develop a centre allowing walk-ins.
5. Following a discussion about smoking it was noted that this had reduced nationally and in Enfield, although there were increasing concerns about vaping. There were plans to increase areas designated as smoke free, however it was a culture change and could impact civil liberties. It was suggested to have focussed and targeted help, for example pregnant women and young people.
6. Cllr Hockney asked about health visitor appointments and officers confirmed these were now face-to-face and drop-in clinics were running. The Leader highlighted potential issues with access/opening hours.
7. Cllr Adeleke asked about a review of health inequalities. Officers advised that all their work focussed on this and that recommendations from the Epic report remained relevant.
8. A discussion took place around Covid and plans for the winter, rising cases and vaccines. It was noted this was a standing item on the Health & Wellbeing Board.
9. Cllr Islam questioned about council run care homes and officers confirmed there was only one in the borough, however Enfield commissioned approximately eighty and still had responsibilities around quality of care.
The Chair extended thanks to the Leader and Officers for the very detailed overview of the priorities and for answering questions.
The Leader and Officers left the meeting at this point.