To receive apologies from Elected Members and Co-optees unable to attend.

Apologies for absence were received from Councillor Blakemore.

To receive declarations of interest from members relating to items on the agenda.

Margaret Dangoor declared a personal interest in items on the agenda, by virtue of her role as carer to a user of LBRuT Adult Services.

To receive the minutes of the previous meeting and seek approval for signing by the Chairman.

The minutes of the previous meeting were declared as a correct record of events and the Chairman authorised to sign them.

To receive an update from the Director of Adult and Community

Services, the managing Director of NHS South West London Richmond

Branch and the Director of Public Health for Richmond on the latest

changes to local health services.

The Committee received a verbal update providing information on the relevant and important developments that had occurred in local health services since the last meeting.

In addition a written report had been received by members containing a summary of the Director of Public Health’s annual report and her response to requests from members to evaluate the need for children’s health services scrutiny.

These were taken as items a) and b) of item 4 on the agenda.

4a) In attendance to speak to the item were Cathy Kerr, Director of Adult and Community Services, LBRuT, Dagmar Zeuner, Director of Public Health.  During their respective updates it was reported that:

         I.            CCGs continued to make steady progress toward being fully established

       II.            The HWBB was currently drafting its strategy and preparing to move from shadow status to fully functioning Board.

      III.            Public Health and local NHS commissioning staff were moving to the civic centre offices as previously reported to the committee and it was hoped this would happen at the beginning of July.  [After the meeting it was confirmed that this move would now take place in the Autumn 2012.]

    IV.            Cathy Kerr and Dagmar Zeuner had both taken part in a scoring day exercise as part of the work being undertaken in the Better Services Better Value Review to reshape acute hospital services in South West London

      V.            Dominic Wright, Managing Director of Richmond PCT had been named as the accountable officer for Richmond CCG . This position was designate while the CCG operated in shadow form until 31 March 2013.

Following questions raised and comments made the committee heard the following further information from Officers:

That the planned 24 hour strike of doctors was unlikely to cause disruption to services in Richmond as 80% of doctors would continue to work and the other 20% would still perform emergency duties.  It was agreed that information on any possible disruptions would be sent to councillors on the committee in order that they could inform residents.

4b) The Director of Public Health summarised her annual report.and explained how it complemented the JSNA. 

Regarding children’s health issues, four potential areas were highlighted: troubled families, children with special educational needs, the transition from Children’s to Adult’s services and immunisations.

There was discussion about the validity of some mental health figures from an externally commissioned report (Beacon report) that had been quoted in a recent JSNA newsletter. Officers were aware and these would be corrected and updated during work over the summer on mental health JSNA. It would, as far as possible, inform the mental health consultation, but it was not possible to hold back the mental health consultation until the JSNA was fully complete.

It was RESOLVED that the information received be NOTED.

To receive a report of the Director of Adult and Community Services providing an update on the implementation of changes to Adult Social Care that were agreed by the Cabinet on 24 January 2011 and were implemented during the 2011/12 financial year. 

Cathy Kerr, The Director of Adult and Community Services, introduced the report to the committee, the purpose of which was to provide an update on the implementation of changes to local social care services agreed in 2011. Bonnie Green, Chair of Richmond LINk was invited to answer questions on the report and comment on the survey carried out jointly with the Council.

Major changes implemented included: changes to Council run day care services for older people; changes to eligibility criteria for Adult Social Care Services and changes to the Contributions Policy so that disability benefits were taken into account in the financial assessment and the removal of the cap on contributions.

The removal of the cap had meant that 5 people now met the full cost of their care above the previous capped level and 19 people continue to pay a capped contribution of £350 under the arrangements for existing service users.

Feedback had been received, following a survey conducted in conjunction with Richmond LINk and local voluntary sector organisations, regarding the changes in contributions policy. The main impacts identified through the survey were a reduced ability to take part in social events and concerns had been raised about this leading to social isolation.

Bonnie Green reported concerns particularly about the high numbers of carers responding that they had a reduced level of social interaction owing to the changes and hoped that this would be addressed.

Cathy Kerr thanked Richmond LINk for their help with the matter and reported that the partnership work had been successful and appreciated.

The day centres that had stayed open and been subject to improvements had a high satisfaction rating and most people had transferred.  Travel times had improved as hoped.

It was harder to assess the impact of the changed eligibility criteria as it was only applied to new users. A range of universal services were offered outside of the eligibility criteria and these were provided to 300 people with Moderate needs in 2011/12.

Following a question to officers it was agreed that information would be circulated to Committee Members on work taking place with telecare.

The Cabinet Member for Adult Services, Health and Housing approached the table and reported that she was pleased that the Council was working with Richmond LINk and voluntary sector partners to understand the impact of the changes implemented. Whilst these changes may not have been undertaken in better economic circumstances, they were necessary to protect services for the most vulnerable and were being implemented with the aim of having the least possible impact and even improved services in places.  Most importantly the most vulnerable had been protected. 

The committee recognised the need to make efficiencies, but was divided in accepting the extent to which these efficiencies should come from Adult Social Care Services.

It was agreed that the report be noted.

To receive a report of the Head of Joint Commissioning – Mental Health and Substance Misuse which provides a brief update on Mental Health commissioning highlighting key achievements and priorities and forthcoming public consultation on proposed changes to commissioning plans for Adult Rehabilitation services. 

The Committee received a report of the Director of Adult and Community Services the purpose of which was to provide an update on mental health commissioning.

The Committee received a representation from Kathy Sheldon, representing Friends of Barnes Hospital.  She questioned the legitimacy of the Beacon report and defended the work being carried out at the Riverside ward which she argued combined hospital care with community care.

The Director of Adult Services and Aarti Joshi, Head of Joint Mental Health and Substance Misuse Commissioning, spoke to the report and outlined the key points within it.

Following comments made and questions raised the committee heard the following further information from officers:

         I.            That some of the changes had incurred double running costs whilst new services were created.  It was agreed that a briefing note be produced on these costs.

       II.            That the memory clinic leaflets had been widely distributed, including to Doctors surgeries in the area.

      III.            That the picture being built of mental health services in the borough would be informed by the JSNA but would also involve consultation with those in the community such as GPs.

    IV.            Any change for current residents of Riversdale Lodge would be carefully planned on an individual basis to ensure that their needs continued to be met.

      V.            That the CCG was currently considering whether it will support SWL & St Georges NHT application for Foundation Trust Status.

Aarti Joshi continued to address the committee; she reported that the Mental Health consultation would take place shortly.  An independent company had been commissioned to collate the information.

Following comments and questions from the committee, Aarti Joshi further explained that:

         I.            Housing Suppliers had been approached to discuss the possibility of housing those people displaced from Mental Health wards such as Riverside.  Continuity would be sought for all of those affected and each case would be reviewed independently.

       II.            That at 65 the adult service provision ends and people with Mental Health issues are treated under different services and strategies, although continuity of care was paramount for people already using services as they turned 65.

      III.            That should Riverside close it would be decommissioned and the owners – the Mental Health Trust – would decide how to best use or dispose of the land.

    IV.            That the Joint Commissioning Strategy which contained the overall vision was available online.

On a separate matter, officers confirmed that the CCG had written a letter of support for Hounslow & Richmond Community Healthcare NHS Trust’s (HRCH) application for Foundation Trust Status, but would keep a close watching brief.

The following information was promised to the committee:

-          The report that Barnes Hospital Working Group had written and distributed would be resent.

-          A list of Mental Health ward names and the services they provide would be sent to Members.

To receive a report of the Director of Adult and Community Services setting out the procurement activity identified from the three year procurement plans which Overview and Scrutiny Committees have agreed to consider as part of their future work plans

The Committee received a report of the Director of Adult and Community Services setting out the procurement activity identified from three year plans and those particularly relevant to the HHASO&S Committee in order that the Committee consider its future work plan.

It was RESOLVED:

1. That the procurement programme and appropriate means of scrutiny for each be NOTED.

2. That the overall programme be NOTED

3. That the specific items for the HHASO&S Committee’s consideration be agreed.

To receive a report of the Director of Adult and Community Services summarising the provisional outturn position for the Adult and Community Services (ACS) Directorate.  In addition it reviews the implications for the service and the Council’s Medium Term Financial Strategy (MTFS). 

The Committee received a report of the Director of Adult and Community Services, the purpose of which was to summarise for consideration the provisional revenue and capital outturn for the Adult and Community Services Directorate. Overall the Directorate underspent by 2m, including an under spend of £0.8m on Adult Social Care, an under spend of £0.3m on Housing and under spend of £0.2m on corporate support services and £0.7m on voluntary sector grants of which £0.6m would be carried forward to 2012/13.

It was reported, following a question on the matter, that monies from the NHS for Adult Social Care were not ring- fenced for health services, therefore services provided with that funding were subject to the Council’s usual charging policies.

It was agreed that the report be noted.

To receive a report of the Director of Adult and Community Services providing an update on performance in relation to projects and indicators for Adult Social Care and Housing for the period January to March 2012.  It also provides a brief update on the local impact of national housing changes and information about the first Local Account published for Adult Social Care in Richmond.

The Committee received a nil report on performance from the Director of Adult and Community Services, there being no performance indicators that met the criteria for reporting.

The report did however detail the numbers in temporary accommodation as requested at a previous committee and this had increased by 13 households since the previous quarter.  This was likely to continue and the recent availability of new build housing in Richmond had so far disguised the rising trend.

It was resolved that the report be NOTED.

To receive a report of the head of Democratic Services providing an update on the ‘Shaping a Healthier Future’ review of Healthcare currently taking place in North West London and the Joint Health Overview and Scrutiny Committee established to scrutinise it.

An update was provided on the North West London Joint Health Overview and Scrutiny Committee which was in the process of being established.

It was RESOLVED:

1. That Councillor Jones be appointed to the North West London Joint Health Overview and Scrutiny Committee as a voting member.

2. That Maureen Chatterley be appointed to the North West London Joint Health Overview and Scrutiny Committee as a non voting member.

To receive a report of the Head of Democratic Services giving details of the proposed work programme for the Health, Housing and Adult Services Overview and Scrutiny Committee.

The Committee received a report of the Head of Democratic Services detailing the workplan for the remainder of the municipal year.

It was RESOLVED that the report be NOTED.