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Health and Adult Social Care Scrutiny Panel - Thursday, 7th November, 2024 6.30 pm

November 7, 2024 View on council website  Watch video of meeting or read trancript
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Summary

The meeting discussed two topics; an update on mental health provision in the Borough from Oxleas NHS Foundation Trust, and a report on the Council's Integrated Commissioning of adult social care services.

Mental Health Update

The meeting received a presentation on mental health from the Director of Community Mental Health and Learning Disability Services at Oxleas NHS Foundation Trust. Demand for mental health services has increased substantially since the start of the Covid Pandemic, with an 80% increase in front door activity since 2019. The Trust attributed this to the pandemic, as well as the cost of living crisis and the war in Ukraine.

Oxleas has developed a 'hub' based approach to providing mental health care in Greenwich, with a Mental Health Hub located at Plumstead Health Centre. The hubs provide a range of services including assessments, talking therapies, social prescribing, and multidisciplinary team meetings, and include provision from the voluntary sector. In partnership with the Council, the Trust is also employing 12 Primary Care Network mental health practitioners to work at GP practices in the Borough. There was some discussion about the effectiveness of these roles, which are still new.

The Trust reported that they were seeing a large number of referrals to their ADAPT teams, which provide support for anxiety, depression, personality disorder and trauma. In order to manage this increased demand, the Trust has redesigned this pathway to provide a core treatment offer to patients, and to enable clinicians to move to more episodic care by having a clear end goal for each treatment spell.

Oxleas are working with the Council to improve the physical health of people with serious mental illness, as they have a much lower life expectancy than the general population. An Agile Physical Health Intervention Team (APHIT) is working within community mental health teams to identify patients who need support with their physical health.

Integrated Commissioning Update

The meeting considered a report on Integrated Commissioning of adult social care services. The Integrated Director of Commissioning at the Council described the work that her team is doing to commission new services for the borough. There was some criticism from Councillors that the report was high level and did not include many concrete examples of what the team had achieved.

Councillor Olubemi raised concerns about the proliferation of supported living accommodation in her ward, Thamesmead, and called for the Council to work more closely with the planning department to limit the number of planning applications for this type of housing in residential areas. The Director acknowledged the Councillor's concerns and stated that the Council is working more closely with housing colleagues to improve its processes. She also mentioned that there is a movement of people between boroughs for supported living placements, and the Council is working closely with other boroughs to manage this.

Councillor Morrow asked for a practical example of assistive technology, which is to be rolled out more widely across the borough from January 2025. The Director explained that the sorts of devices that are being used include sensors and devices that can check whether people might have fallen or wandered out of their homes. Other examples include watches to understand people's different vital signs, and tablets in the home so that people can do interactive speaking. The Director agreed to provide more information to the Panel after the new assistive technology service goes live in January.

A resident, Elizabeth Muncie, attended the meeting to ask questions about The Source, a community health centre on Septhorpe Road in Horn Park. The Source provides a range of services, including GP appointments, sexual health services, and wellbeing support. Ms Muncie explained that the centre has had its opening hours reduced and that there are issues with internet connectivity. She asked why the centre is not able to provide clinical service provision to people under 18, despite having a nurse practitioner who is qualified to do so. The Director said that she had been in touch with colleagues about the issues raised by Ms Muncie, and that some of the improvements she is seeking are already being put in place, including improved internet connectivity and an increase in the number of hours that the centre is open each week. Councillor Lolavar said that a report on neighbourhood health plans, including The Source, is due to be presented to the Panel in January 2025.

Councillor Olubemi asked about the impact of the increasing cost of living on the care workforce, and suggested that the Council should do more to recognise and appreciate the work that carers do. The Director agreed that recognition is important, and said that the Council is working with providers to develop care awards and other ways of recognising and appreciating the work of carers. She also said that the Council is trying to address the issue of low pay in the care sector by building requirements into contracts to pay the London Living Wage.

Attendees

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