Transcript

Transcript

Transcript

Good evening, everybody. We are now going to start the meeting, if that's all right. Thank you all for attending this meeting of the Adults Health and Ovary and Scrutiny Subcommittee. I'm Councillor Caroline Stock, Vice Chairman of the Adults and Health Ovary and Scrutiny Subcommittee, and I'm chairing in the absence of Councillor Philip Cohen. I'm just going to mention this is actually a themed meeting where we're going to have a deep dive into the work of the Barnet Public Health Department, which is going to provide an update on the year's work and the current progress on the renewal of the Joint Health and Wellbeing Scrutiny. Is that correct? Strategy. Please note that meetings may be recorded and broadcast by people present, as allowed for in law or by the Council. By attending, either in person or online, you may be picked up on the recordings. Council recordings are covered by our privacy notice, which can be found at www.barnet.gov.uk and might be retained and made available online. Can I remind members and officers, please, to use the microphones and go forward so people can hear you? Last night, Councillor Barnes and I were at a meeting and actually it was sometimes very difficult to hear, so I shall try and follow my own advice about that. So item agenda item number one minutes of the last meeting, pages five to 14. Can I ask is there are there any comments? And for me, when I was looking to there were quite a few actions for Dr Walters in the report, and I just want to know how these actually being sent off, because I think they were actually meant to be sent to the committee. They've now been published on the website. Lovely. Thank you very much. Therefore, can I ask please the committee for approval and actions, please, to be noted? Is that all right? Thank you very much indeed. Item number two, absence of member Councillor Perbo, Councillor Cohen and Councillor Chabrobati aren't here, but they're being placed by Councillor Leon Woodcock Velleman, who is substituting for Councillor Pearlberg. Welcome, and Councillor Andrea Bell Bower, who will substitute for Councillor Chakraborty. Welcome. Thank you very much indeed. And there are there any declarations of members pecuniary interest? The microphone's on, please. Yeah, sorry that I have a husband who has dementia and is receiving services in a care home. But you know, and also in my work, my day job, I work with adults and children who have ADHD. Fine, I think that's worth I think that if you could please if the Government's office can note that. Anybody else? Yes. I'm not sure whether it's relevant or not, but I just wanted to flag up that I've been appointed the chair of the Age Friendly Alliance Group. Thank you very much indeed. Dispensations by the Monastery Officer, they're not. I'm so sorry. I work as a community link worker at Barnet Mencap, and I also have had contact with the complaints department in adult social care. And also, I'm volunteer council at Barnet bereavement service. And I also volunteer at the Barnet Mencap Autism Hub. Thank you very much indeed. Moving on then to number four. Good. Dispensations by the monitoring officer. There are none. Number five, public comments and questions. Now, there has actually been one from Ben Samuel, which has been published on the agenda page. He will not be attending tonight, but I will read a short response. And I'm reading it because apparently I have to just want to say that. Data suggests an increase of fifteen thousand four hundred economically inactive residents since the period from June 2018 to July 2019, when the figure was actually fifty nine thousand. According to the ONS, which actually stands for the Office of National Statistics, eleven thousand nine hundred residents were economically inactive due to long term illness compared to eight thousand between June 2018 and July 2019. This represents an increase of three thousand nine hundred over the past five years. The period that includes the pandemic 19 period. However, the available data data does not tell how much of this increase can be attributed to long COVID or other causes. The figures regarding the increase in economic activity should not be taken at face value and should be interpreted with extra caution due to the low response of the ONS labor force for survey and the greater margin for error. Hepa filters and germicidal UV devices are effective at reducing airborne particles, but their impact on infection rates in real world settings such as schools and care homes remains uncertain, although the evidence base is not yet robust. It is steadily growing. Thank you very much indeed. Item number six is members items. None. Thank you very much. Now, the next item is an update from cabinet members. This item actually was not published on the agenda, but I am very happy that Councillor Paul Edwards and Councillor Asmore do come to the table to give us a brief update. So I don't know if you both want to come up together. I think I think probably three minutes is going to be. Is that adequate for you both? Three minutes. Yeah, I'll ask. Yeah, Councillor Moore's going to go first and you've got three minutes, please, to give us an update. Thank you. OK, I shall keep mine brief because obviously you've got a really substantive item about areas I have covered before. So I talked at the last meeting about the relevance and role of the joint health and well-being strategy and the process of engagement and the previous meeting around the joint strategic meeting analysis, both of which John Dejomba will touch on in her discussion. So I'll leave further details on this occasion to her as part of her report. However, I just wanted to say, other than to remind members that it's a statutory document, it's a shared commitment with partners on the health and well-being board that works to improve the health and well-being of residents in the borough and across the life course, and ideally in ways that reduce health inequalities and consider the impact of wider determinants of health. And as I said previously, it's heavily involved by the joint strategic needs analysis. I just want to say that I've just spent two days at an LGA course leading healthy places and meeting with the chairs of health and well-being boards from across the country. And I think that enables Barnet to draw on the experience from a range of authorities and sector specialists, which I hope will inform the development and delivery of our new strategy as we go forward. So it's been an energising and a timely opportunity to go and to do that. And it is such an important and pivotal piece of work that we do collectively within public health and the local health economy. On other fronts, we continue to develop the work of the Combating Drugs Partnership Board, which doesn't meet in public but reports into both the health and well-being board and also the Safer Communities Partnership Board. We are currently focusing on fewer strategic meetings with the whole board and putting more activity through delivery through the three work stream groups, which are aligned around tackling the supply of drugs, working to develop world-class treatment and education functions. And so we'll be reporting back on that at future meetings of the health and well-being board. But I just wanted to bring that to your attention, because it is one of our statutory and funded areas to look at. And it has become – it's developed into quite a vibrant partnership. And I think it really does show that getting the right partners right around the table and defining where you need to be can be very productive. And it has developing all sorts of impacts as we go forward. Like a number of people around the table, I attended the food summit recently, and that was in the context, in my case, of the food plan, which obviously is one of our key pieces of work, and the partnership working around food and health. And I've got a particular interest in the health aspect of food. I'm happy to answer any questions on that. I just wanted to then finally to draw members' attention to two things that you'll have received. The first is the email from Francis O'Callaghan, the chief exec of the North Central London ICB. And that's around your local health team promotion that will be going on as part of the winter preparedness work that they're doing in the NHS. And it's very much formed around getting the right health care in the right place. So if you haven't already had a look at that email, it's worth doing so and helping to promote. And it's very much around getting the care you need, getting vaccinated, staying healthy, and meeting the team. And the emphasis is very much around those areas that individuals can go to, whether it be pharmacies or other health professionals as part of that. That's over four minutes. Yeah, absolutely. And then one final ask to draw your attention to one final element. You may well have picked up on the oil company bulletin that there will be zero suicide lunch and learn on the 27th of November between 12.30 and 1.30. If you've not logged on to that in recent years, it really is worth doing. The zero suicide alliance training forms part of that. I thought it was really valuable the first time I did it. I think it's really important that all of us have that opportunity. It's intended obviously for staff, but actually members are very welcome, and it's a really important part of that. Thank you very much. And for our two members of the committee, if you don't have those links, I'm sure we can make sure that you do. Thank you. Are there any questions? Thank you. Thank you very much indeed. If I can ask Councillor Edwards, please, if you could speak for three minutes. Sorry, I just rushed back from Birmingham after a funeral of a friend, so I'm just a bit hot under the colours. Would you prefer to speak after, are you sure? No, I'm fine. Really, what I wanted to do was to start off by saying a huge big thank you to the people who work for us in adult social care, particularly given that it was in August, I think, wasn't it Darren? The CQC came in to inspect adult social care. We're still awaiting the outcome of that inspection. However, I'm reasonably confident, and I'll probably get shot down later, but I'm reasonably confident that we'll be doing okay in relation to the outcome. Unfortunately, it's just a one word outcome and doesn't really go into too much detail about the good quality work that is going on in our adult social care departments. And I do visit the staff quite frequently, and I just get a feel and a vibe for the enthusiasm that our staff have for helping and supporting the people at Barnet. Having said all that, adult social care remains a huge challenge for the council in terms of the demand for the service versus the amount of resources we have to meet that demand. And I suppose I could say that we're not the only one. I mean, most local authorities, particularly in London, are facing the same challenges. And in Barnet, we have our particular challenges and that's to do with really the demographic of Barnet. And there are two key areas which are huge pressures for adult social care in Barnet. Obviously, we have a growing older population and that's something to be celebrated as one of them is in that group of people. But what we do know is that in the last 20 years of a person's life, that's when they're more likely to be ill and in need of support and care and adult social care plays a key role in that. And this administration is really keen to keep people in their own homes in their local communities where they can find the support that they're used to having. And what we do know is that's far more expensive than putting people into a residential home. And in fact, we see the decline in the number of people going into residential care. That's the cheapest form of care, if I'm blunt, but that's not the best for most people. It's not the best option for most people. And so, there's been something like over 14% increase in the numbers of people in Barnet receiving support from adult social care since 2020. And that's quite a significant amount of people in those years. And Africa is starting to grow and will continue to grow. And what that means in cash terms is that we're spending somewhere in the region, all they spend is increased by £1 million a week on adult social care as a result of that trend over the last few years. And so, I'm sure this is going to get, we might get asked the question, but as you know, in the budget, there was a £600 million allocation for social care. However, we don't know what that means in terms of how we're going to be able to spend that on what the focus should be, but we do know that it's divided between adults and children. So that's 600 million, and whatever that is divided by the number of local authorities that have a statutory duty of adult social care, we're still waiting to find out what the details of that are and what are the consequences are for us. But bear in mind that it is going to be divided between adults and children. So they're the key things really. I mean, it's a tough... I've done my minutes, have I? Alright, I'll shut up then. Suitably scolded. I was more or less finished with it, Caroline. It's a tough gig as they say, but it's a rewarding one, and I'm finished by you as I started. I don't think we could do this without our staff and the leadership of Dawn and her other colleagues in the senior management team. So thank you very much. Are there any questions? Yes, Emma. It's more of a comment, really. I think I will echo what you said about your staff, but I also want to echo about... I know last time you were here, you mentioned about the voluntary sector as well, and how important that is, and I think looking at the fact that we're looking at funding is needed and it's going up, and people are getting older, but I know that we can talk about this in public health, but I'm wondering if putting more funding into public health and things like that and preventative things would be beneficial as well, but it's also just to recognise the amount that the staff have done and things, so I just wanted to note that. Thank you very much. Yeah, and thank you for reminding me. I forgot the voluntary sector, and I do apologise for that. It's a huge... We have a huge voluntary sector in Bali, and I don't want to single out anyone because I don't want to... I'm sure I'll forget others, and I think it's a fact that without them, we wouldn't be able to provide the kind of support that we are not necessarily having a statutory duty for, but nevertheless, it prevents them coming into contact with the statutory services, and so thank you for reminding me. I did say that before, and I'll echo it again, but obviously, funding them is a complicated one. It's not just adult social care, but it's public health money and other forms of money that comes from the council, so in the round, we'll have to see how that goes in relation to how the finances look, but I fundamentally agree with you. This voluntary sector is brilliant and I'll keep on it. Thank you both very much indeed. Councillor Sargent. Yes, thank you very much, and I see... I was just talking about some grounds for optimism in this, and obviously, one of them is the staff that we have, and it would be interesting to see the results of the CQC reports as well, and I just wanted to add, of course, we are trying to do things with Age-Friendly Barnet, which hopefully, in the long term, might come up with some pointers that can help with some of the really tricky issues. We're only 18 months into it, but I just wondered if you had any other pointers for optimism that you saw? I'm always optimistic, Councillor Sargent, but also with a touch of realism. It's really important to be optimistic, despite some of the challenges and the difficulties that we're facing. Otherwise, what else did you do? And I think the work we've done with the voluntary sector, and you've been involved in that, I know, around the Age-Friendly Barnet has been particularly creative and productive, and of course, it looks at Age-Friendly beyond just adult social care. So public transport, for example, has come up, I know, in other areas of people's lives that there are things that need to be said, and so I'm optimistic in the sense that we have an experience in Barnet of our citizens who engage and are prepared to engage not only in the debates and the dialogue, but also as volunteers in supporting their neighbours and their families to live a good quality and decent, dignified life. So I'm optimistic about the people who live here. I was not going to say I'm optimistic about the funding, but I'm certainly optimistic about our people here. Thank you very much indeed. Are there any other questions? Can you be short, though? Can there actually be a question, Emma? Yes, is that all right? Thank both of you very, very much indeed for coming. I do appreciate the particulars. You've had such a long journey today, Councillor Edwards. Thank you very much for both of you coming. Pleasure. I'm now going to go to item number seven, which is minutes of the JOSC. Now, there are none because the actual meeting couldn't be ratified, but they therefore will come to the following meeting but are available in draft format on the Harringay, the London Borough of Harringay's website. Are there any questions? Item number eight, the discharge to access Task and Finish Group. Task and Finish Group. Now, this was published as a late supplement, but very kindly, Councillor Sargent has agreed to give us a brief update on the discharge, please, if you could. How long do I have? It's very difficult to time you, but it would be really good to do that. So maybe five minutes at the most. Would that be possible? And then questions as well, please. Right. Well, first of all, I'm sorry that Councillor Cohen isn't here because of ill health because I know he would have liked to have been here because he's put a lot of work into this and I want to thank him for chairing it and for all the work he's done in this and please do. So maybe we'll note that if that's all right. We'll note that. We'll get the governance office to note that. And I'd also like to thank the other members of the Task and Finish Group and also the people we interviewed who really - can people hear me, by the way?

• Do you want me to start again? - No, I'm a bit lost on the screen. Right. Can you hear me now? Good. I do think it's important you can hear, because it's a fairly basic thing. Right. Okay. So you heard my thanks. Yes. And also to Tracey for all the work she's done on this, because it has had a number of iterations, this report, so thank you for that. It was a very important report, because as anybody who reads the paper, discharge has been a really, really serious issue. So we did feel we were being charged with something important. We have no magic bullets, no magic bullets, but Councillor Cohen has actually picked out three of our recommendations as examples of the issues raised, and I'd like to just reiterate this. This was firstly the importance of the involvement of carers and family members. I don't know if people are looking at this, it's in the Chair's introduction. So it's paragraph 4, the Chair's introduction. Is everybody on the page? Good. I would pick out three of our recommendations. The involvement of carers and family members, the lack of transport to take people home, and the need for better interagency collaboration. And the other point, which I thought was really important, it was difficult to find good quantitative data on how well the discharge process is communicated to informal carers. And we came up with several recommendations. The first one is to review the provision and support targeted to informal carers. The second one is to report on the CRCH and Marbury Hospital, to report on plans to improve transport from hospital. The third recommendation is to provide a report to the committee to summarise the data. The fourth is to improve the provision on on-site office space for social work. And I think that's a very important one, because we found social workers didn't have space in the hospitals. So if we're talking about communication and you can't find where anybody is, it seems a fairly crucial one. The fifth is to oversee the implementation of tools to improve sharing of case updates between health and social care. And the sixth is to ensure the better fund process continues to look at whether there is value for money in the system. And I'd like to give a little update as well, if people wouldn't mind very quickly. So this afternoon, I didn't say actually, I have an interest to declare, because my stepmother's in the care home. And I was talking to the person who's involved in receiving discharge patients. And I was also talking to somebody from the Royal Free, who deals with the volunteers. And this real mismatch between information sharing is the most important. The care home says you have no idea who she's speaking to, quite often, in the discharge team. And the volunteer person said, even basic things, volunteers are not allowed to transport patients out of hospital, because of insurance purposes. So we really have to think of some way in which we can improve this, because it's not working. People are working extremely hard, and I think they're going around. And one of the counsellors said, her mother was in hospital and she saw somebody discharged from her bed, sitting all day to wait the transport. And I think we have to think creatively about how we can provide the transport, because the ambulance service, however much we pour into it, is not able to deal with this. The final point I want to make is that I do think we need to look at the stats in terms of ages of people. There was an Age UK report added to this that concentrated on the ages of people, and the number of people being discharged who are 90 and 100 is quite concerning. And I think those need to be flagged up as well. I can see our chair being very good, and saying I've spoken for my five minutes. But as you can see, it was a very interesting task and finish group. I don't think we've solved the problem, but we've raised a few questions. Thank you. Do you feel that everything has been said, though? Are you happy with that it's all been covered? I mean, I did read it was a very good report. But I do think we need to, there's a lot of further work to be done. What I would also like to say is I'd like to get this reported back to this committee. When can we do that? Roughly? Because I think it would be very useful. We can request a response in six months time. But when the report goes to cabinet, we can request an initial response within 28 days, and then follow up within six months. Because it is such a serious issue. I mean, I think even this morning, there was something on the radio about how surgeons aren't able to do their work because people aren't arriving in hospital. Can I ask are there any questions? Councillor Wakeley. I'm going to be bad. It's not really a question, but I just wanted to say it's a really good report. And it's a really important issue. And you've made some great recommendations. So sorry, not a question. But I would really endorse that. Councillor Sargent, it is a very, very good report. And it's a very important topic. And I mean, we can certainly, when it goes to cabinet, we can make sure that within 28 days, that there is actually a response. And then if you want, we can actually put it on to the forward plan. We actually look at it in a more, if things happen being done, absolutely. You know, it's a huge, it's really well, that's a really good point about task and finish groups. If you do the work, but we actually follow up on them and see where we've got to. So thank you very much indeed. Well, I have to say she's one in a million. What can we say? She is, honestly, from doing the task and finish with her. It's she's, well, we know that because we worked on the other one together. And Councillor Cornelius. Yes. Just commenting that Councillor Edwards was talking about being an optimist. Are you optimistic that any of the recommendations that you have made? Yes. And is it the NHS who are going to implement them? Yes. They are. Yes. You're convinced of that? Yes. Okay. Well, I wish you luck. Thank you very much indeed. We're going to bring it back to a yes, it has been done. I shall look forward to you telling us that yes, things have been done and in a timely manner. Ah, timely manner, I think is very important here. Okay, by coming into winter, and I happen to know last year, somebody that Councillor Barnes and I know who's the chairman of a care home that we're both involved in, was discharged in his gown with nothing on his feet in subzero temperatures to go home without his watch or his personal belongings at all. There was a complaint lodged to the hospital involved. But you know, I think we we need to hold the NHS accountable and it would be good if you could get some results. Thank you. The gentleman who was waiting for a day in the hospital waiting to be discharged. Yes. So maybe you might want to put in the case study. Thank you very, very much indeed. And we're now going to move on to item number nine, which is the public health grant report, which hopefully you've all read on page 15 to 62. We're going to hand over to Dr Janet Jombra, who is the director of public health, who will now present this item. Thank you very much. Thank you very much for the opportunity to introduce the Bannet Public Health Department and share some of the highlights of our work, but also some of the challenges we are facing recently. This slide, this is just a summary, a formal summary of what the responsibilities of public health departments are and what my function is in the council. What it means practically is that we use local evidence as well as the national evidence data to inform actions to improve Bannet residents' health and well-being. We are working with our health partners. The main partner is the NCLICB, but also across the council to deliver outcomes that are supporting the health and well-being of residents. We are working with the UK Health Security Agency to protect our residents from health threats, from infectious diseases and environmental threats. That's been the most prominent lately over the COVID-19 pandemic. Now we have ongoing challenges with infectious diseases, but what is even more emerging threat over the past years are challenges related to climate. So now we are increasingly focusing on seasonal health, how to respond to extreme winters, extreme summers, but also other more localized environmental threats. We are the local authorities' health partner for the NCLICB, so we provide input and support for our local NHS partners. And also we are the first point of contact for everything health-related to elected members and officers. The main three areas of public health, they are roughly summarized into health improvement. That includes health promotion, all activities to prevent onset of diseases, to prolong healthy life, to minimize impacts of wider determinants of health. Then health protection, as I said, is such to prevent infectious diseases and environmental threats. And healthcare public health, which is very closely related to the work of our NHS partners. It is really important to be involved in wider health systems locally. We were talking about the Barnett-Borow partnership, also in different boards and committees. There is the Health and Wellbeing Board, which is a statutory duty for all local authorities. And public health is heavily involved, as well as this Health and Overview and Scrutiny Committee. You probably heard about public health statutory duties. This is the core of what we are doing, what we were mandated to deliver after the move of public health from NHS to local authorities. And the statutory duties, as set out in the NHS and Social Care Act 2012, is mandating local authorities, public health, to ensure access to sexual health services. This means that we are commission services that deliver sexual health offer. We are not delivering it itself, because local authorities, we are not healthcare institutions. So, we commission, we are following the procurement processes and commission providers for that. Then, health protection is a statutory function. This includes mainly the expertise and the public health capacity to provide advice and lead on health protection emergencies and incidents and work with partners to protect the residents. Then, statutory duty is to provide public health advice to NHS commissioners. As I said earlier, we work closely with the NCLICB, and it is a two-way relationship. Then, the National Child Measurement Programme, everyone who has children would be aware of that, because they would receive letters with results, outcomes, and advice on how to proceed. This, in BANET, National Child Measurement Programme is included, is embedded within the Healthy Child Programme, which I'll touch on later. And we are also responsible to commission and to ensure the uptake of NHS health checks. Again, this is delivered within the NHS, precisely in primary healthcare. So, it is BANET's GPs who deliver NHS health checks, but we are funding it, we are monitoring it, we are promoting it, and ensuring that eligible residents can have their health checks. Then, there is additional set of services that were mandated to local authorities by the central government. This is smoking cessation, so we are commissioning services for smoking cessation, then substance misuse services, and support for homeless people or sleepers. Then, whatever is left in capacity and funding is for discretionary services, as we call them, and this is to ensure that local needs, local specialties are addressed. And that's where we focus on the evidence we have. You would have known the Joint Strategic Needs Analysis, the JSNA, which is the main data repository, if you say so, that informs what we are doing, and also all the work we are doing with residents and the rest of the Council is helping us to identify the priorities that we are working on. And very important, we are developing our delivery in line also with our plan for BANET, with the corporate plan. So, the BANET priorities generally are reflected in the public health priorities as well, when it comes to health and wellbeing of residents. The next two slides are just some snapshots of what the Public Health Department has delivered over the year. I have sent around the BANET Public Health Work Plan, or the Business Plan, which has a lot of details, and I wouldn't expect you to read all of it, but it does show, really, the wide areas that we are addressing. And it is all about making BANET a healthier, or the healthiest borough in London, if we can. And it is about influencing everything the Council does to make everyone's business, or in public health terms we are talking about health in all policies, where we are keen that it is not only what we deliver within public health, but we are supporting strategies, programs, policies across the Council to take into account residents and health and wellbeing. There isn't a strategy where we wouldn't really stick our nose in and look and see how could it be used to improve health, what is the impact on health. We have just finished a quite lengthy process on developing a health impact assessment approach, which will mainly be used, and the primary use is to work with the planning team. As you know, there are so many developments happening in BANET, and we want to make sure that it's really looked into what impact it has on people's health and wellbeing, but the health impact assessment approach can be used wider, not only for planning applications, but also for major projects, or even strategies are subject to health impact assessment, because we want to make sure again that health is everyone's business. And for that we are collaborating, we are working closely with services across the Council, with our health partners. The voluntary community sector, they are an increasingly important partner for public health, because there is a lot of focus and a lot of shift towards community participation, because we are very well aware that health is happening in communities, and we want to work with our residents, with community groups, to empower them to be able to take better care for their own health. It is a work in progress, but it is a very exciting piece of work with a lot of potential, and we are getting better at this month by month, year by year. And you would see that I also grouped those achievements according to our plan for BANET, so we as well are focusing on people, places, and the planet. The Prevention Fund is an initiative that started a few years ago, and was supporting the delivery of public health outcomes across the Council. So the fund was meant for projects delivered by departments, by services outside public health, so elsewhere in the Council, where they could demonstrate the benefit for health and well-being of BANET residents. Members of the Public Health Department, they could have been involved, they could provide expertise when needed, or being involved in planning or evaluation, but the aim was really to fund and support projects across the Council. On this slide, there are only a few of them mentioned, and what I wasn't able to add is the latest update, because I got it after I submitted the slides, but we can share an update later. It's about the latest round of projects. And for example, Danse BANET is one of the loveliest projects, I would say. It's been very well received, and it was really aiming at people with different disabilities to allow them to express themselves. And I've just received an update recently that the program secured funding from elsewhere, so it's going into another year, into another round. And we consider this as a good outcome because it means that we funded a really good project which had benefits for certain communities, and it was successful, good enough to secure funding. And that's what we would like to see. We would like to fund and support good pilot projects where it's proven that they are beneficial for BANET residents, and then receiving and continuing alternative sources of funding. Overall, how the funding is used, or where are we getting it from? The public health grant is allocated by the Office for Health Improvement and Disparities, or OHIT, shortly, and that's the core public health grant which is meant for statutory mandated and discretionary programs. Then, through the years, some additional ring fence funds have emerged. The most important ones recently are the substance misuse grant, the rough sleeping grant. There is an additional smoking cessation grant. They are time limited, and this is one of the challenges that we are facing at the moment because the substance misuse grant and the rough sleeping grant are expiring with this financial year. So beyond March 25, there is no certainty yet to whether those funds will be either substituted with some other sources of funding, whether they will be extended. They were introduced to provide additional services because there was a need identified, and for the substance misuse grant, one of the conditions was combating drugs partnerships, which some of you would know, and that aims bringing together different partners to really tackle substance misuse and reduce the impact on communities. So we are eagerly awaiting updates on those funds. The asylum seeker health funding is a combined funding from the government and NCL and has really driven for migrant health and the wider asylum seeker health work, which is delivered mainly by the sanctuary team and public health is contributing from the public health perspective. The Resilience Schools Program has the ring fence funding and is delivering mental health programs to increase the resilience of students in schools and then we have some smaller funds as well. This slide shows where we are compared to London. As you would see, we have a very small allocation compared to our neighboring boroughs and across London and I've just been told I'm probably running overtime, so I will try to speed up. I said most of it already. The pressures are through the mandated and statutory services. Those are services delivered by NHS providers or some of them like the substance misuse services by non-NHS. From the grant, we need to cover the general change uplift and most recently national insurance contributions where applicable and the grant allocation doesn't necessarily follow the increased costs. Where services are demand-led, like the sexual health services where we don't have a quota for the providers, but we have to fund the actual need. This is a pressure additionally because it's unpredictable and to theorize in sexually transmitted diseases, especially after the pandemic which is adding to the pressure. The transfer of the Healthy Child Program has been a necessary and positive move and we see benefits of it already, but it did come with the additional financial pressures. And last but not least, the public health allocation at the origin in 2013, it didn't take into account the actual needs of Barnett's population and it hasn't been adjusted since. Despite the year-longs really flagging the issue, flagging that Barnett's population is changing. Barnett might be a wealthy borrower on the outside, but we do have pockets of deprivation which are driving inequalities and we keep pushing and lobbying and every year we hope for a more accurate allocation. Right now, we are waiting for the allocation for the next financial year and we will see how that will look like. I got carried away but I apologize because I would really like to use the time and the opportunity to share with you and ask for your input on the renewed health and wellbeing strategy which we aim to publish next year. We are currently in the first consultation phase which includes seeking input from partners from different groups including this committee which will then inform the first draft. Every renewal of the health and wellbeing strategy gives an opportunity really to step back and have a look. What have we achieved? What needs to be done? Have the priorities changed? How has the borough changed? How have the capacities and the resources changed? And we are now looking forward to really reviewing and updating our priorities and to see how we can align them with services across the Council and across the sector. This slide is showing how important it is to work together and the joint health and wellbeing strategy does bring relevant partners together and mental health work is a good example because mental health issues is a public health issue in Barnett. Mental health outcomes were not very favorable for Barnett residents but partnership has proven impact. Suicide rates are low in comparison to neighboring boroughs and initiatives are showing positive impact. As I said, we are at the moment in the consultation phase with partners, community groups and certain resident groups and this is a list. It keeps growing so you might find that you miss some organizations but it is a snowball so we are including them as we go along. But I would like to see your input, probably not this evening, we might run out of time but it is an invite to get in touch and really let us know, have we got the priorities right? Is there anything missing? Should we reconsider anything? And what you see on this slide is the outcome of a brainstorming session with the Health and Wellbeing Board and we are consulting on those four main priorities and goals. After this phase, so that will be early next year, we will draft a strategy which will then go into consultation following the consultation process so everyone will have an opportunity to feed back. Then we will write up a final strategy which will then be presented again. My questions are, have we got the right priorities and goals? Are we missing anything? Which of those priorities, I just want to go back for you, you think are the most important, where should we really put them? And apologies again for taking more time. That's very important because this is actually the whole thing this evening, so it's very, very important. You've seen the questions, so that's something that I think, can we go back please to your first bit about the grant, because that's phenomenally important. Before going, yes, before going into the actual strategy, because I know Councillor Cohen was very concerned that Barnet's Public Health Grant is one of the lowest in London. It's one of the lowest in the NCL and hasn't changed since 2013, despite the increased demand for services that we've heard tonight and changes to the London Borough Barnet's population, which we all know is increasing, as is the elderly population. Why is this? And is there any thing that the committee can do to push this for revision of the grant to go upwards? So I just would like to put that to you, because this is actually really important. I mean, we cannot carry on with being the lowest. I know it's something that repeatedly, with the task and finish group, we tried very, very hard, and Tracy did as well, to get people from the NCL to come and actually explain to us the budget and how much Barnet we're actually getting per capita. And we were completely, I mean, finance is not my issue, but I have all my understanding, but I really, really, we could not understand it. And I think we do now have to, as a committee, push for there to be the right allocation for Barnet's population. So maybe tonight we can then come to a conclusion, which I think we would like to do, and then maybe we can come to your strategy, the questions afterwards. So can I ask, Councillor Sargent's got a question? Yes, thank you very much. Yes, I was most confused as to why the City of London has such a difference. Now, I know it's because there's a smaller per capita population, but surely that should be amended so it looks a bit more like Barnet, because, you know, I just would like an explanation, which we haven't got here. That's an answer, I'm afraid. I can't… Absolutely. I think that is something from tonight. I really, really would like to take that away and somehow get the NCL to come back again to the next committee. I mean, it's so important. We cannot let that carry on. It really is. You know, I was sort of trying very hard to try and understand the figures and I can't. I know we had Councillor Mearing-Smith, who has a financial, which I think Councillor Barnes remember, we tried very hard, didn't we, to try and get the figures out, and they will not actually clearly tell us why. Barnet does not get the right figure. I'm not sure anybody really seems to understand what complicated formula has been used to put it together. It's certainly due to be revisited, if it was set back in 2013. Though I might suggest caution, because we might find that we end up still in a very similar sort of place, when different measures of deprivation and need are assessed across London, we might end up fairly near the bottom again. If I may add, that's an answer that we in fact did get on one occasion when we were asking for a review and there was a response from the likes, you might be careful what you wish for, but it's showing that the calculation, that the formula doesn't really reflect the needs of local authorities, that there is generally an underfunding of outer London boroughs, because the situation, the needs, the complexities are different than in inner London boroughs. For Barnet, for all boroughs, the allocation has been calculated based on what's been spent on before, so when public health was under NHS, and I'm afraid that's way before my time, so I can't tell what was the financial situation before that, but the fact is that it hasn't been reviewed or changed since we are pushing for a review at every possible opportunity, and I think we just have to continue, and it is important also to note that the NCL has little or if any impact on that, the public health grant is given by the central government. How much we can get out of NCL, that's a different question and we are addressing this in different forums. Thank you very much, I mean I really do take your point, I mean sometimes be careful what you wish for, but on the other hand if it hasn't been reviewed, I mean our population has absolutely gone up, and we do have the highest number of care homes and the highest number of elderly people, particularly in the top group with multi-complex problems, and we do have areas of real deprivation, so I think all those factors really need to be taken into account. We've got other questions, but is it something that, how would you suggest that we go forward, do we bring NCL in to advise us what we can do, or what do you suggest that we do, because obviously you've presented this and we need to answer it, so could you tell us how we should go forward. Joining efforts with NCL would certainly be beneficial and perhaps hopefully it would increase the impact if the NCL is backing us so that health needs, public health needs cannot be met appropriately. Right if I can then, I think we've got Councillor Wakeley and then, yeah. And maybe if I can just add that also to utilise NCL and really getting the most out of NCL where we can because it's a different location, it's a different funding stream, but NCL, if we can hold them to account on joint work areas where they have responsibility, either funding-wise or strategic-wise, if they really play their part, that could potentially reduce some of the pressures as well. Yeah, I think I'm going to be the autist in the room and say I think this comes down to statistics and recording, so for me it sounds like you're not able to support some people because you're not getting the funding that you need, and I feel like that needs to be recorded and fed back to them, and as I mentioned before, I'm a big believer in bringing back the disability register and registering actually what you are spending on people, the amount of people that do need support, because then you can actually go back and say look, these are the amount of people that, for example, the task I'm finishing don't have a GP or aren't receiving this support, rather than just saying we have disproportionate areas and they're going to come back and say where's the evidence for that. Thank you very much, Councillor Cornelius. I was just going to say that looking at the chart of which boroughs get which, it's very obvious that when you look at the ones that are below the London average, they're all outer London boroughs, and it's all the inner London boroughs. The question is, if this is central government who's got to review it, then I think perhaps a letter from this committee, from the chairman to the current Secretary of State for Health, West Streeting might be in order to have it reviewed. If there is only one pot, then I'm not sure the inner London boroughs are going to be wanting to give up any of their money to give them a fairer distribution to the outer London boroughs. I presume originally the inner London boroughs had the poorer people, but gradually they've moved out as they cannot afford inner London borough prices, and therefore we have, as you said, we've got the older and everybody is moving further and further out to afford accommodation. So, as I said, if there's one pot, it's a question of lobbying the inner London boroughs to give some to the outer London boroughs. Is that something that would help, actually, writing a letter to West Streeting, would that help? It won't harm. It won't harm, definitely, and I think if more committees would write letters like this, I think another relation would help. I mean, one of the issues Councillor Connealy is actually really apt is the fact that a lot of, if you visit a lot of the care homes, the actual people in the care homes come from Haringey or come from, they come over all Camden town, they actually come over into Barnet because they know we have our homes, and that's a very serious issue. You know, we're actually looking after them. But they can't afford, there are very few care homes in Camden or in our NCL number five in the London boroughs. Very, very few, because care homes can't afford to open in the inner London boroughs, because property is too expensive to buy the land to have a care home. So they ship them out to the outer London boroughs. Thank you. Right, I'm just going to go in order. I'm very sorry, I will go then backwards. But, Neela Senator, it's more than a question, it's more about maybe a suggestion that if we are not being recognised as the population has grown in Barnet and the need has grown and we're not getting that funding, maybe that it's a presentation of the figures and the numbers needs to be changed slightly, so to give it priority. And if we are saying a lot of people in our care homes are from outer boroughs or other boroughs, are they bringing the funding with them? And in the same way, I know that some of our older residents are also going to the other boroughs like Herob. So are we also giving the funding up there? So how does that work? I mean, it's just a question. I mean, I think with the care homes, we are the highest. I think Councillor Moore, if you correct me, but we are now, have the highest number of care homes. Yeah, therefore, yeah, yeah, we do. Would you suggest that we don't do a letter? Is it worth us writing from the script? That's what I was thinking. Perfect. Right. Thank you very much indeed. I'm just going to go in order if that's all right. Is that answering? You want to speak on this particular point? I just want to say, it seems like the committee goes in a circle and I didn't realise there was even so much letters going around and conversations. But should we be following the actual order of how to appeal this, which is to go to the Secretary of State? Because it seems like they're not listening and residents aren't getting what they need. I think from what Councillor Moore's saying, they have actually done that. Is that correct? They have done that. They've followed exactly what they should do. Yeah. OK, and then we will also send, we'll also send a letter. We'll do that. Councillor Bellarmine. I feel like everyone's giving their own suggestions. I was planning to do before when we talk about your suggestion. Could we invite someone from the Office for Health Improvement and Disparities to address the committee? Because it's one thing about lobbying for a change, but if they could explain to us their rationale for how they, I'm sure, you know, officers have obviously understand the process, but for committee members to understand from the office what the process is and why we get such a bad deal and why, for example, we might get even a worse deal if we were to, if they were to update the process. So if we could do a formal invite to the Office for Health Improvement and Disparities to address the committee, I guess in lieu of that written representation, answering various questions, that might be a different way that we can obviously write letters forever, but someone actually sitting here and telling us why we get such a raw deal. And then my second suggestion was, rather than going through NCL, was to, whether we engage with other councils, to look at joining up as many of the outer London boroughs as possible, to do some joint outer London borough letters rather than NCL, where half of them are doing very well out of their allocation per capita. They're very good suggestions. I do know we have actually had people coming to speak, and trust me, no, no, it's not that. I mean, they're just learning with science. But anyway, it's a very good suggestion, and I think that we should do that. Councillor Wake. I was also actually just going to say, has any work been done with Harrow, obviously they're our neighbour, and they're in the same situation with us. Has there been any joint lobbying from them? Is that something we could look at? Yes, and I think in this letter there is no harm in saying the size of our borough has changed. I mean, we are the same size as Croydon, but if we're just talking absolute numbers, and they're significantly higher than us. Demographic has changed, and I think with the high influx of refugees and asylum seekers, they have a lot of mental health problems, and that's a huge increase in burden on the budget. So maybe we can ask, is it something you'd be prepared to write for us, that we could maybe – that we've got Christmas coming up anyway, we've got another committee very early in the new year – would you be prepared to write a letter for us that we then bring to the committee for next time, that you send out, and then we all add what we want to, and we can just go through it quickly at the beginning of the meeting, would that be all right? So we make sure all our opinions are on there. Yes, and if I can also just answer to the bit on joining outer London boroughs. There is a body, it's the Association of Directors of Public Health, and the London, a group, the London branch, it is pushing for this as well. They keep raising this inequality across London, but with a similar slow, if any, progress than anything else. But it is – the ADPH is a strong ally on this, on lobbying for the public health grant, and we were all looking at the latest autumn statement, and we are still hoping that between the lines, when they're talking about improving our funding for NHS, that maybe there is something for us as well. They just haven't told us yet, but yeah, we are eagerly awaiting for the grant allocation, but I would say my optimism is more on the cautious side. Yeah, I mean, we are a scrutiny committee, and it's the one thing we really need to do and take seriously, so I think we should try and do that and write a really strong letter, and maybe we can all sign it as a – just actually each sign it, the letter. Right. Now are there – if that's all right, are we happy with the public health grant? So the two questions that you had at the end of your strategy, do you want to just very quickly repeat them, and then we'll finish this part of the meeting? Yeah, I will stop here so you can see the priorities and goals. The question is, have we got it right with those priorities? I would like to add that we did start with, I think, how many priorities were there for shortlisting? Definitely more than four, but we did slim them down, because what is important to keep in mind, we have to be realistic. Among the original list of priorities were items like housing, for example, which is a huge need for our residents, a huge priority for our residents, but the question was, what are we able to achieve, actually, as Health and Wellbeing Board? How can we impact? And we came to the conclusion that it's more for us influencing others, rather than focusing on it, and we should really focus where we have the maximum impact, and that's how we came up with those four priorities, which is still, again, it is still a work in progress. There is still room for changes, room for input. If not tonight, at any point, just send me your comments, ideas, input, it will be very much appreciated. That was one question, and also, is there anything that for you stands out in terms of priority, anything that you find particularly important? Councillor Sargent? Yes, do you think you can just reiterate again what you said about housing? Housing is an important area. It is a priority for residents, for the Council, for public health, for the Health and Wellbeing Board, but whether it is a good priority for the Health and Wellbeing Strategy, that's the question, because of the reach that we have, the impact that we have. Can the Health and Wellbeing Strategy, even together with partner, can we sort out housing less likely? It doesn't mean that we want to do anything. We will just use existing strategies, existing work in place, and use our impact, but we wanted to choose strategy priorities where we have more levers and more impact. I think where they can actually make a difference, because we can want to change the world, but in reality, because I think actually they are very good, and I suppose people with suggestions, so I think that's what you're asking for tonight, is that you would write. Housing is included. It can be considered within those priorities where we are talking about starting better. We wish children to be born and grow up in good homes. I just wonder whether there's something about care homes and sheltered housing, and whether there's something in the increased feelings of community connectedness about... Yes, definitely. It can be added within all of those existing priorities, most definitely. It does fit under age better into better health for all, just because it's not a named priority. It doesn't mean that we don't think it's important. I just think it might be quite useful, because I do think since it's changing so dramatically, you know, I do think if you can specifically say, you know, increasing the community and also within care homes and sheltered homes. Thank you. Councillor Wakeley. Thank you. First of all, I agree, I think the priorities are really good, and there's nothing major that I think is missing. I would agree about housing. When you talk about housing, do you mean like damper mould? Like, would that be a public health? Including. I also just want to ask a question, which isn't to a priority, sorry, but I wanted to ask about the smoking strategy and the use of vapes. Is that best practice? I don't know, because I know that was done previously, but obviously there seems to be a move to get people to stop vaping as well. So I just wondered about that. I was not shocked, but slightly surprised when I saw in the presentation in terms of how that works. There is progress also in terms of legislation, and yes, vaping initially, years ago, it was considered as the lesser evil than smoking. But then with the growing evidence, it is getting increasingly obvious, vaping isn't good for health either. So we are now looking into similar programs, similar approaches to stop vaping, similarly that we looked at quitting smoking years ago. But at the moment, is the Council still encouraging people to vape instead of smoking? It is encouraging swapping, so vaping instead of smoking, but definitely preventing children and young people to start vaping. That's the focus, because swapping cigarettes for vapes is one thing, but starting vaping instead of smoking. Children and young people shouldn't do either, really, for their health. To me as well, because I think the message that we are giving young people is that it is okay to vape. Because look, my parents are stopping cigarettes, but they are having vapes. And there is a huge, huge problem in our secondary schools of children vaping. And it's so accessible to them, because you don't see a child in school with a cigarette, but they are in school, they are vaping, they are vaping in the lessons. I worked for two years in a secondary school and I was shocked, I was really shocked at how the vapes were passed around being sold, kids were vaping in the classroom, in the playgrounds. And I approached the school and I said is there no education program for these kids, because there are some very, very bad side effects. Because the kids have no regulator, they will just puff and puff and puff and puff and puff and puff. Yes, indeed. And the additional grant that we received for smoking cessation programs will help us now to focus on this group of children and young people, because as you say... Education is always the key. We have got to have strong education programs in the schools. It's vital, it's vital, because the kids, you know, I talk to the kids about it and they'll tell me things and I'll show them on, you know, get some YouTube videos and show them the damage that it does, that vaping does. And, you know, until they see that, they don't believe it. So I think we've got a lot of work to do in educating children. Councillor Cornelius. Just very briefly, you and I were involved with the Totteridge Residence Association, that we went out with our litter pickers and it was quite interesting. You mentioned secondary school, Totteridge Academy, if I can name it. We picked up an awful lot of vapes that had been discarded outside the front gate. So it's not only bad for them, but it also doesn't help our fly tipping. Thank you very much indeed. I did want to say something about the housing. It may not seem like it's a priority for public health, but it is for the council. So maybe you need to think about how you can work closely with the council on that. And do you pick up? Because in the longer term, it does affect the health. Yes, it does indeed. And I just want to also just say that it's not that it's not a priority for public health, it very much is. And a lot of officers' time is dedicated to it already. Just when we are outlining the priorities, the main priorities for the strategy, we just had to be realistic that as a separate strategy, we would have limited impact. But we will include it wherever it fits underneath, and the work will continue, of course. And we are building on that last year's beginning when we started raising awareness around dampen mold and where I found it really important that all residents have access to advice, regardless whether they live in council buildings or private buildings, whether they are tenants or owners. So I think we made a good start last year where there is lots of work still needs to be done and we are continuing. Right, we have one last question. Emma. It's actually a comment. So it was just to say, I think you're doing really well considering that your funding is quite limited. And in terms of things like not getting too deep into the housing thing, because there are other departments that can work with that and the dampen mold thing actually personally, as a support worker, I've actually had access to officers within the council. You know, there's been funding for that through Barnet Homes and things. I think it's a really sensible thing to do to work with other partners. So, yeah, I'm so well done. Thank you very much indeed for a really comprehensive report and your time. So hopefully we can get somewhere, but we will continue with Councillor Moore. We will try and actually get all the try and get some extra funding. So if I can ask you, can we please note the recommendations? Yes. Thank you very much indeed. So going on to item number 10 with Barnet multi-agency safeguarding adults annual report. As you will have read, this is the last report that Fiona Bateman is going to give because she's now stepping down. Now, I have actually sat on many committees with you over the years. And can I thank you really on behalf of the council for all your hard work and the huge attention to detail in your reports? And I know that wherever you go next, I'm not quite sure. Maybe you can tell us what you're planning to do, but wherever you go next, you will be a success. And I just wanted to give this to you before you start. This is just from behalf of committee. Thank you very much indeed. Where am I going next? I've actually already gone. So can I just say that we've allocated, if that's right, five minutes. I do my very best to do a little self-taught. Because I think everyone hopefully has actually read the report. So it's not a matter of going through. In which case we can ask questions. So we could do four minutes. If we just say four minutes, then you have one more minute. Is that all right? Perfect. Thank you. I mean, you have already read it. So I will just I mean, for me, this being my final year, I do feel like I should sing a few trumpets, not from my point of view, because the work on this is not me. It's hundreds of people across voluntary sector, across statutory services. But I am most proud of the way in which we have worked solidly with the voluntary sector to really ensure that they sit and have parity with the statutory services. I think that's one of the biggest achievements and something that Barnet does better than anywhere else, if I'm most. Over the course of the year, we saw numbers of concerns rise, which often seems frightening. But actually, for me, it makes me think when more people realize that it's not OK to be suffering abuse and neglect. More people are aware. More people refer in. So that's positive. We saw MSP data that was really strong, so most people reporting that the risks have been removed or reduced, which was really positive. And the the work that we did with reframing safeguarding project, looking at why some people from our diverse communities aren't disproportionately or not proportionately being reporting in concerns was really welcomed and really well respected. So much so that actually Community Barnet has gone on and got some MOPAC funding to take that work forward. So where we have lost a little bit of funding over the course of this year, actually, they've been really innovative and gone and found it from other sources, which is, you know, really, really positive. We've what else have we done? We have focused on homelessness and housing. And actually, do you mind if I take a few moments just to kind of we we worked really closely with Homelessness Action Barnet throughout this period. Joe, who's led it for many, many years and was a huge leader and really championed sadly passed away this month. So I just wanted to kind of, if we can, minute that we as a board are forever grateful for his input. We had the councillors all had a letter that went round. So we do. It's very sad because he has he used to come actually and present things here. And he's a very, very special man and will be very, very sad. Yeah, very sadly missed. So, I mean, yeah, his work over the course of that year helped us to not only understand what went wrong in the two cases that we had to do a review into, but also made sure that those recommendations were implemented. And we've put out on the website, sorry, put out onto the website how all of the partner agencies have taken that work forward. And what else have we done? We've done some work on fire safety, which is really, really crucial because we did have people who lack, you know, less mobility are far more at risk of fatal fires. And so we are now really pushing that agenda forward too. And our SAPAP, which I can never remember what it stands for, but it's basically where our partner organisations rate us and rate the value of our board. Said some very positive things, which was always nice to see as well. So that's it in a kind of a real nutshell. I'm very happy to take questions. There's also a video that if you guys want to share, you know, within your organisations and across that was produced as part of that reframing Safeguarding project as well, which just kind of, I suppose, breaks it down a little bit more, explains what we do a little bit more eloquently than I am. Would you send that to us? Would you send it? Yeah, please do. If you send it on our website. Yeah, that'd be really useful. Thank you. Perfect. So, yes. Any questions? And why that is, is because it's a really, as always, a very succinct report. Yes, please. No, but I think it really is. Honestly, you always do such a good report. So, Councillor Sargent, I mean, I've got some questions as well. I just want to ask in the context of the new bill going through Parliament on assisted dying, this would obviously come under Safeguarding, wouldn't it? My view, but it is my view rather than anybody else's, is it might make it safer. If there was some proper implementation, you know, we have we've had some steps in place since Harry Chipman that has improved those kinds of situations. But actually, it is a very great area and I think it may well make it safer, but of course, we'll be keeping a very close eye on it. What I really took some comfort from was the fact that there would be very, very strong sanctions, strong criminal prosecutions for individuals where there were elements of coercive and controlling behaviours. And one of the things we saw very often, slightly different, but during the work that we did in this period around financial abuse, is the level of coercion sometimes people are under that leaves them without the necessary care and support in their older years or, you know, even adults at working age with disabilities can find themselves in very difficult situations. And it's not always recognised, it's not always responded to in quite the same way as other forms of domestic abuse might be. And we've had in the NCL area domestic homicide reviews that have really brought that to the fore as well. So for me, it kind of anything that shines a spotlight on coercive and controlling behaviours, on putting pressures on vulnerable people can only be a good thing, particularly if it's followed up by strong police action to prosecute, if I'm honest. I don't know if it's a quick answer to that one, if it would come to your committee, if it goes through it will be law. I mean, what we would be looking at is in the safeguarding board potentially looking at how we would help support the safe implementation of that in much the same way that we did during this period in Right Care Right Person. That was a huge policy change that could have left a very vulnerable cohort without support. And I think we worked really hard and we have been able to also start, you know, how you've had your task and finish group. We've also had a task and finish group working with the police, the fire brigade. That's this year, though, so I should probably not steal Leslie's thunder for next year. But we've been working with the police and the other emergency responders to make sure that actually the implementation of that has been safe. So we do something similar, I imagine, if that does go through. I have a question that Councillor Combs asked. He said, ask why outcomes have improved, risks reduced or removed. The question is by I'm just I'm just the person giving the question is just ask why outcomes have improved, risks reduced or removed. So at the end of a safeguarding inquiry, when the worker will have worked with the adult at risk to kind of make sure they're asked, do you think the risks and the professionals and the person assess whether they think the risk has been removed or reduced or if it remains? In some instances, it may remain. In part, that might be because the adult refuses to engage in or and that sounds wrong. But it's very adamant that they you know, they don't want the potentially criminal justice involved in terms of family members or something like that. All the risk is. Yeah, I'm trying to think of an example off the top of my head. The vast majority of cases, I think it's 58 percent. So nearly 60 percent of the risks are removed, reduced in reference to the fact that, you know, it's not always easy to remove them completely. And then there's 38 percent are actually removed. So we're hitting a very high rate of good outcomes. Very few are left then where the risk remains, which is really positive. Thank you. On page 80, there's the SAB Development Day report that you said that in there it says that only 11 of the 29 members attended. I mean, that's very low. Less than how. Why? Why was that? One of the things I think a lot of safeguarding ad awards have struggled with post Covid actually is active engagement in the board. We're quite lucky in Barnet in that the three statutory partners are committed and engaged. The voluntary sector, though, to pick up a lot of slack. And but a lot of our organizations do have competing priorities. And actually, a full day event where we're asking them to kind of look at our strategy can be really time consuming. So we have to be a bit inventive. We did pull everybody together because we, you know, and offered everybody the option. Those 11 safeguarding partners were people who are really clearly involved and are engaged every day. But then we had loads of other methods of getting information, you know, around how we change our strategy, how we do our work. But, you know, much like the health and well-being strategy, we've had to think about actually given the resources, given everybody's resources. How do we achieve what we want to achieve? How do we stay ambitious but realistic about how we make the impact we want to make? I do think, if I'm honest, Barnet partners punch above their weight, you know, on the regional stage, on the national stage, actually. We've we've, you know, contributed some of our work straight into government policies and, you know, looked at kind of safe care at home and things like that. Although that's still stealing thunder from next year's report. But one of the things that we all the way through my tenure for seven years, we've been arguing for is a really good, appropriate adult service for anybody over the age of 18. There is no statutory duty to anyone fund that. And so here in Barnet, it was reliant on volunteers who were excellent, but dwindled in numbers during Covid, if we're honest. MOPAC have just agreed to fund it. So it starts from January and they're funding it for the whole of London. So it does show that sometimes the data persevering and just being a bit pain in the backside and very good at scrutinising reports, it does help. It finally does kind of, but it does take sometimes too long. Very much. Are there any other questions? I noted on I think it's page 73 of our pack, but it's early on in the summary section around the time for reviewing a concern that the median time was three working days, but the average time was seven point four days, which is up to two working days from the previous year. To me, basic understanding of maths suggests that there were some cases that must have taken quite a long time. It says in the report, in part, it was due to increased demand and pressure on resources. Were you able to see any sort of case studies on some of the ones that took a really long time, whether that was around complexity of needs rather than just untimeliness of response? Or do you think it was simply because I would expect to see the median and the average to be relatively similar if it was just a time pressure thing. But if the median and the average are quite heavily different, then it's just that there must be other things at play. There is. And one of the reasons that we chose during this period to change our strategic plan and to focus on something called cost inquiries was because actually we saw that when it wasn't the local authority that was leading on the investigation, you know, the information gathering, that time it stretched. I don't have any case studies, if I'm honest, but what we do do, we have a subgroup of performance and quality assurance who go through this data. And Barnet Council are very generous in the time that they give us from their data analysis, who are all over this. But equally, Soto is the head of service for safeguarding. So at any point when we get this and we ask those questions, she is able to say to me, right, so we had five cases here, which were, I looked at them, I reviewed them, we escalated, this is how we resolved them. So as an independent chair, sometimes when you ask those difficult questions, you kind of don't always get a really robust answer here in Barnet. Monica and her team, they really know the cases, they know, but there's nothing getting away from the fact that concerns are going up. The resource to respond to those are not. And equally, some of the changes that were introduced by the police in how they shape and put forward the data has put increased pressures on that front, on the MASH team to try and progress those quickly. Thank you very much indeed. So thank you very much again, Fiona. I know it is very clear, we are hopefully coming towards the end because I think people are now getting very, very cold. Thank you very much indeed. I do appreciate it. And what are you going to do? Fantastic. But I'm sure we will meet all of us with some other place. So thank you very, very much indeed. Thank you. It's a pleasure. So if we now move on to item number 11, which is the adult social care, and can I actually note the recommendations from that? Thank you. Thank you. The adult social care annual complaints report. I think we have hopefully is Courtney online. She's not come. I know you know, I do realise you're going to know I was going to say it to you, but I know that we thought that Courtney might, but she's not going to come. OK, so Darren, who is our interim director of adult social care, will introduce this item and really answer any questions. But I think it should be fairly, fairly sort of a swift thing. It's not going to be in case of the interests of freezing people. I notice there's a few jackets go on and so we'll keep it very brief. You're probably already aware of this. The council has a statutory duty to have a complaint system for adult social care as well as the complaint system that the council has. And we also have a duty to do an annual report on that system and what that tells us, the volume and what we learn from the complaints. So the report that you've got in front of you is for the year April 23 to March 24 and summarises the complaints of that period and the learning we took from that. And I'm happy to take questions. Hi. Yeah, so I was just wondering, in terms of the complaints that people received compensation, are you able to find out how much compensation overall was received? How many hours were used to sort of work on those complaints for staff? I know you can't get the answers right now and whether it would have been useful to actually have somebody employed to deal with those complaints instead. Yes, to the first question. Not off the top of my head, but I'll be able to find that out. The second question, it's probably a bit difficult to work out how much time it takes to do a complaint because it really depends on every individual's approach to dealing with that. Some of us will say, right, I've got this, I'm going to knock it off and be able to respond to it completely. Other people will do it in between bits of work. We do have a complaints team that triaged and passed a complaint out. My view is it is the right thing to do for the person involved in that or the oversight of that work to be responding to that complaint, because it would be harder for somebody else to go into the file and get the detail. But there is work that we need to do to make that process run smoother so that our response times can be much timerier. Yes, I was just looking at page 102 and this was statutory complaints by service area, and it was interesting that some are just up and down fractionally, but I noticed hospitals and health partnerships had gone up from 13 to 24, which seemed quite a big increase. And I wondered if you could explain why. So I happen to have reviewed all the complaints for the hospital team in advance, because I noticed that myself. So the theme around that, there's communication issues around the discharge process, which I think the committee's review have already picked up. In the time people were talking about, the hospital social workers weren't always present in the hospital to do some of that work. But I think added to that, and that's changed now, they're on site to make sure they're able to engage in conversations and make sure those assessments are face to face, noting the committee's recommendation about the space that they've got to work from. But there's a plan around that as well. Because I thought in time gone by, Dawn Wakeling always assured this committee that somebody was always at Barnet Hospital to deal with discharges. The team always had a presence on site, but they weren't all there all the time doing the assessments. So as a hangover from COVID period, there was still a lot of people working from home. So I'm talking about a period that I wasn't here, but with a new head of service for hospitals and health starting early in the year. I can't tell you the date. And she's got the team working on site a lot more. So there's a lot more on site activity. Which in fact ties up then with you, Councillor Sargent. We're actually going to bring this back to then review this. It'll actually be on the next. I think this does need to be done. So that ties in together. Are there any other questions? Thank you very much indeed. Again, can we note that, please? So if we move on to the budget out term report. Again, this is something I'm going to turn to you about, but I think it's very difficult because we don't have everything for adults. But I mean, maybe you can explain that to adults and health. Maybe you can explain where we should go with this. So this is the quarter to budget out turn for the health council. But just to put in context of the adult social care element of that, our budget is roughly 150 million. Roughly 130 million of that, which is about 87% of that budget, is spent on care packages for residents of Barnet. So people that are having care in the home, people that are in other bedded settings, so we've mentioned care homes quite a lot tonight. So that's what that money is all spent on our Barnet residents. As Councillor Edward said earlier in the meeting, demand is increasing and the demand is much more than the budget can pay for. That page or section 2.12 in the report gives a bit of context around what's driving the pressure. So we've got significant pressure around our supported living budget and that tends to be working age adults that need a lot of support to live independently. And we have seen improvements in what we're spending in home care and in residential and nursing provision. But supported living is the biggest pressure at the moment. I'm happy to take questions again. Yeah, so I wanted to just mention about the fee charges consultation, which is closing today. And I wanted to mention how it wasn't actually accessible. And yeah, that was mostly it and I felt like it wasn't, that wasn't okay for residents. So Emma and I spoke about this before the meeting, but as a segue off from the budget, we wanted to ask about the fees and charges consultation because Emma shared with me the letter that went out to residents that have had interactions with adult social care in Barnet. I was quite shocked that there wasn't anywhere on that letter to give any options of more accessible ways of responding to the consultation. The only way of responding was via an online form. There was no option of calling anyone. There was no option of sometimes the conversations they let you go into the library and fill out a physical form. There was no, which I thought was really strange because obviously a consultation for adult social care is normally directed at adults with disabilities or with learning difficulties. And I was quite shocked and I just wondered if as a committee we could ask that for future consultations, especially for adult social care, if they can make sure there's accessible options to respond as well. We've got the cabinet members here as well, so I don't know if you saw that as an issue or it was raised with you about the consultation. I just don't see the point in doing consultation on fees and charges if people that use the service aren't going to be able to respond to it or are less likely to be able to respond to it. Thank you. Sorry. So we're going to have, yeah, Councillor, if you do comment and then Darren wants to come back on that as well. Yeah, well, specifically because I was asked directly, so I'm sitting here, I'm more than happy to respond. I noted, can I also please note that this is not an agenda item. This is not something, this is actually bringing this up within the budget. I can't really hear what you're saying. Sorry, this is not actually part of an agenda item, we're bringing it up, so you're commenting on it. Yeah, yeah, that's right. Well, if there are some clear examples where we're not getting it right in terms of formats that are accessible for people in a way that they understand and fully understand, then please bring them to our attention because I'm sure that Darren is more than happy to try and improve on accessibility. I mean, I'm really keen on that. And so I'm more than happy to receive any representations with concrete examples of why it failed or why it didn't work. Sorry, and I don't want to talk to Emma, so I'll let her, but Emma did raise this when the consultation was first launched. I don't know if you want to share who you raised it with, but that's, I was, yeah, sorry. Sorry. Yeah, I did raise it and I've asked to kind of come in and give some advice to the people that are running the consultation for free that wouldn't require any resources or cost anything. So that next time you do run a consultation, it would be accessible. And I haven't heard anything back. So, yeah, I know that it's not an item, so apologies. That's absolutely fine, so if I can, yeah, now turn to, because we have an answer here, please, from Darren. So, Emma, I can't remember if it's you, or Barnett, Inclusion Barnett. I spoke to Courtney and Courtney's listened to that, so I'm sure she'll take that on board and will take feedback back. We have had lots of responses to the concert. I'm not negating your point. We've had lots of responses that had emails, letters, it's not all just the online form. And I think we have offered to meet with people if people have requested that. But I'm not negating the point you made, Emma. But with this, that will be minuted, all right. Thank you very much indeed. Are there any other questions? In that case, we will move on to item number 13 with the mid-year quality accounts. There we'd be given the responses from the different organisations who provided their quality accounts in May. So are there any questions? Otherwise, we'll just note them. So we will note those. Thank you very much indeed. Number 14 is the task and finish groups update. Tracy, could you just very quickly give us an update? So this is the progress on all the task and finish groups to date. And Appendix B shows that three have already gone to cabinet. The discharge to assess report will go to cabinet in December. And there's four new task and finish groups planned for next year already started. So it's just to note any questions. Any questions? We will then go to the forward plans. Again, this is for noting. Would anyone like to comment on anything? No, then we will go to item number 16, the cabinet forward plan. Tracy, again, you have I think it's all in the report. Just for information, if committee members feel there's anything ever in the cabinet forward plan they want to look into. It's just if someone wants to comment on the forward plan. Yeah, that's fine. Therefore, if there isn't any on that, then number 17 is any items the chair decides are urgent. I haven't received any. So therefore, I will conclude that meeting at eight fifty six. appreciate