The Committee discussed an update from the Cabinet Member for Health, Wellbeing and Adult Social Care, progress on developing employment support for residents experiencing health inequalities, and a report by Healthwatch Camden on the experiences of women in Camden living with endometriosis. The Committee also considered the latest performance data from across the Council and received an update on the work programme for the year.

Update from the Cabinet Member for Health, Wellbeing and Adult Social Care

Councillor Anna Wright, Cabinet Member for Health, Wellbeing and Adult Social Care provided a verbal update to the Committee.

The waiting lists for Adult Social Care were discussed. The Committee was advised that there had been more than 3,000 requests for support in the first six months of the 2024/25 financial year. This was compared to 3,942 requests in the whole of the 2023/24 financial year. The Committee was told that the increasing demand, coupled with the increasing complexity of need, was contributing to increased waiting times for assessment and review.

The Committee was told that an increase in safeguarding referrals to Adult Social Care was reflective of the national trend, with an increase being seen across all sectors.

The Committee were given an update on the recent Care Quality Commission (CQC) inspection of Adult Social Care. The inspection had taken place from 18-20 November 2024, with a final meeting with inspectors scheduled for 3 December.

There was discussion on the Cash Transfers in Pregnancy Pilot, which is due to go live in April 2025. The pilot would involve a one-off payment of £500 to pregnant women in Camden who are receiving qualifying benefits. The Committee was advised that the pilot had benefits beyond reducing the prevalence of low birth weight babies, including contributing to Camden's response to child poverty.

Councillor Wright told the Committee that work was ongoing across the Council to address anti-social behaviour holistically. This work was being carried out in partnership with colleagues in Community Safety, Housing, Legal, Mental Health Commissioning and Health and Wellbeing. Alongside improvements to anti-social behaviour reporting, resident engagement, enforcement, and case escalation, Councillor Wright told the Committee that ambitions around prevention and early intervention were being explored, including a longer-term aim of introducing evidence-based and data-driven system change.

Councillor Wright gave an update on the progress of the East Integrated Neighbourhood Team (INT). The Committee were told that staff from Adult Social Care and Central and North West London NHS Foundation Trust had begun working together at Kentish Town Health Centre in September 2024. Councillor Wright said that there had been immediate positive impacts from the co-location of staff, including easier communication with GPs, information sharing and the opportunity for joint working on complex cases.

Councillor Wright reported that the Integrated Care Board had taken a decision to end the contracts of five GP practices run by AT Medics Ltd, a subsidiary of Operose Health Ltd. The practices affected were the Brunswick Medical Centre, Camden Health Improvement Practice, Kings Cross Surgery, Somers Town Medical Centre and the Mitchison Road Surgery. Councillor Wright told the Committee that the contracts would be re-procured over the next eighteen months.

The Committee was given an update on the relocation of the St Pancras Kidney and Diabetes Centre. Councillor Wright told the Committee that following a stakeholder workshop, it had been determined that specialist diabetes and kidney services did not need to be co-located.

The Committee asked a number of questions about services in Camden during the winter period. They were advised that although Respiratory Syncytial Virus (RSV) rates were stable, there had been increases in flu, norovirus and A&E admissions across North Central London. The Committee were assured that bed capacity remained adequate across the local health and care system.

The Committee were informed that Camden's response to the government consultation on the 10 Year Health Plan for England would be shared with Healthwatch Camden.

Progress Update on Health, Disability and Employment

The Committee received a verbal update from Sue Hogarth, Deputy Director of Health and Wellbeing and Michael Godfrey, Public Health Strategist (Healthy Lives).

The Committee discussed the number of Camden residents who had entered employment via Good Work Camden and the IPS service. They were told that Good Work Camden had supported 57 people into employment in health and care roles in 2023/24 and that the IPS service was working towards targets agreed as part of its contract with the Council. The Committee asked for greater granularity on performance outcomes in future reports.

The short-term nature of funding for employment support projects was discussed. The Committee noted the challenges of securing sustainable outcomes for residents when funding only covers a defined period of time, with concerns expressed about what would happen to services after funding ended.

The Committee asked whether there was a risk that residents at greater risk of ill health might be directed towards jobs or sectors with higher sickness absence rates. They were assured that services were working to identify employment opportunities that were right for the individual and that work was ongoing with large employers on what it meant to be a 'good' employer.

Living with Endometriosis in Camden 2024

Stephen Heard, Director of Healthwatch Camden, and Nikita Limbu, Healthwatch Camden's Projects Lead, introduced a report on endometriosis in Camden.

Healthwatch's report summarised the findings of 16 in-depth interviews with women in Camden who had received a diagnosis of endometriosis or were awaiting a diagnosis.

The report highlighted a number of significant challenges experienced by women with endometriosis, including delayed diagnosis, the normalisation and dismissal of pain, a lack of understanding of the condition among healthcare practitioners, and the cultural taboo that surrounds discussion of menstruation. The report set out a number of recommendations for the council and its partners, including:

• The establishment of a women’s health hub by the North Central London Integrated Care Board.
• The creation of a local support group for women with endometriosis.
• Improved menstrual health education in schools.
• The development of clear guidelines for primary care on recognising endometriosis and escalating care.
• A commitment to continuous care pathways for endometriosis patients.
• Improved management of endometriosis symptoms and improved access to treatments.
• Enhanced training for healthcare professionals on compassionate and empathetic care for women with endometriosis.

The Committee thanked Healthwatch Camden for their work in highlighting the issues faced by women with endometriosis and noted that a formal response from the council would be provided to Healthwatch. The Committee discussed potential opportunities for education on menstruation and endometriosis beyond schools, including within family hubs or other support groups for parents.

The Committee were told that work was ongoing to develop a Reproductive Health Strategy for Camden and that this work would be carried out in partnership with Healthwatch Camden. The Committee also noted that menstrual health is included within the Relationships and Sex Education (RSE) and Personal, Social, Health and Economic (PSHE) curriculum, though more work needed to be done to standardise provision across all Camden schools.

Insight, Learning and Impact Report

The Committee received a verbal update from Jess McGregor, Executive Director Adults and Health and Kirsten Watters, Director of Health and Wellbeing.

The Committee were given an overview of the latest performance data from across the council.

The Director of Health and Wellbeing highlighted a number of challenges facing public health services in Camden, including:

• Camden had been identified as an 'enhanced support' area for drugs and alcohol by the Office for Health Improvement and Disparities (OHID). This meant that the service was facing greater scrutiny of its performance and potential financial penalties for unmet targets. The Director told the Committee that a data cleansing exercise in 2023/24 had identified duplicate records, leading to a reduction in the number of people recorded as being in treatment. There had also been challenges in securing referrals into treatment services, particularly via the Courts and Justice system. The Director noted that the targets agreed as part of the national drugs strategy did not take into account the mobility of more vulnerable cohorts of residents, including the street homeless, who often needed multiple contacts with services before they would engage with treatment. The Director told the Committee that if performance targets were not met, OHID might impose a financial penalty.
• Progress in increasing the uptake of childhood immunisations had stalled. The Director confirmed that the decline in immunisation rates had worsened since the Covid-19 pandemic, and that a multi-pronged approach, including a variety of communications, was needed to address the issue. The Director committed to sharing campaign materials with the Committee, particularly those targeted at the Somali community.
• Cost pressures had been identified by the provider of North Central London's Integrated Sexual Health service.
• Resources for the London real-time suicide surveillance system had been reduced.

The Committee queried whether the targets agreed by OHID as part of the national drugs strategy took into account the mobility of the street homeless, given that many rough sleepers are not Camden residents. They were told that this was not the case.

The Committee discussed the relatively low number of people receiving Direct Payments in Camden. They were told that work was ongoing to increase this, including by streamlining the bureaucracy around the process and making sure the right support and services were available for purchase.

The Executive Director Adults and Health told the Committee that although there had been a slight reduction in demand for Adult Social Care in Quarter 2, the waiting lists for assessment and review remained higher than expected. The Committee were told that managers were prioritising work according to risk and urgency, and that waiting times were reported to the Executive Director on a weekly basis.

Work Programme and Action Tracker

The Committee were given an update on their work programme for the year. The Committee asked for the following additions to be scheduled:

• An update on the evaluation of the Cash Transfers in Pregnancy Pilot.
• A report on the proposed merger of the Tavistock and Portman NHS Foundation Trust with another NHS Trust.
• A further update on the Start Well consultation on proposals for maternity services.
• A report on men’s health and their engagement with adult social care, to be scheduled in conjunction with the publication of the NHS Men's Health Strategy.

The Committee were told that the Integrated Care Board had requested to postpone their report on Community Pharmacies until July 2025.