This meeting of Newham Council's Health and Adult Social Care Scrutiny Commission was scheduled to receive updates on the impact of national developments on local services, discuss the role and impact of health literacy within Newham's health and care system, consider the outcomes of Newham's Adult Social Care Peer Review, and review the Commission's work programme for the 2024/25 municipal year.

Adult Safeguarding

The Commission was scheduled to receive an update from the Newham Safeguarding Adults Board (SAB), including an overview of the Board's achievements, progress, and priorities, as well as an update from Newham’s Adult Safeguarding Team. It was also scheduled to discuss the upcoming Safeguarding Adults Report, the impact of the Metropolitan Police’s Right Care, Right Person strategy, the primary safeguarding risks currently observed in the NHS and the populations most affected, and the involvement and regular attendance of partners beyond the statutory members outlined in the Care Act 2014.¹

The Committee was also scheduled to discuss progress in addressing disproportionality and underreporting within safeguarding cases involving global majority communities and the challenges of reaching individuals experiencing self-neglect.

Finally, the Committee was scheduled to discuss the challenges of balancing the need for enhanced resident engagement in safeguarding with the challenges of limited resources and increasing service demands, and to consider local authority performance in terms of safeguarding inquiries.

Adult Social Care Peer Review

The Committee was scheduled to consider the outcomes of Newham's Adult Social Care Peer Review, which had taken place in June 2024.

The Care Quality Commission (CQC) has new powers under the Health and Care Act 2022² to independently assess how well Local Authorities are fulfilling their Social Care duties and responsibilities under Part 1 of the Care Act 2014.

The Commission was scheduled to consider the CQC's rating system and how this would be applied to assess the Council's Adult Social Care Services, as well as the potential regulatory actions or enforcement measures that may be applied to councils whose adult social care services are deemed underperforming.

The Committee was also scheduled to consider the key areas of development identified by the Peer Review, such as embedding a strengths-based approach into frontline practice and improving the recruitment and retention of permanent Social Workers and Occupational Therapists.

The peer review identified the following key areas of development. The underlying challenges relate to progressing the required developments while managing the increasing demand and complexity of care and support needs of people who draw on care and support, and carers; unprecedented economic challenges and inequalities experienced by residents, significant national recruitment and retention issues related to Social Workers and Occupational Therapists, against a backdrop of unprecedented financial challenge for the Local Authority and Health and Social Care System.

ASC Peer Review Report 28.01.25

The Committee was scheduled to discuss how Newham can shape, support, and improve the local adult social care market in line with its duties under the Care Act, and how it is managing financial risks while ensuring adult social care services remain effective and sustainable.

Health Literacy

The Commission was scheduled to consider a report on Health Literacy in Newham, prepared by Newham Public Health, to support a discussion on the role and impact of health literacy within Newham’s health and care system.

Health literacy was identified as a priority for scrutiny by stakeholders, due to concerns that Newham has some of the lowest levels of health literacy in England.

As a borough, Newham has been deemed to have some of the lowest levels of health literacy in England. The commission was keen to understand the basis for this assessment and consider its potential impact on the health of local residents.

Health Literacy_Cover

The report was scheduled to cover:

• The definition of health literacy and how it is measured
• The local context of health literacy in Newham
• Community insights on where residents seek health information and the type of information that is most frequently requested

0-19 Health Services

The Commission was scheduled to review the 0-19 Health Services³, which were transferred to local authority oversight in 2017. The 0-5 Health Visiting Service was undergoing a reorganisation at the time of the meeting, which the Committee was scheduled to discuss.

The Committee was scheduled to discuss the vision for the service and how this has been communicated to schools.

The Committee queried the overarching vision for the Health Visiting Service under local authority oversight...She acknowledged feedback from schools, as highlighted by the Chair, had revealed a lack of awareness of this.

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It was also scheduled to explore the flexibility within the service's tiered structure, and whether resources could be shifted from lower-need cases to prioritise families with higher needs, and to discuss the integration of local teams into communities and whether this supported continuity of relationships for new mothers.

The Committee also asked about the integration of local teams into communities and whether the neighbourhood-based arrangement supports continuity of relationships for new mothers, a key theme in a previous maternity report.

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The Committee was scheduled to hear about the reasons for overspending in the service, and how the proposed reorganisation would improve efficiency and outcomes, and to discuss the functionality of planned digital tools and the specific improvements that these would bring.

The Committee was also scheduled to discuss the School Nursing Service, in particular, to discuss vaccination levels and to hear about the service's capacity to address children’s mental health needs. The Committee was scheduled to hear about the challenges of managing waiting lists for Child and Adolescent Mental Health Services (CAMHS).

Laura acknowledged that while school nurses are well-equipped to identify mental health issues, responding to those needs remains challenging, particularly due to waiting lists for Child and Adolescent Mental Health Services (CAMHS), which is both a national and local issue.

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Finally, the Committee was scheduled to hear about the impact of the loss of a dedicated nurse for each school on the service's relationship with headteachers, and whether the service would be better positioned under NHS management.

Work Programme

The Commission was scheduled to review and note its work programme for the 2024/25 municipal year, which was developed during a work planning session held in July 2024.

This document is intended to serve as a planning tool for the entire year’s reports to and from scrutiny committees. It will include further scoping of topics ahead of committee meetings, using the information and discussions from the scrutiny work planning process to define the topics and report requests.

HASCSC Workplan

It included items on:

• Meeting Newham's Future Needs, following the completion of a year-long analysis (2023/24) of the health and care system's preparedness for significant population growth and changing demographics over the next 15 years.
• Leisure in Newham, to explore measures to address low physical activity levels in Newham and evaluate whether the newly commissioned leisure facilities and the new provider's strategies align with market changes and community needs.
• Community Mental Health Care, to evaluate the model of mental health care for psychosis in Trieste, Italy, and its implications for the approach in the UK.
• The Maternity report revisit, to revisit the previous health scrutiny report on ethnic inequalities in maternity experiences and to evaluate the impact of pilot initiatives on closing the gap.