Here is a summary of the scheduled discussions for the Health and Adult Social Care Scrutiny Committee meeting of Waltham Forest Council on 22 April 2025.

The agenda included a review of the committee's activities, a proposal to consult on changes to the Minimum Income Guarantee, an update on hospital discharges, discussion of safeguarding lessons learned, and an update on the new befriending service contract.

Fairer Contributions Policy: Proposal for changes to Minimum Income Guarantee uplift

A report was prepared to introduce a proposal to consult on potential changes to the discretionary uplift applied to the Minimum Income Guarantee (MIG) within the council’s Fairer Contributions Policy for adults receiving non-residential care.

The report stated that the council was required to make a minimum of £35 million in savings over the next three years to maintain a balanced budget, and that Adult Social Care represented a significant proportion of council expenditure.

The report noted that all financial assessments are means tested to ensure residents contributions are in line with statutory requirements under the Care Act 2014. As part of this assessment, a MIG is applied, which ensures that individuals retain a protected level of income to meet their basic living costs. Waltham Forest has historically applied a 25% uplift to the statutory MIG, but a consultation was proposed on a phased reduction of this uplift:

• From 25% to 10% in 2025/26
• From 10% to 0% in 2026/27

The consultation, planned for May to August 2025, would seek views on the financial and personal impacts of reducing the uplift, how any changes should be introduced, and what support measures might be necessary to mitigate hardship. Approximately 3,500 adults receiving non-residential care services may be affected.

The report also included an Equalities Impact Assessment (EQIA) that suggested the proposed changes may disproportionately impact younger adults under 25, older adults aged 65 and over, disabled residents, and residents with mental health conditions. Potential support measures to mitigate adverse effects included targeted financial assistance, enhanced engagement and communication, and income maximisation support.

Safeguarding Lessons Learned

The committee was scheduled to discuss the findings of a Safeguarding Adults Review (SAR) related to the death of ‘Jodie’, a 51-year-old woman whose decomposed body was found in 2023. The Safeguarding Adults Review for ‘Jodie’ identified missed opportunities to engage with Jodie and her mother, and outlined several learning points for the partnership.

The SAR outlined several missed opportunities to engage the family:

• Housing Association: proactive follow up in relation to utility checks
• Housing Association: clarifying vulnerabilities of tenants and any dependents,
• ASC: proactive response to referrals and progressing joint home visits as applicable,
• NHS England: circumstances of vulnerable people being taken off GP lists, etc.

It also identified several learning points for the partnership, namely:

• update and promote its escalation process for all agencies to include who to contact with phone numbers and e-mail addresses. This has been incorporated into the SAB’s multi-agency “Team Around the Person” initiative to support cross agency support / guidance.
• update and promote referral processes, including the importance of human dialogue and mutual respect.

The report also detailed actions progressed by LBWF Adult Social Care, including reviews of processes, improved data capture, and specific training sessions for staff. The Safeguarding Adults Board Partnership Response to SAR Jodie outlined the SAB's commitment to taking forward the learning from the tragic circumstances of Jodie’s death.

Hospital Discharges

The committee was scheduled to receive an update on the discharge of vulnerable and older residents from Whipps Cross and out-of-borough hospitals. The report reflected the partnership between the Integrated Care System and Waltham Forest Place Based Partnership. It noted pressures related to capacity, complexity, and flow, and set out partnership priorities for 2025/2026.

The report stated that the Waltham Forest Integrated Discharge Hub (IDH) oversees the discharge, operating a Discharge to Assess (D2A) Home First Model. The four discharge pathways under the D2A model are:

• Pathway 0: discharges home or to a usual place of residence with no new or additional health and or social care needs.
• Pathway 1: discharges home or to a usual place of residence with new or additional health and or social care needs
• Pathway 2: discharges to a community bed-based setting which has dedicated recovery support. New or additional health and / or social care and support is required in the short-term to help the person recover in a community bed-based setting before being supported to return home.
• Pathway 3: discharges to a new residential or nursing home setting, for people who are considered likely to need long-term residential or nursing home care. The pathway is used only in exceptional circumstances because residents are rarely discharged from hospital into long term care provisions.

The report also provided information on the Bridging Service, reablement services, Age UK's Whipps Cross Home and Settle Service, the Transfer of Care Hub, Whipps Cross Frailty Virtual Ward, provision of community equipment, patient and resident experience, and the Integrated Discharge Housing Pathway.

Update on the new Befriending Service contract for Waltham Forest

The committee was scheduled to receive an update on the implementation of the new Befriending Service contract for Waltham Forest, which went live on 1 April 2025. The new service is being delivered by Lifeline Community Projects and is intended to support reducing social isolation and enhance independence and resilience for adults 18 years and above.

The report noted that Waltham Forest previously funded two separate befriending services, one for adults aged 60 and above and one for adults under 60. Following a co-designed model developed in consultation with stakeholders, a new service was procured via an open tender process. The new service features an integrated approach to volunteer engagement, mental health support, and client welfare.

The report also highlighted transition arrangements, key challenges, risks, and mitigations, including volunteer retention and transition challenges, transition of individuals currently supported by the Age UK Befriending Service to Lifeline, and concerns about the timeline and transition support.

The Scrutiny Report

The committee was scheduled to review the action and recommendation trackers, and to review the draft summary of committee activity for the Scrutiny Annual Report. The draft summary of committee activity provided a summary of committee activity for the 24/25 municipal year. The action tracker captured all actions required of officers by the committee at the previous scrutiny meeting and provided an update on progress. The recommendation tracker captured all recommendations made by the committee at the previous scrutiny meeting.

The committee was also scheduled to discuss key decisions falling under the remit of the committee in the upcoming Cabinet Forward Plan, including the London Sexual Health Programme and the Proposal for Change to the Minimal Guarantee Uplift (MIG). Finally, the committee was scheduled to review the Communities Scrutiny Committee Forward Plan for the remainder of the municipal year.