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Health, Wellbeing and Adult Social Care Scrutiny Committee - Tuesday, 29th April, 2025 7.30 pm

April 29, 2025 View on council website Watch video of meeting
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Summary

Councillor Jilani Chowdhury, Chair of the Health, Wellbeing and Adult Social Care Scrutiny Committee, oversaw a meeting where the committee reviewed performance updates from the Whittington Hospital and University College London Hospitals (UCLH), discussed quality assurance in home care, and considered the Adult Social Care (ASC) Quarter 3 performance report. The committee also approved draft recommendations from a scrutiny review.

Whittington Hospital Performance

Sarah Wilding, Chief Nurse and Director of Allied Health Professionals at Whittington Health NHS Trust, presented the hospital's performance report, highlighting key achievements and ongoing challenges.

  • Royal Free Paternity Ward Closure: The Whittington Hospital is preparing to support mothers from a wider geographical area following the closure of the Royal Free paternity ward. Working groups have been established through the Integrated Care Board (ICB) to manage the transition, focusing on workforce and finance. The hospital anticipates an increase in patients before the closure and is collaborating with UCLH to manage patient flow. They are also working with maternity neonatal voices partnerships to co-design pathways that work.
  • Integrated Care Board (ICB) Cuts: The Whittington is navigating significant cuts to ICB resourcing and changes at NHS England by focusing on reducing temporary staff, agency, and bank staff. No service provisions have been cut, but the hospital is working with UCLH on fragile services and pathways to strengthen relationships and develop the workforce.
  • A&E Waiting Times: While there had been improvements in A&E performance, there has been a recent dip. In March, 72% of patients were seen within the four-hour standard. The hospital is working to improve ambulance handover times and address challenges related to mental health patients awaiting placement.
  • Key Priorities: The hospital's key priorities include addressing hospital-acquired deconditioning, improving access to appointments, and reducing health inequalities. Specific areas of focus include pressure area care, virtual wards, nutrition, and support for patients with learning disabilities and autism.
  • Patient Experience: The hospital has made improvements in patient experience, particularly in cancer care, and is working with UCLH to ensure timely access to treatment. They are also focusing on environmental issues to improve patient experience, such as upgrading flooring and fabrics in wards.
  • Digital System: Councillor Tricia Clarke, Chair of Environment, Climate Change & Transport Scrutiny Committee, noted the difficulty in changing appointments using the digital system and Sarah Wilding, Chief Nurse and Director of Allied Health Professionals, said she would provide feedback and assurance on this.

UCLH Annual Performance Update

David Probert, Chief Executive of UCLH, provided an annual performance update, highlighting key areas such as infection rates, waiting times, cancer performance, and workforce.

  • Infection Control: UCLH has maintained low levels of infections like MRSA and Clostridium difficile, despite increasingly stringent targets. There have been four cases of MRSA infection across 2024/25, above the tolerance of zero and the two in 2023/24. There have been 65 cases of clostridium difficile over 2024/25, which is worse than 24/25 target of 59.
  • Waiting Times: UCLH is working to reduce referral to treatment waiting times, with a focus on patients waiting longer than 65 weeks. The aim is to get 65% of patients treated within 18 weeks. Diagnostic waiting times are close to the standard of 95% of patients being tested within six weeks.
  • Cancer Performance: UCLH has exceeded national targets for diagnosing patients within 28 days and treating 96% of patients within 31 days of a treatment decision.
  • A&E Performance: A&E performance is around the London average, with 72.8% of patients waiting less than four hours in ED. UCLH has one of the best performances in London regarding ambulance handover times.
  • Collaboration with Whittington: Collaboration between UCLH and the Whittington is progressing well, with joint clinical and operational teams working to improve care. Nuclear medicine services are now jointly run, improving access for local residents. Joint appointments are also being made for cancer services.
  • ICB Changes: UCLH is working with the ICB to address financial challenges and potential workforce reductions. Collaboration and service integration are being explored to support the ICB's work.
  • Strike Planning: UCLH is beginning to plan for potential industrial action, particularly with nursing colleagues and doctors in training, to minimise disruption to patient care.
  • Appointment System: Councillor Jilani Chowdhury, Chair of the Health, Wellbeing and Adult Social Care Scrutiny Committee, raised concerns about the digitalization of the appointment system and difficulties faced by older people. David Probert, Chief Executive of UCLH, acknowledged the issues and said that improvements to the telephony system and centralization of administrative functions are underway.
  • Coroner's Court Orders: In response to questions from Councillor McHugh, David Probert, Chief Executive of UCLH, clarified the process for responding to coroner's court orders, stating that the hospital's legal team reviews cases and provides witness statements or evidence as requested by the coroner.
  • Diagnostic Errors: UCLH reported five diagnostic errors in the emergency department over the past year and outlined measures to mitigate such errors, including learning initiatives and training.

Quality Assurance and Home Care

Anna Makepeace, the assistant director of quality contracts and brokerage, presented a report on the council's quality assurance processes for home care providers.

  • Quality Assurance Framework: The council launched a rewritten Quality Assurance Framework in September 2024, emphasizing resident feedback. The framework includes annual quality audits, contract review meetings, and annual quality statements.
  • Risk-Based Approach: The council uses a risk-rated approach to monitoring contracts, with more frequent monitoring for higher-risk providers, such as those providing personal care.
  • Care Quality Commission (CQC): The council works closely with the CQC and monitors their activity and ratings of providers.
  • Staff and Union Engagement: The council directly engages with staff during audits to gather feedback and ensure understanding of whistleblowing policies. Councillor Benali Hamdache, Leader of the Independent and Green Group, suggested exploring engagement with unions representing care workers.
  • Ethical Ownership: Councillor Benali Hamdache, Leader of the Independent and Green Group, raised concerns about private equity firms in care homes and home care spaces. Anna Makepeace, the assistant director of quality contracts and brokerage, said that the council checks providers' financial sustainability and addresses financial issues through a serious concerns process.
  • Complaints: Four complaints from residents were received in the past year.
  • Serious Concerns Process: The council has a process for managing providers who are not delivering the expected standard of care, including enhanced contract monitoring and quality improvement plans.

Adult Social Care (ASC) Quarter 3 Performance Report

Councillor Flora Williamson presented the Quarter 3 performance report for Adult Social Care, highlighting key performance indicators and areas for improvement.

  • Key Performance Indicators: Most KPIs are on target and better than last year, particularly those related to supporting people's independence.
  • Reablement Service: The reablement service is performing well, with 76% of residents not needing ongoing support after reablement. Councillor Benali Hamdache, Leader of the Independent and Green Group, raised concerns about the proposed privatisation of the service, but Councillor Flora Williamson said that the decision is not coming in place for nearly three years.
  • New Admissions to Care Homes: New admissions to nursing or residential care homes are within target, with 128 new admissions in Q3.
  • Service User Reviews: 44% of service users receiving long-term support have received at least one review, exceeding the target of 39%.
  • Direct Payments: 30% of service users receiving services in the community are supported via direct payments, an improvement from last year.
  • Safeguarding: 95% of service users supported with safeguarding reported that their desired outcomes were fully or partially achieved, exceeding the target.
  • Digitalization: Councillor Jilani Chowdhury, Chair of the Health, Wellbeing and Adult Social Care Scrutiny Committee, raised concerns about the digitalization system and lack of replies to inquiries. Councillor Flora Williamson requested specific examples to investigate.
  • Unmet Care Needs: A member of the public, Mrs. Roy, raised concerns about her father's unmet care needs, stating that he is not receiving the 24-hour care he has been assessed as needing. Councillor Flora Williamson said she would follow up on the case.

Scrutiny Review - Draft Recommendations

The committee approved the draft recommendations from a scrutiny review, with Councillor Benali Hamdache, Leader of the Independent and Green Group, suggesting checking the recommendations with the planning committee.

Work Programme

The committee noted the work programme, with a plan for the next year to be provided at the next scrutiny meeting. Councillor Jilani Chowdhury, Chair of the Health, Wellbeing and Adult Social Care Scrutiny Committee, announced that this would be his last meeting as chair.

Attendees

Profile image for Councillor Jilani Chowdhury
Councillor Jilani Chowdhury  Labour Party •  Barnsbury
Profile image for Councillor Joseph Croft
Councillor Joseph Croft  Chair of Health, Wellbeing & Adult Social Care Scrutiny Committe and Mental Health Champion •  Labour Party •  St Mary's and St James'
Profile image for Councillor Janet Burgess MBE
Councillor Janet Burgess MBE  Carers Champion •  Labour Party •  Junction
Profile image for Councillor Tricia Clarke
Councillor Tricia Clarke  Labour Party •  Tufnell Park
Profile image for Councillor Troy Gallagher
Councillor Troy Gallagher  Small Business, Co-ops & Social Enterprise Champion •  Labour Party •  Bunhill
Profile image for Councillor Mick Gilgunn
Councillor Mick Gilgunn  Labour Party •  Tollington
Profile image for Councillor Benali Hamdache
Councillor Benali Hamdache  Leader of the Independent and Green Group •  Green Party •  Highbury
Profile image for Councillor Praful Nargund
Councillor Praful Nargund  Labour Party •  Barnsbury
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