The Health Overview and Scrutiny Committee met to discuss integrated care developments, the corporate plan, mental health services, budget monitoring, and the committee's work programme. Councillors reviewed the impact of ICB ¹ cost savings, the rollout of neighbourhood health services, and the performance of various council services. They also discussed ways to improve the committee's effectiveness in scrutinising health and social care issues in Wandsworth.

Integrated Care Development in Wandsworth

The committee received an update on integrated care developments in Wandsworth, focusing on the implementation of neighbourhood health services and changes to Integrated Care Boards. Mark Creelman, Executive Director for Place for Merton and Wandsworth, explained that ICBs were instructed to save 58% of their management costs and to operate as strategic commissioners. Katie Bolger, Deputy Director for Primary Care and Transformation, added that the London Target Operating Model (TOM) for neighbourhood health services requires a step change in the pace and scale of integrated care.

Several councillors raised concerns about the impact of the cuts on services for Wandsworth residents. Councillor Norman Marshall asked how the cuts would affect residents, and Councillor Daniel Ghossain said that the report lacked data on how the changes would affect Wandsworth. Councillor George Crivelli described a paragraph in the report as gobbledygookish and asked for a lay explanation. Councillor Steffi Sutters asked what would happen to Putney, as Battersea, Roehampton and Tooting were mentioned as Phase 1 sites.

Creelman clarified that commissioned services would continue, but future developments might face challenges. Bolger assured the committee that Putney would not be left out and that the approach would be rolled out across the borough. Stephen Hickey, Chair of Health Watch, raised concerns about the cumulative impact of back-office cuts on front-line services. Creelman responded that all decisions would have a quality and equality impact assessment.

Wandsworth Corporate Plan Actions and Key Performance Indicators

The committee reviewed the 2024/25 Wandsworth Corporate Plan Actions and Key Performance Indicators (KPIs). Jamie, Head of Policy and Strategy, reported that of the 18 indicators, 10 were on target, none were amber rated, and two were red rated, relating to admissions into residential and nursing care, and the time for occupational therapy assessments.

Councillor Crivelli asked about the deployment of police resources and the role of safer neighbourhood teams. Kieran, online, confirmed that the neighbourhood policing related to the safer neighbourhood teams. Councillor Sutters raised concerns about the visibility of safer neighbourhood teams in West Putney and the targeting of meetings. Kieran responded that the teams provide information on local crime and that councillors can contact their local sergeants directly.

Councillor Ghossain questioned the quality of data, particularly regarding trust in the police among specific communities and the evidence of the impact of outreach initiatives. He also asked about the CCTV strategy and the Mental Capacity Act training. Councillor Henderson said that knife crime had decreased by 16% over the past 12 months, and 73% in the past three months. Lynne Wilde, Assistant Director for Health and Care, explained that the Mental Capacity Act training was to ensure consistency in practice, given evolving case law and staff turnover.

Stephen Hickey asked for clarification on the wait times for occupational therapy and the success of projects supporting physically inactive adults. Claire Tew, Assistant Director for Assurance and Innovation, said that the occupational therapy waiting times were improving due to changes in methodology and the use of digital technology. Shannon Couture, the Director of Public Health, outlined the council's physical activity plan and various initiatives to support people to become more active.

Mental Health Specific Place Programmes Across Wandsworth

Dr. Tom Coffey, Wandsworth Clinical Lead for Mental Health, provided an update on mental health programmes in Wandsworth. He highlighted successes such as the mental health school trailblazers and the expansion of mental health first aid training, but also noted challenges including financial constraints and mismatches in supply and demand for ADHD and ASD services.

Councillor Maurice McLeod asked how the Ethnicity and Mental Health Improvement Project (EMHIP) would break down health inequalities. Coffey explained that the project aimed to address disparities in access, experience, and outcomes for black patients by improving access points, inpatient experiences, and social support structures. Councillor Lee asked how to address the mismatch between supply and demand. Coffey responded that the council needed to look at service providers, pathways and to repurpose money.

Councillor Ghossain requested outcome data for the various projects. Temi Fasiga said that some outcomes were included in the report and that further data could be provided. Councillor Crivelli asked whether the crisis family placement scheme was an alternative to sectioning patients. Coffey clarified that it was for people in crisis who would otherwise be in hospital, but who were not subject to sectioning. Stephen Hickey asked about inpatient beds and pressures. Coffey said that inappropriate out-of-area placements had decreased.

Outturn Position for 2024/25

Sarah Evans, Director of Business Resources in Adult Social Care and Public Health, presented the outturn position for 2024/25, reporting an overspend of £2.7 million against a revenue budget of £102.3 million. The overspend was attributed to increased demand, more complex care needs, and increased costs of care services.

Councillor Crivelli asked about the sustainability of social care providers. Rachel Soney, Director of Commissioning, acknowledged the challenges faced by providers and outlined measures to support them. Councillor Crumby asked about savings from the Transforming Social Care programme. Evans said that the programme included initiatives aimed at preventing, reducing, or delaying the need for social care, with efficiencies of around £1 million built into the 25-26 programme.

Work Programme

The committee discussed the methodology for selecting items for scrutiny in the future. Councillor Lizzy Dobres said that the new approach would be more collaborative. Councillor McLeod suggested looking at digital inclusion. Stephen Hickey asked whether the information considered would include input from service users and people with lived experience. The committee agreed to note the report and to hold a work planning meeting on 23 July.