The Community and Wellbeing Scrutiny Committee met on Tuesday 30 January 2024 to discuss a range of important issues affecting Brent residents. Key topics included proposed changes to maternity, neonatal, and children's surgical services, preparations for the Care Quality Commission's inspection of Adult Social Care, and an update on the Brent Youth Strategy. The committee also reviewed the Scrutiny Recommendations Tracker.

NHS Start Well: Proposed Changes to Maternity, Neonatal, and Children's Surgical Services

The committee received an update on the NHS Start Well programme, which is consulting on proposed changes to maternity, neonatal, and children's surgical services across North Central London (NCL) and North West London (NWL). Sarah Mansuralli, Chief Strategy and Population Health Officer for NCL ICB, clarified that the proposals are driven by a need to improve outcomes and ensure clinical competencies, rather than cost reductions. The programme aims to consolidate services into four units, with two options being consulted on: Option A, which would see the Royal Free Hospital's maternity and neonatal services cease, and Option B, which would involve the closure of services at Whittington Hospital.

Councillor Neil Nerva, Cabinet Member for Public Health and Adult Social Care, expressed disappointment at the limited involvement of local authorities in the early stages of the consultation. The committee raised concerns about the potential impact on vulnerable communities, particularly in areas like Willesden and Harlesden, which have existing poorer health outcomes. They questioned how funding would follow patient activity and what support would be offered to mitigate adverse impacts, such as increased travel costs and the need for language and communication support.

Anna Stewart, Programme Director for NHS Start Well, outlined the extensive consultation process, which includes engagement with over 300 voluntary and community sector organisations, translated materials, and targeted outreach in affected areas. The committee recommended that future reports should detail assurances against staff fatigue, human error, and overcrowding, consider the financial impact on prospective parents, ensure a wider geographical consultation with interpretation services, and assess the impact of any implemented changes. Information requests were made regarding engagement activity details.

Preparations for Care Quality Commission (CQC) Inspection of Adult Social Care

Councillor Neil Nerva introduced the report on Brent Council's preparations for the Care Quality Commission's (CQC) inspection of Adult Social Care services. This is the first statutory inspection of its kind in over a decade, following legislative changes introduced by the Health and Care Act 2022. The CQC will assess the Council's performance against its statutory duties under Part 1 of the Care Act 2014, using a new Single Assessment Framework (SAF).

Claudia Brown, Director of Adult Social Care, explained that the Directorate has developed a comprehensive preparation approach, including self-assessments against the SAF's four domains and nine quality statements. The committee discussed the impact of funding constraints on the Council's ability to retain staff and invest in training, with officers noting that while Brent has managed the market well, the broader care market faces systemic issues. Concerns were raised about the training and monitoring of private care providers, and the committee heard about ongoing work to improve transitions from childhood to adulthood, support for carers, and collaboration with housing and health services.

The committee was informed that Brent's hospital discharge service is performing well, typically discharging patients within 2-3 days. In terms of readiness for an imminent inspection, officers estimated a requires improvement rating as a worst-case scenario and good as a best-case scenario. The committee recommended that the Council's work on CQC assurance should inform the committee's work plan and that any identified gaps should be addressed.

Brent Youth Strategy

Councillor Gwen Grahl, Cabinet Member for Children, Young People and Schools, presented an update on the delivery of the Brent Youth Strategy 2021-2023 and plans for its refresh. She highlighted the significant impact of austerity on youth services nationally and locally, with most youth centres in Brent closing in 2015 following funding cuts. The Council now partners with the Young Brent Foundation (YBF) to coordinate youth provision with community and voluntary sector organisations.

Nigel Chapman, Corporate Director for Children and Young People, emphasised the strategy's focus on partnership with the voluntary and community sector and the importance of young people's voices in its development. Chris Murray, CEO of YBF, highlighted successful funding bids and ongoing work on youth employment.

The committee raised concerns about the lack of specific success metrics in the report and asked for assurance on delivery. Officers explained that funded programmes have targeted measures, and data on outcomes is reported elsewhere, such as the Council's Corporate Performance Scorecard. Councillor Grahl acknowledged that community organisations reach parts of the community the Council does not, and the deputation from Roundwood Youth Club underscored the importance of youth services.

A deputation from Roundwood Youth Club highlighted significant disruption caused by a lack of access to their site, impacting training, volunteering hours, and the mental health of young people. They advocated for the £2m capital funding for youth provision buildings to be used for improving existing services like theirs. The committee recommended that young people be represented on the Youth Strategy Steering Group, with representation from across the sector and geographical areas. They also recommended setting more specific engagement targets for young people, creative solutions for funding current provision, and public communication of the Council's communications strategy. Information requests were made for performance data and clarity on how the department mitigates the impact of cuts.

NHS Start Well: Proposed Changes to Maternity, Neonatal, and Children’s Surgical Services

The committee received an update on the NHS Start Well programme, which is consulting on proposed changes to maternity, neonatal, and children's surgical services across North Central London (NCL) and North West London (NWL). Sarah Mansuralli, Chief Strategy and Population Health Officer for NCL ICB, clarified that the proposals are driven by a need to improve outcomes and ensure clinical competencies, rather than cost reductions. The programme aims to consolidate services into four units, with two options being consulted on: Option A, which would see the Royal Free Hospital's maternity and neonatal services cease, and Option B, which would involve the closure of services at Whittington Hospital.

Councillor Neil Nerva, Cabinet Member for Public Health and Adult Social Care, expressed disappointment at the limited involvement of local authorities in the early stages of the consultation. The committee raised concerns about the potential impact on vulnerable communities, particularly in areas like Willesden and Harlesden, which have existing poorer health outcomes. They questioned how funding would follow patient activity and what support would be offered to mitigate adverse impacts, such as increased travel costs and the need for language and communication support.

Anna Stewart, Programme Director for NHS Start Well, outlined the extensive consultation process, which includes engagement with over 300 voluntary and community sector organisations, translated materials, and targeted outreach in affected areas. The committee recommended that future reports should detail assurances against staff fatigue, human error, and overcrowding, consider the financial impact on prospective parents, ensure a wider geographical consultation with interpretation services, and assess the impact of any implemented changes. Information requests were made regarding engagement activity details.

Community and Wellbeing Scrutiny Committee Recommendations Tracker

The committee noted the recommendations tracker, which provides an update on the progress of scrutiny recommendations and information requests made by the committee.