The Adults & Health Scrutiny Panel of Haringey Council met on Thursday 22 February 2024 to discuss significant proposals for maternity and neonatal services, receive an update on aids and adaptations, and question the Cabinet Member for Health, Social Care & Well-being. Key decisions included seeking assurances on the quality of adult social care, the support for the local voluntary sector, and requesting further information on various budget and service proposals.

Maternity Services & Start Well Programme

The Panel received a briefing on the North Central London (NCL) Start Well programme, which aims to improve maternity, neonatal, and children's surgical services. A public consultation is currently underway regarding proposals to consolidate maternity and neonatal units from five to four. Option A, the preferred option, would see services cease at the Royal Free Hospital in Hampstead, while Option B would involve the closure of services at the Whittington Hospital. Services at UCLH, North Middlesex University Hospital NHS Trust (NMUH), and Barnet Hospital would remain. The programme also proposes closing the birthing suites at Edgware Birth Centre and streamlining paediatric surgical care pathways.

Concerns were raised regarding the current CQC ratings for maternity services at NMUH ('inadequate') and Whittington Hospital ('requires improvement'). Representatives from the Trusts detailed actions being taken to address these issues, including increased midwife recruitment, improved training, and enhanced safety protocols. The Panel noted that approximately £40 million of capital investment is earmarked for the remaining sites. The consultation period for these proposals runs until 17 March 2024.

Aids & Adaptations - Update

An update was provided on the Council's response to previous recommendations concerning aids and adaptations and the Disabled Facilities Grant (DFG). Significant improvements have been made to communication, with residents now receiving regular updates on their waiting list position and direct contact details for occupational therapists and surveyors. An increase in staff capacity, including the recruitment of additional occupational therapists and assistants, has helped reduce waiting lists. The Council is also offering advocacy services and has implemented a new case management system to improve record-keeping and track delays.

Despite these improvements, some residents shared experiences of continued delays, poor communication, and difficulties in obtaining accurate information, particularly in complex cases requiring coordination with multiple services. The Panel recommended that clear explanations of any delays be provided, that residents be given the opportunity to discuss changes, and that feedback be given to residents who participate in workshops. Further details were requested on how complex cases will be managed, target timescales for adaptations, and how to widen provider choice. The finalisation of the draft Aids & Adaptations Policy 2024-27 was also requested.

Cabinet Member Questions

Councillor Lucia das Neves, Cabinet Member for Health, Social Care & Well-being, responded to questions on various issues. Regarding the Osborne Grove Nursing Home project, she acknowledged disappointment that its future had been put on hold due to economic circumstances, but confirmed that a significant sum remains in the capital programme for its future development, subject to a business case. The co-production steering group was informed of the pause in December 2023, and the Council committed to sharing financial analysis and working with an external organisation on best practice for co-production.

Concerns were raised about the decline in life expectancy in Haringey, with factors such as Covid-19, poverty, and air quality cited. Councillor das Neves agreed this was worrying and highlighted the impact of poverty and the need for a 'Marmot' approach to tackle health inequalities. Updates were also provided on the Canning Crescent project, the uptake of the measles vaccine, and the use of physician associate positions in GP practices. The Panel also noted Haringey's high rate of flu vaccinations in schools.

Osborne Grove Nursing Home Deputation

A deputation presented concerns regarding the paused Osborne Grove Nursing Home project. They highlighted a five-year co-production process that had developed plans for a facility providing 70 places for elderly people and those with learning disabilities. The deputation requested that Osborne Grove be prioritised in the Council's Medium Term Financial Strategy, that a full cost-benefit analysis be shared, that the co-production steering group be reconvened, and that the Council issue a statement recognising the project's importance and commitment to co-production. Councillor das Neves responded, acknowledging the time and expertise of the co-production steering group and stating that while the project was paused due to economic circumstances, a significant sum remained in the capital programme for its future development. She agreed to share financial analysis and reiterated the Council's commitment to a local care system. The Panel emphasised the importance of continued communication and transparency with the co-production group.