The Health in Hackney Scrutiny Commission met on Tuesday 23 June 2026 to discuss the draft strategy for Adult Social Care and the Homerton Healthcare draft Quality Account for 2025-26. Key decisions included noting the draft Adult Social Care strategy and agreeing to a response to Homerton Healthcare's Quality Account.

Draft Strategy for Adult Social Care

The Commission reviewed the draft strategy for Adult Social Care for 2026-2031. The current service had received a 'Requires Improvement' rating from the CQC, scoring 62 out of a possible score for 'Good'. Officers presented the strategy, which aims to embed a reablement-first culture, eliminate access barriers, foster co-production, and invest in a skilled workforce.

During the discussion, members raised several points:

• Accessibility for Specific Communities: Questions were asked about improving access for the Charedi community and other socially conservative groups. Officers explained that quarterly meetings are held with the Charedi community, and a pilot is underway to conduct assessments within their community hubs.
• Demographics and Recruitment: Concerns were raised about the demographic breakdown of engagement activities and plans for recruiting care workers from the Charedi community. Officers stated that engagement sessions had been held, and they were exploring links with Charedi providers and the Shared Lives initiative for recruitment.
• Communication and Visibility: Members sought to understand how services would reach Hackney's diverse ethnic populations with better communication in various languages and formats. The strategy aims for proactive outreach through community organisations and GP surgeries, with information to be provided in multiple formats and languages.
• Staff Training and Co-production: Clarification was sought on staff training content and whether service users are compensated for co-production work. Annual training will cover diverse cultures, religions, LGBTQ+ support, and specific disabilities. A reward and recognition policy exists to reimburse residents for co-production activities.
• Workforce Strain and Turnover: Members expressed concerns about high staff turnover and workforce strain. Officers acknowledged the national workforce crisis but highlighted efforts to improve organisational culture and staff well-being. A grow our own strategy, including apprenticeships and supportive supervision for new practitioners, is in place.
• Direct Payments: Barriers to direct payment uptake were discussed, with officers identifying a lack of awareness and concerns about losing service security as primary issues. The council is establishing a personal assistant network and considering trial periods for direct payments.
• Insourcing vs. Outsourcing: The feasibility of bringing outsourced care in-house was questioned. Officers stated that while there is a commitment to insourcing, bringing care in-house is currently significantly more expensive and carries greater management risks.
• Apprenticeship Contracts: It was confirmed that there are no contractual obligations for apprenticeship graduates to remain employed within the borough, with retention being encouraged through a supportive environment.
• Mental Health Strategy: Members queried how the strategy would address the high prevalence of serious mental illness in Hackney. Officers explained that the strategy targets health inequalities, and collaboration with the East London Foundation Trust (ELFT) and public health data will guide service integration.
• Use of AI: The use of AI tools was discussed, with officers reporting the testing of Beam Notes to assist with note-taking. They stressed that participation is optional and the trial is being handled with caution.

Councillor Sally Zlotowitz, Cabinet Member for Healthy Communities and Adult Social Care, highlighted that the new administration would integrate manifesto commitments into the upcoming plan, emphasising co-production, addressing severe mental illness, and developing social care cooperatives.

The Commission noted the report and discussion, requesting that future updates include information on resident demographics, staff turnover, and improved access to translation and interpretation services.

Homerton Healthcare Draft Quality Account 2025-26 and HiH Response

The Commission reviewed the draft Quality Account for Homerton Healthcare NHS Foundation Trust for 2025-26 and prepared a response. Breeda McManus, Chief Nurse at Homerton Healthcare, presented the account, highlighting achievements such as strong performance in the emergency department, elective care, and cancer services. The trust has also implemented the Patient Safety Incident Response Framework (PSIRF) and Martha's Rule.

Areas for development included increased readmission rates, a need to improve volunteer services, and a rise in complaints, partly due to service demand and industrial action.

Members raised several questions:

• Staffing Shortages: Breeda McManus confirmed that inpatient and midwifery wards were fully staffed, though vacancies existed in specialised units like ITU and the emergency department. She stated there was no discernible impact from immigration policy changes and that the trust prioritised staff well-being and retention.
• Mortality and Sepsis: Regarding mortality, a rigorous review process is in place, with each death reviewed independently. Sepsis remains a priority, with ongoing learning from individual cases. It was clarified that no patients are discharged unless medically fit, and early discharge due to bed pressure is not standard practice.
• Patient Communication: To address increased complaints, particularly regarding waiting times, the focus is on managing patient expectations with clear, specialty-specific information and developing a comprehensive communications plan.
• Data Quality: Recurring issues with data completeness were acknowledged, with staff being prioritised for training and oversight to ensure accurate data entry, which is crucial for funding.
• Mental Health Training in A&E: To support patients with mental health needs in A&E, bespoke training programs have been implemented, and registered mental health nurses have been recruited to the department.
• End-of-Life Care Documentation: While documentation gaps exist, a seven-day palliative care service is in place, and feedback from families on the palliative care team remains positive.
• Health Inequalities and Inclusivity: The trust is working with partners to address health inequalities, with specific efforts in maternity services. They are also collaborating with national teams to ensure compliance with new guidance on transgender inclusivity. Dr Stephanie Coughlin undertook to provide a more comprehensive update on health inequalities and the City and Hackney Place Based Partnership at a future meeting.

The Commission noted the report and discussion, with a letter of response being drafted for the Trust.

Minutes of the Previous Meeting

The minutes of the meeting held on 2 March 2026 were agreed as a correct record.

Health in Hackney Scrutiny Commission Work Programme

Members considered a draft work programme for the year ahead. The Chair emphasised the importance of selecting topics relevant to local communities and encouraged members to circulate the public engagement survey link to their networks. The survey closes on 28 June, and responses will be published at the next meeting.

Any Other Business

There was no other business.

The meeting concluded at 9:00 pm.