The Health & Adults Scrutiny Sub-Committee meeting on 05 November 2024 focused on improving preventative care for residents over 55, revising the charging policy for community care, and updating on winter planning. Key decisions included noting the presentations on these topics and agreeing that further details on funding for the free community care policy and performance data for Tower Hamlets Connect and Linkage Plus would be provided to the sub-committee.

Support for Over 55s Preventative Care

The committee received an update on services aimed at supporting residents over 55, with presentations from Age UK East London, who deliver the Tower Hamlets Connect service, and Linkage Plus, managed by Toynbee Hall.

Dr Somen Banerjee, Director of Public Health, highlighted that while Tower Hamlets has a lower proportion of older residents compared to national averages, this demographic is projected to grow significantly. He noted that older residents in the borough experience higher levels of income deprivation and poorer health outcomes, with particular inequalities affecting Bangladeshi and Black older adults who have higher rates of stroke, diabetes, and heart disease.

Larissa Howells from Age UK East London explained that Tower Hamlets Connect aims to help older people maintain independence and improve their well-being. The service, which receives 86% of its calls from residents over 55, successfully diverts 73% of referrals away from adult social care assessments into community support. Emily Bird from Linkage Plus detailed how their service supports residents over 50 to improve well-being, enhance social networks, and tackle isolation through various activities and one-to-one support.

Councillors raised questions regarding staff training in safeguarding and health and safety, future funding arrangements for these services, and the rationale behind the 55-year-old benchmark for support. It was clarified that Age UK has a dedicated team of experienced advisors, and discussions regarding future funding are ongoing, with current contracts extending until March 2025 with an option for extension. The 55-year age threshold was explained as an indicator of health inequalities in the borough, with long-term health conditions appearing earlier than the national average. Linkage Plus also noted an increase in men under 65 accessing their services, primarily for welfare assistance advice, particularly since the pandemic.

Concerns were raised about the accessibility of services for housebound residents and the need for more skilled personnel. The importance of a partnership approach with organisations like Gateway Housing Association was stressed, although challenges in engaging residents in sheltered housing post-pandemic were acknowledged. Officers confirmed that performance is monitored through Key Performance Indicators (KPIs) and regular contract reviews.

The sub-committee resolved to note the presentation and agreed that performance data for Tower Hamlets Connect and Linkage Plus would be brought back for review.

Free Community Care: April 2025 - Revised Charging Policy

Councillor Gulam Kibria Choudhury, Cabinet Member for Health, Wellbeing and Social Care, presented the revised charging policy for community care, which will come into effect in April 2025. This policy aligns with the council's manifesto pledge to provide free home care for all residents with long-term disabilities and health conditions.

Georgia Chimbani, Corporate Director for Adult Social Care, explained that under the new policy, residents with assets above the national threshold will no longer be assessed for contributions towards community-based support. However, those requiring residential or nursing care will still undergo financial assessments.

In response to questions about managing potential increases in demand, officers acknowledged that this is difficult to quantify but is being actively addressed by finance colleagues. The funding for this policy has been allocated, and further details on its source will be provided to the sub-committee via the Section 151 Officer. Regarding financial assessments, it was confirmed that these are governed by national legislation, and while there is no formal appeal process, residents can request a reassessment if they believe their assessment is inaccurate.

The sub-committee resolved to note the presentation and agreed that details on the funding for the free community care policy would be provided.

Winter Planning Update

Julie Dublin, Senior Transformation Manager, presented the Winter Plan for 2024-2025. She informed the committee that NHS England's winter letter focuses on improving Urgent and Emergency Care (UEC) recovery, with targets for A&E performance, ambulance response times, and reducing 12-hour waits.

Ms Dublin noted that there is no additional winter funding from NHS England this year, and the council will work with existing allocations. Physical Capacity Funding of £3 million has been allocated for general and acute beds, with £723,000 for out-of-hospital support. These funds will be used for schemes aimed at admission avoidance, discharge, and reducing hospital length of stay. The schemes are currently in draft and will be subject to sign-off by the Tower Hamlets Together Board and the Urgent Care Working Group.

Details of existing commissioned services, such as flu vaccination campaigns, Tower Hamlets Connect, and social prescribing, were outlined, alongside new schemes including additional step-down beds in the community and increased resources within social care.

Councillor Amy Lee raised concerns about the accessibility of the presentation materials due to the use of acronyms and questioned the nature of the High Intensity User Programme. It was clarified that this programme, provided by the East London Foundation Trust's Mental Health team, supports patients with complex co-morbidities.

The sub-committee resolved that the final version of the Winter Schemes would be forwarded for review and noted the presentation.

Any Other Business

The Chair informed members of a forthcoming scrutiny review on Maternity Services and support for new mothers, with sessions planned for December 2024 and February 2025. Members were encouraged to attend these policy development sessions.

The meeting concluded at 8:39 p.m.