Transcript

Welcome to today's meeting of the Health and Social Care Select Committee at the London Borough of Hillingdon. This meeting is being broadcast on the Council's YouTube channel, Hillingdon London. The purpose of this committee is to monitor services provided by health partners and adult social care and review their performance. We also undertake in-depth reviews, witness sessions on specific topics and submit our findings to the Decision-Making Cabinet. My name is Councillor Nick Dennis and I'm the Chair of this committee. Before we start, I have some important housekeeping for everyone present. Please ensure that any mobile phones around you are on silent. We're not expecting a fire drill, so if the fire alarm does go off, please follow Nicky out of the building. Please keep your microphones muted when you aren't speaking and then unmute to speak. As Chair, I will call on those to speak during the meeting. It's worth noting that some councillors on this committee may be using devices to access agendas and papers for the meeting. So I'm now going to move on to the agenda. Do you have any apologies for absence? Chair, there are no apologies for absence today. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you very much. That's good. And everything is going to be in public, isn't it? Brilliant. Fantastic. Okay. So we come on to our first item, which is the Hillingdon Hospital redevelopment. So we have Jason Sees, Deputy Chief Executive of the Hillingdon Hospital Trust. And I think, are you involved in Chelsea and Westminster now as well, Jason? Yeah. Thank you, Chair. Can you hear me all right? Yeah, yeah, we can hear you. If you want to present your paper, then we can ask questions. That would be great. Thank you. So just to clarify on that point, so the NHS do love a title, so I'm now Joint Chief Infrastructure and Redevelopment Officer for Chelsea and Westminster NHS Foundation Trust and Hillingdon Hospitals Foundation Trust. And so as part of that role, I continue as the SRO, which is the Senior Responsible Officer for the Hillingdon Redevelopment. So I can't actually recall last time I was here. I think it might have been last year. So just in terms of a recap, because a lot's been going on. So in 2019, you had the Health Infrastructure Plan, and that was the sort of broad announcement of 40 new hospitals. As part of that program, in 2021, we became referred to as a Pathfinder. So in that 40, there was sort of a front eight schemes, and those front eight schemes were supported to proceed at pace. Those pathfinders then became known as cohort three. So that was sort of the pre-context. With the change in sort of government administration last year, there was a piece on reviewing that new hospitals program. And there was an announcement by the government in January this year that the program would be re-profiled in three waves. So there would be a wave one where you have construction between 2025 and 2030, a wave two with construction 2030 to 2035, and a wave three with construction expected 2035 to 2039. I think it's a testament to probably all colleagues in this room and all the support of our sort of local population and stakeholders. Hillingdon was announced in wave one. And in sort of just the context for wave one, the vast majority of the schemes that announced were the rack hospitals. So it's those hospitals that have aerated concrete and sort of labeled as a priority to be rebuilt. So apart from the wave one piece of the rack hospitals, there was Milton Keynes, which is a smaller build, Manchester, which is a bigger build, and Hillingdon. So I'd love to just probably say to everybody, thank you for all the ongoing support. So in that context, we are in the paper as sort of outlined, now working through those next stages. So the paper sort of outlines we are just about to imminently sort of commence the design refresh. And that's in relation to something called Hospital 2.0. So when we probably presented here last in terms of our design and the design we've got full planning approval for, that was designed at a time when it was fully compliant with all the new hospital program requirements. But what's happened with Hospital 2.0, some of those requirements have been updated. Probably the most significant one is single rooms. So previously our scheme with full planning, probably single rooms is about 73%. What we're going to be doing in the updated design is 100% single rooms. The other element about Hospital 2.0 at a very simple level to sort of incorporate modern methods of construction is looking to have a very standardized approach to all design and sort of key aspects of the areas of the hospital. With the piece then, at a national level, you can become systematic in off-site construction as well. So a number of these areas as part of Hospital 2.0 will not only be a standardized sort of design in our hospital, but also in the other racks and Manchester. So a huge amount of work that we're just about to embark on with that. Again, probably from a Hillingdon perspective, we were recognized previously just for the amount of clinical engagement we had. So a huge amount of clinical engagement again to start internally. I will say also I will probably be boring all your local communities again as I come around to say, right, this is how the hospital is evolving. And as ever, if you think we are areas we can still improve or change things and work things differently, that is a conversation that we will continue to have with the new hospitals program. So going through with that, the culmination of that then will be in the NHS you have a three-stage business case process. We need to refresh our outline business case, which we're looking at sort of October next year. Then a full business case looking sort of predicted about March 28th, but we're finalizing the dates with the new hospitals program for construction to start in 2028. And in that, if you come onto the site currently at Hillingdon, we've got our enabling and decant program, and we're looking to have the whole west side of the hospital site cleared by Autumn 27. So much work going on. And if it's okay there, Chair, I'll pause for questions. Yeah, no, thank you. And before we go into questions, I would like to say a big thanks to you and your team for all the work you've done. I've known for many years in terms of speaking to you about what's going on, about the hard work that's been put into place to getting us towards front of the queue. And this involves not just being compliant and also being willing to work with central government on such things, which can be at times be frustrating, but also as well being very open in terms of offering up opportunities for, you know, government officials and senior politicians to come and visit and experiment and talk, which meant I think Hillingdon was always at the forefront of people's minds when they're thinking about this stuff, and you can't devalue that. So I think the fact that we are in Wave 1, one of the few sort of proper hospital rebuilds in Wave 1 is a great testament to you and your team. So thank you very much for that. So before I open it up to other people, I will ask a couple of questions myself. The first one is, I was interested to note at the beginning of the paper when you said Hillingdon Hospital will act as a test bed for future hospital redevelopments in England, and this places an additional expectation and focus on this overall programme. Could you talk to us more about what that really means? Thank you, Chair. So if you look at the sort of recent history of the NHS, probably the last big building programme was the hospitals funded through sort of private finance, so that was what was called Pier 5, so Private Finance Initiative. And they're probably going back sort of 20, 30 years. So in terms of a major build programme, this is probably, if you look at the knowledge gap in the NHS and the construction industry, we will be doing things for the first time at a national level that haven't been done in quite a while. So you'll be amazed at the different levels that we are becoming to get involved in. So that Hospital 2.0 design of what is a standardised design for a hospital bathroom? I will not bore you about how many iterations that has gone through, but that, hopefully, if you can get people to a standardised design. Same with the wards. The other areas where you look at models of care, the key piece that we are highlighting to the new hospitals programme, so that's the Department of Health and NHS England, is the hospital will only be as good as the model of care. And so what we are really doing at place level, so we've got Hillington Health and Care Partners, and the marvellous thing about Hillington Health and Care Partners is on that model of care, it will be quite pioneering. So what we are trying to do with that is really test, actually, from a patient perspective. Do people like going to a hospital? No. Not in the main. So making sure that the hospital actually does those acute services, and those acute services really well. And then as part of Hillington Health and Care Partners, we're looking at the sort of transformation of primary community care, all our other partner services, and there's something affectionately known as sort of the three super hubs. And we're going to plan those together, which will be quite pioneering. So if we look at outpatients, or if we look at some of the services that traditionally have been in the hospital setting, about actually how we could provide them in a setting that the patients probably prefer to go to. And that's in the context of the NHS does look for strategy, so there will be a new strategy for the NHS coming out this year for the 10-year plan, and there's something that's sort of referred to as a right-to-left shift. So what services that sort of traditionally have been provided in a hospital, what could be provided better in a community and primary care setting? And if we can be pioneering that, I think it would be fabulous. I mean, one of the things that we've been looking at as a committee is actually, you know, the creation of those hubs. We visited one of them a couple of months ago, I think. And the whole sort of concept of care in different ways. And I think it's really interesting that the designers' hospital is built into that. So it must work, that sort of more care in the community, which I think we all think is a very good thing. I'm going to ask a sort of slightly curveball question, because other people I think I'm going to ask more about Hillingham Hospital itself. What about Mount Vernon in all of this? Because obviously Mount Vernon seems to be a bit of a Cinderella. It's a great sort of location and a really super space, but maybe feels slightly less loved than Hillingham Hospital, because obviously you've had to put a lot of effort into Hillingham Hospital. So is there any sort of thoughts or plans about Mount Vernon, or is it too early to think about what might happen with Mount Vernon? So, I mean, it's a very pertinent question. So if you just look at our title, we're called Hillingham Hospital's Foundation Trust. So there are two hospitals. You've got Hillingham more middle south of the borough, and then you've got Mount Vernon Hospital in the north of the borough. When you sort of go onto the Mount Vernon site, the key piece that sometimes we keep having to remind ourselves of, Hillingham Hospital's Foundation Trust is predominantly a landlord. So as you drive around the site, the majority of the services on the Mount Vernon site are run by other people. So obviously there's the dental practice, there's sort of the private hospital and other services. The main piece that people see there is the Mount Vernon Cancer Centre. And the Mount Vernon Cancer Centre is run by Eastern North Hearts NHS Trust. There are proposals potentially for it to transfer to another provider. But the main piece for them is trying to work out the long-term future of the Mount Vernon Cancer Centre in terms of they are looking at an option that is probably not going to be the Mount Vernon site and whether they can rebuild a new Cancer Centre on another site. So lots of work going on there. From a Hillingham perspective and the enabling and decant plan I referred to earlier, actually as part of our enabling and decant, we've been using, in terms of that site clearance, Mount Vernon more. So we've got some corporate services, so when you talk about back office, our finance department, our HR department have moved over to the Mount Vernon site in the last few years. And there's been some temporary moves of clinical services up there to help us free the site. So lots going on. To answer your question in a direct way, the key piece then about how you build on that narrative is we then need to sit down with partners and everybody else and just look at the long-term master plan of that site. And that is a piece of work we haven't started yet. But I think with Mount Vernon Cancer Centre becoming clearer, hopefully, in terms of their next steps, I think it's something we can proceed on shortly. Fantastic. And when you do, obviously, we'll be interested to sort of be involved in that. So thank you. Councillor Martin. Hi, Jason. Hi. Under the previous government, the hospital seemed ready to go sort of a couple of years ago. I was in a residence meeting with the new MP for Archbishop and Southwisdale late last year. And he indicated to the residents that the hospital was not ready. The funding wasn't in place. It had never been in place at that point of the change of government. So it's good news to see the hospital, that's now changed and it's going to open in phase one. But what sort of delay has that led to the services at Hillinden? Has there been an impact? Because I remember in a previous meeting, I think you were moving wards, mothballing some wards. So have you seen an impact on the waiting list, the times people wait for procedures? And are you able to commit to 100% current capacity through to 2033? Thank you. So if it's okay, if I break it down into different stages. So you're absolutely right. An absolute key part of program management is that momentum and smooth consistency. And as the chair said, any large infrastructure program, be it in this country or other, is subject to the ebbs and flows of how things are being shaped on a wider macro level. So with that, we've always been looking at, in terms of the main hospital site, the main hospital site would remain operational throughout the build of the new hospital. Your point is well made, though. The estate is not in the best condition. So there is something called backlog maintenance. And there is sort of a significant amount of money we still need to pay in making sure that our current facilities are working. But with that, that current capacity won't change over the course of construction. That the piece about the enabling and decant, in part, that was sort of not paused, but probably wasn't going at the pace that we'd initially set out on when we were going through the government review process last year. But part of it now is we're sort of making sort of a real clear push now to get back to that pace so we can get all those site moves. The main piece last year, though, that we did carry on with is the power. So I don't want to bore everybody with power, but if you think about your house on a much bigger scale, the wiring needs to be redone. So the key piece that we sort of were continuing last year, and I probably should apologize if I haven't seen any of you for a while, is all those roadworks for those sort of five or six kilometres and all those traffic lights was digging up the roadworks to put the infrastructure in under the roads for the new power cables to come in. So that piece of work has been completed, and then we're looking at sort of the next stage with the substations, et cetera. And also the work on the sewers was done. So there's huge bits happening around that. The current capacity will continue to be operational, but the key piece as well with that is just to make sure in terms of that backlog maintenance, we carry on making sure that the site works. I mean, was it a few weeks ago when we had the terrible rain? You can imagine. And you said this is the first time in 20 years that we've been building hospitals at this scale. Judging by some of the recent projects, say HS2, and the over-budgeting or the overspend and the length of time it's taken, how confident is the trust of 2033 as an opening day? And would there be a contingency if that was missed? So the main bit, and I can say this with a straight face now, of our NHP colleagues, you can't call it a project plan anymore. And if anybody's well-versed in the terminology, they call it a FRAGNET. Anyway, so in terms of that FRAGNET we are trying to finalise with them, it is all about locking down those dates because to keep that momentum, to keep things working through, the key piece that we sort of referenced, one of the big milestones will be getting the builder on board. So in the new hospitals program approach and that risk base, they want to do things more at a national level. So selecting the builders at a national level first and then it comes down to us. Once we've got the builder on board, that will be a huge step. And I think actually, it is that piece of everybody absolutely singing in Hillingdon because they want it has just allowed us to say, no, we want to keep going at this pace. Other places, if you look at where they probably haven't had the level of support from all their stakeholders and partners, maybe have fallen slightly at the wayside. The Hillingdon voice has just been fantastic. So I think if we absolutely continue that, we can keep that pace. Thank you. Councillor Hagger. Yes, thank you, Chair. Really interesting and good to see it all coming together. Obviously, it's quite a lot of collaboration, so with all the parties coming together and having an agreement. And as with collaborations, what do you see would be maybe the obstacles or the issues that might come about? Because it's brand new, it's a new setting, I'm hearing that everything's new, so the way we might be running the hospital again is new. So it seems like there's quite a few new things. What do you see as the obstacles? I'm sure it would be fluid, so if there is a problem, you know, you'd address it, maybe re-look at it and revisit it. But how do you feel about all that? And the obstacles are really in the way. Thank you. It's such a good question. So sometimes you can get so caught up in the building, you forget about the people. So if you look in East London, you've got something called the Royal London Hospital in Whitechapel, and in part with things like that, everybody got caught so much up in technology. The lifts were out of sort of Star Wars, they were marvellous. But from a member of staff perspective, geez, and it's things like that of you need to absolutely take your staff with you. And in terms of that transformation as you're working up to doing, to the previous question of how you maintain the capacity you currently got. So people working, and everybody's blooming busy, but making sure people have got the time out as well to get to know the new ways of working. Because again, if you take the Royal London as an example, most English hospitals that you go to are, everybody's sort of just used to long walks horizontally. Everybody's just used to, you go, you walk and walk and walk, but you're on the same level. More in European, and on that one, the Royal London, everything was up and across. Travel time was less, but it's just people becoming comfortable with, well, actually, this person needs to get somewhere and they're very, very sick, but feeling comfortable in a lift. So we had a number of elements such as that. So there is a real need in those sort of year prior to opening to make sure people have the time to get used to the building. And you do mock-ups. And then previous to that, I don't know if anybody's had a chance to go down to Brighton recently. They're one of the few hospitals that's sort of been built in the last sort of 10 years. They had all these whizzy goggles, sort of the 3D sort of layouts for staff to really get familiar in the planning stage. And then letting people have that time out when they open up. And then realistically, your point about capacity earlier, when you open, you're not probably going to be going as fast as you were previously for those first few months, because it's just unrealistic as people can get to know things. Thank you. Councillor Punja. Thank you. Thank you, Jason. It's really glad to see the improvements and the progress that is being made. It's fantastic. I'm really glad to hear that Hospital 2.0 is now being kind of redesigned and we are meeting up with these updates that have gone on there. But I just wanted to kind of understand this single room that's gone from 73% to 100% because what does that actually mean? Is it like we're not going to have any wards anymore? My fault then for explaining it really, really badly. So if you walk into many hospitals now, you probably see bays and you can have bays of four, you can have bays of eight. But there will be some single rooms on a ward as well. The Hospital 2.0 model is when you walk on a ward, I think we're back to 32 bedded wards, but every bedroom, it will be single rooms. So primarily, if you look at that, that is fantastic for infection prevention and control. So if you look at some of the things that you pointed out earlier about hospital capacity, in the winter months, there's not a nice way of putting it. Things like diarrhea and vomiting, if you have open areas, it does spread a lot more if you're really stringent with infection prevention and control. And that takes down capacity. If you've got single rooms, it obviously is a lot easier to manage. The other piece that, gosh, people, it's less in people's minds, but with COVID, and if you looked at the learning from some of COVID, again, with single rooms about how you can manage infection outbreaks and make sure that you can sort of partition areas properly, that's a key piece. So what is the flip side? There will be probably some patients, there will be some clinicians as well, that would say maybe, on the less sort of positive side of that, of maybe the social contact with other people. So particularly if you sort of think care of the elderly ward, where you have a bay and people can talk. So there are elements, and your point, about those models of care and how you set things up. If you are in 100% single rooms, how you also ensure that there's social interaction as well. Okay. Yeah. Sorry, and how would you ensure that? Because that was one of my... Yeah, so that's in the hospital. So as you design your hospital ward is to make sure that there are areas so that patients can work through it. Same with the rehab areas, there's all these areas that you just need to sort of think of. Make sure that people have that social connection as well. Thank you. Okay, go on. So Councillor Punja has one more. Councillor Burles wants to ask, and then I'm going to shut it down unless anybody else... Yep. Okay. That's fine. Okay, then we'll move on to the next item. So one more from Councillor Punja, then Councillor Burles. Okay. Fantastic. And I was really interested in what you were talking about in terms of standardisation and what you were almost... what I understood from what you were saying in terms of the construction, it was always most of a fast kind of construction in that it's off-site construction that then gets assembled on site. Is that correct? And is that what's going to happen and how that can deliver mass scale almost? So part of where we're working with the new hospitals programme is finalising that. So it's then to really work through... So in part of our sort of previous planning and working things through, there's something about, well actually, on one level you want to really ensure that it's an investment in your local community for apprenticeships and sort of re-skilling your local workforce. So there's an element of that, but there is also an element of the new hospitals programme are looking at how much you can standardise and have off-site. I mean, I can't remember the figures, but if you look about how many different types of door handles, doors there are in the NHS, it is unfortunately quite frightening. And so if you can just standardise all of these parts of the return on investment in terms of the build will be, that's what they're aiming to bring down. Thank you. Thank you. Thank you. Councillor Belles. Thank you, Chair. And thank you for your presentation, someone who was born in Hilliordan Hospital many, many years ago, when it was partly huts and everything. Be welcome. I'm just still interested about your links with the business society and the university. You mentioned in your report that you're connecting with Brunel University as key partners, et cetera. Can you expand on that a bit more? So our estates and facilities department have got sort of a sort of research partnership with Brunel about sort of new ways of working and working its way through. The other elements which we haven't finalised yet, but I think education and training. So if you think about how the NHS works in terms of training staff about how we can work more closely with them. So they opened a sort of non, I think it's a non-NHS medical school a few years ago. But how we can work more closely with them on some of those innovative models of care. The other point, if you look at the skill base up at Brunel is that they do have building experts there. And so bringing those in of just checking what we're doing. So now we're gearing up again, we will hopefully link up with the Vice-Chancellor about looking at what the opportunities are again. Thank you. Okay. Thank you. Thank you, Jason. Obviously, if there is any form of sort of consultation on any of the aspects of Fiddling 2.0, we'll be interested in that as well as the Mount Vernon stuff. And I imagine we'll see you again at some point soonish. I mean, certainly, I imagine October 2026 would be a very good time when the outline business case submission goes through. But obviously, if anything else is of importance, then if you come back to us, that'd be great. Thank you. Oh, yes, yeah. And if anybody wants to come down, meet the team, spend more time with us. I mean, we can bore you on Hospital 2.0. There is, there is just, you wouldn't believe how much information there is. So there is any, and if you want to have a tour so you can see how the site's changing, just get in contact with me. So let's do that as a committee, yeah, for those who are interested. I mean, I'm quite interested in the 3D glasses if they ever turn up. But beyond that, yeah, let's do, I mean, obviously, if you can speak to Nicky and we can organise a tour for those who are interested, that'd be really great. Thank you. Brilliant. Thank you. Great, good stuff. Okay, thanks. Right, so we'll move on to our next agenda item. Jason, you can obviously leave if you want to, so... I mean, you can... I know, you can... You can stay if you wish. I mean, you're very welcome. But, okay, so we're going to move on to item seven, which is the adult social care early intervention and prevention investigation that we're doing, and this is the third witness session. So what I'd like to do is I'd like to hand over to Gary Collier, our health and social care integration manager, to sort of help run this part because we've got a lot of speakers. When you speak, if you could just introduce yourself so people here who are watching know what's up. So, Gary. Thank you, Chair. As you say, this is the third witness session for this review. Previous witness sessions have discussed the fact that we were in the process of commissioning a number of key contracts that would actually form part of our approach to supporting the independence of our residents and preventing or delaying the escalation of need and, therefore, the increase in demand on statutory services. The opportunity that the committee has today is to look in at two of those services in more detail, the Information, Advice, Guidance and Wellbeing Support Service and the Mental Health Early Intervention and Prevention Programme. The third service, the carer support service contract, to remind the committee that it was agreed that this would be deferred until your meeting in October, which will align then with the annual review report on support services for carers. What I would suggest, Chair, with your permission for this meeting, if we take the Healing and Advice Partnership presentation first, and I will look once Julian has had the opportunity to do his presentation and I will say a few words about the contract monitoring process and then the committee to have the opportunity to ask questions and then we take mental health services afterwards. That sounds like a really good way to proceed, so I'm very happy with that. I will have to apologise in advance because there will be the slight technical hitch of actually changing custody of the clicker as we go through. Maybe we need clicker 2.0 or something. That sounds like a good way forward, so I'm very happy to proceed on that basis. So, with your permission, Chair, I would suggest we invite Julian from A2K to present. Thank you, Chair. Hi. Thank you, Chair. I'm Julian Lloyd. I'm Chief Executive of A2K, Hillingdon, Harrow and Brent, and joined my colleague, Baljeet, who's the Chief Executive of Nucleus Legal Advice Centre, but I'll be running through the slides and just giving a bit of an overview to the committee about the new Hillingdon Advice Partnership and how we're structured and the services that we're going to provide. So, just to begin with, I've got a few slides just to run through. So, the service is essentially for Hillingdon residents over the age of 18 through to end of life and we provide advice, information advice and guidance on a wide range of topics. I've listed here some of the more common areas, but the service certainly won't be limited to these areas. And we're sort of looking at predominantly welfare benefits, we're looking at housing, finances and debt, etc., and really looking, as Gary said, at services that complement the services that are provided by the local authority and looking at how we can empower and sort of provide residents with the tools to be resilient and to lead a good quality and level of life. So, the partnership is made up. It's led by Age UK, Hillingdon and Herring and Brent and we've got a consortium of partners who are working with us. Age UK, locally, you'll be reasonably familiar, I hope, with the services that we provide for older residents and information advice is really core and to the heart of the services that we provide. And then we're supported by Nucleus, who provide a range of specialisms, particularly around housing, around debt and employment, and more the sort of working age type support services. And also the other local partners that we have in the partnership are DASH, again, who I hope will be known to select committee, who specialise in providing information, advice and guidance to people with physical and learning disabilities. And Bell Farm, who are based over in West Drayton, who have a particular area of specialism, working with the travelling community and with asylum seekers and refugees locally as well, and are very established and are very much a trusted resource to those particular communities. And we feel is sort of a vital part to our overall partnership as well. So those are the core delivery partners, but we're also, as a partnership, we're very bedded in to the local infrastructure. We've got a very well established working relationship with the local authority, and we see the delivery of this service being one of partnership, and that's the way that it was framed in the specification, that's the way that we put together our proposal and very much the sort of spirit that we've launched. The service is working in partnership with the local authority. But we're also bedded in with the wider infrastructure, with the wider third sector. We're founding members and the H-UK's founding member and DASHR of H-For-All and 3ST, which are the sort of, almost become the sort of infrastructure and the bonding sort of organisation for the third sector within the borough, but we're also members, signed up members to the H-UK's Health and Care Partnership as well. And as a VCS, we are fully integrated, not only with the local authority, but also with health partners and with the new neighbourhood developments in particular that Jason was referring to. We're very much sort of bedded into those structures as well. So, I've sort of touched on some of the areas that Gary suggested might be interest to the partnership. And I think firstly, talking about some of the structure of the partnership. So, we're not four organisations delivering four different services. We're very much delivering as a partnership and as a single service. We're working on a single client management system. We'll be working on Salesforce. We're working on a single IT system. We're fully integrated and really using technology to be able to deliver a coherent service and to optimise the capacity that we have because it's an open access service. So, we're expecting high levels of demand and we've developed a structure that will enable us to deal with that as effectively as we can. So, we've got a single entry system into the service via our website through a web form which feeds directly into our CRM. So, people can fill in their details which will populate. So, they've asked off having to write up notes, et cetera. So, it will populate our CRM and we will allocate cases out through a central triage system to partners across the organisation. But the advice workers within that partnership will work as a fully integrated team. Our base for that integrated team will be the Hillingdon office, the AGUK office. But we'll be delivering services across the borough through a range of outreach points as well. We've got telephone services, our second point of access. So, we've got a digital point of access. We've got telephone access. That will be provided 9 to 5 Monday to Friday. But we've also got agreement from AGUK National that we can use the AGUK National helpline as a spillover for that service as well. So, rather than hitting an answer machine at 9 o'clock, we've actually got extended hour provision. So, we'll be able to divert the phone line to provide an 8 to 7 service 365 days a year that people will be able to speak to a real person. And again, those referrals, if they're simple, will be dealt with there. Otherwise, they'll be signposted down and they'll be picked up locally again. And we're looking at developing a range of face-to-face. So, we recognise as well that some people, some residents do require face-to-face support. And we need to use our resource effectively. So, where people can receive the advising guidance they need digitally or by phone, then we will utilise that. But where people do need face-to-face, we will be providing that as well through a range of surgeries. And what we've put in a proposition and what we're hoping to agree with council is to be using libraries, potentially for that as well as a range of other community resources around how we deliver locally. And then next, really, how we manage demand over the lifetime of the contracts. And I suppose that's potentially the biggest challenge. You know, we've got a finite resource. There's a good investment that the council has made in this service. But we still are seeing increasing demand year on year in the borough. We're seeing that across the partnership. So, we've looked at the service design in terms of how we manage that demand. And first on there, as a reference, is really looking at how we utilise technology to reduce administration within the service and incorporating AI within that as well. So, trying to reduce the administrative burden of staff and looking at automatic note-taking, transcription of phone calls and face-to-face calls as well to cut down on the writing of notes that staff have to undertake. We're looking at building our volunteer base as well and really integrating volunteers into the model and using volunteers in our call centre but also supporting face-to-face provision. And that's already part of our advice provision locally, but we're looking to develop and build on that and bring in more volunteers as part of the service. We're wanting to draw on our knowledge and really draw on the wider resource that there is across the VPS and also using our ability to leverage in additional funds as well, additional resource ourselves through the partnership and through the wider partners. In terms of sort of challenges and opportunities, because it's open access, there will be peaks and troughs in demand and predominantly peaks. And there will be external factors that will drive that. And, you know, we've developed a service that we think can respond to that. Those things are outside of our control, but we need to make sure that we've got the capacity to deal with that. And there will be things that we've seen already, you know, last year with the winter fuel payments that sort of drove a spike towards us, certainly AGK. The changes that have been discussed at the moment around potential changes, the eligibility of PIP, some of these sort of national legislative changes can drive demand at a local level. So we need to make sure that we're keeping an eye on that, we're responding, we're flexible with our resource and looking at how we're dealing with that. The model that we've designed is very much around trying to ensure that people get through to us. We're trying to minimize taking messages, voicemails, et cetera, and responding, doing quick responses and then booking people in for the work that they need for the case work. So we're always accessible. We're trying to avoid people bouncing away, trying to reduce the risk of sort of complaints, because that can create work in its own, you know, that can be a diversion. So if we can deal with people quickly and effectively, that's going to help us manage demand and manage capacity. As I say, we're looking at leveraging in resources and we have access through Age UK to funding opportunities, but also through a range of grant providers as well for various different services that can complement the advice provision that we have locally. So even this week, we just secured some funding for warm homes, which doesn't seem... But we've got funding to support advice and guidance around people, older people particularly, who are potentially going to be struggling with heating and bills through the winter. So we've got funding for additional capacity for the team already through the winter months to support that. And we're also looking...we've got outcome measures that we've built into the service, but we're working with 3ST who are developing an outcomes framework and we're looking to pilot that within the model as well to look at how we are able to demonstrate effective outcomes for the service. Again, Salesforce, we've got really good reporting capability. We've got historic contracts with local authority that you're already familiar. Certainly your officers are familiar with the reporting capability that we have through Salesforce and that's why we chose that out of the CRMs for the one that we will use for reporting. The outcome measures that Gary will describe, we've built those in already into the system so we're able to report on the outcomes that have been specified by the local authority. And as I said, we're looking to incorporate the 3ST impact framework as well into our reporting. And looking at a cycle of continuous improvement, really working very closely with local authority to review the outcomes, to review our performance and to look at how we can collectively develop that and improve on that. And I'll stop there and open to questions. Thank you. Gary, you just wanted to say something, didn't you, before we went to questions? Yes, Chair, we'll just change custody of the clicker. I'll pass that around. Who's taking custody? All right, thank you. We either need two clickers or hold music, don't we, for this part to make it work, as a sort of... Freak incident. Good stuff. But thank you, Julian, for your presentation. I've certainly got some questions already, so after Gary's added to that, then we'll open up to questions for everyone. Thank you, Chair. I thought the committee would be interested to know on some of the things that... about some of the things that we're actually monitoring as part of the contract. Julian's already talked about some of the outcomes. So these are the outcome measures that we've included within the specification. This is sort of qualitative based, so it's based on what users of the service actually tell us. We will be working together collaboratively to work out baselines and reviewing targets during the lifetime of the contract. And the expectation is that these will change over time in response also to the feedback that we actually get from users of the service. Some of the other key indicators, more sort of output related, are actually set out here. What we are particularly interested in is the evidence of impact. And that part of that will actually be supplied through case studies. The type of things which the committee will be familiar from reports that it's received in the past, particularly in respect of support for carers. The battery seems to have died, unfortunately. We do have a printout here, so you can carry on. The next slide, Chair, actually looks at some of the monitoring arrangements. So the annual value of this contract is £749,000. It's important to note that this is actually a new model of provision. It's a new provider with new arrangements. So as a consequence of that, we will actually be having... Right, we're there. We will be having monthly meetings for the first six months with the Hillington Advice Partnership. And that will then move to quarterly thereafter. Included within those meetings from the council perspective will be the service manager lead for the service representatives from our contract and supplier relationship team. And what we want to do this time round is actually have greater involvement from social work teams, both from the perspective of actually being able to feedback on the feedback that they're getting of people actually using the service, but also about actually having greater understanding of what the service is about, what it's actually delivering. So we're looking at staff actually working much, much more closely with the service. Thank you, Chair. No, thank you. It's useful to... We can now take questions. Good, good. It's useful for us to know how the contract will be managed and monitored actually. And we're looking forward to some of those case studies coming through. So I've got a couple of questions and the rest of the committee are obviously very welcome to come in. My question is about demand actually. Really, so how many people can you help and what is the demand that you're expecting? And I mean, one of the things you said about the sort of sometimes you get peaks, you're mainly expecting peaks. I would have thought peaks are when you really need to help people, but that's when you're going to be at most stressed capacity. So yeah, how many people can you help? So I haven't got the numbers in front of me to be able to say how many. I mean, some of the numbers were put together in the specification. We designed our model around that. So looking at some of the historic data. So we had that as a benchmark in terms of how we've designed the service and the team to be able to respond to that. But as I said, I think looking at bringing volunteers in is one way to build additional capacity into the service. And, you know, we will have to have waiting lists at time. But what we're looking at is really that sort of front door piece is really key. It's getting people in first, acknowledging their call, giving them realistic expectations around we'll get back to them, prioritising people as well based upon their level of need and sort of using that stratification process. So those people who are obviously in a critical need, bringing them in. But also I think that relationship with the local authority is going to be quite key as well. As Gary said, that sort of partnership and our link into the social services team, to the housing team, so that we're able to support people who maybe have issues that do relate to the local authority. We can sort of deal with people that are outside of that, outside of scope, and look at accessing service and sort of support elsewhere. But plugging people into the local authority as we need. So I don't know if that answers your question directly, but... Well, you hope you can do it, which is, I think, a fair answer in the sense that you don't know what demand is really going to be. But it's my interpretation. You do have some plans to do it, and obviously, but, you know, there might be something that happens that explodes that, you know, so you can't plan for every eventuality is my translation of what you said. Yeah, it is, and I think it's about having that open dialogue. So, you know, as Gary said, we have monthly meetings to start with, so being able to feed back on the levels of demand for the service, have that conversation, and if we do have issues, working that through together in terms of how we might deal with particular issues as well. And so my second main question for the moment anyway is, you know, one of the things in just general health service and also other sort of well-being services and, you know, these type of things is you have lots of different bits delivering, and how do those bits speak to each other and make sure that people don't fall through the net, make sure that information can be transferred so people aren't having to repeat themselves. So, I mean, I think I'm hearing that there is sort of like a one front door type of policy, whether that's the internet or the phone, but obviously people who need certain services are probably likely to need other services. And, yeah, so how does that work? Are you able to sort of, is information being able to transfer between the different providers who, you know, in order to make sure that the person who needs help can get help without having to jump through bureaucratic hoops again and again and again? So, yeah, certainly in terms of how the partnership is structured, it's very much set up in that way. So, we're working on a single system, from the point of entry into the service, when somebody signs their consent, they're consenting to four organisations holding their data, so we don't need to go back to people for permissions, straightaway that understanding that information is held and is accessible by partners. We'll have information sharing agreements with local authority, we already have them with NHS colleagues as well, so that we can pass data backwards and forwards again with permission of the service user to minimise the risks of people having to tell their story more than once. And we've already got good established relationships with the other providers as well, with MIND and with healing and carers. Okay, that's good. Thank you. Councillor Nelson. Thank you, Chair. Just wanted to, Lloyd, to find out, you stated that you will be using libraries to provide some services. My concern is, will there be a special area for that to sort for the service or for individuals to literally have access? And the reason being is that if you're going to provide the service in a library, a library will be open and it can cause distraction. And if there's any member who come in or invited to come there to do a face-to-face, at the same time they can be in crisis. So how will they be able to, how would the library be an area for them to come to? And that is a concern I have. And a really good point, and we were discussing that earlier today. So we are looking at mapping out and having conversations with the local authority because some libraries do have those confidential spaces and some don't. So we would look at the available premises and choose those that offer that opportunity for confidentiality in terms of private meeting rooms, etc. So that is key because of the nature of the service. There are going to be bookable appointments. People are going to be sharing confidential information, financial information, and they need to be able to do that in a confidential setting. Thank you. Councillor Martin. Thank you, Chair. I just have two small questions. Leading on from Councillor Nelson's questions about some residents will need face-to-face meetings. And you mentioned there will be various locations, primarily using libraries. Libraries are not available everywhere, and I'm assuming you'll be using other locations. But I recently got to visit Hillendrum Pride Hub, which uses libraries on a rotating basis. And one of the residents there was travelling from the south in the Heathrow Villages area up to Harefield, where that hub was taking place. And I wonder whether there's any plans for transportation of people or remote service where you can go closer to those people if you can't be near them at the time of crisis when they need the service. So, I mean, we're looking at having outreach at a range of locations around the borough to try and reduce the need to travel. And we'll do that on a rotational basis so that we can look at booking in people into a face-to-face surgery at a location that's convenient to them. And one of the reasons we chose libraries is because they tend to be located at quite good central positions that are on bus routes and quite easy to access locally. There will be situations where somebody maybe needs an urgent face-to-face and that won't necessarily fit into the voter and we'll just need to deal with that on a case-by-case basis. Just quickly, you mentioned in times of high demand, similar to COVID, I suppose, if times were tricky, that some people would be pushed onto a waiting list. And I'm curious what your understanding is of an acceptable waiting list and what sort of situations would push people onto a waiting list rather than an appointment sooner? I mean, I think the sort of waiting list tends to be, I suppose, if we're looking at benefits. So, it might be things like, I suppose, the areas that I'm more familiar with from an AGK perspective would be things like blue badges or attendance allowance, where there might be at times a waiting list that we would run, but we would make sure that's within the parameters that you can still do a backdated claim, et cetera, so it's not going to be detrimental. So, again, I think we'd be selective around prioritising the nature of the inquiry and only using waiting lists where it's going to have minimal impact potentially on the person involved in that situation. And is there anyone currently on a waiting list or is the service available today at the point of need? So, it's open, it's available at the point of need in terms of people getting access. There is a waiting list for certain pieces of case work at the moment, and that's in part down to we're still in week three of delivery and mobilisation, and there's been transfer of staff, transfer of case work, et cetera. So, we're working through a transition process and a little bit of backlog, but we're hoping to clear through that. But in terms of access to the service, people can access, they can get through on the phone lines, they can get through on the web form. Can I just add something? Yeah, go for it. Yeah, yeah, of course. Go for it. Our model has flipped that aside. The idea is to have access of web, phone, face-to-face, right at the beginning, and on the first contact to try and assess what the need is. The vulnerability of the individual, which could be language, could be learning difficulty, could be an older person, anything like that. Any disability as well. And also assess what the problem is. So, not all problems are as urgent. So, someone facing homelessness is not the same as somebody who's looking to fill a form in for attendance lamps or something like that. And that's what we mean by waiting lists. We will put them in different waiting lists according to the subject, what the issue is, and what the deadline is. And on top of that, it would be vulnerability as well, because we would push people who need more help right to the top of the list, so they get seen first, because they're likely to be more anxious, there could be some health difficulties and things like that. But the idea is to have that assessment and the first call. So, when somebody rings up, we'll have a case plan to say, this is what's going to happen. And when they've got that information, it really does help bring down the stress levels, bring down the anxiety levels, because they've got a plan, they know what's going to happen. If we keep to that timetable, we've got their confidence, and we can take that forward really together. That's the idea in partnership with the client. Thank you, that's useful, very useful context. Councillor Belles. Thank you, Chair. I'll declare an interest. I'm involved with the Hidden Advice, Citizens Advice Bureau, and so I've been aware of what's been going on, and I'm aware that some of our advisors have trooped it over to the new Hidden Advice Partnership. I'm a little bit concerned that you haven't got, knowing the nature of a lot of the clients that you'll get attending, a lot of them don't use telephones. Language, English is not the first language. They're like somewhere to come to, somewhere where they know it's going to be open. And, you know, I'm just a little bit worried that people are going to be left behind. And also about your training of your advisors, because there's certain levels. I know that we have at the Bureau, there's certain levels of training that they have to reach before they're allowed, let loose on them. Will you be following the same patterns as well? Do you want to go on the training side of things? Yes. I understand that Nucleus Legal Advice Centre is quite new to the borough. We've been delivering advice in West London for about 50 odd years. All the partners have got quality standards. So we do follow, we have quality marks as far as the advice we give, the training that staff have, training that volunteers have, and the procedures that we follow. Nucleus in itself, we run a very similar service in Ealing. We have a telephone advice line which is on a similar model. And there are issues, you're absolutely right, about some people not being able to access the phone first. What we need to do is complement them with different services and different streams. But the idea, again, is to try and have the most appropriate channel for that person in front of you. And that's going to take a bit of time, but we will develop them over time. As far as developing training is concerned, we have access to, and we do train all our staff, they have to meet certain standards, they have to have certain continuous development, sorry, I'll start again, CPD points, Continual Professional Development Points. And we have access to free training through shelter at NHS. We have access to debt advice through Wiser Advisor, and all of our volunteers go on that before they start advising. And also through social enterprise to offer benefits and so on. So we are used to making sure people come up to a certain centre before they start delivering advice. And on top of that, every single piece of advice will be supervised. And it will be supervised by, you know, some of the staff you mentioned, staff who have got over 20 years' worth of experience in working in these areas. And we've got in-depth knowledge about the complexity of things like universal credit, where the DWP does let people down, where people are likely to fail, where the systems like to fail them. And that comes back to what we were saying before. The idea is to create a case plan by somebody who knows the situation, who knows what's likely to happen, right at the beginning of the case. So you know where these issues are likely to arise. And you can intervene at the right time to make sure it doesn't happen. I want to delve in a little bit more about what we can do maybe for those who telephone isn't the most obvious way of communicating or computer. And also added into that, actually, is how do people know, A, that you exist, and B, how they can contact in different ways. So maybe you might not have the full answer straight away, and I appreciate that for right now. But obviously from the previous experience, how can we make sure that those people who are possibly some of the most vulnerable people actually can access this service? Yeah. And the face-to-face is a key part of the model, and we will be providing surgeries around the borough as described. And that's the primary mode of operation from Bell Farm is face-to-face, and for the client groups that they serve, that's really the only mechanism that they have confidence with. But what we're looking at is how we manage that. We want to avoid the situation where people are queuing around the corner and getting frustrated and waiting, which is always a risk with face-to-face. So we will be doing that on a bookable system, but we won't be saying, it's only if people drop in to a face-to-face, we will still be seeing them, but not doing the full assessment, doing that light touch triage and saying, actually, yes, we can make an appointment for you. We can't do the full assessment now, but we can book you in. So we're still seeing people. People are going away satisfied. They know who they're seeing, where they're seeing them, et cetera. So that face-to-face is still going to be a key part that people can do drop-in or bookable as well. Thank you. Councillor Hager. Thank you, Chair. And that was essentially part of my question. And I think I'll say, again, if that's okay, is with how do people know about or will know about it? We know from other collaborations that we've done. We started off at H4ALL. I know we learned a lot from that and working through that. I mean, it's really good. But how will people know about it? How will people understand what we're offering clearly without there being a complexity in it? Because you are offering quite a lot. So for someone to understand the clarity of it, how will we actually be delivering that? And how will we recognise? I know Gary was saying about people, you know, not slipping through the nets or be looking back, but how can we be rest assured that we haven't lost anyone en route? And the other thing is, you know, I presume we have already told H4ALL because obviously they're part of the collaboration. And they obviously tell all the other charities and the small groups. I mean, we haven't heard of it yet, but I presume that it's going out in their media coverage. Yeah? Yeah. And I think those are really the things. And maybe what have we taken back or what have we learned? And I think you picked up on some of this from past collaborations because we are having a one-stop door, which is great. But obviously, people, everyone needs to know about it. And it can, the complexity of that one-stop, we don't want people ringing if it's an emergency because it's not an emergency service. So it's being clear. I think that's my concern. So how are we going to be clear to people showing what's on offer and be clear that it's not an emergency service because obviously that isn't what it is? Yeah? So, as you've seen, we've created a new brand and new identity for the partnership. And rightly, that's new. We need to socialise that locally. And we've got a regular communications plan that we've been updating weekly with the local authority. And we're sort of moving that through phases. So we've been looking at how we promote that, the launch of the brand. We're also now looking at the engagement function of that as well, which is actually getting out and talking to the key partners, the social work team, the housing team, the neighbourhood teams, et cetera, and making sure that professionals know exactly what we do and how to refer in to us and what we do do and what we don't do within the service. And I think, you know, key going forward is also going to be our relationship with systems advice. And we've actually got, I think, despite the changes, got a really good working relationship with systems advice, liaising very closely with Mark, the interim chair there. Jazz, who's two feet across to us, is actually working part-time for systems advice and part-time for us as well. So we've actually got quite a nice interface there between the organisations. We've got agreement about how we refer backwards and forwards. And I think recognising that systems advice brand is still very strong and a lot of people will still go there by default. And we've made sure there's a fast-track route in from systems advice to our service as well. So we've sort of managed that interim process. Thank you. And obviously, over time, this is something for us to sort of hopefully see, get out there and how the system is actually used as well. So, yeah, councillor, sorry, no, you're not a councillor, are you? Gary, go for it. I was just saying, Chair, that around the comms plan, I think we didn't make the committee aware that the contract only actually became operational. It was the 2nd of June. So it is very, very recent. So it is a case of actually building that up incrementally. Thank you. So the last question on this point will be, or questions, maybe from Councillor Punja, and then we'll move on to Hillian and Mind, who have been very patiently sitting here waiting for their turn. So Councillor Punja. Thank you. I was interested in your CRM system because obviously that has to mean that everybody's working towards us on the same CRM system, which you did say so. But what mitigations have you got for issues? Because I know Salesforce quite well, and I know the problems that Salesforce can come up with as well. So just want you to know what mitigations, because you're obviously dealing at a mass bulk load of information that will go onto the CRM system. And the other question that I had was, I do appreciate that this is that you're only into this three weeks, but I do hope that actually a comms plan is developed and actually being implemented as we speak, because there's no point waiting six months for a comms plan to start. So just kind of those two questions. Thanks. So to start on the comms plan, so absolutely assurance that we are working on that. But as Gary mentioned, we only went live on the 2nd of June, and it was important that we didn't put anything out before then, because people were using existing services, so we could only begin promoting it a couple of weeks ago, but we do have a full communications plan in process, and that's evolving. On the Salesforce side, it's very established. We've moved over to Salesforce, I think, three years ago now. So we're very established on it. We've certainly welled through a lot of the teething programs, teething issues, and we're bringing partners onto our system, so it's established, it's set up, and a lot of those potential issues are dealt with. We've got a robust training program in place for new staff coming onto the system to ensure that they're using it effectively. Thank you. So, Gary, if we can move on now to the next part of our presentation. Thank you. Sure, if I may. Would you be happy for Julian and Balgett to leave if they wish to do so? Yeah, definitely, sorry, yes. You're very welcome to leave if you wish to. Thank you, Chair. We do look forward to sort of finding out more information in six months to a year, maybe about how things are embedding, so thank you for coming to speak to us. Chair, I would actually recommend if we say come back to the committee in a year's time. I think that would be a really good idea if you could come back to the committee in a year's time just to report on how it's been, so that would be very good. Thanks. Thank you. Thank you. Thank you. Thank you. Anyway? Thank you. So thank you. I think firstly I'd just like to say thank you for having the confidence in us to continue delivering our early intervention and prevention service. It's something we've been doing for a while now so it's enabled that continuity of care for our residents and obviously our volunteers and our staff base. Thank you. So just in case anybody doesn't know, we have been around for about 40 years in the borough now and I think the average length of service of our staff is about 10 years. So we're quite embedded in the local community. Hopefully our local residents are aware of us and what we do. And although we're independent in the borough, we do belong to the National Mine Federated Network, which allows us to draw on the resources, the evidence-based practice, and, you know, our whole communities of practice out there with our other local mines as well. And although it says 5,000, there's, you know, more or less 5,000 local residents that we support annually. And we support people with a wide range of mental health issues, not necessarily people who have that diagnosis, but that wide range, you know, mild anxiety and depression through to some people with quite severe and enduring issues. And really importantly as well, we have an ethos of peer support and co-production and recently just won a national award for our workforce and volunteer program. So just a little bit of background there. Bear with me. Yeah. Oh, there we go. There we go. Yeah. So just a little bit about the early intervention service. So obviously borough-wide and we support adults 18 plus. And the reason I put about service access through self-referral or professional referral, but also outreach as well. We've recognized that not everybody out there recognizes that they have mental health issues. And a lot of our referrals actually come to our outreach program. And the main provision that we have, we're looking to support people to access self-care and really preventative support in the borough and support to navigate our other community resources as well. And that's a really important part of the work we do. And we do that through one-to-one provision, therapeutic groups, peer support groups, and also digital face-to-face provision as well. So really trying to help people to have access to a wide variety of service provision. And in our next contract period, we'd like to focus on some of the underserved groups in our local areas. So recognizing where some of those issues are lying, some of the people that aren't accessing the support that they're entitled to and reaching out through our assertive community outreach program. And as our colleagues at the partnership have already mentioned, looking at that delivery across the borough, because we recognize that we're a very elongated borough, a lot of services tend to be based here in Uxbridge, but we're recognizing the need to have community outreach in those different areas as well. And really importantly as well, training up the local residents, training, awareness raising, and helping our colleagues in some of the smaller community organizations as well through mental health first aid training as well. And again, as we've already heard, that focus on partnership working in collaboration, both with our statutory services and our colleagues in the third sector. And also as well, you know, private companies as well, that for us is a way of bringing in extra funding that supports the delivery of the service as well. So we'll go out and we'll be delivering mental health first aid, mental health employment focus training, that type of thing. And really thinking about our services alignment with the CARE Act, you know, a strengths-based, person-centered approach, integrating trauma-informed practice, and really trying to promote resilience building as well across our communities as well, and promoting well-being. So just thinking about how we integrate and complement our existing services, so thinking about our service as that preventative service, helping people to recognize the early signs of mental health issues, trying to develop people's resilience, and looking at the social and economic determinants of mental health as well, and helping people to overcome some of those practical issues affecting their mental well-being. You know, with regards to our colleagues in our community mental health services, you know, we're not there to diagnose. That's very much their speciality. And we're not there to give out clinical treatment or diagnoses or looking at complex care. It's about that early intervention. And again, we don't have a medical model. It's very much strength-based, holistic, and community-led as well. Where necessary, we identify where cases need to be referred on to safeguarding, so liaising closely with our safeguarding partnership and our colleagues in adult social care, and also the community mental health service. So we have good established relationships across the board where we have easy transfer of data where necessary and to ensure that our residents are kept safe where necessary, but also as well us providing that step-down service for our statutory partners. You know, we have shared assessments, joint care planning, involvement in different MDT meetings as well. And the main outcome as well, we're looking to help people to maintain their independence and reducing that crisis escalation and reducing the demand on our statutory services as well, which hopefully we've demonstrated in years gone by as well. Sorry, I'm very sensitive. It's a hair trigger. Apologies. Now I want to go back. I think I'm in your way, Lisa. I think I'm blocking. Apologies. That's it. There we go. So just thinking as well about some of our key strategic partnerships, you know, we've spent a long time developing this service over the years, and we have, you know, key partnership working with a variety of partners here in the borough, so well-established partnerships. And I've just put a few of them. It's not limited to these, but particularly we work very closely with the GP Confederation. We have a lot of referrals come through the GP practices. We've worked very closely with the social prescribers and health and well-being coaches and looking for that timely and holistic intervention for residents there. Adult social care goes without saying. You know, we look to promote Care Act and needs assessment and also looking at safeguarding and strength-based planning as well. Also, we work very closely with our service manager from the mental health social work team. Local education providers as well. Thinking about early signposting for a lot of our younger residents as well. So the local colleges, the local universities. Not just looking at student well-being, but also looking to deliver training, interventions, and offering student placements which help complement our service as well. We've got a couple of social work students on board at the moment. So providing those ongoing learning placements and being a learning provider as well is really important to us. And that, as I said, enables us to have more expertise within our service. We've set on a wide variety of panels as well. So we're looking at joint risk management and information sharing and really feeding back up as what we're seeing on the sort of front line, as it were, within the voluntary sector. And as I've already said, we're part of that wider mind federation. So we're able to put into place relatively innovative working. Co-production is a key part. And we have our mind quality mark inspection. So we have to ensure that we meet that standard. So we've got that coming up. As I said, we won an award for our workforce and volunteering program. So as well, we have an established partnership with many of our third sector partners. And we're always looking to make sure that we're going out into the community and supporting some of those smaller community organisations as well, like I said, with outreach, training, offering sort of peer support training, going out and doing workshops and that type of thing. Apologies. Apologies. It's very, it's very, um, oh, sensitive. I think I've played some bullshit for you, yeah. Yeah. Apologies. You're doing so well. And then I keep losing where I am with the thing. Back. Okay. Okay. So it's the next one. There we go. So I won't read through all of this, but just thinking about some of the innovative approaches that we've put into place already and we're continuing. So really important for us as well to help people access what's already on their doorstep. So we've developed a programme of nature-based interventions, so something called forest therapy, but even just encouraging walking and gardening, access to ecotherapy as well. We work very closely with a couple of the local parks to make sure people are aware that, yep, you know, we've got wonderful green spaces in the borough. Let's get out there and use them and think about the positive effect that has on our well-being. Also looking as well at, you know, it's very fast-paced of developing AI models as well. So we're looking, as we've, you know, heard from our colleagues, looking into the use of AI in an ethical and, you know, safe manner as well, you know, thinking about the GDPR element of that, but looking at how we can use that within our own service to be more efficient. And where possible is where, well, we try to upskill our service users. We recognise that a lot of people in our community, unfortunately, don't use IT and we don't want them to be left behind. So we always ensure that our provision covers accessible resources, not just IT-based as well, because a lot of our service users don't even have smartphones. So we do have a wonderful programme with some volunteer mentors who actually work on a one-to-one basis with people to actually upskill them and help them, particularly important at the moment with the transfer to universal credit as well. We've seen that affecting a lot of our service users. So as I said as well, you know, community hubs, pop-ins around the borough as well, so making sure that we are as accessible as possible moving forward as well and not just based solely in Uxbridge as well, that's key. And as I've said, culturally targeted outreach, we have an ongoing programme with several established community groups as well. As well, we're trying to make sure that the approach that we take is holistic, recognising for some people life skills that are an issue, so thinking about helping them with employment. And I'll hand over to you in a minute, Gordon. Employment, a key part of the provision is employment support and supporting people back into meaningful employment activities, training, that type of thing as well. And that joint work as well to share data as well across sectors, so some of the innovation that we've put into place. Service provision there. Again, I won't read through it all, but just to highlight as well, the integration of this service with our existing services like counselling, our serious mental illness support service, which promotes health access for people with mental health, severe mental health issues, and our integration with our existing carers project as well. Really important to think about supporting the families and those around the person that's experiencing mental health issues. So health promotion, carers, peer support, you know, some key elements of our service provision. Again, I won't read through all of those, but the reason that we have our group activities, that's based on feedback from people that they want accessible activities as a stepping stone back into the community, so giving them the confidence to then go on and move on to an access community provision. But it also provides an opportunity for us to be perhaps more efficient because we can deliver workshops, training, sessions to a wider number of people. But also, again, in a preventative capacity, people will access our provision, and we're able to actually pick up when people are having issues at an early stage. We'll often notice, won't we, that people are experiencing difficulties, and it gives them an opportunity to then approach us and share perhaps some of their issues. And again, part of that early intervention strategy. So I think, so we're down on to this. So I know you're going to talk a little bit about the outcomes. The reason that we've implemented the triangle outcomes measurement tools is because they're an evidence-based tool. They also enable us to have a framework to support people through their journey of change. Perhaps you might be able to ask something to, you know, using it on the front line, as it were. But it also enables us to measure outcomes and track outcomes through that journey of change process. And also as a service to be able to look and see within the 10 life areas that it covers, where are there issues remaining? Where do we perhaps have to review service provision to support people? For example, in the past, we've noticed that the use of time needed sort of work, as it were. So that's where we strengthened our employment support. And it might be that, for example, we need to look at addictions and work closely with our partners around addictions. It really does help us to have that service review. We also use the GAD 7 and PHQ 9 just as a risk management tool and to assess people's mental health when they come into the service as well. And that highlights when we need to escalate and risk management as well. Service user surveys and case studies, as we've already mentioned as well. As part of our agreement with MIND, we have to complete and put into place feedback methods and service user surveys are a way that we do that throughout the year. So just thinking about some of the opportunities that we've already seen and we continue to see as we go along, we're seeing much more, you know, this implementation of AI to analyse data and to help with perhaps as well developing those targeted interventions as well. Thinking as well about population-specific support as well. So within MIND, we have a strong focus on, as I said, those underserved groups. So we'll be looking at specific provision around the LGBTQ and racialised communities and working with our partners as well around neurodivergence as we get a lot of referrals for people with neurodivergence issues. We continue our development of our volunteering and employment, promoting that to our service users as well where possible. Upskilling our own service users and carving out roles for them within our organisation is really important to us and our resources at MIND is very much around that as well. So, as I said before about the early identification of needs and being able to respond to that and in partnership with our other, you know, the other providers in the borough as well. We like to think that we can have a voice within the borough and within the wider mental health community. So, you know, we're able to feed back to our national MIND partners as well where we see emerging issues and where we feel that, you know, there needs to be development of resources or strategies as well. Obviously, as well being in the voluntary sector, we're always on the lookout for additional funding, additional ways of raising money to enhance the service. So a lot of that is around our delivery of training. Also, as well, looking at other funding streams as well, really important as well. So we continue to do that and upskilling our wider workforce, upskilling social prescribers, GPs, staff, other community partners as well, so that they're equipped with the tools and the strategies to support people at an early stage and prevent that crisis escalation as well. Again, similar challenges as we've already heard. You know, we're always seeing high volumes of need within the service. We're seeing the impact of some of the changes to benefits, causing anxieties within our service users. So it's about being able to respond and look at ways that we can promote resilience as well, because we understand that for some people accessing services, there are waiting lists. So as much as we can, we're promoting self-help resources and, again, trying to build resilience and increasing our volunteer base as well. I think that that's a key strategy that we have to be able to provide a larger service to people as well. As I said, we're seeing increased demand due to those housing and benefits issues, so it's really good to know that we have the advice partnership as a valuable resource to be able to refer into. Digital exclusion, for many of our service users, digital exclusion, as I said, is key. Although we've literally just heard that we may be getting things like donated laptops from an organisation, so thinking about how we can upskill and support people to develop the IT confidence as well. And although we are seeing improvements through the use of AI, you know, it's just making sure that we're working ethically and data security as well is key as well with the use of AI. Workforce pressures, as we've already heard, finding volunteers can be challenging, but we have developed a way of carving out roles for people and really trying to offer that supervision and support across the board. Yeah, so I think that's probably there. I think that's probably it. That's probably it, I think. Yeah, I think it's just... Oh, thank you. Just, sorry, just very, very briefly. Yeah, OK. Very briefly. I'm aware of the time, so very briefly. And I think one of the things that we've found, as I said, was to enhance our group provision as well, to offer, you know, a wider access to our services and really that triage system as well that we've already heard because sometimes we can have people that are in abject crisis, so we do have to ensure that they get timely access to services. And we do that through our triage process as well. But really trying to promote that resilience in our community, guided self-help, accessing what we already have available through MIND and our partners as well. So, yeah, I think that's it. I mean, obviously we'll answer any questions you have because we're doing this on a daily basis, an hourly basis, minute by minute. So anything you need to ask us, you can elaborate on. We definitely will have questions. I think we have a couple of others as well. But I think, Gary, did you want to sort of come in on something before we came to a question? Chair, what I was going to suggest is rather than put the presentation up, because I believe that members have actually received the information, just to make a couple of points really that provided the committee with examples of the outcomes performance indicators and performance measures are actually reflected in the contract. in terms of monitoring arrangements, slightly different situation with the MIND service compared to the Hiddings and Advice Partnership, to an annual value of $230,000 a year. But we have an established provider with an established delivery model. So on that basis, we feel there's actually less support actually required. So monitoring arrangements are based on quarterly meetings. Evelyn, et cetera, explained some of the information that's provided, again, the emphasis on the provision of case studies as examples of evidence of difference. It's a similar approach to the Hiddings and Advice Partnership. The lead is at service manager level, and again, we will be seeking to involve more sort of operational staff in understanding how the service is actually operating and reporting on feedback. Thank you, Chair. Okay, thank you. So I'm going to, as it's a bit later, it's warm, I'm going to cut to the chase and ask my big main question straight away. So we're doing a report into early intervention and prevention, and one of the things that we definitely, I have picked up in other reports that I've done is, with mental health, the earlier the intervention, the better you have a chance of improving the situation, is always what I've found. So in terms of the report we're going to be doing, if you could give us a wish list of okay to make early intervention and prevention happen better in the mental health sphere in Hillingdon, what do you think would be some good ideas for us to put in our report? Obviously, we will choose if we put them into our report or not, but literally, this is the thing I'm really looking for. So, yeah, this is your chance to tell us. Oh, God, where do we start? Where do we start? Nicky? Gordon? You're on the front line, so I wonder if you can come up with something. I'll reply. So my name's Gordon Milne. I'm a mental health support officer at Hillingdon Mine, but I'm also a peer support worker. Very briefly, I'm here because I had an absolute mental breakdown about eight years ago. I was introduced to Evelyn by my caseworker at CNWL, and I became a volunteer at Hillingdon Mine about four years ago, five years ago. And when a role on the staff became available, I applied for that. So as a peer of our clients, of our service users, and I'm not the only peer at Hillingdon Mine. It's a peer-led culture. I know that people need to talk about their mental health problems without inhibition or any sense of stigma. That's it. So my wish list is a budget so that we can have more people who are proud to wear their mind lanyards. So one way I advertise mind is when people come up to me in Uxbridge. Some of them are my service users, some of them are our services, others aren't. And I'm quite proud of, well, I'm very proud of working at Hillingdon Mine. It's the best job I've ever had. But in order to do it better, we need a channel with which to express our sincere voice that we encourage people to talk. Okay. Yep, that answers your question. That does. I have a slight challenge on that, then I'll come to you, Nicky. So in terms of obviously budgets, budgets are tight everywhere, aren't they? Choices are having to be made across every single public service. We know that completely. So is there a way of evidencing that better budget spent on early intervention could actually increase better outcomes earlier, which would reduce budgets later on? I'm just thinking in terms of if we are to put a recommendation in the report saying more money should go into having people who can talk and listen and help at an earlier stage, and that will help, which sounds very logical to me. But if we are going to make that argument, we need to make the argument in the way that maybe those who have choices on budget, they will have to consider it. So is there such a way of trying to work that out or anything? I think one of the ways that we've tried to sort of overcome this issue of getting people to talk is to go out and offer training, because I think the other thing is it's okay to encourage people to talk, but then you need to know, you know, not necessarily what the answer is, but how to respond, I think, is the key thing as well, which can be tricky, can't it? It can be tricky. And I think that by going out and being able to offer training within the community is key, so that people feel confident talking about their mental health, are able to respond safely as well, and ensuring that they know where to get support as well. Well, they know what to do if somebody's in crisis. And I think as well, the fact that we work closely together to help people overcome those practical determinants, you know, those social determinants of mental health issue, I think is key as well. So again, that joined up working, because it's all very well, you know, people can have mental health issues for a wide variety of reasons. And I think sometimes, unless you actually help them sort out those practical issues, you're not going to be able to... Early intervention. Yeah. Yeah. Okay. So, Nicky, I'm going to let you sort of answer the question, and I'll go to other committee members to ask questions as well. So, what are your thoughts on this topic? Well, if you whip out your magic wand, I would say it would be reducing the waiting list of services across the board, really. Because we have a lot of residents come to us with complex issues, a range of different difficulties from housing, mental health, physical health. And we're left holding these people that have all these different issues, and sometimes we don't have the resources to be able to provide that support. So, when we do the necessary referrals, signposting, we're having to wait for them to receive that right support. We're cradling these cases to make sure their mental health is maintained or improved, and sometimes it can be quite difficult to continue that support, isn't it? So, in essence, obviously you can help, but if somebody really is being, if their mental health is being really impacted by the fact they don't have a permanent place that they couldn't call home, no matter how much you help, if there is a delay in the system over there, that really isn't going to help. I mean, I suppose my sort of follow-on from that is, and maybe it's not something you could answer straight away, but if you could come back to us, it would be very interesting. I mean, is there, do you sort of capture maybe which services are slow and having most impact? Because I think for me, it'd be really interesting to know that actually, yes, there are delays here, here, and here, but actually the delays here are really causing big problems that we can't go over, but the delays over here, not great, but we can sort of mitigate them. But that sort of information, I think for me, is really interesting, because it might try and help targeting resources. If that information is possible for you to sort of think about, we'd be very interested in that. Okay, brilliant, thank you. So, okay, I'm going to go to the rest of the committee now. Councillor Nelson, you had your hand up first, I think. I do. Thank you very much, and the work that mine do is absolutely marvellous and wonderful, and if you can get more money and we can help you to get that, we'll be welcome. But one of the things I just wanted to publicise in regards to mine and what they do, we've got a lot of lotment across the borough, and you're using some of those, you know, allotment to help people in crisis. And I know about that. And getting more people involved in that way might be another way of showing what it is that you do, because a lot of that work that's going on within on the allotment and around the allotment doesn't get publicised that much. And it does help, because I have sit down, they've got coffee, people work with their coffee, they work with their biscuits, and it's amazing to listen. Just the way that people just have that conversation and are listening ears does help. So I just wanted you to know about that, because we've got a lot mentally that is really, really being worked upon. Thank you for that. Councillor Punja. Equally, thank you so much for the work that you do in our borough. Extremely valued. I just have a little bit of interest in the demographics that come to mind, and the specific trends that you might see, because whilst you're providing all of these services, which are absolutely fantastic, but I just kind of, you know, that access to service and access to points is quite important, I feel. And so do the demographics and trends kind of shape what you're doing, and how do you look at the trends, all the demographics, and kind of go, well, what are we missing as well? Yeah, yeah. Oh, I'm sorry. Thank you. So just thinking about our, you know, the demographics of people who use our service, they, you know, quite representative of the borough. So that's key to helping us understand, you know, who is actually coming in, where do we need to put in a little bit of extra work, shall I say? One of the things that we've seen at the moment is a rise in asylum seekers from the hotels. And that's been very challenging, because we don't have a lot of resources, I'll be honest with you, and I know that that's a key problem, actually, across services, and we're very much involved with REAP and, you know, the mental health meetings that we have there. But what we're looking to do is to try to go to our National Mind colleagues and say, look, we've got this issue. We're trying to develop resources in community languages. You've got more money than we have. Can you provide this for us as an example? And also thinking about, as I said, you know, what's going on across our own federation as well, because there's been some work going into targeting young people, LGBT communities as well. So, drawing on what's already working out there to implement that in the borough, where we feel, you know, there's a lack of resources. But as well, as I said, you know, trying to get out into the community and, you know, as Councillor Nelson said as well, trying to, you know, enhance our profile as well and helping people access what's already in the community as well, I think is key. So, if I could just quickly add something even. So, and one thing that we're endeavouring to do is just physically outreach and do a bit of networking, a bit of business development and find venues perhaps in other parts of the borough outside Uxbridge where we can collaborate. So, for example, there's an art centre in West Great in Southlands Art Centre. It's a lovely venue. It's at the south of the borough. We're working with them where we have a space which they are allowing us to use. And in return, we're providing mental health support for their staff as well as for the people who come there. And we're hosting workshops there. And we're looking for other locations in other parts of the borough which we can use, where we can collaborate, where we can be present, where we can be available as a sort of clinic once a week to take, you know, queries from people and in return invite people who can't make it across the borough to attend some of the stuff we do where they are. So, that's an ongoing thing. But we're looking for the venues and we're also looking for support from the mothership to provide us with cultural resources so we can spread our message in more languages than we can. Can I just add to that as well? You know, thinking about what's already out there in the borough, sometimes it seems like it's a simple idea to say, well, we'll go and do a group session down here or a bit of outreach down there. But it's not always that simple because there's often challenges and barriers to accessing different community venues. That's something I would like to put on my wish list would be greater collaboration and sharing of community resources. I think that's key as well. You know, even things like the library, you know, the libraries across the borough, it's all very well. But sometimes, you know, we've been quoted sort of, you know, rental costs and things like that. So I think as much as possible, if we can share resources, key, key. I think that's something important for us to look at, isn't it, as well, in terms of these recommendations. Councillor Chamdale. Thank you, Chair. Thank you for your presentation. I was aware of mine, but I wasn't aware of all the activities that you do. So it's similar to what Councillor Nelson was saying. How do you get referred to these activities? Can I just walk in? Because sometimes loneliness can cause depression, can't it? So if I was interested in your book club, can I just come along to the book club or is it referred and how is it advertised? So one of the things that we have to do to maintain a safe space is to have a referral process. However, we do get people say to us, well, can I bring my friend along that's lonely or I know this person. But what we like to do is sit down with somebody before they attend just to make sure that we're aware of what their needs are and how we can support them. And that is purely for a safety perspective, maintaining the group safe, because we have had issues in the past where people have sort of dropped in. However, we have a weekly social group on a Wednesday where we will often, unfortunately, we will get people who are, you know, and I say unfortunately because they're lonely and they'll come along and say, look, you know, can I have a cup of tea? And we try to be as welcoming as possible, but just managing that risk as well. We just have to be careful because we want it to be a safe space for everybody. Thank you. Councillor Bell. Thank you, Chair. Thank you for your presentation, very interesting. I used to work at Relates and I know that where appropriate that we would refer people to and vice versa as well, that you would, do you work with many other organisations? We do work very closely with a wide range just because we recognise that we might not be the sort of experts for that person, you know, there might be a more appropriate organisation so we'll work closely with many different, from many different sort of spheres, yeah, different counselling organisations, other local charities, you know, where relevant because I think it's about us recognising our limitations as well, you know. And also, I was listening to the writers today and Heston, during the time, was on there talking about his journey and it's going to get, there's a TV programme going out tonight, etc. Do you find you get a spike in enquiries after a well-known person has... Often, yeah. Yeah, we have had that in the past, definitely. Yeah, and you can cope with... Yeah, yeah. I think as well, you know, we do have backing from our national team as well, so we have an emotional support line that's available for people and an information line, so, you know, where appropriate, it might be that we're, again, signposting to some of our national resources. And if I could just very, very briefly add a point, councillor, to if we are referring somebody else on to another resource. It's important for all of us to make the person know that they're not being fobbed off, that they are being listened to, that their needs are important. And so, when we do refer somebody on, we explain that it's because that's the best resource for them. Sometimes people have come to us, and we were talking about IT earlier, they can't get through, they can't use the internet. When they actually speak to us for the first time, they're not necessarily in a good place. They're frustrated. They're angry. And once we listen to them, we speak to them, and we realise that perhaps they need help with their relationship, rather than, or whatever it is, then we are very happy to refer them on to the other organisations we're happy to be in partnership with. But we do make sure that the people we're talking to know that they're being listened to and cared for, and that the referral elsewhere is not because we're fobbing them off. That's part of what we do, and that's a very important part of what we do when we do make referrals. Yeah. That's very important. Right. Last question on this session to Councillor Hager. Thank you. First of all, congratulations on your award as well. Mine's been amazing, I think, with such an asset to have you in our borough. We really are, after all the years, you know, it's been really good. And thank you also, Gordon, for sharing personally, you know, about your mental health. I think that's so important, and for being brave and bold and doing that. Thank you. You know, that's amazing. So thank you. Thank you. My question is, what do we see in Hillingdon being the biggest growth area of mental health, and what age is that? So is it younger? Is it older? Is it stress? Is it anxiety? Is it, you know, burnout? But what are we seeing a big increase in, and how, again, can we help with that prevention area? I think, can I hand over to you, Nikki? Maybe young people, I think, issues with young people. I was at the young people's lead on the project, and they are very, very difficult to engage, motivate, keep focused throughout the whole project. Sometimes they don't even want to answer the phone, but they ask for help, so you do try and help. For me, it's about being patient and listening, working in collaboration with the schools, helping them promote their attendance, because they had issues of attendance, they may have family issues. It's helping them resolve any issues they have, but also helping them recognize their strengths as well, but they are very, it's very challenging, just to motivate them, wasn't it? It was, yeah. I think as well, housing, I think, is an issue, and it's a very, very difficult issue to be able to support with, practically. I think housing has to be one of the main issues, and the cost of living. You know, cost of living, I think it's not just about people on benefits, but it's also what I would consider the working poor. We have a lot of people that are very stressed out about being able to sort of get to the end of the month, so they're definitely sort of key issues. Anything else, Gordon? Sorry. A common issue along, I would probably say, around 90% of young people that I've seen all had an issue with self-harming. So there was a lack of training within schools and understanding within families around safe harming. So one of my roles is to do direct work with them around that, helping them understand their triggers, in working with them to find better, healthy ways of coping, really. So I just went to that. No, no. Yeah. And also, there's the issue of employment, and sort of, we support people who are looking for employment, and in recent times, the employment issue, it will have been affected by COVID. So a particular profile, who might not have expected to be unemployed, may find themselves unemployed. But it's the lack of employment is also evident of a lack of self-regard and confidence and self-belief. So we support people into employment. But the first step is actually to support people in recognizing their own worth and their own value before they can make the next step. And people can have been out of work because they've been caring for members of their family. And, you know, part of what we do is explain that having looked after a member of your family for five years involves some of the decisions that CEOs and small businesses have to do as well on a daily basis and actually help them realize that what they've been doing is running a project of caring for somebody and negotiating fees of carers and stuff like that. And then they realize that they can transfer the skills. So that's the thing of transferring skills. So that employment can only come from hope in the first place. That's a nice message to end on. There we go. This session. Thank you. So thank you so much for taking the time to be with us and listen, first of all, and then give us an interesting presentation. Obviously, there's some extra information if you're able to pull together, I think we would find very useful. Any other ideas that you might have, you can very well contact us through Nicky or through Gavin or Gary or whoever. Yeah, good. All ideas are good ideas. So thank you. You're free to go now if you wish to. I shall hand it. Yeah, yeah. And Gavin and Gary, you can leave as well because I don't think the next two items are relevant for you particularly either. So thank you. Good stuff. Right. Thank you. Thank you. So do we have anything to say on the Cabinet Forward Plan? No? Are we happy to move on from that item? Yeah. Brilliant. And then we come to the work programme. So our next meeting in July, we've got down a single meeting review, and this is on GP coverage and how GPs are working across Hillingdon. Obviously, an issue that sort of comes up many times in other areas. So are we still happy to proceed with that? Yeah. Good. Thank you. Good stuff. And then when we get to September, we're going to be looking heavily at the budget and what's going on in the adult social care budget. So that's when we've got some other updates. So yeah, happy with both of those. Are we happy? May I? Yeah. Yeah, Nikki. Chair, members, just so you're aware, I mentioned previously about budget training, budget scrutiny training. We were unable to get it scheduled for June, but we have managed to get it. I think we're having it on the 10th of September. Information will be coming out to members about this in due course, but it will be before our September meeting, which will be the next time we actually get a report on the budget. Okay. Well, that'll be super useful. Thank you. Also, I don't know if members actually clocked this when he said it, but Gary mentioned earlier about the possibility of having the Carers Trust in as another witness session as part of our adult social care early intervention prevention, and said about having it at our October meeting. We don't actually have a meeting in October, and what I wanted to ask members was, do you want a meeting in October? Because I think in terms of the availability of Carers Trust, they're not going to be able to make it for September, and I don't think they can make it. I think November's going to be too late. I mean, it's easy for me to say, because I'll be forcing everyone else to do extra than everyone else, but I just look at September's work programme as well, and I think some of that should be shifted. If we had an October meeting, looking at the meeting of Carers Trust, which I think is important, and we could shift some of the other stuff into that, you know, because September looks really busy, so I personally would favour an October meeting, obviously, and I completely understand if we couldn't have full attendance, I completely understand because it's random, but I think it's a good idea. So should we try and find a date that we can all do, and if a couple of us can't, then that's okay, but let's go for an October meeting. I will send a message out to members, identify some possible dates where there aren't other meetings on, and see where the best date would be. Yeah, good. We were happy with everything else. Brilliant. That's it, isn't it? Brilliant. Okay, thank you very much. The meeting is closed.