The Health and Social Care Scrutiny Commission met to discuss children's respite care, cancer prevention, a nursing care home delivery scrutiny review report, safeguarding, and the commission's work programme. The meeting was scheduled to include presentations from Southwark Council's Public Health team and the South East London Cancer Alliance (SELCA).

Cancer Prevention

A presentation from Southwark Council's Public Health team and the South East London Cancer Alliance (SELCA) was scheduled to support a scrutiny mini review on cancer prevention and early diagnosis.

The presentation was due to cover:

• The role of Cancer Alliances, which were established in 2016 to improve cancer services.
• Governance and funding for cancer programmes at a national level.
• The Core20PLUS5¹ approach to reducing health inequalities.
• Priorities for cancer prevention and screening in 2025/26.
• Primary prevention strategies, such as improving uptake of the HPV vaccine² through awareness campaigns.
• Secondary prevention priorities across South East London, including improving uptake of bowel screening and rolling out lung screening.
• Examples of SELCA's breast and prostate awareness campaigns targeting black populations.
• Data on early diagnosis of all cancers.
• Southwark Public Health's approach to cancer prevention, focusing on targeted awareness, making the most of every contact with residents, and using public health interventions to tackle the causes of cancer, with a case study on tobacco.
• Projects and outcomes related to tobacco control, including the Tobacco Control Strategy 2024-2030 and stop smoking services.

The presentation also included examples of place-based projects aimed at improving screening and timely presentation, such as HPV catch-up programmes, projects targeting people with learning disabilities and serious mental health illnesses, and campaigns to promote cervical and breast screening.

Children's Respite Care

The commission was scheduled to receive a presentation on short breaks and preventative care for children, focusing on the impact of moving away from the previous short break model. The presentation was expected to cover:

• An overview of short breaks, including core provision (after-school, weekend, holiday playschemes) and workshops, trips, and family events.
• How the new short breaks offer reflects the guiding principles of Southwark's 2030 Vision³, including strengthening preventative services, reducing inequality, and empowering people.
• Delivery locations for short breaks provision.
• Demographics and feedback from users of targeted short breaks services, including ethnicity and ratings of provision.
• Information on overnight short breaks, including the number of children and young people accessing them, the total days provided, and the overall cost.
• A comparison of overnight short breaks provision at Orient Street in 2022 with current provision.

Nursing Care Home Delivery Scrutiny Review Report

The commission was scheduled to note the final scrutiny review report on nursing care home delivery. The review examined the delivery of a new nursing home, responding to plans to deliver one on Asylum Road. The commission sought to ensure that all available options to deliver the home had been thoroughly considered, including a market-led approach, commissioning a development partner through a procurement process, direct delivery, and exploring potential partnerships with the NHS and charitable sector.

The report outlined the decision-making history and approach, including the intention to pursue a development-partner approach and the subsequent commencement of a market-led approach. It noted that members had asked why a Gateway 0 report⁴ had not been pursued, as this could have been an early opportunity to undertake a strategic assessment of options.

The report summarised the options considered to deliver a care home:

• Market-led approach (adopted): This approach involves inviting the market to step forward with proposals to deliver a targeted nil-cost solution, with the council offering a long lease on the land.
• Development partner procurement: This approach was rejected because procurement is considered a longer and more costly process.
• Direct delivery: This approach was rejected because the Capital Monitor funding allocation had been largely expended with the purchase of Tower Bridge Nursing Home, and there was no further capital budget allocation.

The commission expressed concerns about the precarious nature of care homes in Southwark and the variable quality of provision, noting the loss of three homes over the last decade. Members were also concerned about value for money and delivering high-quality care, questioning the business model used by large providers and the potential for profit leakage.

The report discussed council levers to improve care home quality, including commissioning leverage and monitoring arrangements. It also highlighted the importance of future-proofing the building and operating quality, suggesting that council ownership of the asset would prevent closures.

The commission made a recommendation that a Gateway 0 options appraisal report be produced for the cabinet to ensure a more thorough process is followed and that all the delivery options are fully considered. This should include consideration of direct delivery, the impact of each delivery model on the revenue account, and partnerships with the NHS and charitable associations.

Safeguarding Scrutiny Review

The commission was scheduled to recap on progress to date and plan future items for the Safeguarding Scrutiny Review.

Work Programme

The commission was scheduled to discuss its work programme for 2025-26. The Health & Social Care Scrutiny Commission Work Programme 2024 - 25 listed the issues the commission was considering, including:

• Adult Safeguarding
• Cancer prevention and early diagnosis (mini review)
• Damp and mould
• Pain management clinic
• Blue Badge update
• Care Nursing Care Home model delivery (mini review)
• FGM update
• Children's respite care
• GP appointments
• Improving access to toilets update on review
• TFL: explore an earlier bus pass starting time and driver behaviour

The work programme also included standing items such as an interview with the Independent Chair of the Southwark Safeguarding Adults Board (SSAB) and interviews with cabinet members.