The Scrutiny Health & Social Care Sub-Committee were scheduled to meet to discuss the financial position of Adult Social Care and Health, the Adults Living Independently transformation programme, and the Croydon Health Service Quality Accounts. The sub-committee was also expected to review responses from the cabinet to scrutiny recommendations, receive an update from Healthwatch Croydon, and consider the sub-committee's work programme for the coming year.

Adult Social Care and Health Financial Position

The sub-committee was scheduled to note the progress of the Adult Social Care and Health Directorate's financial position, based on an update extracted from the 25 June 2025 cabinet papers.

The report indicated that at period 10, January 2025, the directorate had a forecast overspend of £5.3m (3.2%) against a budget of £164.0m. Adult Social Care Operations were forecast to overspend by £7.1m, which was partially offset by an underspend of £1.8m in Adult Strategic Commissioning, Policy and Improvement.

The report stated that increasing care costs were being experienced nationally and regionally, and that despite best efforts, including over-delivering on savings targets, the directorate remained in an adverse position. It noted a continual increase in the demand for home care, as well as high demand and levels of need from acute hospitals. The report also cited the increasing cost of nursing and residential care beds for new placements as a significant factor in the underlying forecast overspend.

The report stated that the directorate was forecast to deliver its £5m savings target in 2024-25 on placements and care packages through demand management, commissioning and review of care packages.

Croydon Health Service Quality Accounts 2024-25

The sub-committee was scheduled to receive and note the Croydon Health Service Quality Accounts 2024-25. The quality account is a statutory annual report that reflects the trust's performance over the past year in key areas such as patient safety, clinical effectiveness, patient experience, and leadership. It highlights achievements, identifies areas for improvement, and outlines future priorities, providing transparency and supporting continuous improvement in the quality of care provided to Croydon residents.

The report included information on:

• Patient Advice & Liaison Service (PALS)
• Complaints & PALS Themes
• Care Environment
• Overview of Clinical effectiveness
• Mortality Reviews and Learning from Deaths
• Learning Disability Deaths
• Clinical Standards for seven-day hospital service
• WELL-LED
• Well-Led review
• Risk Management
• Quality Improvement
• The National staff Survey
• Staff Wellbeing & Staff engagement
• Quality Priorities for Improvement 2025/26
• Statements of Assurance 2024/25
• Review of Services
• Information on Participation in National Clinical Audits (NCA) and National Confidential Enquiries (NCE)
• Commissioning for Quality and Innovation (CQUIN)
• Care Quality Commission (CQC) Inspection
• Information Governance Assessment
• Reported Data Protection and Security Incidents
• Freedom of Information Act (FOIA)
• Subject Access Requests
• Operational Performance as a Quality Indicator
• Our Approach to Population Health Management, Prevent III-Health, and Health Inequalities 2024/2025
• Mental Health Services
• Digital Services development (Information & Communication Technology
• Croydon Health Charity
• Chaplaincy & Spiritual Care
• Statements from external stakeholders

Update on Transformation and Stabilisation Plan

The sub-committee was scheduled to note the progress of the Adults Living Independently programme and the delivery of the directorate's elements of the stabilisation plan.

The Adults Living Independently transformation programme is the core transformation and savings delivery model of the Adult Social Care and Health Directorate's 2024-2028 Medium Term Financial Strategy. The programme aims to support residents to increase their independence wherever possible, enhancing their outcomes and quality of life while reducing reliance on commissioned care services.

Key workstream highlights included:

• Older people workstream – Localities: The 'Collaborative Discussion Space' has been rolled out across all six localities[^1]. [^1]: Croydon is divided into six localities for the purpose of delivering local services.
• Older People workstream – Acute: New 'Let's Talk Home?' discussions and earlier identification of potential residential care packages, have been rolled out to 10 targeted Croydon University Hospital wards.
• Reablement workstream: The reablement workstream is now piloting the new operating model, with the Active Reablement team working alongside external reablement providers.
• Disabilities workstream: 'Needs Scores' have been introduced to allow the service to identify the current and future potential strengths / capabilities of each resident, in line with the domains of the Care Act[^2]. [^2]: The Care Act 2014 sets out how people should be assessed for social care, and what sort of care they are entitled to.
• Transitions workstream: This workstream is aiming to reduce the age at which a discussion is held between Children's and Adult's social work teams, providing the maximum opportunity to plan for the transition well with the child and their support network.
• Mental Health workstream: The focus within the Mental Health service has been on identifying the residents who have the potential to live more independently.
• Digital workstream: A 'System Visibility' dashboards workshop was held with representatives from this Sub-Committee on 19 July 2025.

Update from Healthwatch Croydon

The sub-committee was scheduled to receive an update from Healthwatch Croydon Co-optee, Gordon Kay, on the latest report from his organisation.

Cabinet Response to Scrutiny Recommendations

The sub-committee was scheduled to be presented with an up to date list of responses from Cabinet to recommendations made by the sub-committee for review.

The sub-committee was asked to review the responses given and consider whether any further action was necessary.

Scrutiny Work Programme 2025-2026

The sub-committee was asked to note the draft version of its work programme, as presented in the report, and consider whether there were any other items that should be provisionally added to the work programme as a result of the discussions held during the meeting.