The Scrutiny Health & Social Care Sub-Committee meeting focused on the needs of older residents, the implementation of neighbourhood health initiatives, and updates on the Adults Living Independently programme. Key decisions included noting the findings of the Older People Needs Assessment, endorsing the continuation of the Neighbourhood Health and Care programme, and reviewing the progress and savings targets for the Adults Living Independently transformation programme.

Older People Needs Assessment

The committee received the findings of the Older People Needs Assessment, which highlighted a projected 25% increase in Croydon's over-65 population by 2030. The assessment identified significant health inequalities, with life expectancy varying considerably between the most and least deprived areas. Key health challenges include a high prevalence of dementia, cardiovascular disease, and depression, alongside social determinants such as inadequate housing, transportation barriers, and digital exclusion. Nineteen recommendations were made, grouped into four themes: becoming an age-friendly borough, strengthening preventive care, enhancing integrated care for complex needs, and addressing social isolation and mental health. The implementation of these recommendations will be overseen by the Ageing and Dying Well Steering Group.

Neighbourhood Health and Care: National Neighbourhood Health Implementation Programme (NNHIP)

Croydon has been selected as one of 43 Wave 1 sites for the National Neighbourhood Health Implementation Programme (NNHIP). This initiative builds on Croydon's existing approach to integrated, proactive, and preventative multi-disciplinary team working through Integrated Neighbourhood Teams. The programme aims to improve primary care access, focus on high-priority cohorts with complex health needs, and foster co-production with residents. Early learning from pilot sites indicates the need for stronger resident voice, improved inter-agency collaboration, and a focus on prevention. The programme is currently in a 'test and learn' phase, with plans to scale up successful interventions.

Adults Living Independently Transformation Programme and savings update for 2025/26 and 2026/27

An update was provided on the Adults Living Independently (ALI) transformation programme, which aims to support residents to live independently for longer, enhancing their outcomes and reducing reliance on commissioned care services. The programme is on track to meet its savings targets for 2025/26 and has proposals for further savings in 2026/27. Key performance indicators show progress in areas such as residential starts and domiciliary care hours for older people, and reablement success rates. Challenges remain in managing domiciliary care hours originating from acute settings and in achieving step-down targets for mental health and disabilities. The programme is being supported by Newton Europe, and a 'health check' has indicated positive progress, though areas for focus include domiciliary care from acute settings and mental health accommodation. The Sub-Committee raised concerns about the level of detail provided regarding the 2026/27 savings proposals and the budget.

Update from Healthwatch Croydon

Healthwatch Croydon presented updates on their recent reports concerning Type 2 diabetes care among Black African and Caribbean residents in Croydon, and neurodiversity and healthcare access. The diabetes report highlighted that while many respondents found services helpful, there were significant barriers related to culturally appropriate care, lifestyle advice, and mental health support. The neurodiversity report revealed that many neurodivergent individuals in Croydon experience challenges accessing healthcare due to a lack of understanding, communication barriers, and system complexity. Healthwatch Croydon also briefed the committee on potential changes to the Healthwatch structure nationally, expressing concerns about the independence of patient and resident voice, the integration of services, and the focus on seldom-heard communities. The committee expressed strong support for the principles of Healthwatch and agreed to draft a letter to the government advocating for their continuation.

Scrutiny Work Programme 2025-2026

The Sub-Committee noted the draft work programme for 2025-26. A suggestion was made to include an item on the governance of Prevention of Future Deaths notices and how learning from these reports is embedded across Adult Social Care commissioning, safeguarding, and transformation programmes.