The Community and Wellbeing Scrutiny Committee met on Tuesday 30 January 2024 to discuss several key issues affecting Brent residents. The committee received updates on the NHS Start Well programme, preparations for the Care Quality Commission (CQC) inspection of Adult Social Care, and the delivery of the Brent Youth Strategy. A deputation from Roundwood Youth Club also highlighted concerns regarding youth provision in Harlesden.

NHS Start Well Programme

The committee received an update on the NHS Start Well programme, which proposes changes to maternity, neonatal, and children's surgical services across North Central London (NCL). Sarah Mansuralli, Chief Strategy and Population Health Officer for NCL ICB, explained that the proposals aim to improve the quality and equity of care, not to reduce costs. The programme is currently in a 14-week public consultation period, running until 17 March 2024, with a decision expected in Autumn/Winter 2024/25.

Two options are being consulted on:

• Option A (Preferred): Consolidating services at UCLH, North Mid, Barnet, and Whittington hospitals, with the Royal Free Hospital ceasing maternity and neonatal services. This option would involve moving approximately 2,560 deliveries.
• Option B: Consolidating services at UCLH, North Mid, Barnet, and the Royal Free Hospital, with Whittington Hospital ceasing maternity and neonatal services. This option would involve moving approximately 3,391 deliveries.

Both options propose closing the birthing suites at Edgware Birth Centre due to low usage and increasing birth complexity. The committee raised concerns about the potential impact on residents in areas like Harlesden and Willesden, particularly regarding travel costs and accessibility. The NHS representatives assured the committee that a hyper-local approach to engagement is being taken in these areas, with mitigations being developed, including language and communication support, and transport options.

The committee made several recommendations, including:

• Future reports detailing assurances on mitigations against staff fatigue, human error, and overcrowding.
• Consideration of the impact of travel costs on prospective parents' choice in the final business case.
• Consultation with a wider geographical area and provision of interpretation services in various languages.
• Post-implementation review of the impact of any changes.

The committee also requested detailed information on engagement activities undertaken to date.

Adult Social Care CQC Inspection Preparations

Councillor Neil Nerva, Cabinet Member for Public Health and Adult Social Care, introduced a report on preparations for the Care Quality Commission (CQC) inspection of local authority Adult Social Care services. This will be the first formal statutory inspection in ten years. The CQC's new Single Assessment Framework (SAF) will be used, assessing services on whether they are safe, effective, caring, responsive, and well-led.

The committee discussed the impact of funding constraints on the Council's ability to achieve a good inspection rating. Rachel Crossley, Corporate Director for Care, Health and Wellbeing, stated that while funding constraints affect workforce retention and training, Brent has focused on practice standards through supervision and case reviews. Councillor Nerva added that the Council is committed to parity of esteem between children's and adult's social care and is offering enhancements to attract permanent staff.

The committee raised concerns about the monitoring and training of care providers, particularly in light of negative national media reports. Officers explained that provider contracts are monitored, and mandatory training is required. The Council also offers safeguarding awareness training.

Key areas for improvement identified included transitions from childhood to adulthood, support for carers, and oversight of housing and health services' duty of care towards vulnerable adults. The committee was informed that Adult Social Care has a waiting list of around 300 assessments, with a plan to clear this by May 2024. Brent's hospital discharge service was highlighted as performing well, typically discharging patients within 2-3 days.

The committee was assured that the Council is preparing for the inspection, with a self-assessment process underway. Officers anticipate a requires improvement rating in a worst-case scenario, and good in a best-case scenario.

Brent Youth Strategy

Councillor Gwen Grahl, Cabinet Member for Children, Young People and Schools, presented an update on the delivery of the Brent Youth Strategy 2021-2023 and plans for its refresh. The strategy focuses on eight themes: Engagement and Voice, Activities, Skills and Opportunities, Place and Facilities, Wellbeing and Mental Health, Safety, Access and Awareness, and The Environment.

A deputation from Roundwood Youth Club highlighted concerns about access to their facilities and the impact of youth service cuts. Representatives advocated for funding to be directed towards improving existing services rather than solely on building new infrastructure. They also stressed the importance of involving young people in future decision-making.

The committee discussed the impact of funding cuts on youth services, with Councillor Grahl noting that the Council now relies on the voluntary and community sector, supported by organisations like the Young Brent Foundation (YBF). Nigel Chapman, Corporate Director for Children and Young People, confirmed that £2 million in capital funding is available for improving youth provision buildings, but this cannot be used for revenue costs of running services.

The committee made several recommendations for the Youth Strategy refresh, including:

• Representation of young people on the Youth Strategy Steering Group, ensuring geographical and sectoral diversity.
• Setting more specific engagement targets for reaching young people.
• Continuing to explore creative solutions for funding current provision.
• Publicly communicating the Council's communications strategy for youth engagement.

Information requests were made for future reports to detail performance data and clarify the impact of cuts and mitigation strategies.

Other Matters

The committee noted the recommendations tracker, which outlines the progress of recommendations made in previous meetings. No other urgent business was raised.