The Adult Social Care & Health Overview and Scrutiny Committee of Bexley Council met on Wednesday 31 January 2024 to discuss the draft budget and financial plans for 2024/25, explore inequalities in mental health services for Black communities, and receive an update on direct payments recommendations. The committee also reviewed their work programme and received updates on various ongoing projects and initiatives.

Draft Budget and Financial Plans 2024/25

The committee reviewed the draft budget and financial plans for Adult Social Care for 2024/25. Members noted that demographic growth and increased acuity of care needs, particularly since the pandemic, are placing significant pressure on budgets. Councillor David Leaf, Deputy Leader and Cabinet Member for Resources, assured the committee that the council has a statutory duty to provide a safe service and that finances would not be a reason for failing to do so. He also highlighted ongoing lobbying efforts for additional government funding to meet the rising demand. The committee was informed that while some more expensive discharge packages had been scaled back, residents' outcomes were not negatively affected, and in some cases, improved. Concerns were raised about the potential impact of budget constraints on service quality and longer hospital waits, with assurances that the council is working with partners to maximise resource use. The committee also discussed the challenges posed by the Fair Cost of Care exercise and the ongoing need for increased government funding.

Exploring Inequalities - Black Communities and Access to Mental Health Services

The committee discussed a report examining inequalities faced by Black communities in accessing mental health services in Bexley. Public Health officers presented data indicating that while Bexley's picture of inequality differs from national trends, there are still variations between different Black ethnic groups. The report highlighted that men in the Other Black category showed higher than expected admissions to acute mental health services, while other groups had lower than expected admissions. Similarly, treatment rates for mental health conditions varied significantly across different Black ethnic groups.

Recommendations included further qualitative research to understand the Other Black demographic, targeted communication campaigns, and support for initiatives like the recently commissioned barber shop project, which aims to facilitate conversations about mental health in a confidential setting. The committee resolved to investigate if specific data exists regarding the Sikh community's access to mental health services and to receive a breakdown of participants in the Men in Sheds initiative by ethnicity.

Six Month Update on the Recommendations of the ASC Direct Payments Scrutiny Project Sub-Group

An update was provided on the progress made in implementing the recommendations from the Adult Social Care Direct Payments Scrutiny Project Sub-Group. The committee noted that a list of acceptable spending for Direct Payments is being developed in consultation with the community, with officers expecting its finalisation and user-friendly launch in the coming weeks. Efforts are being made to maintain ongoing conversations with groups previously consulted to ensure the changes meet their needs. While a slight increase in Direct Payment uptake has been observed, it was noted that it is too early to determine the full impact. The committee also sought an update on the popularity of adult day care centres, with a mixed picture reported depending on age groups, and a commitment to provide up-to-date data on their use by older populations.

Work Programme

The committee reviewed and noted the proposed annual work programme, including updates on the Primary Care Recovery Plans Scrutiny Project Sub-Group and the South East London Joint Health Overview and Scrutiny Committee. Members discussed planned reality checking visits to Urgent Treatment Centres (UTCs) and queried the availability of data on resident usage of various local UTCs. It was noted that data on Bexley residents using neighbouring services is monitored, and that the popularity of Erith UTC is high. The committee resolved to request data on vacancies within the Adult Social Care workforce and, if possible, within health services for their upcoming meeting on 19 March.

The committee also noted the briefing on the new health service reconfiguration arrangements and the removal of local authorities' powers of referral to the Secretary of State, while their broader scrutiny responsibilities remain unchanged. Updates were also received on reality checking visits and a briefing on the Adult Social Care Vision and Market Position Statement.