The Adult Social Care & Health Overview and Scrutiny Committee met on Tuesday, 25 June 2024, to discuss updates on the Care Quality Commission (CQC) Assurance Programme, the Care at Home Transformation, and the final report from the Primary Care Recovery Plans Scrutiny Project Sub-Group. Key decisions included the approval of the sub-group's recommendations to be sent to the NHS and the establishment of new sub-groups and committee memberships.

Establishing Sub-Groups and Joint Health Overview and Scrutiny Committee Membership

The committee agreed to establish formal sub-groups for scrutiny project work, with a limit of four such groups operating across all Overview and Scrutiny Committees at any one time. They also agreed that specific one-off sub-groups could be formed for significant policy issues or key decisions. Membership for these sub-groups will consist of three Conservative and one Labour member, agreed in consultation with the Chairman and Opposition Spokesman. Councillors Janice Ward-Wilson and Lisa Moore were appointed as the committee's representatives on the South East London Joint Health Overview and Scrutiny Committee (SEL JHOSC).

CQC Assurance Programme: Update on Self-Assessment, Adult Social Care Vision and Market Position Statement

An update was provided on Bexley's Care Quality Commission (CQC) Assurance self-assessment and action plan, alongside the new Adult Social Care Vision and Market Position Statement. The committee discussed the self-assessment's themes, noting strengths in partnership working and urgent support, but also areas for improvement in personalisation and reflecting individuals' voices. It was agreed that the outcome of the upcoming Peer Review would be added to the work programme, along with associated targets and objectives.

Care at Home Transformation Update

The committee received an update on the ongoing transformation of the Care at Home service. The new model aims to reduce the number of home care providers from 42 to 6, focusing on an outcomes-based approach rather than the traditional time and task model. While residents' feedback has been largely positive, with regular carers and good infection control practices noted, some areas for development were identified, including inconsistent encouragement from carers and language barriers. The committee expressed concern about the reduced number of providers but was assured that market sustainability plans are in place. It was agreed that reality checking visits would be explored and that Care Transformation at Home would be added to the work programme for further updates.

Final Report and Recommendations of the Primary Care Recovery Plans Scrutiny Project Sub-Group

The committee received the final report and recommendations from the Primary Care Recovery Plans Scrutiny Project Sub-Group. The sub-group's work highlighted that while Bexley has a high number of appointments and face-to-face appointments compared to other areas in South East London, patient experiences vary. Challenges remain in consistent implementation of new tools like Cloud-Based Telephony and AccuRX, with some practices still facing an 8am rush. The report noted that demand continues to outstrip resources, and there is a shortage of GPs. Patient experiences with digital tools are mixed, and there is a need for greater education and support, particularly for older and digitally excluded individuals. The sub-group's recommendations, which will be forwarded to the NHS for response, include completing the rollout of the Modern GP Access model, providing training for patients on digital tools, reviewing premises to accommodate additional roles, improving communication about available services, and enhancing engagement with Patient Participation Groups (PPGs). The committee agreed to share the Better Access Bexley presentation with the committee in due course.

Work Programme

The committee noted the proposed work programme for 2024/25, with several amendments and additions suggested. These included placing Vaping on hold due to data collection challenges, moving the Draft Budget to October, and adding Shared Lives, Autism Strategy, Community Day hubs / Inspire, Better Care Fund, Update of Direct Payments, Transformation Care at Home, and Reality checking Darent Valley Hospital and Queen Elizabeth UTCc and Reality checking Care Transformation at Home to the programme. The committee also noted the Quarter 4 2023/24 status report and agreed to continue the joint sub-group for the SEND action plan with the Children's Services & Education OSC. An update on the Ransomware Cyber-attack on Synnovis was received, with assurances of work being done to ensure security and mutual aid for patient services.