The Health and Adult Social Services Scrutiny Panel met on Tuesday 19 March 2024 to discuss several key issues affecting residents. The panel reviewed the proposed changes to primary care access across North West London, the Ealing Safeguarding Adults Board's annual report, and the council's initiatives to promote social care choice and community resilience. They also examined the Health of the Borough report, which details the council's efforts to tackle health inequalities.

NWL Primary Care and Same Day Access to GP Primary Care

The panel discussed the North West London (NWL) Integrated Care Board's (ICB) proposal to introduce same day access hubs across NW London. This initiative aims to improve patient access to primary care by directing patients to a separate hub for triage, rather than directly to their GP practice.

Concerns were raised by GPs and members of the public about the potential impact on continuity of care and the risk of non-clinicians seeing undifferentiated conditions. The North West London Joint Health Overview and Scrutiny Committee (JHOSC) had previously recommended delaying full implementation by one financial year, undertaking Equality and Human Rights Impact Assessments, and conducting meaningful consultation with patients and GPs. NHS NWL representatives stated that the proposal was about providing options and choice, and that no changes to how people access their GP would occur from 1 April 2024. They also clarified that funding previously allocated to Ealing Clinical Commissioning Group (CCG) for enhanced access would be repurposed for quality improvement work.

The panel resolved to endorse the JHOSC's recommendations, to have sight of the approaches Ealing's Primary Care Networks (PCNs) are proposing to improve access, and to receive feedback on the same-day access model being run by Northolt PCN.

Ealing Safeguarding Adults Board Annual Report 2022-23

Robert McCulloch-Graham, the Independent Chair of the Ealing Safeguarding Adults Partnership Board, presented the annual report for 2022-23. The report highlighted an increase in safeguarding concerns and inquiries, with neglect and psychological abuse being the most common types. The primary location for abuse remained residents' own homes.

The board noted ongoing pressure across all services, with an increase in demand coupled with increased complexity. Financial challenges and the economic crisis were identified as impacting the most vulnerable. The partnership is focusing on working more closely with communities and ensuring data is not only collected but also interrogated to better plan services. Panel members raised questions about whether certain communities were being missed and the disproportionate reporting by gender in older age groups. The report also detailed the work of the partnership in reviewing care quality, provider assurance, and learning from four Safeguarding Adult Reviews (SARs) conducted during the year.

The panel noted the report, acknowledging the significant work undertaken and looking forward to receiving future reports with more detailed data.

Social Care and Community Choice

Kerry Stevens, Strategic Director of Adult Social Care and Public Health, presented a report on promoting independence and community resilience through direct payments. Direct payments give individuals control over how their social care needs are met, allowing them to employ their own staff or purchase services. Ealing currently has a lower take-up rate of direct payments compared to other London boroughs.

Feedback from stakeholder engagement indicated that most people with direct payments feel more in control but desire greater flexibility and trust from the council. Challenges in managing direct payments and staff recruitment were also highlighted. The review of internal processes found that Ealing Direct has a solid foundation but would benefit from investment to streamline processes and create a more diverse market.

The panel welcomed the work to increase direct payments and looked forward to hearing about the progress of these plans. They resolved to note the report and requested written information on the length of time direct payments have been in operation in Ealing.

Health of the Borough

Dr. Maddy Gupta-Wright, Public Health Consultant, presented the draft Health of the Borough report, which outlines the council's achievements in tackling health inequalities during 2023-24. The report highlighted successes in securing £5 million in funding for a research infrastructure to promote healthy communities, co-producing a suicide and self-harm action plan, and engaging communities in active travel initiatives.

Panel members inquired about standardised methods for reporting the impact of initiatives and identifying trends. Anna Bryden, Director of Public Health, confirmed that data trends are showcased in various ways and that efforts are being made to ensure data is accessible and interactive across the borough partnership. Questions were also raised about provision of meals during school holidays, support for homeless young people, and plans to reduce alcohol-related hospital admissions.

The panel resolved to note the report and requested additional written information on meal provision during school holidays, support for homeless young people, and plans to prevent alcohol misuse, along with the Substance Misuse JSNA report.

The next meeting of the panel was scheduled for Thursday, 16 May 2024.