The Healthier Communities and Older People Overview and Scrutiny Panel met on 21 November 2024 to discuss the Budget and Business Plan, the Annual Public Health Report on tackling drugs, and the Merton Safeguarding Adults Board Annual Report. The panel also received a presentation on defibrillators from the London Ambulance Service and an update on Adult Social Care's preparation for the Care Quality Commission Assurance framework.

Budget and Business Plan - Round 1

Councillor Billy Christie, Cabinet Member for Finance, introduced the Budget and Business Plan for 2025/26. The Executive Director of Adult Social Care, Integrated Care and Public Health detailed seven draft savings proposals within the department: an Assistive Technology Strategy, an uplift of homecare charges for self-funders to the current borough market rate, a review of high-cost care packages, changes to Voluntary and Community Sector grant funding and the community response hub, a review of Adult Social Care structures, adjustments to low-cost packages, and better utilisation of the Disabled Facilities Grant (DFG).

Annual Public Health Report

The Director of Public Health presented the key elements of the 2024/25 Annual Public Health Report, titled Tackling Drugs Together. The report highlights the scale of alcohol and drug problems in Merton, the harms they cause, and recommends a multi-agency response. Key concerns include the presence of synthetic opioids like nitazenes in the drug supply and the associated risks of overdose. The report also addresses chemsex and the need for tailored interventions for specific groups, including LGBTQIA+ individuals, women, heroin users, and older people. Recommendations focus on improving data sharing, normalising screening for substance misuse, providing preventative interventions and harm reduction, increasing access to specialist treatment, developing recovery support, improving care for co-occurring mental health needs, tackling stigma, strengthening user voice, and regulating drug and alcohol supply.

Defibrillators - London Ambulance Service Presentation

Sam Wilcox, Community Defibrillation Manager, and Jessica Burgess, Head of Charity, from the London Ambulance Service presented on the Heart Starter campaign. The campaign aims to increase the number of defibrillators in areas where they are most needed. Merton Council currently has four defibrillators registered, but the campaign recommends funding and installing five more in areas such as Figges Marsh, Longthornton, and Pollards Hill. Councillors were encouraged to support the campaign through donations, fundraising, acting as defibrillator guardians, sponsoring defibrillators, or spreading the word. Information was also provided on defibrillator training, maintenance, and the need for an electrical supply to keep them rescue ready.

Adult Safeguarding - Annual Report

Aileen Buckton, Independent Chair of the Merton Safeguarding Adults Board (MSAB), provided an overview of the MSAB Annual Report 2023/24. The MSAB is an independent strategic body overseeing safeguarding arrangements in Merton to ensure adults at risk are protected from abuse and neglect. The report details the partnership's work, progress against strategic priorities, and findings from Safeguarding Adults Reviews (SARs). Key achievements include the development of the Community Safeguarding Champions Network, engagement with people with lived experience, and improvements in data analysis, particularly concerning ethnicity in safeguarding. The report also highlights that risk was reduced or removed in over 93% of concluded enquiries and that 95% of people's desired outcomes were fully or partially met in Making Safeguarding Personal processes. The MSAB has received seven SAR referrals, with one discretionary SAR nearing completion and another being undertaken jointly with Kingston. The Noah SAR, completed and published during the year, provided important learning on transitions and the need for suitable community provision for individuals with complex needs.

Adult Social Care Self-Assessment

The Interim Director of Integrated Care, Commissioning & Assurance presented an update on Adult Social Care's preparation for the Care Quality Commission (CQC) Assurance framework and the associated Self-Assessment Report. The LGA Peer Challenge in June 2024 provided positive feedback, highlighting strengths such as strong political leadership, positive member-officer relationships, a visible and approachable Director of Adult Social Services, a committed workforce, effective safeguarding partnerships, and well-managed finances. Considerations included the need for a clearer strategic approach, completing outstanding strategies, embedding the voice of people with lived experience, clarifying waiting list narratives, co-producing a practice model, strengthening quality assurance, and addressing recruitment challenges. The department is updating its information return for the CQC, with an onsite visit anticipated in April or May 2025. Progress on the action plan is good, with 25 out of 63 actions completed, including updating the self-assessment with outcome-focused case examples and implementing mandatory risk assessments in Mosaic.

Work Programme

The panel agreed to add gynaecology waiting lists to the work programme.