The Adults and Health Overview and Scrutiny Sub-Committee met to discuss adult social care performance, safeguarding, and primary care access in Barnet. The committee reviewed the Adult Social Care Performance Report, the Barnet Safeguarding Adult Board Annual Report, and received an update on the Primary Care (GP) Access Task and Finish Group. They also discussed the merger of two Integrated Care Boards and its potential impact on local healthcare.

Primary Care Access

The committee received an update on the Primary Care (GP) Access Task and Finish Group, which has been working to improve access to GP services in the borough. As a practical outcome of this work, the committee agreed to disseminate leaflets created by Community Barnet, with the support of the Director of Public Health.

Sue Blaine, a volunteer with the NHS for 20 years and former co-chair of the Community Barnet primary care group, and Azina Remtala, the current chair, presented information sheets designed to help patients navigate the primary care system. The sheets included information on remote consultations, where to go for medical care, and the roles of different members of the GP surgery team.

Councillor Caroline Stock asked if the leaflets could be disseminated under the direction of the Director of Public Health, who agreed to use established channels and networks to distribute the information.

The leaflets include:

• A remote consultation sheet, designed to help patients prepare for and remember the outcomes of telephone consultations.
• A diagram showing where to go for medical care, with links to local pharmacies and NHS 111.
• A care navigation sheet, explaining the roles of receptionists and other members of the GP surgery team.

Integrated Care Board Merger

The committee discussed the proposed merger of the North Central London and West London Integrated Care Boards (ICB). Councillor Paul Edwards, Cabinet Member for Health and Adult Social Care, explained that the merger would create a larger, more strategic organisation responsible for commissioning services for approximately half the population of London.

Councillor Edwards said that the boards argue that:

a single merged ICB would possess the scale and authority required to address those challenges more effectively than either board could achieve alone.

He added that the merger is intended to address pressures such as a nationally imposed running cost ceiling, rising demographic demand, and significant health inequalities.

Concerns were raised about the potential impact of the merger on local services and resident representation. It was noted that the Joint Health Overview and Scrutiny Committee (JHOSC) had previously discussed the merger and voiced concerns that the merged ICB would be more remote from residents, especially given the reduced role for Healthwatch¹.

The JHOSC noted that councillors' role in providing democratic scrutiny of any proposals for change to NHS services becomes even more important.

Adult Social Care Performance Report

The committee reviewed the Adult Social Care Performance Report, which is produced twice a year, instead of quarterly. Paul Kennedy, Head of Business Intelligence, presented the report and answered questions from committee members.

Issues raised included:

• Debt Chasing: Letters chasing bad debt were not fit for purpose, requiring staff to spend time following up with residents and clients.
• Restructuring: The implications of restructuring for service delivery were discussed.
• Survey Data: Councillor Stock questioned the figures in Appendix A, particularly those related to the adjusted social care related quality of life and user satisfaction. Dawn Whiteclink, Executive Director, Adults, Communities and Health, offered to circulate definitions of the survey data to aid understanding.
• Neighbourhood Services: Concerns were raised about the potential for a postcode lottery in the implementation of neighbourhood services. Councillor Stock asked how co-production services could be used to gather more data and tailor services to specific needs.

Safeguarding Board Annual Report

Leslie Hutchinson, the independent chair for the Safeguarding Adult Board, presented the Barnet Safeguarding Adult Board Annual Report. She highlighted the board's work in safeguarding adults with care and support needs, noting that Barnet's performance was in line with national averages and peer groups in London.

Hutchinson noted that the Care Quality Commission (CQC) had commended the council's clear and robust approach to safeguarding. She also addressed concerns about the future of Healthwatch and the changes within the ICBs, emphasising the importance of safeguarding responsibilities in light of these changes.

Councillor Stock asked about the increase in safeguarding inquiries by location, particularly in care homes. Hutchinson explained that the majority of incidents occur in people's own homes, followed by care home settings. Dawn Whiteclink added that Barnet has the largest number of registered care beds for older people of any London borough, and a dedicated provider safeguarding team.

The committee discussed the integration of housing into social care strategies and the board's work on severe and multiple disadvantage, including homelessness.