Agenda and draft minutes

To approve as a correct record the Minutes of the meeting of the Committee held on 19 July 2011 and the Joint Meeting held on 28 July 2011 and authorise the Chairman to sign them.

The minutes of the meeting of the Individuals Overview and Scrutiny Committee held on 19 July 2011 and of the Joint Overview and Scrutiny Meeting held on 28 July 2011 were agreed as a correct record and signed by the Chairman.

A Briefing Note is attached of the topic group’s findings

The Committee considered the briefing note which had been prepared following the outcomes of the Day Opportunities for People with Learning Disabilities Topic Group.  The Chairman thanked the officers for providing time to discuss the meetings that had taken place, and for allowing the members to attend some of the meetings held for users and carers.  The Committee were happy that any concerns raised were dealt with so that users and carers had peace of mind.

The Chairman raised concern about the Victorian Schoolroom which was located at Western Road.  She added that she had spoken to the Lead Member for Culture, Town and Communities who had stated that the schoolroom would be digitally recorded and put into the museum which could then be used by local schools.  Members asked that given the work that users had put into the romm, could it not be dismantled and taken to Nason Water.  Officers informed that Committee that there were now new activities at Nason Waters including researching of who Nason Waters was, and the flora and fauna of the Country Park.

The Committee discussed a number of options and places where the schoolroom may be of benefit.  Officers agreed to explore the ideas.  Officers informed the Committee that the users at both Nason Waters and Western Road had already carried out some joint working, in the form of a joint funday.

The Committee asked that a review on the progress come back to the full OSC in March 2012.

Performance information on Dial a Ride, across London, Havering and Barking and Dagenham

The Committee received a presentation from the Project Manager, Finance & Commerce on performance information received from Dial a Ride, across London, and in particular Havering and Barking and Dagenham.

The Committee were informed that the Dial a Ride service is a statutory service provided by Transport for London (TfL) and is funded by the Department of Transport and via the Council Tax precept to the Greater London Assembly.

The Committee viewed a number of graphs which showed the comparison between the service received by Havering and Barking and Dagenham residents: for the number of requested trips, the number of refusals and the number of trips actually carried out.  This highlighted that there continues to be a noticeable difference in the refusal rates between the neighbouring boroughs (B&D 4.7%, yet Havering 6.6%).

It was confirmed that the data collected for refusals included instances where a trip was wanted at a specific time, and Dial a Ride was unable to fulfil the need.  The officer informed the Committee that whilst this data is captured by the call centre, this is not released to the Council, and therefore he would not be able to suggest what precisely was included in the total of refusals.

Members were concerned that the cost per trip was now over £25, and discussed the implications this had for value for money in comparison with taxis and minicabs.  Members also voiced concerns at the poor vehicle scheduling which meant that Dial a Ride’s relatively large minibuses were observed carrying only one passenger on the vast majority of occasions.

The Officer explained that Havering had attempted to work in partnership with Dial a Ride, suggesting services could be undertaken by the council’s vehicle fleet, in the ethos of joint working as set out by the Mayor of London’s Door2Door Strategy.  The Committee was informed that there was capacity in the internal fleet to assist Dial a Ride, throughout the day during school holidays (76 weekdays per year) and between 11am and 2pm during school terms.  This approach was attempted to reduce operating costs for both Dial a Ride and Havering vehicle fleets and improve the services offered to Havering residents by reducing the level of refusals.  This approach has not been taken up by Dial a Ride management.

Copies of the letters both sent to, and received from Dial a Ride were included in the presentation.

The Committee noted the poor service being received by Dial A Ride users in Havering, evidenced by the refusals levels given in the presentation as well as the extremely high costs of providing the service to the general tax and council tax payers within the borough of providing the service.  It was agreed that a letter should be written to the Lead Member setting out that the Individuals Overview and Scrutiny Committee found the Dial a Ride service provided to Havering by Transport for London to be extremely inefficient and not cost effective.

Report attached.

The Committee received a report from the Project Manager, NHS Support for Social Care on Integrated Case Management.  The aims of the  Integrated Case Management programme (ICM) were to avoid unnecessary hospitalisations, to reduce demand on health and social care, to maintain independence in the community, to promote self care and self control over individuals’ own lives and to reduce disabilities and disadvantages arising from chronic illnesses.  This was carried out by providing suitable individuals with intensive support for a 3 month period.  At the end of this period the individual would have an increase confidence in managing their own conditions, better awareness of the support available and decreased social isolation.

The Committee noted that there were existing links between Health and Social Care and these were being strengthened through ICM and other Health and Social Care developments.  The annual cost of ICM was £822,000.  There was other funding available for reablement.

Research into ICM had been carried out by the University of East London and Kings College, London.  In the last year there had been a pilot however very few GP practices participated with only 10 from the Havering area.  Officers explained that this was Health-led and brought together multi-agency, multi-disciplinary person centred support.  The service consisted of a team of Community Matrons and Social Workers who provided support to individuals in their own home, coordinated other interventions and helped individuals develop the capability to support themselves.

From the research and the pilot it had been estimated that ICM had led to a reduction of emergency admission of approximately 30%.  The Committee were informed that for ICM to be effective, it was essential to identify the right patients.  This was done through a tool called Health Analytics which matches data from GP records and hospital records and predicted risk of unplanned admissions using an algorithm developed by the Kings Fund.  This stratifies the patient list, identifying both very high and high risk individuals who are then clinically prioritised for referral to ICM.  The key was for GP’s to take ownership, and all practices would have links to ICM.

The Committee were informed that Community Matrons have fortnightly meetings to validate new patients and ensure that interventions were in place for patients already on the caseload. 

The service will be reviewed alongside similar services in place across outer north east London in December to ensure that the service is optimised and that there is the correct mix of multi-agency, multi-disciplinary support.

The Chairman asked what the view of the service users had been. Officers stated that there had been both six and twelve monthly reviews of how the service had helped with daily life, and there had been an 80% improvement rate in A&E admissions.

A member asked what the length of the additional budget would be.  Officers confirmed that the service was currently in its first year, and the second year was due to end in March 2013.  However this could continue into a third  ...  view the full minutes text for item 11.

The Head of Adult Social Care will give an overview of the budget variances within the Committee’s remit.

The Head of Adult Social Care explained to the Committee that they were currently between budget reporting periods and that, since there had been lots of changes with Shared Services, it was difficult to draw down reports on budgets.

The Committee were informed that monthly reports were being kept and as of Period 5 there were no unexpected material variances.  Officers explained that there were lots of pressures on Adult Social Care that residential placements were currently down however this could change over the winter period. 

Members asked if there were any strains of flu which could impact on the service.  Officers explained that Public Health and the PCT were taking a cautious view and pulling together a Winter Plan which officers could share with the committee at a later date.

Members requested that information on budget variance be included within agenda packs for the next meeting.

Committee Members are invited to indicate to the Chairman, items within this Committee’s terms of reference they would like to see discussed at a future meeting.  Note: it is not considered appropriate for issues relating to individuals to be discussed under this provision.

Members requested that information on Unpaid Debts be made available at a future meeting.