Healthier Communities Select Committee - Wednesday, 23rd September 2020 at 7:30pm - Lewisham Council Webcasting

Healthier Communities Select Committee
Wednesday, 23rd September 2020 at 7:30pm 

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Start of webcast
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1 Confirmation of Chair and Vice-Chair
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2 Minutes of the meeting held on 15 January 2020
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3 Declarations of interest
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4 Mayor and Cabinet response to referral on Adult Safeguarding
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5 Financial stabilisation - budget update and medium term plan
7 Leisure Contract Management
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8 Select Committee work programme

good even everybody welcome to this meeting of the healthier Communities CERT Committee my name is John Barden's and scrutiny much of this committee

1 Confirmation of Chair and Vice-Chair

as this is the first Committee Neeson of this municipal year the first year only to ask me to do is to confirm its Chair and Vice Chair for the year ahead so please can I invite the Committee to show and to confirm by a show of hands Councillor John Muldoon as Chair and Councillor Corrall Howard as Vice-Chair
yet I can see fresher showed unsaid thank you very much I will pass onto the confirmed share Councillor Noon to carry out this meeting
some parties have agreed on and thanks to the Committee and I welcome to members of the Committee to officers here tonight and to all those viewing from home and to in the press and
On Councillor John Muldoon I'm Chair this Select Committee and I got a few notes to read out first about how the meeting will be conducted so you bear with me whilst I read them and
unless you're a member of the Committee your camera should be switched off until it is your item on the agenda or I have specifically asked you to speak please keep your microphone muted until you're invited to speak please type a queue in the chat function to indicate you wish to speak any other point in the meeting that's important because I could concede the order that people have indicated as well it's a quite clear and spike for the benefit of webcast viewers please state your name before you speak and other messages and questions left on the chat panel will not be responded to the chat panel is not the general discussion if you get disconnected from the meeting due to technical difficulties you should use the link you're sent initially to return to the meeting please note that this meeting is being webcast and a recording will be available on the Council website
are there any apologies for absence John
no Chairman I note that the Assistant Chief Executive or seen him or her is in attendance and congratulations to her on appointments so first meeting we've had this committee since her appointment on came at Chair he will

2 Minutes of the meeting held on 15 January 2020

we now move on to Item 2 which is minutes of the AGM last meeting and these are on this'll meeting held in January this year and they start on page 7 for those using paper and other any comments any amendments and corrections that people have to them
nope I don't I see no indication
are they agreed as a true record
agreed as a true record

3 Declarations of interest

ITEM 3 declarations of interest do any Member and as of the committee have any declarations of interest to make now if people become aware late on during the meeting that they have a something I wish to fly please shout out or put a queue in the box rather than shout out but a queue in the chat box and your declaration you be invited to say what it is and John Barnes will love our note it I will go in the minutes so other any declarations of interest
no
I just wanted to say chair hadn't that we've got an item on fusion and I to work in the fitness industry it's a it's not that there's no relationship between me enfusion but I just thought I want to be open about her
because the by Georgina a lawyer on that but I put in might not my view it's not a pecuniary interest tell Council depended on them but judging you have a view on that no I agree with the Chair that's but that's not to prejudicial interest until the Esmael not know how to and can actually follow to be open about fair absolute atmosphere that none of its now I've funding is no more than interested someone who was of possibly of effusion user for example yes

4 Mayor and Cabinet response to referral on Adult Safeguarding

item 4 responses from a Mayor and Cabinet and PFIs and Members will recall that of after the and Adult Safeguarding Annual report last year we made a referral to na and cabinet and about and people numbers got an Isil brochure and does not but all I full page post on the pay for postal Backpage are with information about Adil safeguarding issues how to refer concerns I did take this to the I referred to the Mayor cabinet and those response made at the last mayor and cabinet and that agenda item 4 paid 17 and things had been some overtaken by covert and but you'll see are on page 18 of the paper agenda that some the communication engagement strategies Kelly bring revised and will now include these have information posters as a methodology to be used in key public buildings where this can be managed and monitored so there's been delayed because of Cove it but they took on board our suggestion and the they may have posters in relevant or key public buildings such as libraries leisure centres customer service of the community centres by the end of 20 20 so only a year after we made the referral so we'll we look forward to seeing that but as I say and when the stand why though delays and we understand why it wasn't a top priority for Mayor and Cabinet to and respond to so am
the the gate to the next item is a proposal to vary the agenda are slightly the reason being that and we have an outside questioner from the Save Lewisham Hospital campaign so the up my proposal as we take the health and care system recovery plan before the financial stabilisation Budget update and that will mean that 10 years on from the hospital campaign can interact with the the officers at his questions in and I'm at then be and released from the Committee was econ what as a member of the public he wants to but that is not obliged to and so my pat my proposal Zattoo agreed
the agreed as finding

6 Lewisham health and care recovery plan

have gotten let no one say I guess so if we can go on to Item 6 on the agenda paid 69 2 1 4 5 Lewisham health and care system recovery plan Tom Brown Executive Director for customer services is going to introduce the item we also have a number of other officers who will have briefly contribute before we moving to a questioning and debate and we have well as Tom Bramley have Sir Sarah way in a Director system transformation or Martin Wilkinson director of integrated care and commissioning Donna Hayward Sussex Service Director South not an enormously
Angela Chief nurse Lucian Grainge Trust and Simon part and whose quite regulars to this committee whose a Chair of be on Lewisham local medical committee Sir Tom Brown are overtly you please
thank you thank you Chair them very much by way of introduction MRSA over this is a very lengthy documents it's a at that that the Lewisham contribution to end the south-east London NHS recovery plan but it's also very much part of our local system recovery plan and so also needs to be seen in terms of it being part of the Council's recovery plan for the wellbeing and health and wellbeing of the residents of the Borough so it is is driven by us it's a high level plan and it sets out what we intend to do by working together and to both continue and indeed accelerate our efforts to tackle inequalities and improve health and wellbeing in Lewisham and would each do this will continue to safeguard local people and and indeed stuff as well not least as we're you're Plealey going into a second wave of the covert infection
key priorities for us include supporting prevention yet early intervention building community resilience
of course supporting the hospitals and also our care homes ensure residence and mental health and well being is looked after including of course children young people and their families those in crisis those with long-term conditions those who are living in increased poverty am as the economy further deteriorate and therefore out prone to those wider determinants of health negative impacts and supporting our own stuff and those of our local system to do what we can to mitigate against all of these problems and utilise opportunities like digital growth to make sure that we can reduce barriers to access for services and make the best job we can in terms of working as a system to keep people safe and probably useful I think then for me to hand over the partners because I think the Council is very much and a partner in this book likewise I am by could introduce and
other stakeholders that Angela from and Lewisham Greenwich Tris donor from slum and at Simon from Eddie Local medical Committee and it tells you if your agreeable could I invite them in that order to to contribute that I can pick up anything afterwards yes so and you're Sciandri first was that
so yes please check so yes actually if you can just you your on to yeah sure so I'm Angela Heller I'm them Chief nurse for at Lewisham and Greenwich NHS trust and I'll give a summary of our recovery plan at Lewisham and Greenwich so obviously during the peak of the pandemic most of our elective care was a stood down and so that we could make room for increased critical care beds are but also to protect per hour patience because we didn't want is vulnerable patients coming in and being exposed to covert and that's in line with pretty much every acute hospital or in the country and what we did do though is to continue with some sort of high risk surgery so patients with cancer or those requiring life-saving surgery to that continued as a result of that our waiting lists have grown quite considerably and so we have a whole programme of work at which is in line with the NHS targets there was a letter issued in August 2 all acute trusts setting out the expectations of NHS England around our recovery and and that includes to fully restore cancer services at to restore elective activity to between 90 and 100 percent of pre-pandemic levels by October developer week by week plan to optimise our use of the independent sector and also to implement very stringent infection prevention and control procedures so just to say that we're working very closely with other other acute providers in south-east London and so that equity of access is maximised across south-east London because there is real variation in terms of
waiting times depending on special teas and depending on an access route so as I say were working very closely together on on how we do that so happy to take any questions
once what was the threat his release I enclose the end the presentations are so arm the next next speakers is diary with Sussex service refine and slam
thank you Chair so you some Donna Hayward Sussex and I'm the Service Director for Adult Services in South London and Maudsley trust a brief update from me I think the key things that were important to us at the start of the pandemic was trying to maintain seeing our patience are which was proving difficult face to face and we spent her older time mobilising mobiles for our patients so that we could stay in contact with them and I have to say that that's largely stayed in place we have resumed a lot of our face to face services but that contact that phone contact has remained during this period because we recognise that we can staying more contact more frequent contact with our patience
as you'd expect we needed to create specific pathways within our impatience unit so that we've got what we class as hot and cold ward so people that have been diagnosed with having COVID on intrigue are put on a certain Ward and those that are don't have COVID on another ward
we we undertook some prediction work around some of our most vulnerable patients and we put specific packages around those patients in partnership with our social care or colleagues and moving on now we're looking at again resuming our community transformation programme which is about working much closer with our GPs and you may remember arm I spoke about that when I was last invited in regards to sharing the GP patient database so the mental health and physical health can have a much closer working relationship with our patience so that workers as resumed specifically in partnership with Angela's colleagues at Lewisham hospital we set up I'm a an assessment function so that we could seize many patients that present with mental health out of the emergency department and in a specific place for mental health I'm and this are autumn we are increasing the provision to provide six rest bays so that these will be for patients the
I'm might need a longer assessment period of time and we don't want them to be seen in the emergency department we want to be able to see them are in a mental health setting that is much more appropriate for their needs and turning to specific inequality are issues we are really focusing our efforts on creating a BAME specific services including
a specific offers in regards to culturally sensitive interventions the feedback we've had from a colleagues and service users is that very often they find our services very hard to get into and hard to get out of and that's an area the we've got to improve in the sense that we've got to make it easy to get into our services and easy to get out of again answer we're working with colleagues and partners around what some of those offers at may look like
chair I understand you you won't be too to step back now and then I'll come in an attorney questions later on that of a throw-in I'd like to thank you very much for your your comments your report and I can't ask gum some upon book some important whose feature of the Lewisham Local medical Committee so Simon EU here
the John are any news on Simon
I can see him are you muted time him that's not
I just remind you that and yet keep talking as echoes the thank you chance on the keep keeper but my figures mouth to and dot some important let me change position to see if I can get a better is that better
it that is going to carry on Rosslare and I've got some parking GP notion I'm Chair of Lewisham lmc rich Websense GP provided a groups within the bar again spitting are most important to phases looking at the the response to the acute first wave general practice clearly face challenges in
in access and delivering care to patients who may have Koeverden and providing a safe and environment for them so we mobilised quickly in 2 various different types of consultation HMOs including embracing digital at pace which enable patients diet communicate via the internet as well as freeing up capacity for telephone consultations
to support our populations we continue to provide face to face consultations on sites mood rapidly to creating what called Hot sites within the Borough where patients could be safely assessed with appropriate PPE we're transport provided and could be fast tracked for hospital support if required
and that services carried on during the acute to two or three months we worked with the local authority and partner organisations for children patience are reached out to our vulnerable groups who may not so been in the should in a group recognising that whilst there is a move towards distillation of consultation we need to ensure accessible to those that didn't have access to digital platforms
we work closely with our our secondary care colleagues look a pathways and communicated across the whole circus London to develop safe and appropriate responses to the or was a a very changing a world I think the that the pace of change in the Daily communication updates was sometimes a bit overwhelming but we managed to to navigate through those and and got to a good place I think that the strengths of the sponsors was not just in the ability to to to deal with the influx and a mother that she that the collaboration and co-production of the delivery with our healthcare partners across the Borough and relationships have been building for for a long time was strengthened Ford showing that process we've used that platform to continue the work going into what we might call recovery or Second stage if you like and to look at looking at look at some of the the the inequalities that developed through coded the potential for inequity digitalisation how we respond to that with continued to work as Network practical or primary care networks as well as working closely with a federation to develop birth services phlebotomy blood testing for showing patience continued delivering care for patients her socially isolated and building on the kind of collaborative approach that we learned quickly and through a two month period and we be fed into the development of our of our kind of put local bar planning as well as south-east London planning looking at
both recovery in and resumption of Michael new normal work but also recognising the that may be overshadowed fought she by a resurgence of
of covert and and the challenges that winter always faces so in a second area now we're looking at how we can best continue to deliver care for our patients at the same time recognising the next 2 3 4 1 5 months may be more challenging are going ahead and transfers responsive to that as possible and I think one of the the the areas of recognition is that we we need to make sure that we continue to support our patients with long-term conditions and isolation of an ability
whilst clearly being able to do that in a very safe environment and we clearly want to be having as many people as possible face to face but we also need to make sure that we do this in a safe way so you don't become a problem rather than a solution to covert and that has the has presented difficulties to to population we recognise that and I think that there are no doubt challenges ahead and be meatiness challenges Fallon and we recognise that may be where there's some gaps were to fill those gaps and we were open to Claverton an uncooperative and with our partners our population should to make sure that we continue to provide the best for them
and I would like to thank as well if I can if it's a possibility charges that the colleagues around the Commission side and and NHS England who allowed us to pause and some of the contractual elements of UK of our GP delivery services to deal with the pandemic when it hit and that gave us some headspace and capacity to meet that need and also like to thank our patients who went with us on this journey
it's been a very difficult journey and I think that you know we have to work collaboratively I think I'd like to thank them for for their understanding and patience and look forward to continuing to deliver during the what may be the second wave thank you Chair OK thank you my Dr and I'm sure you're your thanks gratitude will be recorded in the minutes and I'm sure they'd be passed down a cascaded down through the council and the NHS I noticed an at the as Deputy Mayor and can amend for health out those gas joined us Councillor best was raising you wanted to say at this point
well I'm we'll move on to questions and am other questions from members of the Committee first and then an move on to questions from safe heart litmus we'll campaign I got some Councillor how it has a question
I had to patient actually John and one for Angela hello and could you close a little bit more about the use of the independent sector and what does it actually mean and is it a a cost to the NHS services but I just like that explained a little bit more and a question for Simon about how did they actually managed to identify the vulnerable who were not shielded and those people who are socially isolated or not did digitally skilled because I know that are I observed the Healthwatch meeting on the 3rd of September and a big statement was at the wasn't sufficient communication to the the sort of public at large thank you
what can you do go ahead with on sprees I just just just just on on the opposite is probably easily fast questions one of the time put into question marks so he acting other separate questions coming thank sorry Kettering OK so in response to the question about the independent sector's so during the pandemic because as I've as I said most acute hospitals had to stand down a lot of their elective and
procedures they NHS England and improvement commissioned space from the independent sector because they were able to protect there pathways e they didn't have covert patients on on their own or patients with covert sorry on on their sites and so it just meant that cancer surgery could continue and some urgent diagnostic work are yes it did come up or could the cost to the NHS but my understanding that term the contract was agreed at the same prices NHS rate so I don't think it was particularly profit making for they independent sector am and as I said are all of us have seen an increase in our waiting lists and so again there have been some negotiations with the independent sector to provide additional capacity so that we can get back on to on track with our waiting lists and obviously the longer any patient waits for a needed procedure will add to the risk and so it's it's really to ensure that we get on top of the waiting lists more more quickly thank you thank you for that are advised by the Executive like jointly could answer the question on shielding
I'm sorry I am here and consequences on children could cry just as to the specific question to be repeated pleas and I with Afghan fine and park Parton GP how the GI paid managed to identify those people who were vulnerable an isolated and perhaps not having a digital access to to to to the doctors directly to jeebies OK so this was an specifically about people who were on the shielding list who had been identified due to their than either so none of this sort of the one to fall between the general population and those over who are more vulnerable yeah yeah I mean I can
elite and prone to answer some of that from a GPS perspective but certainly I'm aware of lots of work that went on in Lewisham homes across Phoenix Community Housing lots of our registered providers as well as work internally using a whole range of matrices to identify vulnerable people including people who lived alone that was identified through single person council tax benefit people over 70 who had any contact with services there was that there was a huge range of different ways that that that vulnerable people are dead but some of them were called by the shielding team the I was involved with with the at we analyst of about 4 thousand or so that we called on behalf of the integrated programme that Sarah Wainer Leeds and I know the in across GPs and I'm sure that the problem was say more about this the social prescribers made a huge amount of course out of honourable people who would be done at 5 using similar matrices such as age and vulnerability I can provide more information after after the meeting as required but as Ali Pont it to provide more more more response how lucky I got Parton Sansa glad have you
yes at that thank you to Councillor James as points and Labour smooth some nuance if you like I guess identified that shielding patience was relatively easy because as an algorithm and a path to to identify those but were able to use our own searches are built in the we could build into our our IT systems to identify Hays's by be coded as vulnerable patients over certainty that wouldn't SA fall into that have defined NHS defined list social scars work work were tasked and did a fantastic job contacting his patience perhaps also to directly reach out nurses were phoning up and particularly nurses who may be weren't doing some of the usual nursing tasks were able to use their capacity and time to to reach out some this patience and Garrett phone calls and been touched with them we used as his Homs within practices both through messaging services and and information on websites that we could actually pose to encourage patients to assure them that we were open are there to support so direct communication themed communication
and I think it's it's also about the fact that the press's know their population so patient may not this had a code but you know there are honourable and unsay used at kind of historical knowledge and and and that that has to be to general practice that we were a family service and when we know we know who needs us there will be a patients who who may fall them in a bit between as lines and McClinton to make sure we pick up on those and it's it's a good question of how do we catch everyone and as learning to be had without shadow of a doubt in terms of the specific question about those that weren't didn't have access to digital found that more tricky and that is problematic because clearly one way you find out about the population is to digital platforms not the contacts us that you can't find out about them you you have ways of finding out who's not accessing it so for example you can that one of the beauties of of e e modules or e contact we consult is that you can see if you are not reaching and then you can have for you can Craik the ways of contacting them and I think one of the things we also learnt was as you move towards a more ditch less platform you able to trip past the on on telephone existence and and those patients that can't access he console to or similar platforms will be able to to communicate directly by the phone and a cost come to the bats
so it it's a measure of mixtures as no one there's no one answered etiquette as a measure measure of a cocktail of solutions I think that's why things that we're learning is that actually when it comes to providing access ability across our population
that there's no one that no one solution you have to pull from all your tools and use the one this appropriate for that particular person has to person centric and I think the Healthwatch study was really informative and really helpful in terms of looking at how it developed things in the future we have to learn from wary the missed opportunities and we have to look at the learning came out of that really vigorous report to say Well what's next challenge how to ensure we catch everyone a little certain in a safe and effective way I hope that answers the question that Councillor Howard yeah thank you very much and actually further detail because we don't always know how these things are resolved or you know found out about thank you that briefly as a Council of power of questions
thank you my first question is to doner and are you talking Pacific Clee about our mental health my question is seeing as I'm probably KoFID has had a popular direct effect and people's mental health I'm what about those people who probably need more access to your services because of their mental health which is probably a consequence of the lockdown how are you working to help those people and specifically how it may affect children
my other question is to Simon I think one of the concerns I had during the lockdown was people not having direct access to doctors which she spoke about before but there's also those people who may have had an health conditions that may be afraid to go to that their doctors particularly people who would need a diagnosis which is a little bit more hands on what's been done to reassure those patients to know that there are these are the there was what you called the heart sites available and how well other advertisers so that people could actually get to use them
so I'm I'm happy to first Councillor Powell
what we actually experienced during the heat of the the height of the pandemic was at share referrals to crease significant player and in fact we were we were quite concerned people want coming forward during that time and and we did quite a lot of publicity about we still got our doors open because we recognise that particularly locked down the isolation and an impact of that on people's mental health
as as has happened nationally we've started to see an increase in referrals again I'm and one of the things that we've introduced with support with our GPs is to do a joint triage on their system very quickly so that we can get people into the service a lot quicker than what we've done before and that's really important because some some people that come to his need a very we might think of a light touch so actually they need a touch point they need to be at to talk to a found this very quickly understand that a lot of what they're experiencing is very normal and have some strategies for managing their of mental health going forward whereas for other people what we know is their mental health has deteriorated significantly during this time and they require a much higher intervention if you will and we need to get those people saying or by a specialist a lot quicker so we managed to car waiting times with that new system while about 25 days which you know can make a significant difference in somebody's life if you're waiting for something to happen so so we really know that whilst we probably prior to COVID wouldn't have recommended a sort of tree arch function for mental health actually what we've learned is that it can work really well and patients are fed back that they really appreciate it because actually they get a lot quicker access to us and wasn't I just want to say on on Arabs again before I move on to Children's mental health
one of the key areas for us is that the unknown patient so I've been talking to my colleagues a lot about actually we can do a lot with people we know a lot of our service users we've known for many years we can reach our we know the well enough to know whether or not they're going to be able to manage and in certain circumstances others might might not manage the well and we can do something about that we've actually seen is a rise particularly those presenting in hospital what the emergency department of patience that they've never had any contact with mental health services in their lives before and now who are leading our support so one of the key things we need to do their in the mental Health Alliance is to make sure that all partners are aware that mental health is not seen as a separate
a separate to our physical health colleagues and actually we have a joined-up response and that that can in fact we've been working with some of Angela's colleagues in the hospital to do follow ups as well with people that have had cove it and are now struggling and potentially with breathing and the psychological effect that that night may have on them so if I may turn to children's mental health I think it's a concern for all of us around what the longer term impact may or may not be on children and young people and I don't think I we don't know yet what that might be I'm and as a way off making sure again the we don't repeat which is what's happened with physical mental health is a separation and we don't want to separate children and adults mental health in the same way what we're brand to do is to bring the children's mental health into the mental Health Alliance so that we can begin to start saying as a group what are the interventions one of the things that we might do or for children going forward which will also include of course school support suppor in social care not just the mental Health Trust we have to think about children's mental health collectively and one way of doing that is to bring us all together in the mental Health Alliance
chair Mike Williams asked the following question yes justice across the site and Alkerton intervene that although we were to take the the message about having continue them up we do have a children young people Select Committee and they may be better placed to a probe are the children's mental health services are just carry on Councillor Powell and you'll summation that you were doing some work quickly and ease I just wondering do you have a breakdown of the be amazed the black Asian or multi-ethnic is it any particular group that you see a rise in the take-up of your services
and we do have that information Councillor power don't have it to to hand we we know that actually the referrals that are coming into his 8 very broad it's there is no specific ethnic group that we if you like or spite and we're concerned about having said that we know that particularly for our black communities they don't access mental health services readily there's lots of encouragement needed so clearly that an area that we're concentrating on and we can only really do that in partnership with our community and that's where we're focusing our efforts thank you done thank you
Nigel bonus from Healthwatch England a couple of questions and so each year and there was a question for Simon
sign in carrying it thank you thank you sir thank you Councillor power in a really interesting question she can support when this is quite difficult one to answer over the easy Mark first of all which is the the use part sites particular to heart sites in the washing and the marvels Lane they weren't were walking sites so they had to be patient had to be triaged assessed by the Job practitioner than referred into the to the site's as opposed to to a walk inside so we didn't we didn't want to or have capacity to to have walking like an any type services walking sites so there was triage through general practice and in terms of that that the question the garden accessibility and patients who needed things but the warmest too frightened to come down I think it is it's ever something that was troubling us all the way through the acute Coburn first wave if you like nothing those absolutely no doubt that you hit the nail on the head there was definitely a fear and anxiety about presenting the healthcare setting whether this ED whether it's primary care Moran probably in those patients who
perceive themselves to be at high risk or indeed were high-risk sometimes that may been fair because they they were anxious that there might be referred to hospital or be admitted and course at the time the media was frankly frightening intensive and avenues as coming out for people it may people who are vulnerable for even more fundable and find so those a large piece of work that have been through a passes to to to say that we opened and also to say that we were safe and and to encourage patients to to access so it sat slightly paradox situation maybe from the Health Select Committees a year ago maybe Tues gonna be taught about managing demand and supply were here we are as she said please come and see us and while contact us reach out to us we are available for you and trying to to ensure the population knew that we were providing safe environment and a lot of work went in to to making a sites over secure involved in one way as systems and and an end and dispensers and so forth so to try and provide some assurance to our population than we were safe environment an an intense of those patients who had ongoing healthcare needs are clearly there are some
who lacks assessing contacted us but they were patients who probably needed to contact us and maybe they didn't refined or they they couldn't and each practice has different response to that for some practice for example went through there at that they're they're earnest patients with asthma amid reached out and see how they were one of the key actions to take us to make sure that as we rapidly changed our delivery model we make sure it was safe so one of the areas for concern for example was making sure Scotter safe because patients still needed to have
a drug or treatment of his land for example and blood tests on him and we couldn't put them at the Botticellis prerequisite what everything we did but I think it's fair to say we have catch up works to as well there are patients with long-term conditions who who may refer who may be but the the after leave their reviews for example the need to get in I mean it catch up on us and works to that and as possible abuse charges now is how do we catch up with those patients in a safe way bearing in mind that we also may be lurking looking Danner a second way of coming and it is a challenge but we're looking at all sorts of solutions some of those nations of their Moat surface until their earliest of and types of digitalised reviews that that can be done then not perfect they don't get the same detail as face to face that you're captures information we can look at her using video platforms for example to communicate with groups of patients were used for dear consultation throughout the covert which was highly effective and Brindisi talks on actually seeing some men in a world of difference and as she provide us for the assertions I think patience or so much prefer to see someone the so tortured over the phone so much luck waffled mush that's got for point and Councillor power but I think your questions a pittance
thank you Simon
apologies Councillor par for interrupting and stuffing you're getting the answer and I am now at Nigel owners from Healthwatch couple of questions from you yes thank you very much I think the first thing to say their comment really and then to the Healthwatch team are very grateful and were and glad that turned the report has been so useful and I think the the first comic was really about the I'm the focus on digital by default but what seem to be hearing from officers here is that actually the preferred option is digital by choice because digital by default has the potential to to widen health inequalities and create new ones especially given the increasing numbers of people will be made vulnerable by the impact of the pandemic who were not otherwise considered vulnerable so
what kind of comfort and assurance can be given about the ongoing provision for those who are likely to remain digitally challenge for the foreseeable future I think that that that would be would be the first question on just just generally pitched out and the second one really is some is about the next six months and how confident commissioners and providers are that the various parts of the system which are very different in some ways primary care secondary care care homes non domiciliary care can cope with with what's coming down the pipeline
what services won't be provided and what comes an engagement that have been or will be with public impatience about that and so that's fairly lengthy showered us wanted to lecture us as comprehensive as possible
thank you
yes
and able to respond
alone from from an acute perspective on the virtual reduced offering us you start yet OK and thank you for the question so I'm we are we are are trying to encourage digital consultations but that's not everybody in we absolutely recognise that not everybody has even access to a computer or a mobile phone let alone you know anything else so there that so in terms of offering an outpatient appointment the letter goes out to say that it can be conducted virtually in that that's our preference but if there are any issues they that people should contact us and certainly for patients who we know might have a challenge with that then the face-to-face is still stood available any if I can also answer the question about the next six months and I think we've all we've we've got good plans in place the intention is that we continue with all our services I think we got none of us know really they extent of the second wave obviously wherein it I think we are better set up them we were for the first wave because without all the learning from that so as I say the intention is that we carry on with all our services
took part of the dual time Justin the pillages under full full and interrupting the still so and notorious in terms of the sugar from saving it looks the digital arm of GP practices at all and it is touring in in the equipment that we can use to support our patience in its it should never be seen as as the only option and because as exactly saying crate almost has been uneventfully inequity in delivery and it is right for some people it's not about fathers
one of the what we saw with the Coburn was represent immortalisation of the toll and wittier and Terry telephone or concessions in a way that would maybe thought about an hour that she someplace that planned over the next 6 months activate within two or three weeks so it was at pace and some teething problems and maybe the Grinina's out one of the fears and it is a pity and unfair as are there to be proven disproven is that if you
improve accessibility through digital platform you increase accessibility or supply for the montage platform and asked that a theory and we have to see how it plays out but I think that's the idea but if he could move patients who can I'll to want to consult row by Sally hustle to have formed in your fear capacity to deliver those that can't that the nukes is working at how you reach those who contact Ernest that's the challenge and I think it's I'm not going to say we have all the answers for but certainly on our radar that we need to ensure we don't create an equity and it's it's Athene willing every district conversation how the certainly a theme running through the distil first group within within the Borough and I think as after before maybe we also want to work with their partners such as Healthwatch to see how we can co-produced those solutions for those patients that might be 10 she left behind to Mitchell the we support much as possible intense of readiness we have learned a lot I think that we will be better placed in understanding how the artist behaves with a place in understanding the impact it has
we don't know the demand I think it's fair to say we don't know yet the none of us that we may see also the effect the cocktail of hopeless winter and so the will will be ready for for me not challenged the Ulsterman essential part of is that we have to and will continue to support patients who will continue accessible we will still be open and will be different safely HAP making both the Environment co-researcher and our sponsors safe and will that he pulls on that other ticketing and I'd like to say no or Braham promised that I think it's sad to see what happens intensive femme into intensive the movement of work the aim is to do is to pause as little as possible to live as much as we can one of the challenges that we we faces is not not just in in knowing how patients can access but that she containing a workforce to deliver care
and I think that's a theme that runs across all our health and social care partners we have to make sure that the ultimate we don't pass his not fail to be open because there hadn't got started his there are sick and it's finding that balance I guess and I think actually that the solutions with us all I think it's something that we have to develop together as a community both with our population partners Healthwatch analogy sector
it's not going to be a solution to concentrate on doing their own thing it has to their collective response that answered the question on thank you I got an Executive director and up diehard Sussex of both offered to make broad brief responses
thank you want to add to them
thank you Chair yet and I think it's just two cue I think reiterates that and the digital solutions I think are part of the response approach to offering appropriate interventions where we would want to for example had reduced footfall into a care home to review somebody's package yes we need to make sure they said yes we need to make sure that we're going on what we don't want is a series of people for example going in when an iPad held by one of the staff there will allow us to have some of those interactions with people in Kent or indeed in their own homes so it's not about one size fits all I think it's trying to tailor solutions Nigel that maximise independence but also reduce people's anxieties will as their risk I thought
yes thank you Chair suit so Nigel very similar to to my colleagues really arm in regards to it's it's not all about digital can't be mental health as you will appreciate I think we've learnt a lot about maybe who will respond well to a telephone contact and zoom etc and other patience that absolutely it's not appropriate and an example of that might be
somebody who is known to be a hoarder you know they might other telephone tell us that everything so Kai but actually we know that without seeing that person there could be a some serious consequences we we've actually resumed outpatients across all our service areas arm and we're working on a principle that only 25 percent of the workforce can be inside those buildings to offer those face-to-face consultations and that simply means
that staff that can work from home administrator administrators and sometimes the manager's etc or work from home freeing up that capacity to allow clinicians to actually see patience or indeed expanding more to going out visiting people so that we're not inviting people into our environment's would be doing much more about going out to to to see a patient just briefly the only thing I think we would
potentially need to review very quickly again is probably our crisis Café and simply because that's quite a difficult environment have people just coming into the cafe and and also because it's on the Lewisham hospital site were wanting to reduce footfall on that site rather than encourage people at that sites that were actually reviewing that service at the moment it's still up and running but it's it's right it operating in a different way and I suspect that we may have to make a decision about that service going forward in a different format towards its currently in at the moment
thank you
I request that I which I accede to from ESCC as Jacko shoot ask a question and then up Councillor Alan Smith has a comment and that will be the final question comment so Councillor Jack pursue her thank you Chair a good question that I wanted to ask her for Tom Brown and or been in contact with officers due in the lockdown and the time after that because I've been approached by residents about the loss of of services of those who use day services or adult education provision as data look patient and in the light of what's happening at the moment and the continued restrictions I wondered what support work was being given to those people now
this response
you'll muted
sorry I pressed it twice
thank you Chair thank you Councillor pursuit yes the we'll we do have plans to actually reopen the eyesore at Llywel unit in and in the coming weeks assuming as I think this is assuming the end with the the risk doesn't increase with we have plans in place fought for that we have been selected that unit I think because it is clearly the at the cohort of them carers who under the greatest strain and we've we've also had we have had some
Terrace who have actively said they don't want to use services and quite understandably I think they're anxious about that but what we have tried to do is to offer alternatives for people who need things which includes outreach services many of the and Daycare providers have been at going out and trying to an offer breaks to carers or meaningful them engagement with with with folk it's a
it is a minimum offer compared to what we would normally be able to provide them but I think it's been the only way that we found to be safe and Adult end is it's it's back and is it is is opening but again it needs to be in a way which will be them safe and secure for people using the services so we are trying to get back to some new what new normality but we know clearly it's good to be a long time before able to offer what we're offering set back in February
but we do want to make sure that we don't leave care as high and dry
I am thank you item Councillor Smith
since working again please to say no
I was one of the people advised to shield as a result of surgery I had more than 50 years ago
that was followed up as I was done by letter and it was followed up by a number of phone calls from people Lewisham council to make sure Rose OK and surviving so there's no no recourse to digital as a result of that and I thought it was handled remarkably well
it demonstrated a couple of things to me really which I hope the NHS is rightly proud of it it shows to me that
your health records are far more up-to-date an additional 4 and virtually all government departments at the moment if you got records from more than 50 years ago in your database that's pretty good going and he's also showed to me that your algorithms and search systems are significantly more effective and robust in any of the track and trace systems to round at the moment so I think you should be rightly proud of yourselves for that
thank you for that comment on I'm not sure responses needle-sharp be noted though and cascaded down through our health partners that then is the an end Members question I got up Tony O'Sullivan from Save Lewisham hospital campaign a question I just remind Members that we've just just got just less an hour left of this meeting forget to address the agenda so Tony O'Sullivan
if you ask a question about track and trace
thank you very much Chair of only and to the Committee for allowing me to address you this is an issue that we raised at the CCG's borough based board on Tuesday
and we think that the Director of public Health Katharine Beamer for her response then and nothing Wilkinson but we also wanted the Select Committee to add your scrutiny and the sense of urgency to this issue as we enter a second wave and here today that the infection rate today is the highest in the whole of the pandemic very worrying that the case referred to it and I'm not sure it everybody has seen so I'll just say very briefly is illustrative of houses so question coming please yes throws yes
have you seen you've seen it already so there was a a child who is the son of one of our campaigners had a temperature fluctuating over three days between 13 40 point 8 and it he they used the 1 1 1 Service who told them not to go to A&E and not to go to their GP fell to say that and to go to Stansted airport where they were then refused a test and I should say they then ventured got very good service from the GP and the hearts hub that Simon partners referred to the worry there it that I want you to address is that this is illustrative of how our a highly centralised outsource service is failing
Lewisham residents and nationally and yet how good the local services are so what we're asking is if you as a body could grow suits could join the the national call for Trask test and trace services to be embedded locally and not highly centralised an outsourced to the private sector and could Lewisham council add your voices to those other councils and local public Health Leeds in demanding funding from so it's from central government to support the the building back of this very good local service where public Health Local government primary care and the NHS labs in the hospital can work together for the safety of the population
and the the the the the subsidiary question is that I was very worried that this that the 1 one service was using an algorithm in a way that gave quite dangerous advice to the parent of a Chartered could have had septicemia and could have died with the advice that there are given thank you thank you I'll what are I'll formally proposed to make a referral tomorrow and cabinet along those lines and a new regime we make referrals on the hoof as we go rather than make again for meeting so I'm given we have an Executive now I would ask our proposed we make a referral to now encamped along the lines of your first request in terms of making Council policy again Council policy is in the Mayoral Authority made by Marin cabinets at the Council motions are merely advisory so again I think I'm by making referred to marry cabinet the Mayor and Cabinet will be able to determine policy and I'd hope it be along the lines are too far as suggested so am I I'm formally proposing we make a referral to Naren cameras along those lines did you do have a note of that John John Barnes

5 Financial stabilisation - budget update and medium term plan

yes No to challenge it is our second are yes Councillor Howard I think I think I'm out as it does anyone oppose that and if so can I give their reasons for opposing it now I think it's some unanimous thing so thank you thank you a continuous on for coming tonight and we welcome your suggestion and we've acted on it thank you very much you'll welcome your welcome so at that brings us the end of that item as I say we do have that Thabet other business a gap 3 before the end of the agenda we now go on to finalisation of because the financial stabilisation budget update Medium Term Plan and to Catherine need is going to introduce this report there's on page 19 to 67 of your paper agendas
sort of Catherine
evening thank you Chair
Even committee
so the paper that you have an in front of you is effectively setting out the financial backdrop and help with understanding of the wider context that's ahead of the detail proposals which officers will be bringing in a Member to your Committee for review
as much as the Council has and continues to plan prudently in respect of the financial stewardship of the council and its use of public funds the current circumstances present more uncertainty and unprecedented challenge than usual and this is across four separate finance firstly we have the covert pandemic impact and the and the impact on both resident services in our finances we've got our current in year overspending which effectively cost and demand that has grown as our population has grown we have extreme public finance uncertainty in particular for local government with deferrals on the comprehensive spending Review the Local government Finance Settlement the Fair funding Review business rates review etc and finally we have the the impact on the economy which is the the recession that we've started entering into which is obviously compounded by covert as well as Brexit's now as I said we do plan and manage our finances prudently and we would normally be able to manage in one and cope with possibly even two of these
however to address all four at once as we're now having to do is a situation leave not faced even during a decade of austerity
the report of the said is effectively in two parts the first part sets out the in-year pressures and risks to the finances and the second part sets out the Medium Term Strategy and the funding gap that's presented
in year the focus has been on providing critical services in response to Covid and managing the service overspend
in total the pressures from these two items on nearly 20 million crowbarred and circa 17 million pounds for overspends respectively
reporting and lobbying the government continues on the first and management action has been taken on the second the Management action to date has identified over 5 million pounds of in-year cash reductions which is going to reduce the level of own overspending further
the Medium Term financial Strategy sets out the assumptions identifies the need for student fight least 40 million pounds of cuts over the next three years with the majority of these being needed in the first year which is next year and that circuit when she 4 million pounds the report talks to the approach officers are taking to identify these draft proposals and were working away to avoid salami or silo working so I'm slicing apologies in terms of slicing budgets
it is through things that we are intending to encourage collaboration across services and look for opportunities to transform services whilst reducing budgets focusing first on the needs of the community priorities the Council and then working back that through into operational arrangements in budgets
the timetable that's in the report is there to answer any questions now on the context and the approach that we're taking with the detail cuts proposals returning to ourselves in November then subject to the decisions of Mary Cabinet in December and announcements from the chancellor in the autumn budget the local finances Local government Finance Settlement in December that will enable us to make any changes in January and present the budget for approval to Council in February
that that effectively is the introduction to the reports and are more than happy set questions I also should mention that we do have other Members of EMT with us this evening who can perhaps answers specific questions if they relate to specific in specific areas thank you you you mentioned the Autumn Budget which I believe
is not going to be happening in the same format this year but Sir but Surrey with we await the financial settlements definitely I'm preside for Tom Brown I do note that you want to come in on on the specific points
and nothing particular to add Chair at this point was happy to take any questions that toggle question from Nigel bonus
thank you very much Chair that yet obviously the that the pressures are huge and and the time scale is significantly truncated for these cuts and for the transformation programme Sir surrounding them I think it would be extremely helpful
to to to have sight of the corporate sort of comes and engagement strategy a rounds around its heart how the
that is how the council is an and various council officers and departments proposing to engage with the public on this keeping people informed of what's going on and and getting their imports because I think can Catherine just mentioned that the first the first priority is to shape the services around the communities so it some getting an understanding of how that process will look like that would be helpful thank you
I'm sorry dwellers take as one is the son our yes you started so let me finish because sorry apologies my answer half of that in part and ask Selina to supplemented so as always with proposals where where the detail is worked up which is what will happen in the period up to November where those have direct implications that require consultation that consultation will take place I'm as is required so that will be for specific proposals where they need you know consultation to take place in terms of a sort of broader engagement communication Strategy Selina is there a bit more we can say because there is something that is being worked up with the with the current team
as Selina here I know she I guess is she left I had bothered to check out there was a technical issue another meeting I had to duck after but by Ambac yes in terms of communication there is becomes theme around this that the consumer working on to make sure that messaging is getting out there appropriately of the alight at the same time obviously dealing with a lot of communication around second wave management so so it is a is a challenging time but yes absolutely there is an approach to communicating this on once we've been through and we come to them November periods where the proposals that you are going to be looking at that time are confirmed then absolutely as well as consultation or be clear communication around that as well
thank you Councillor Smith
you to obviously
Spoon
first eight years of this
they can lead last decade I should say should know quite heavily involved in in the budgeting process after austerity started to kick in and what was really notable through that whole process really was that by probably 2 thousand and 5 we got to the point where we were no longer trimming away any fat not that was much too true in the first place and that were into a realm of picking the lesser of two evils really picking the the battle worse as places to reduce the budget what was also noticeable through that time is firstly the government has had a complete deficit to it but that the indicative budget and then the final settlements were getting later and later and later and much closer to the wire leaving far less time to really work out all the things we need to do
so my question is do we can't know where were even go to have sight of an indicative budget let alone a final settlement an are you expect new to actually come in time rested make any real inroads into trying to delve into this budget and financial stabilisation
as Catherine
thank you
I mean it's an excellent point yes they delayed it more and more on and and pushed and pushed items back and left us with more than one certainty we we try to manage this in a number of ways we've been Conservative and our assumptions in the medium term financial Strategy with regards to what that sits on it might be like and not being overly optimistic so that with any luck you know the the the figure will the figure may improve but it shouldn't worsen in terms of the timing they have to make settlement inner before January I appreciate if they leave it as late as January though it it does leave us with with no we're really to go other than simply to to start top-slicing top-slicing budgets in order to pass' a balanced budget in February part of the reason of of changing approach and working in themes is to try and make sure that we can be confident though that the the savings target will be delivered and then with that without slight what you know with a slight conservatism that we've had in terms of what are or seem settlement would be meaning that hopefully won't get a shock to the system if it's late end and not not good news so there is no certainty but we we are we are plan prudently and hoping that with our own ability to to make savings is difficult cuts I should say is difficult as they will be there will be able to manage that process and hopefully it won't go Wanger 2 January but will come out in December
thank you
you don't come back on that Councillor Smith
no but as I expected really we always have tried to be prudent and and second guess what the Treasury is intending to do but I know it gets progressively more and more difficult than you'll be working late in late night the down
sorry Chair you're mute but sorry sorry
it's it's contagious it's contagious and and John ask any merger can come on the Committee of the time Scott timetable for this and it goes public accounts for the year stabilisation update and then married cabinet are the because the paper refers to a council report on 28 October without courses now 21st October I believe
that's the point of Council yes the it'll at the cuts they are coming to this Committee on 11th November
but as well as talking about the these are budget uptight after we just heard last night yes cuts come to the next Committee and our but there is a up a public accounts select committee meeting which will take any referral of this committee were to make tonight on the stabilisation Nattrass yet Saajid at this to Murray yes as tomorrow night so so the there is an off-duty to night for this committee to make any comments about the
financial stabilisation in year cuts arm although next year's budget we will be having a a report and full discussion about that at our next committee meeting and and that will inform a future mayor and cabinet or prior to going to a future Council when become to set the budget so that a timetable and are there any comments of people wish to send to public councillor committee from tonight's discussion
no I'd I see no indication I think we are in difficult times I know and immensely grateful to our resources Sir direct read out our officers who are working hard to work in what an impossible situation that not going to get any easier despite what some in other places I say I think we're in unchartered territory and now we get the best we can to preserve services for the most vulnerable of our people so unless they won't have any further comments I think we note the report and we thank at Catherine and up officers for the work done in preparing the report so thank you thank you very much getting

7 Leisure Contract Management

it is an offence and pathways we move on to the next item which is the and leisure contract and this has already been a disgusted mayor and cabinet and and disgusting part 2 which on a spoken and also speak to the business Panel overview and scrutiny committee business Powell were in part to as eager that tonight we didn't need to delve into part two that we could and do as much as possible under part 1 which means the public and press a presence which means that certain issues about commercial sensitivity couldn't be discussed I decided and the visitors and it has been made has a man can it's better business panel and good generally who will explain matters I've had some questions sent to me via Twitter and which I have been out over with their power legal officer to make sure that I'm not going to slip into a park two matters goes and as I would say that if that those who have sent questions into me and don't get answers tonight there is a chance to put questions in to full Council the deadline for submitting questions is midnight on Tuesday the 29th of September so or if you don't get an answers tonight you can put answer questions into full council where you're getting a response from the Cabinet Member or the Mayor so James are you going to introduce this item
gesture OK good brief cause that cause I'm aware that people have many questions probably aren't covered in this report which is which is very brief and factual and just to reiterate those those facts that Ling ABUHB Lewisham is in the process of transferring its leisure management contract from fusion lifestyle to Greenwich Leisure limited G allow
the impact of Covid is significant on on the leisure market and an as yet has yet to fully play out so we don't know exactly what services are will look like but as part of the transfer we are undertaking that the usual consultations with staff and we are we will be seeking to assess the covert security of each of the FSA facilities ahead of a proposed reopening towards the end dearth October and beginning of November
I thank you at of Aiken a start up Councillor Smith you could declaration yes sorry I dot should pick this up earlier but Mr. I am chair of the board of a small social enterprise based in Woolage that has in the past given business and financial advice to JLL particularly during its original set-up
it currently has no contract with them and I have as I am an unpaid non-exec I have no pecuniary interest but of course it may in the future offer that advice the organisation as I think I should just declare that that I do have that rather tenuous connection no I say I had no pecuniary interest
Georgie that you have any comments on that I can stay in the meeting Kathy I think so Chair he says or there's no this our current involvement that's fine I tell you if part of calcite nothing different cause just ask a a quick question so so there has been a matter of far arm correspondence to all Members of the Council as about the relation ship path between the all-island trade unions or whether there are Union recognition agreements with our with whom they are and also the our status of TP negotiations with trade union involvement so let us just an easy one star with yes absolutely a Gilo have full union recognition they recognise all all unions or whoever members on their sites that would primarily be Unite Unison and GMB could earn conceivably be others those are fully recognised and and the required time and space is given to union representatives to fulfil leggie teas in terms of Tupi negotiations both organisations recognise unions and JLL in particular the the trendy increasingly actually go through the process the importance of the the receiving organisation is is paramount and day and JLL are committed to following the Akass guidelines on Tupi which include recognition unions
I thank you and I got a Nigel bonus as a question below I'll just say our four members have not been on this committee before over the years we did receive an quite a few and reports that are about the leisure contract and about our the performance of fusion how we use it took those as part too so Ann members who have been on the Committee for a while or have read committee papers in the past or will know that Sir possibly no surprise that some few fusion wasn't able to carry on except a Nigel thank you very much Chair this is we replace than nothing to do with that or anything to the report so it some really about what steps JLL we'll be taking as as they mobilise her to reopen to ensure that their the sites are accessible to to disabled people and will there be carrying out any sort of publicity campaigns to be a lot of people have been negatively impacted in terms of their capacity to exercise and take part in leisure activities by the lockdown or by covert and are and I'm just wondering what
what the trailer will be doing to him
to mobilise basically
as soon as the Tories take that nurture yes please carry on that yeah we're we're currently in the process as I said transferring the contract and this includes the leases for sites once DNO have access full access to those sites they will be undertaking their mobilisation inspections are not ensure that includes making sure that the facilities are fully covert safe and fully accessible to disabled people and and and to everybody else arm JLL have significant experience of running contract across London and they have open many facilities another Borras Paris acted men Member Councillor born recently listed one of their sites in Croydon to see how they made these covert safe and accessible and there will be a significant marketing and mobilisation campaign arm as Council an LDO has mentioned it hasn't been without issue our leisure provision in in the recent past and we see this as a real opportunity for refreshed are and until it to ensure that the leisure provision is emitting the very real needs of of of our communities not least because exercise has a beneficial impact on physical mental wellbeing and a whole range of of all the things you know it has been described as a as a miracle cure for for so many things if it hadn't if it didn't exist in the past and some of discovered it they would think it was the most wonderful 8 it to medical wellbeing that there had ever been discovered
that gives our steps thank you I got Councillor Howard with a question but does before that and James I can pick up our two things while you've just when you have a contract be signed yet actually been signed if not when you anticipate being signed
and the what lessons if any have you learned from the failure of a fusions contract and the contract is not been signed as yet we're we're aiming for a date in in Maeda mid-October the exact date to be to be defined but but relatively soon arm
the lessons I I mean I I suppose the lessons learned from from the fusion contract are that well
particularly at the moment leisure services are possibly more expensive to run than than we previously had taken account for changes in the market and changes in in demographic means that running public accessible swimming pools are is very expensive and to try and try and hold on prices down Klum and expect a very high standard of delivery maybe asking too much so it may be the in the mobilisation phase we need to come back to Members and consider what our overall approach to leathery to ensure that accessible and for those on low incomes but attractive for those who can who can afford to pay
thank you Councillor Howard
thank you game could I care start I don't know if it term or right to share this information what would be the length of the contract because I think there are sometimes difficulties that if difficulties arise if it's a very long term contract then it can be difficult to make a change so you know I and many other people are all very keen to get back to our various sports classes and so on but we want to know that this is going to be a good that a good contract for Lewisham
the initial contract length is is two years so very very short and Eliza terms there is an option to extend that contract for a further 3 years subject to arm the quality of the performance and delivery and the consideration of all other options in including insourcing the provision I'm the reason that Leisure contract are usually very long arm Turnastone learning this to my own
to the detriment of my my own wellbeing at the moment is that they're incredibly complicated and the number of moving parts and buildings and leases and kit transferred and all the rest of it means that it is a hugely labour-intensive piece of work to let these contracts and also they require significant capital investment arm the running of a swimming pool on in itself is is a huge and complicated undertaking and that the plans and the kit and the investment that is required to keep that show on the road is significant and that is usually depreciated over a significant period which is why in order to promote investment on on both side contracts tend to be quite long but you're right when you were in a long contract and things aren't working out so well it's not it's not so ideal
these these these arrangements do often worked very well as you know in your own ward we have the even longer contract with one life under the peer funding and and think what you like about those arrangements that contract is delivering very well at the moment
thank you thank you OK I just jumping up because there's a break clause in this are proposed contract isn't that it's well it's two years I mean that the initial break if you like with an option to extend for a further 3 after those initial 2 years so that's that that's the break after the first two
so you'd expect Jello to take the risk that you wouldn't continued after two years yes they they've agreed agreed to to do that and inferior I mean obviously we could put something in front of them that that change their mind but we we we don't intend to do that
OK thank you I can't Councillor Smith
let's remember back to the which no fusion contract that was done on under the the what I think laughingly called best value regime whether which gave the significant waiting to finance and far lower rating to quality of service
there were two people really in the rate of that point fusion and JLL who were both pretty new into the market at that point I think they were both spin-outs from local authority leisure services
so I don't think we had an awful lot of history to work on and they equally that didn't have a lot of experience of large scale operation we're in a very very different world now the JLL
provides a fair chunk of the Leisure Services across London so air contract
it's not going to be a significant increase in their workload in in that to that extent they there already know what they're doing so my question really is an under this contract which still presumably as being looked at under the best value regime have we know shifted the waiting more in favour of quality and less in favour of finance than we used to do
it is a other moment it's a very I don't want to go into the specific details of of the contract but I will I will answer in very general terms about what's happening in the leisure industry are due to covert due to the nature of the impact on on leisure contracts it it's widely accepted that this is a this is a changing law code as a change in law event regarding the contracts and for leisure provision and therefore the majority of those contracts are completely broken open and local authorities are liable for for the full cost of of provision as such we we have no one of financial requirements and an our our desire is to improve improved performance
the the the the officer is is possibly true in in terms of the past in the as the local authority liable for the cost it may be us who is seeking to control the cost rather than the provider in previous guises so it is the balance between the two elements cost and quality is very much more in our control
yes I supply free no no that's fine I understand them should have I got Councillor Powell
I James I wanted to ask about some of the business is that are running out of for example Billingham's leisure centre you've got the Ladywell gym and a kind of soft play and business another got some other football football clubs that run out of burying him leisure center wall these and businesses still be able to run under the new contract with that part of the provision is when they took over the contract they would have to still work with these businesses
it's I mean the short of the short answer is well it's a mixed bag I think in terms of some of the larger providers gymnastics club etc. we would be very keen to to to get those buildings reopened and and get them back in as quickly as possible the main impediment to doing that is the COVID risk assessment and there are very clear requirements for indoor sport in terms of air handling and be mount of literature per per hour that needs to circulate within certain size halls so I think for some of the larger larger provision such as the gymnastics that's probably going to be OK things like soft play provision are it may be it may be more difficult so the first job of GLA Jill JLL when they get into the site is to to undertake those risk assessments and to ensure that the buildings are are are able to operate as previously if they are there is a financial considerations we were just talking about but the expectation would be that they continue to work with all of the existing her all of the incumbents we're not looking to change any of the sort of sub lease arrangements at the moment and it's a very similar situation across across the other sites as well
for example the football clubs that operate out of Ladywell arena and can let explore who operate there were working closely with them to ensure that they can return as quickly as possible to use those facilities thank you
Councillor Gibbons and Councillor Hardy anchor Councillor Gibbons please
yeah but Gavin St James's sort of answered my question again or build on Councillor powers regarding the current sub-leases and the kind of small medium businesses that use our leisure facilities and the impact that the come closer to having and they're not was in my mind was forced to park Hefce Luton Borough FC who goes use lay well arena and then not being able to play their current fixtures is going to have a huge impact on them an enter now quite small but they are a bit of a community assets are and I just want some reassurance that when these facilities do reopen has it been disgusted GLA to kind of work
can positively with these organisations if they need a bit more support will they be able to get that but you kind of answer that that at its deftly at the forefront of your mind yeah yeah I just I'll just add a little bit more Turner if if if Chair if Chair allows
yes yes the canal just to say with mats with resident representatives from both of the clubs that that be talked about and there was some concern and because fusion staff have been unfair low
that the condition of the ground and would mean a return has not would not be possible but we've engaged Glendale who most people will know our part contractor to undertake some emergency repair work of the of the ground and we hope to get the clumps back in in the middle of October in the meantime they have liaised with the league and arranged to play their first a full round of fixtures away away from home and so we are we are in regular contact with them and we talking in between them G L about how they may have greater involvement in the running of the facility and in the long term and because it is something that they've always wanted I I'm not something the that that was necessarily
necessarily something we wanted to explore under the future contract
thank you Councillor the anchor
thank you care and I have worked in the fitness industry for over 20 years and an I never ever seen it on its knees like this as it is at the moment so I hope I know chains in what you said that you are aware of this but I just want to it's a kind of life and Dos what you said because it is in a mess and I'd like some assurance from you if it's possible that you're not going to allow key allowed her closest from imposed because I do agree with everything you said about how expensive they are to run I know that when LA fitness closed down the company that took them over just close them all because it was just much cheaper for them so I wouldn't want that to happen and I know that I've only got one pool in my ward and it's not the most glamorous I wouldn't like to see that happen across our centres and I have been contacted by residents about any idea or dates when we might be able to reopen offer solicitors I've been sending them to down him
so do you have any any comments alarm I know so if you go anything that you won't come and chat me about about the industry or anything like that I'm very very how paid to trap to you if that's helpful you Liam UK my regret making that offer I think anybody use willing to share my pain around leisure at the moment is might get there via ear to doff for quite some time but an in in answer to your question I'll I'll I'll take them in the order you ask them
I mean I I like you are are passionately keen to get the centres openers as quickly as possible and particularly the swimming pools because the swimming pools of the things that the private sector will will never deliver and Meshaw willing to pay 90 pounds a month for your for your membership
the the problem that we have and I think we just have to be open about this essentially what is was the content of of Catherine's report just before this one is that the Council is in a a dire financial position
and we are you know these these centres cost a significant amount of money I mean so significant that it that its way outside my remit to to to to have any say over whether the pools will will earn close in that would be a member decision we would if it if there was proposal any the pools work were to close it would be bringing that for full Our scrutiny and and sinister one it won't happen without you knowing about it as a as it were in terms of the the reopening the plan and there was I think we did a press release on Thursday last week the plan is to reopen a glass Mill Forest Hill pools and weighed less so to focus on the pools so we ever could spread of pool so we then have down and glass Mill Forest Helen and wave lent open as quickly as possible on and we're hoping that that would be in
early probably early November now on and during that time we will be reviewing the other side because those are the sites that we have more concerns about regarding their ability to be covert Vitacor or in terms of the handling facilities etc.
so so that will be the that will be the process for reopening but we're we're hoping to get the pools open areas iffy and please do keep sending people to down and because will people get used to the idea that things can be savoured emulates not ideal having to turn up in your in your Kate etc but it can be safe and and people can get back to using the facilities
if I may make a short further comment on that chaplain's carry on carry-on
just to say and that and thank you very much for your reassurances I understand that you can't promise the world that that I am here as a helpful voice if you need it
I agree appreciator thing
thank you I got that Councillor Jack pursue has a question on the Standing orders
yeah it's it it's about the Building Centre and the last term like contact with the year than in a community project they were asking when they might get access to their office again ITT male officers about this and times moved on since then and I wanted to know if because they relocated into the Leisure Centre get a couple of years go if they've now got an access to offices although obviously since then people are advised to work from home again but they they were quite keen that they have access to their offices again
I don't I don't think I don't think you got access right at the moment and for the reasons that you mention an but I have regular conversations with Julian routes from from BCP certainly the last time I spoke to him he was he was it was evident in his own kitchen so he wasn't back in his office but but I will and keep in touch with with Julian and ensure that they get they get access to the facilities that they that they rightly should have access because they cause they own them
as soon as possible
I thank you and
our question time and in the past some previous iterations of this committee did receive performance management reports on the Leisure contract
and without delving into what would become part two matters Duke and his by using similar performance indicators or will you have riff refined them somewhat and can you show us how be focused on the outcomes as well as process and finance
yeah I mean yes absolutely I mean some of the indicators will remain the same and they were some of the indicators that we earn brought to you to indicate that we weren't happy with the formats
I think what an constrained as in the past was on
a a contract that that was clearly deficient in infant and as we talked about previously because of the nature of covert though some of those constraints have been removed and as such
at the the the Arsenal of Athens in terms of managing and monitoring performance are are vastly then increased
plans and we went Batley of indicators to deploy
if it's a yes absolutely Ted if I'm if I'm honest though the number one the number one indicator the that we use is is customer feedback number visits to sites customer feedback you know eyeballing inspections am in it was it didn't require or it doesn't require a very very sophisticated monitoring monitoring system to listen to what people say to go and look at centres had gone look at site to to see whether their clean to see where the classes of running on time it's it's it relatively easy to monitor performance it what you do with that information that is there is the question and previously the constraints the that we had meant that changing that without significant financial implications was very difficult
the problem we have at the moment is is that we have those SIF significant financial implications due to the change in law so it may well be that the our approaches is changed due to them
thank you for that so recommendation is that we note the report that a great

8 Select Committee work programme

thank you thank you so thanks for your contribution tonight James and we look forward to hearing more when the contract is let and the ceiling leisure being reopened and rolling out so thank you very much when I move on the Work Programme John are John Arden's as we Manager John to introduce this please and as this is the first meeting of the municipal year
the Chinese to consider its priorities and agree a work programme for the year ahead in your attendance on 800 81 you'll see there is a draft work programme company populated with some suggestions at facing glitches interest and then previous work and its remit you'll see there's some capacity in January
so in short the Committee needs to discuss its priorities considers priorities think about what it needs to do with the spare capacity it has in January and agree work programme for the year ahead and bet your job right arm yet so I think as I intimated earlier tonight something I would like to recommend for November is a report on the pathology contract that was let last week and there had been an act and a temple adequate are requested discuss it tonight by a third party but because they contact us only determined at the end of last week we didn't meet the 5 day five clear working day notification requirements to have a report tonight but I think I would like to have a report from the commissioners about the new pathology arrangements CERT my proposal to up could that any at all I think it requires more than just information I too I think I'll be questions to be asked about it in November so that could be my suggestion of I think we have to remind full that under the the new one way over Scrutiny we can have two major items per meeting the meetings only last 2 hours and those fewer
meetings throughout the year so we bear that in mind are of so
people are members the Committee be minded to include a report on the pathology contract
yes yes I'd say no and no one are shaking as a Notting it so can we add that John please
yes 0 appendix that will ensure as you rightly identified there are currently two and substantive item scheduled in one on the budget cuts and one on the scope of the Burnham Aleutian often qualities review and still be matter of discussion the Committee and gender planning for work out the best time instead all of those to come as I think I think as budget cuts had to be taken then because they then inform public accounts Select Committee which then reports to Mayor and Cabinet which then reported to full Council to set the budget so weak there is no room for slippage on that one of till I do think be helping Equalities Review of although it does have for an academic board and an advice report and I still and I think technically at accountable I think the Health and Wellbeing Board on my right or is turmeric cabinet John
chapter of which executive Treacy goes to and it it either goes to hell them are being bored or mayor and cabinet so we have as we have a say a scrutiny input but I don't think is directly accountable to us nevertheless I think we should keep an eye on it
so I think we must keep that in the agenda because I think I get Kelly asked questions about it and I think we need we need to keep an eye on what's what it's methodologies scoping how it's progressing and get the interim feedback
progress reports from it so that we can we can go back to our communities to our constituents and say yes we can tell you what's happening because I'm not saying I not and not for one minute suggesting that there's anything secretive it's just that I do think we as a backbench councillors
should keep on as do other Members agree yes agreed so yes sir now future meetings
so it we have a proposal January Cahill's market stability and space for one other item other any any bids
I put a question on
to Roseville
a comment and suggest recall Councillor Smith carry on us yeah I have paid Helen 79 and page hundred Neti which should have had no information the no page 1 8 once I read then I won't have you got modern Gov no no well I've got more they open and look at it will I'm read talking to you well Patti Page 1 they want with the last papers I probably fell off if you have paper copies I do yes I probably fell off and so I'll I'll quickly tell you what is on the work programme or after we've received about November January we have carefully was a market stability with any Pelley crucial because they are in a pretty precarious condition before cove it and as has the space for another and the final meeting of the useful year health or social care workforce health and wellbeing priorities we have a
information item was the adults Safeguarding Board OK which we got to to help Wellbeing Board I believe John
yet things go to the next meeting and that goes a substantive item at the Health and Wellbeing Board which is in December I believe that my December the third
John yet the structure as by surface the the Annual Safeguarding report will be discussed fully at the December the 13th of of being bored Nigel you have suggestion Jeff yes Chair and thank you very much at adjusting thought it might be helpful for your Committee to get an update on the half-turn care recovery plan at some point and how that adds progressing it became perfectly width that focus that you mentioned on non domiciliary and domiciliary care because a I just to pick up on the response to Councillor Howard's point earlier
I think perhaps local housing providers and others could be invited to report to your Committee specifically on their actions are learning from the covert welfare system and how how their working with a wider system perhaps I'm not quite sure how you would embed that in your work programme but it just feels like the sort of thing your Committee needs to know about and get some assurance as well around the corporate comms and engagement approach to service change once you know what services are likely to be impacted in up to an including formal consultations but beyond bit beyond that and my final point really was for your for as you fee was back bench Councillors are you fully aware of of how to access Healthwatch Lewisham's services and that you can sign post that you can actually access the website and the if you have come to constituents with complaints about NHS services you can actually refer them to Healthwatch solutions complaints NHS complaints advocacy service so it's just trying I gotten on the man of the Kinnear don't just to make it a broader pitched it to make sure that Members are actually aware of the that Healthwatch Lewisham is a resource that you can act use as well so
the voice of the patient a date and did absolutely so as others just suggest some thoughts there anybody around your work programmes and just to give them promote health but a little bit so so I of Castle Howard says go hand up its arm of John Barnes have you any any thought how to incorporate the Healthbook proposal
An update on the recovery plan means that could be skittled inferred generally than we have discussions of officers in gender them to see how that would work yes OK we'll take that to agenda planning then Councillor Howard
and adjust personally to add to that we also need to look in general don't me about the older Adult Day services I think it was some now included in what you were talking about Nigel what what the progression is going to be gradually in terms of re offering services for Learning Disability and older
An elderly people in need and the other thing that we said we were going to try and
come back to was the issue of migrant charging yes I don't know if there's any scope for perhaps just a briefing I I we could certainly have a a information I too because this was set up I don't know what progress has been made I think covert overtook it somewhat but certainly are it was established that you should be reporting back
I think it's only appropriate report back as to this committee as an information item I I think John can you chase I please
yes just income from Brown was really quick commence a nicer guested a quick comment because we're up against the clock to yes thank you Chair just on the migrant charging very helpfully I had an e-mail yesterday from a petered Lookman who the Independent Chair is re reconvening the the group and it will be meeting in the next week or two so I think something should be coming out later in the calendar year so I think that would be very timely but I think so had repeated Lookman Sir well established independent chair and a former and shall Sir senior managers so he is a highly regarded as Sir as as a chair so I look forward to seeing that any other suggestions I think we had quite a few we can take this to the next agenda planning meeting and this is an as a living document the workprogramme even other feel meetings this this year we will we will bring back the next committee to report on North discussions at agenda planning so unless any further comments on that and we will
chaired like the making suggestions
could we get a report also own food insecurities and how it if Aphex low income families yes in the Berlin yes and I think card
I'll be guided by the chaired overview and scrutiny on that one and I think obviously food is a very important factor for health that I will be guided by him about by Councillor Brown's comments on out
whether if this committee or possibly even a task and finish group task finish given it is cross reaches not just adults it's children it's not just unhealthy people it's healthy people I think yes
as I think I'll be guided by ASC out John Barnes take that to the and Head of overview and scrutiny for a steer from the Chair of in scrutiny I think it's important it is addressed
as John Jones huge understand so
understand OK so if you could take that to the check to the head of overview and scrutiny for discussion and I have to Papa the discussion with the Chair of in screen is the best way forward on that matter yet so subject to that if people agree that we will of course bring it back to Ademola meeting I think that is our business full tonight so the next meeting of this Committee will be at 7 30 on Wednesday the 11th of November
so people have that growth in the Dari
that we'll I imagine still be a virtual meeting to which goes the public and press will be invited so I thank those who farm been watching at home and thanked the press for their attendance thank all Members of a Committee or officers of appeared before us tonight thank you all for coming tonight
even if it's only virtually and good nightie all that night