Agenda item

Report ACH21-007

The Committee considered a report providing an update of the Portfolio Plan for 2020-21 – Quarter 3.

The Adult Care and Health Portfolio Plan 2018 to 2022 was refreshed for 2020/21 in line with the Council’s Transformation Programme and Bromley the Better Borough. The Plan continued to focus on four priority outcomes:

·  Safeguarding;

·  Life chances, resilience and wellbeing;

·  Integrated health and social care; and

·  Ensuring efficiency and effectiveness.

Within each priority were a number of statements which were underpinned by actions and measures of success within the work of Adult Care and Health Services. During 2020/21 officers had been delivering on the Portfolio Plan at the same time as responding to the COVID-19 pandemic. This included programmes to support residents who were clinically extremely vulnerable to coronavirus as well as other vulnerable residents, to match volunteers with those needing support, to provide social care providers with training, advice and PPE supplies and establish a local Contact, Test and Trace service. However, progress had been made on the majority of the actions within the Portfolio Plan. 

The impact of COVID-19 had seen some positive developments such as new ways of working in partnership with health partners some of which had been incorporated into mainstream ways of working whilst others continued to be evaluated for incorporation into future plans. However, some developmental work and re-commissioning had needed to be delayed. Key achievements in Quarter 3 were:

Priority 1 – Safeguarding:

-  Continuing to raise the profile of safeguarding awareness during COVID-19 by developing the Bromley Safeguarding Adults Board website and launching the Board’s Twitter account.

-  The launch of the Strengths and Outcomes Based Approaches Practice Framework in December 2020 to support front-line professionals and commissioners in developing and improving their practice to promote the independence and wellbeing of vulnerable residents.

Priority 2 – Life chances, resilience and wellbeing:

-  The 0-19 years public health service contract commenced on 1^st October 2020 delivering better, more co-ordinated health guidance and support for children, young people and families.

-  The Public Health response to the COVID-19 pandemic continued with the development of the Outbreak Control Plan, frameworks for outbreaks in specific settings and vulnerable groups, engagement and communication plans and the successful development of the local Contact, Test and Trace programme. 

Priority 3 – Integrated health and social care:

-  The development of the Learning Disability Strategy and the establishment of the Learning Disability Partnership Board to take forward its strategic priorities.

-  Establishing the integrated Rehabilitation and Reablement Pathway as part of the Single Point of Access resulting in increased capacity of 40% operating 7 days a week.

-  Successfully re-tendering the CAMHS service and Direct Payments Support and Payroll Service contracts to begin in April 2021.

Priority 4 – Ensuring efficiency and effectiveness:

-  The strong local response to Winter pressures and the second wave of COVID-19 due to Integrated commissioning arrangements and One Bromley collaborative working.

A Member noted that there were several references made in the Portfolio Plan to the ‘Building a Better Bromley’ document, which had now expired, and enquired when the new version would be published. The Assistant Director for Strategy, Performance and Corporate Transformation responded that an initial draft of the ‘Bromley the Better Borough’ had been presented to the Executive, Resources and Contracts PDS Committee at the end of last year, and Members had made a number of recommendations for refinement. One of the key points was that the initial drafting of the document had taken place prior to the pandemic, since which a number of changes had been made to the way services were delivered. Work had therefore been paused, and two Public Health reports had been commissioned – the first of these related to the impact of the pandemic, which would form part of the Joint Strategic Needs Assessment (JSNA), and the second would address what was being done to respond to these needs. It was noted that the priorities listed in the expired strategy would remain until they were replaced, and the higher-level vision would broadly remain the same. In terms of timeframe, it was anticipated that a redraft of the document would be presented in the summer.

The Member further noted the references made to the Council’s obesity campaign materials. It was highlighted that it would be helpful to see the good work being undertaken by officers and suggested that Members could help to distribute information locally. Councillor Jefferys, Chairman of the Health and Wellbeing Board, advised that the Board had established a sub-group to undertake a piece of work related to obesity. Following discussions at the February meeting, the sub-group had reconvened and would provide an update at the Health and Wellbeing Board on 29^th April 2021. The Director of Public Health said that an obesity campaign had been undertaken during the autumn for which they had tried to circulate information as widely as possible. It was suggested that the update presented to the next Health and Wellbeing Board meeting be circulated to Members of the Adult Care and Health PDS Committee.

In response to questions from a Member, the Director of Adult Social Care advised that the BSAB Conference had been cancelled this year as it was not possible to hold it face to face. However, there had previously been discussions as to whether it provided good value for money and the department were already considering if this was the most appropriate way to bring people together. Members were assured that the Safeguarding Adults Board Manager was continuing to send out communication regularly to keep members “up to speed”. It was noted that information relating to e-learning statistics and the reason for selecting Twitter as the most appropriate social media channel could be sought from the Safeguarding Adults Board Manager following the meeting.

A Member asked for further information relating to the transfer from Children’s to Adult Care Services. The Director of Adult Social Care said that transition remained a challenge. Members were advised that the Children’s Services department were currently undertaking a piece of work to scope the benefits of establishing a 0-25 service which could help to “bridge the gap” between childhood and adulthood.

In response to a question regarding Priority 3 and the integration of heath and care, the Director of Adult Social Care said that there were clear rules regarding what services were charged for, and that it was unlawful for the Local Authority to deliver services that should be provided by health teams. With regards to any disputes, there was a local arrangement in place which was also applied nationally. The authority that initiated any work continued to fund it until the dispute was resolved and therefore the service user was not affected. The Assistant Director for Integrated Commissioning advised that the reference made to ‘brokerage’ related to there being two teams – one within the Local Authority and the other in the Clinical Commissioning Group (CCG). Following a decision being made that an individual required care or support, the teams worked to identify who this would be delivered by. Throughout the pandemic, significantly more joint working had been undertaken and, in the future, it was planned that these two teams would be brought together. This would create a single brokerage service which would bring efficiencies and ensure that clients had more choice. The Member further queried how decisions would be made within an integrated service. The Assistant Director for Integrated Commissioning advised that there were various ways, including using a trusted assessor arrangement whereby other health services or agencies could make decisions on behalf of the Local Authority. However, as part of the process, these decisions were always checked. It was noted that the decision as to who paid for ‘what, where, and when’ would be made prior to the service being established and therefore it would not be made by the brokerage team.

RESOLVED that the report be noted.