Apologies for absence were received from Councillor Simon McGrath and Councillor Matthew Willis attended as a substitute.

There were no declarations of pecinary interests

The minutes of the previous meeting were agreed as a true and accurate record.

The Senior Transformation Manager gave an overview of the report stating it will be a challenge to manage the pressures but there is a plan in place.

A Panel member asked about plans for potential staff shortages and illness, The Director of Transformation said the potential industrial action is new to the NHS and they will use same staff resilience plans. Staff illness is accounted for on the staff rota and adjusted to make additional provision during the winter period.

Panel members asked if people are people taking up vaccinations and how the enhanced primary care hub is supporting this. Also, if the winter plan extends to care homes to relieve capacity and prevent overflow at hospitals.

The Director of Transformation said there has been higher levels of staff absence due to covid and staff resilience measures remain the same. Care homes are included in the winter planning and measures in place to ensure staff and residents are vaccinated. Patients who have covid and a risk of infection but fit to leave hospital will go to temporary alternative discharge destination in the interim.

The Senior Transformation Manager said enhanced primary care hubs run an 8am to 8pm service, and urgent care centre at St Georges. These can all relieve the pressure on accident and emergency services.

A Panel member asked about pick-up times for ambulances, it was reported that there is real time information for ambulances across London to move pressure around the system and can divert some ambulances. Biggest wait for ambulances is when they are occupied with a previous call.

A panel member asked if they have been able to recruit enough carers and district nurses, The Director of Transformation said when there is pressure in the community services they use staff flexibly and move them into other areas of the system.

The Interim Director of Community and Housing highlighted that the council has a strong re-ablement team who provide a care package for patients who go home so they can work toward the level of function they had before. Extra resources have been put into reablement providing additional capacity during the winter period.

The Integrated Head of Learning Disability gave an overview of the report.

The Chair invited a local resident to address the panel. They gave an overview of their concerns stating that; the provision of suitable day opportunities can make a significant difference for those with learning disabilities, day centre activities can be particularly valuable both to the client and their carer. They welcome plans to expand provision to more sites and younger clients, some people benefit from travel training while others cannot manage it. Transport to new facilities is essential as some carers concerned that they will have additional responsibility e.g. arranging transport will be burdensome, even through the direct payment system. The council needs to ensure the system is not harder for carers and there is sufficient funding.

A panel member said we should not rely on voluntary services and asked what the impact of the saving will be. The integrated Head of Learning Disability said they are working closely with voluntary organisations such as Mencap and will provide navigators to support carers to manage they process. However, savings will need to be made.

A panel member asked where a community hub will be located and the governance structure in place. The integrated Head of Learning Disability said there will be a range of options for people to choose from on a sessional basis with a menu of activities.

A panel member asked if skills and new training will be linked to the workplace. The integrated Head of Learning Disability said they are looking at employability which looks at supporting younger people with autism, but they will need support to get into employment.

A panel member asked if there is a shortage of independent living options, the Integrated Head of Learning Disability said there is good availability of service but would like more in the Merton area.

A panel member asked if the team are aware of what the young people want. The integrated Head of Learning Disability said a wide range of consultation had been conducted with young people such as Kids First, Adults First, Merton Mencap and carers and young people in transition and send services. They would also like more young people on reference groups.

The Interim Director of Community and Housing said they have commissioned an external specialist agency who spoke to over 400 people to gauge their views of young people and older people across the borough with moderate to complex learning disabilities.

The Interim Director thanked the local resident for attending and sought to provide reassurance to panel members that there is a new purpose-built day centre at Leyton Road, for people with moderate learning disabilities. The department also has a desire to re-build a current day centre into a state-of-the-art day centre for those with the most complex needs, alongside supported living. The current day centres are well managed and valued by the users, however pre-pandemic it was found that this model is limited and old fashioned. During the pandemic, small groups  ...  view the full minutes text for item 5.

The Interim Assistant Director, Commissioning gave an overview of the report, highlighting the timetable may change due to the legislative calendar.

A panel member asked about the future of care as people would prefer to receive care at home, The Interim Assistant Director, Commissioning said there is a shift from residential to a supportive living model.

A panel member asked about the opportunities in digitalisation and social care the steps being taken to reap the benefits of a digitalised provision. The Interim Assistant Director, Commissioning said they are considering options for online self-assessment. Some clients may have family members who can support them with digital solutions.

A panel member said they are concerned about increased administration in providing assessment and data. The Interim Assistant Director, Commissioning said the council have the knowledge and expertise but will need the resource including social workers and people to do financial assessments. 

A panel asked for the report on suicide to address why Merton has a higher rate of suicide for women.

The agenda for the 10^th January was agreed