No apologies were received.

There were no declarations of pecuniary interest.

Panel members confirmed that these were a true and accurate record of the previous meeting.

Matters arising: Cllr McGrath asked a question about DBS checks following an internal audit. The Executive Director confirmed that there were no ASC/PH agency workers identified as not having DBS’s in the internal audit report.

Cllr Billy Christie, Cabinet Member for Finance, introduced the budget item by explaining that this is the 2^nd round of budget scrutiny. In the previous round of scrutiny, saving proposals totalling a value of around £3m were brought forward. Since then, a further set of savings have been brought forward, bringing the total set of savings to a value of over £4.5m.

Merton have now received the provisional financial government settlement which is projected to increase Merton’s spending power in adults and children’s social care and homelessness which are areas of financial pressure. However, further hard decisions need to be made. Cllr Christie noted his belief that the savings are fair but deliverable and allow Merton to continue to deliver on projects.

The Executive Director of Finance and Digital added that there is also a new extended producer responsibility scheme which recognises the burden on the Local authority clearing up waste and totals around £3 million for next year. However, there are still significant pressures.

In response to questions:

• This year’s savings are on track for 92% achieved. Last year we achieved 78% at the end of the financial year.
• Adult Social Care, Children’s Social Care and homelessness are the three main pressures and these same areas of overspend are seen across London.
• Voluntary & Community Sector Grant Funding - Review the department's VCS Grant programme to check for duplications and ensure grants are aligned with departmental strategic objectives. Chief Executives in the Voluntary Sector are being consulted with.
• Increased Reablement Capacity. We have recently implemented a new electronic shift rota system (previously completed on spreadsheets), which will allow us to increase capacity in the service without adding to costs.  The new rostering system will enable us to electronically manage support worker rotas to maximise the amount of visits each support worker carries out, it is projected this will enable support workers to increase the number of visits to residents by 20%. We are also working with staff to introduce a new staff rota which will allow balance and equity across the shift patterns. An equal number of staff on each shift will allow more capacity to carry out more visits. It will also balance the pattern of shifts, increasing visibility of bottleneck shifts, and managing planned and unplanned absence.
• Maximise Independence for residents with Learning Disabilities - This proposal is to monitor those young people coming through transitions and to put extra resource into that transition time in order to identify and act on opportunities where their current package is not promoting independence.

James Blythe gave a summary of the update report provided to Members.

• Significantly improved our theatre utilisations
• Notable reduction in patient stay - Reduced length of stay by 0.8 days.
• Big challenge remains that we start every day with patients waiting for beds. We have put in extra resources to make sure we are caring for those patients as best we can.
• Almost eliminated 65-week wait time, biggest area of which was gynaecology.
• We delivered 71.8% performance against the 4-hour ED standard in December 2024 compared to October 2024, 74.7%

Following the Government review, we are in the second wave of the Building Your Future Hospital scheme. This delay means we now have a projected start date of 2033.

In response to questions:

There have been a number of improvements in our maternity services as a result of our CQC inspection. Some actions are long standing issues. Out of the 15 total actions identified (9 "Must Do" and 6 "Should Do"), 9 actions are complete, and 6 actions remain in progress. ESTH is projecting full completion of all actions by 31 March 2025, except for the longstanding estate/ premises issues which the new hospital build programme will resolve. i.e. difficulty of providing showers with fully enclosed doors within the current space.

St Helier has the highest amount of maintenance backlog per square metre.

Total cost of addressing backlog maintenance issues is £100m just for building costs. If you add VAT, architect costs, and decamping facilities, it will take the figure to £200m. This would be just to get a compliant hospital but still wouldn’t get you a hospital that was fully compliant to most NHS standards.

‘Significant changes in service delivery and the opportunity to scrutinise’ - Undertake to share with committee under law. Wherever it is possible to permit scrutiny of those changes, but only if there is the time and facility to do so. However, if we had to take urgent steps to safeguard services, we would have to be retrospective in some circumstances.

The Cabinet Member for Health and Social Care asked whether authorisation was given with regards to media coverage? James Blythe responded that many bids are received about winter pressure, and these are utilised to encourage viewers/readers to take certain actions (flu jab etc) and has previously led to bookings increasing by over 100%. Some of this coverage got conflated with the estate challenges.

The Cabinet Member for Health and Social Care commented ‘the people I represent are not devastated at the delay’, they are devasted that you plan to move the hospital away from areas of health inequality’.

Turnaround 80-90% patients in four hours. The problem is in terms with admissions when there is no bed availability. Formal MH assessment adds additional time as do complex needs.

As of December 2024, the Trust is reporting a £10.7m deficit YTD. Cash support from national system to pay staff.

Reduced length of stay by 0.8 days - We measure our readmission rate to ensure that  ...  view the full minutes text for item 5.

This item was presented by Katharine Bugler, Deputy Director for Primary and Community Care Transformation for Merton and Wandsworth, and Dr Karen Worthington, Merton Clinical Lead.

The report covers a number of areas including updates on supporting access, patient experience, and reducing inequalities.

Key points included:

• All practices have online consultations available and are promoting use of NHS App.
• New Interpreting and Translation service covers face to face Interpreting, telephone interpreting, video interpreting and document translation.
• A third of Merton practices have been accredited as Veteran Friendly so far
• Safe Surgeries (100% Merton practices accredited) • A Safe Surgery can be any GP practice which commits to taking steps to tackle the barriers faced by many migrants in accessing healthcare. At a minimum, this means declaring your practice a ‘Safe Surgery’ for everyone and ensuring that lack of ID or proof of address, immigration status or language are not barriers to patient registration.

In response to questions:

There are translators available for all languages, including African. There is a feedback mechanism if any language comes up that is not provided for currently.

This was presented by Mark Creelman, Place Executive for Merton and Wandsworth.

Southwest London ICB took delegated responsibility for Dentistry in April 2023, and we have seen significant improvement in the contracted activity, however we know that access to dentistry remains challenging for many of our residents.

Dentistry budgets for Southwest London total approximately £106m. To address access issues, the ICB is in the process of implementing several projects, specifically with care homes and schools, as well as a number of health promotion activities.

Ben Gladstone, Interim Director of Integrated Care, provided an update on the performance of the homecare contracts that commenced on 1 October 2023.

The work programme was agreed.