To consider the report and make recommendations.

Cllr Story congratulated Council staff and officers for the achievements listed in the report, and stated he wanted to highlight the support that had been given to the 2,324 most clinically vulnerable people in the Borough during the Covid19 restrictions. He invited officers to give a commentary on the three ‘red’ areas listed in the report. Regarding delayed transfers of care from hospitals, Hilary Hall, Director of Adults, Health and Commissioning, explained that targets for local areas are set nationally. The local target was 1.5 delayed transfers of care per 100,000 population and the national target was 3; however, local performance was 3.6 delayed transfers of care per 100,000 population. In many cases this was due to difficulties experienced in transferring patients out of hospital and back to their homes with an appropriate care package; not all patients were medically fit when the time came for them to be discharged. Hilary Hall, Director of Adults, Health and Commissioning said performance had improved since October but the figures could be prone to further fluctuation. Since April during the Covid19 pandemic a number of patients had been transferred out of hospital in a timely manner. Members were told that there was strong domiciliary care support to assist with transfers of care.

Regarding cessation of child protection plans, Kevin McDaniel, Director of Children’s Services, stated that the figures were impacted by two children from the same family being required to stay under a child protection plan for longer than two years. The social care team had indicated they were satisfied that it was appropriate for the plan to remain in place for longer than the recommended two years. Kevin McDaniel, Director of Children’s Services, acknowledged more work needed to be done but said the views of the social care team indicated that the plan was working. He added he was not concerned at the red rating as he was familiar with the circumstances of the family in question.

Kevin McDaniel, Director of Children’s Services, explained there was a national target to complete assessments for children potentially needing an Education Health and Care Plan within 20 weeks. In the vast majority of cases where the assessments had not been completed by this time, it had been done with the agreement of the parents in order to make sure the right information was being collated. However some assessments were delayed as there was often a high turnover of SEN staff at the end of each academic year. Kevin McDaniel, Director of Children’s Services, highlighted that although the performance level of having 86 per cent of assessments completed within 20 weeks was below the Borough’s target of 90 per cent, it was still significantly higher than the national average of 60 per cent and the south east regional average of 60.4 per cent.

Cllr Story raised the issue of the new medical centre in Ascot and asked what was being done to ensure it would not compete with existing service providers. Hilary Hall, Director of Adults, Health and Commissioning, said there was an integrated care plan that had been put together following discussions with health colleagues and care providers to ensure the new centre would complement provision rather than providing competition.

Cllr Tisi asked what were the main risks associated with extending an EHCP assessment beyond 20 weeks and asked where the delays mainly came from. Kevin McDaniel, Director of Children’s Services, said delays often came when the schools that were identified as being appropriate settings for a child were asked to respond; they had a deadline of 20 school days in which to respond but many did not reply until just before the deadline. This slowed the process as a draft EHCP could not be created without the input of the schools.

Cllr Tisi asked officers which targets they felt would be the most difficult to meet in the next review year. Kevin McDaniel, Director of Children’s Services, said good progress had been made in recent years regarding therapeutic care but during the Covid19 restrictions there had been an increase in the number of young people who had not been able to access this service. The Borough had been working with the Local Parent Carer Forum to share practice on helping children in particularly challenging situations, but the chairman of this group had had to step down and it had not been possible to work with the group. Hilary Hall, Director of Adults, Health and Commissioning, said it was anticipated there would be an upsurge in demand for drug and alcohol treatment services post lockdown, particularly low-level support services. She said she was concerned there may be less ability to successfully meet targets relating to treatments. Cllr Carroll said he had been meeting regularly with the Borough’s Primary Care Clinical Lead, Dr Huw Thomas, and raised tackling issues regarding substance dependence and related mental health problems, and this had been useful in building an understanding of the local situation. Public Health England modelling would be used to try to implement a longer-term strategy.

Cllr Carroll told the Panel that direction on tackling any second wave of Covid19 would be led by central government and the SAGE committee. Locally, a number of volunteer groups had helped to identify particularly vulnerable residents and it was acknowledged that the volunteers had been important in providing resilience to other services in the Borough. Hilary Hall, Director of Adults, Health and Commissioning told members that more than 700 volunteers had been recruited during the pandemic and it was important to embed them into future support networks. Cllr Carroll said the NHS Alliance Board was being used to help formulate an integrated care strategy across different care providers. Meetings were taking place every 6-8 weeks.

Kevin McDaniel, Director of Children’s Services, said engagement from the public in terms of receiving feedback was generally positive. However feedback suggested working with services relating to SEND needed some improvement.

It was AGREED UNANIMOUSLY that Panel noted the report and:

i) Noted the 2019/20 Adults, Children and Health Overview and Scrutiny Panel Q4 and End of Year Performance Report in Appendix A.

ii) Requested relevant Lead Members, Directors and Heads of Service to maintain focus on improving performance.