Councillor Laxmi Attawar gave apologies for absence

none

The Minutes were agreed.

The Director of Transforming Primary Care gave an overview of the report highlighting their plans to improve access to primary care. The Director said they were pleased to report that many of these objectives had been achieved and in some cases exceeded, 50,000 appointments had been delivered and they had increased on their ambition from last year. There are now flexible opening times at surgeries with some from 7am some open until 8pm and open on Saturday, same day appointments are also available.

The Clinical Director of Transforming Primary Care added that the Wideway and Wilson hubs are receiving positive feedback from service users. The use of primary care is increasing but it is not at full capacity at the present time. They are training reception staff to signpost people to relevant service which will also improve access.

A panel members asked if there would be additional hubs in north and south Merton given that the current hubs have been so successful. The Director of Transforming Primary Care said the structure is right at the moment as they are not at full capacity. The Clinical Director of Transforming Primary Care added that patients can choose which hub they want to attend.

A number of panel members thanked Merton Clinical Commissioning Group (MCCG)   for their work, highlighting that the hubs are working well and services are improving. Local residents, particularly older people, are finding telephone appointments very useful.

A panel member welcomed receptionist training and highlighted that it is important to prioritise GP training for people in the UK.  They are also concerned that although twelve hour appointment day is excellent, this should not result in GPs and medical professionals working long hours. The Clinical Director of Transforming Primary Care practices in Merton do support local medical training; however this will not provide enough GPs over the next twenty years so we need to look internationally. GPs work shifts at the surgeries so they can manage their work-life balance.

A panel member asked how the 111 service is advertised. The Clinical Director of Transforming Primary Care said some concerns had been raised about this national helpline. MCCG do promote the service and would welcome ideas about how to advertise further.

A panel member asked when the Princes Surgery will be re-located as a move has  been planned for the last 18 months. The Director of Transforming Primary Care said they aim to move to the Patrick Doody building by April this year.

RESOLVED

The Vice -Chair thanked MCCG for their work. 

The Director of Corporate Resources said the budget was reported to Cabinet in December and outlined the assumptions in the Medium Term Financial Strategy as well as provided an update on the business rates. A report will go back to Cabinet in February looking at how the financial position has changed in light of the budget settlement.

A panel member asked about the likely consequences if the deficit is not reduced. It was asked if staff reduction is the main way to the reduce budget gap.  The Director of Corporate Resources said the council is required to set a balanced budget. Services can be re-designed without cutting staff, therefore a range of options need to be considered. Refreshing the Target Operating Models will assist with this process.

The Vice-Chair invited Lyla Adwan – Kamara, Chief Executive, Merton Centre for Independent Living to address the Panel

The Chief Executive welcomed the opportunity to have a dialogue with the Panel. She commented that the replacement savings seemed sensible. She was of the view that there had been a failure to consult with the local community on some of the new and replacement adult social care savings proposals. This is despite the fact the council identified consultation as an important equality objective. Particular concern was raised about CH55; 987,000 – less third party payments through promoting independence. The Chief Executive believed that this saving had been agreed but was not included in the current savings pack. This highlighted a concern about the medium term budget planning process which can result in some items not being discussed. The Chief Executive added that she felt service users would provide a useful and constructive response to savings proposals and they are keen to be involved.

The Director of Community and Housing said adult social care is operating in very challenging financial climate and this has been well documented both locally and  nationally. There has also been a significant change in the landscape since 2015 with the introduction of the Health and Social Care Act  and additional duties placed upon local authorities.

The Director highlighted that having been in post for six months she is reviewing current spend and savings proposals in the context of this borough. Savings are routinely reviewed throughout the year  to ensure they are deliverable within the current environment. The Director will engage with the wider sector  to discuss how to provide the best services and value for money.  This early phase of engagement and meaningful discussion is distinct from a formal consultation. Appropriate consideration will be given to the consultation process if there is significant change to service delivery.  CH55, will be reviewed in line with legislative changes with the implementation of the Health and Social Care Act. 

A Panel member highlighted that this Panel has raised concerns about adult social care during previous budget rounds.

Panel members considered each of the savings for adult social care and public health along with the service plans.

A panel member asked for regular updates on changes to budget savings. The Director of Corporate Resources reported that this is available in the monthly Monitoring Report, regular updates are also provided quarterly to the Financial Monitoring Task Group.

A panel member highlighted that the adult social care service plan highlighted that there is likely to be an overspend of £2-3 million. The Director of Community and Housing reported that spending is under control  at the moment, however the market is volatile therefore the department plan where possible, make use of early intelligence and monthly monitoring all of which helps the section to stay within budget.

Councillor Suzanne Grocott asked that the minute record her concern about the current savings shortfall of £382,000 in adult social care.

RESOLVED

The Vice-Chair thanked officers for their work.

Councillor Sally Kenny, task group chair gave an overview of the report and stated it can support the council’s financial challenges. The task group found that the scheme could have great potential but will take time to establish within the borough.

A Panel member raised concerns about a scheme of this nature due to the potential   safeguarding implications. The task group chair said the Homeshare agency will play a full role in supporting the relationship between the homeowner and home sharer.

RESOLVED

The Vice-Chair thanked the task group for their work and  the panel agreed for the report to go to cabinet.

The work programme was noted