Agenda item

Anne Bristow, Strategic Director for Development and Integration, introduced the report and presentation and reminded the Board that Ambition 2020 was a programme to transform services to ensure their sustainability and continued effectiveness, bearing in mind the projected £63m budget gap to 2020/21 and the £10m savings for children and adults care and support that needed to be achieved.  There were four key elements of the transformation programme that were relevant to the Board and its partners, the details of which were set out in the report.  Anne then drew attention to:

·  Growth and competing pressures, including demographic changes.

·  The different types of needs for adults and children.

·  Complexity of needs of clients, such as children coming through special needs schools into adulthood.

·  London-wide shortage of social workers and the recruitment initiatives being undertaken by the Borough.

·  Services updating so they are fit for the 21^st century including the use of technology.

·  Ensuring the right support was be provided to the right people, at the right time.

·  Building on the work that was already happening in GP surgeries.

·  Innovation and joint commissioning to allow partners to work better and cheaper.

·  A new way of signposting individuals to care and support, whilst tailoring that access for existing long-term users.

Chris Bush, Commissioning Director for Children’s Care and Support, explained that for his area the clients were children that met the threshold of needing acute / high level support.  Chris drew attention to:

·  Services had to be flexible, reactive, holistic and provide a joined-up response.

·  The consistency of the professionals the families contacted was clearly important. The principles of planning the services and stability of the workforce was a primary aim.

·  The service would be moving to locality based assistance. 

·  A key change would be the creation of a cradle to grave, children and adults’ disability service. 

·  Work being undertaken to ensure commissioning was more cost effective, offered good value for money and that the right services were available across the Borough. 

·  The savings anticipated would be in the order of £4.4m.

Chris stressed that by targeted early intervention, before children come into care, could have a significant effect on the family and life choices of the child. 

Mark Tyson, Commissioning Director of Adults’ Care and Support, advised that his service concentrated on people with frailty and older people with mental health problems.  It was important that clients had choices in their care and that people feel safe and connected to the wider community.  Mark explained what the changes would mean and drew attention to:

·  The new IT system to support teams.

·  Preventative, front end support.

·  New accommodation based support options

·  Work with partners to review and improve delivery models.

·  Stronger commissioning.

·  The savings would be in the order of £5.4m

Tudur Williams, Operational Director, Service Development and Improvement, advised that over the last few months the work of designing the new service had been based upon the consultation that had been undertaken with service users on what they wanted.  Tudur drew attention to:

·  The end of age limits by providing for need, not age.

·  There would be a one-stop-shop for all people regardless of age, with a few exceptions, to create a cradle to grave seamless service.

·  The operating model for the Disability Service and the new combined Disability Service would start operating by late April.

·  A holistic service, which would include social workers, sensory and therapy teams.

·  Increased use of assisted technology.

·  New IT system would come into use in February 2018, which would provide better support to teams.

·  The savings would be in the order of £1.7m

The Boards attention was also drawn to the potential impacts on health partners, contact routes and the live sharing of data feeds as the new IT systems come on line, which would reduce duplication and repeated form filling.

The Board discussed several issues, including:

The Chair stressed that the overview shows the significant changes that were being put into place.  Community solutions should remove silo working and would help residents know what they could do for themselves and how they could access the support they need.  An important aspect was to stop residents relying on the Council as a paternalistic service and to encourage them to look for and seek what meets their needs themselves.

Cllr Carpenter, raised concern about how schools would be able to access the educational psychology service.  Anne Bristow advised that this had already been considered at a high level and more detailed work would be done to look at how the offer to schools could be improved alongside the commissioning of 0-19 health services and the CAMHS transformation programme.

Sarah Baker, Independent Chair of LBBD Safeguarding Adults Board and LBBD Safeguarding Children Board, felt that both those Boards could offer support and help and that such work would need to be built into their priorities next year.  Sarah would contact appropriate colleagues to arrange this.

Healthwatch were concerned that help was all being moved to an on-line service and this might be difficult for the frail and elderly or those with little or no IT experience.  The Chair reminded Partners that Care City was developing IT systems to enable quick and direct access to services and suggested that all partners visit Care City to see these.

Sharon Morrow confirmed that colleagues had been sharing plans and the impact on health had been considered, including potential joint commissioning strategies and opportunities.  The aim was to ensure that, wherever possible, the plans and changes come together at the same point in time. 

The Chair advised that further reports on progress would be presented in due course.

The Board:

(i)  Received the report and comprehensive presentation and noted the work being undertaken by the Council in transforming the children and adult social care services in the Borough, including the new Community Solutions initiative; and

(ii)  Noted that further reports will be presented in due course, which would provide additional information on the educational psychology services, the potential to work with the LBBD Safeguarding Adults Board and LBBD Safeguarding Children Board, implementation progresses, impacts the programme may have on partnership activity and any potential opportunities for further integrated activity.