Agenda and minutes

Apologies for absence were received from Cllr Stéphanie Petit.

Any member of the Council who has a disclosable pecuniary interest in a matter to be considered at the meeting is reminded to disclose the interest to the meeting and to leave the Chamber while any discussion or vote on the matter takes place.

Members are also reminded that if they have any other significant interest in a matter to be considered at the meeting, which they feel should be declared in the public interest, such interests should be declared to the meeting. In such circumstances Members should consider whether their continued participation, in the matter relating to the interest, would be reasonable in the circumstances, particularly if the interest may give rise to a perception of a conflict of interests, or whether they should leave the Chamber while any discussion or vote on the matter takes place.

No declarations of interest were made.

The minutes of the meetings held on 18 November 2024 and 2 December 2024 are submitted for confirmation.

Cllr Weeden-Sanz requested their apologies be noted for the meeting held on 18 November 2024.

The minutes of the meetings held on 18 November and 2 December 2024 were confirmed as a correct record and signed by the Chair.

The Chair introduced the item and welcomed Taneisha Scanlon, Assistant Director Place – Central London from the North West London Integrated Care Board, Charlotte Williams, Kensington and Chelsea Manager at Healthwatch, the Lead Member for Adult Social Care and Public Health and the Director of Health Partnerships to the meeting.

The Lead Member presented the report, noting that hospital discharge in the borough was aided by Council staff being based in Chelsea and Westminster hospital. Officers added that the Council worked in partnership with the North West London Integrated Care Board (NWL ICB) and NHS Trusts to deliver the discharge service, and the services met regularly to identify risks and plan accordingly. As a result RBKC was one of the highest performing boroughs in London for hospital discharge. The Council’s number one priority was to ensure residents were discharged to a safe destination to enable them to continue recovery. Ms Scanlon summarised the four discharge pathways identified in the report.

At the invitation of the Chair, Ms Williams summarised the findings of a Healthwatch focused project on Patients’ and carers’ experiences of step-down care access and provision in Westminster and Kensington & Chelsea. The data was collected through semi-structured interviews with 15 participants, including patients, carers, and a community professional. Healthwatch recognised the limitations of the small sample size and cautioned that whilst the local research was valuable information and provided good insight to patient experience, the findings should not be considered representative of the full range of perspectives across the local population who had gone through the hospital discharge pathway. 

The report found that while the quality of step-down care services was generally positive, issues with poor communication, inconsistent care, and challenges during the discharge process caused significant difficulties for patients and carers. Carers frequently took on advocacy roles to navigate the system, with many reporting mental strain and inadequate support. The report made several recommendations including better communication between services, more involvement of patients and carers in decision-making, tailored support for carers, and improved consistency in care delivery.

The Chair invited comments or questions from the Committee. The Committee:

1.      Asked about the main challenges affecting the discharge process. Officers advised the most significant challenge was securing care placements for patients with complex needs at short notice, with a lack of beds or specialist care available to ensure appropriate care of long-term or ongoing needs. Delays could also be caused by patient or familial resistance to long-term residential care placements.

2.      Discussed obtaining feedback from frontline workers to improve service provision. Officers confirmed that feedback was sought from frontline workers and was generally positive. Increasing capacity was key to improving performance and the Council met regularly with its partners to plan, coordinate and reduce pressures on frontline workers where possible.

3.      Sought assurance that residents were discharged locally where care was necessary in a residential and reablement facility. Officers confirmed the Council worked with providers to ensure local capacity, including block-booking beds to enable patients to be discharged to  ...  view the full minutes text for item 4.

The Chair introduced the item and invited the Committee to discuss the Work Programme. The following points were discussed:

1.      Arrangement of a visit with Macmillan Cancer Support to inform scrutiny of the Cancer Services item due at the next meeting.

2.      Scrutiny of the Compassionate Care for All consultation would take place at the North West London Joint Health Overview and Scrutiny Committee due to its classification as a major reconfiguration of services across more than one local authority area. No date had been communicated indicating when a decision on the future care model would be made.

3.      A meeting of the Suicide Prevention working group would take place on Monday 3^rd March 2025.