Tuesday 24 September. 6.30pm. Council Scrutiny & Social Care Sub-committee
Inc. scrutiny of the work to deliver closer alignment between the Croydon Health Service NHT Trust (CHS) and the Clinical Commissioning Group (CCG). For detail see below.
To 12 October. Equiano Exhibition; Mondays – Fridays 3-7opm; Saturdays 2-6pm
Exhibition about Olaudah Equiano, the black abolitionist, featuring his story from his Narrative.
Travelling exhibition by Equiano Society at
Croydon Supplementary Education Project, 32 Sydenham Rd, Croydon CR0 2EF
To 2 November. Saree Reinvented Exhibition
Croydon Clocktower and Museum and Apsara Arts
Saturday 28 September. 11am-4pm. Saree Unwrapped Famiiy Activities
Central Library & Museum
To obtain further information
Council tenants offered access to high-speed broadband in Croydon
In its 2014 report on the Council’s Growth Plan Croydon TUC recommended the installation of broadband access into the proposed new Council hopes to be built and the blocks of flats the Council was leasing to house homeless families.
Supporting school support staff
Please consider signing the GMB petition to support teaching assistants.
South Norwood gets £95m for regeneration
Dozens of homes and businesses raided as police targeting criminals ‘dealing drugs and guns to gangs’ make 25 arrests
Appreciation of Matthews Yard
185 London Road: Vistec House (part 2)
Kake continues her history of London Rd.
Merger of Croydon Health Service NHT Trust (CHS)
and the Clinical Commissioning Group (CCG)
The report to the Scrutiny Committee states:
‘At the same time, the Croydon system recognises it is facing quality challenges; 30% of patients treated in hospital are more suited to a community or home setting, while large numbers of patients are currently leaving the borough to receive elective care elsewhere. There are workforce shortages across multiple professional groups, making it harder for the system to meet its quality targets and driving up costs, as providers rely on agency and locum staff to cover gaps in provision. It is recognised that organisational barriers and siloed working within care settings are compounding these challenges. The competing priorities of individual organisations risk delaying the development and implementation of a sustainable place-based plan to meet the growing health and care needs of the population. To overcome these barriers, Croydon is already undertaking considerable collaborative working across the Croydon system, which has resulted in a number of improvements in care to date. For example, since Croydon CCG and CHS started the process towards greater alignment in July 2018, CHS has seen its 62- day cancer targets improve from 78% to 80% (Nov 2018), its RTT targets have continually remained above the 92% national targets (making it one of the top performing London boroughs) and the number of patients currently waiting on a waiting list has decreased by 12%. These improvements are driven by a joint focus across the two organisations to support the ‘here and now’ challenges facing Croydon. Furthermore, wider system collaboration as part of the One Croydon Alliance (see section 2.3) has seen unplanned admissions.’
‘The One Croydon Alliance has focussed on working together to improve the quality of care provided to the over-65s, shifting from reactive care to proactive care, via the use of multi-disciplinary teams and coordination across care-settings. To date it has implemented several key initiatives, including: • the establishment of six multi-agency, integrated care networks and huddles across Croydon; • the implementation of a Living Independently for Everyone (LIFE) scheme; • the establishment Croydon-wide transformation board to support the change delivered through the Alliance.’
While the reports talk about health inequalities and the concept of place, this is a governance and top-down re-organisation. There is no accompanying analysis of the health inequalities of Croydon different places areas. It talks about six places, which are clearly unrelated to the Council’s Areas of Place in the Local Plan 2018. There does not seem to be any discussion of how resources, including staffing, will be organised in different combinations of specialism to meet the differences in health inequalities. Nor does there seem to be any discussion of how the specialist facilities e.g. at Purley can be matched elsewhere e.g. to avoid people in Croydon North having to travel to Purley.
I have emailed members of the Sub-committee as follows:
‘There are a number of issues arising from this report to meeting on Tuesday which you may want to consider raising questions about.
Page 10. Health Inequalities
While the report recognises there are health inequalities to does not summarise that these are the differences in relation to them in different parts of the Borough. Any reorganisation of services and governance to achieve greater collaboration needs to be based on a full understanding of the inequalities and the geographic differences. I attach the submission I made to the Opportunity and Fairness omission on the geography of inequalities.
Page 47. Organisational barriers
The following part para. is welcome.
‘Further, the lack of a common goal or purpose often creates a dichotomy between what organisations would like to achieve, and what tools they have to get there. These organisational barriers make it difficult to affect holistic service improvement for the benefit of patients and the system. In Croydon this challenge is highlighted in the problems currently facing urgent care, where poor access to primary care, and underfunding of out-of-hospital care has led to significant non-elective overspend in hospitals. Taking a system wide approach will see some of these challenges resolved. …..’
This is a systemic problem within most large organisations so that in local government, for example, Departments are inadvertently operate against each other and prevent each other achieving their maximum effectiveness. This has been one the key underpinning critiques of the need for decentralised place based integrated teams since the early 1970s.
How will the NHS re-organisation link in with the Council structures to ensure improved collaboration?
Page 48 – Older People
The recognition on page 48 of the problems of older people in the health care support system is welcome. One of the problems is how to ensure that the housing needs of older people are better catered for.
Discussion on the housing needs of older people are discussed in Croydon United Retired members branch which I attach.
Page 54 – Place Based Model
The intended move to a place based model ‘to develop a place-based model of integration that delivers the ‘triple integration’ of primary and specialist care, physical and mental health services, and health with social care’ is welcome, as it is recognition of the need for devolution downwards, as the Council is experimenting with.
The paper only talks about six places, and apart from a mention of Selhurst in Figure 6, page 53, it does not state what the six places are. This is far fewer number of areas of place than the Council has in the Local Plan 2018. Will the six places match the boundaries groups of the Plan’s Places? How do they relates to the issues around the geography of health inequalities?