Agenda and draft minutes

Health and Adult Social Care Policy and Accountability Committee - Wednesday, 31st January, 2024 7.00 pm

Venue: 145 King Street (Ground Floor), Hammersmith, W6 9XY. View directions

Contact: David Abbott  Email:

Link: Watch the meeting on YouTube

No. Item


Apologies for Absence


Apologies for absence were received from Councillor Ann Rosenberg, Councillor Emma Apthorp, Councillor Amanda Lloyd-Harris, Lucia Boddington and Keith Mallinson.


Victoria Brignell joined the meeting remotely.


The Chair noted that the meeting was inquorate. Members agreed to hold the meeting as an informal meeting.


Declaration of Interest

If a Councillor has a disclosable pecuniary interest in a particular item, whether or not it is entered in the Authority’s register of interests, or any other significant interest which they consider should be declared in the public interest, they should declare the existence and, unless it is a sensitive interest as defined in the Member Code of Conduct, the nature of the interest at the commencement of the consideration of that item or as soon as it becomes apparent.


At meetings where members of the public are allowed to be in attendance and speak, any Councillor with a disclosable pecuniary interest or other significant interest may also make representations, give evidence or answer questions about the matter. The Councillor must then withdraw immediately from the meeting before the matter is discussed and any vote taken.


Where Members of the public are not allowed to be in attendance and speak, then the Councillor with a disclosable pecuniary interest should withdraw from the meeting whilst the matter is under consideration. Councillors who have declared other significant interests should also withdraw from the meeting if they consider their continued participation in the matter would not be reasonable in the circumstances and may give rise to a perception of a conflict of interest.


Councillors are not obliged to withdraw from the meeting where a dispensation to that effect has been obtained from the Standards Committee.



There were no declarations of interest.


Minutes of the Previous Meeting pdf icon PDF 251 KB

To approve the minutes of the previous meeting as an accurate record and note any outstanding actions.


Matters arising

Jim Grealy noted that at a previous meeting members discussed ongoing delays to the rebuilding of Charing Cross, Hammersmith, and St Mary's Hospitals and the healthcare impacts on residents. He told the Committee that, at a recent meeting of North West London NHS Trusts, the Chief Executive of Imperial College Healthcare NHS Trust said no new money had been offered to the Trust for either refurbishment or rebuild. In light of this, Jim Grealy felt the Committee should write to Matthew Swindells, Chair of the Board at Imperial College Healthcare NHS Trust, to express the Council’s concerns about the funding situation and the impact on health care provision in the borough. The Chair agreed and asked Linda Jackson to help draft a letter.


ACTION: Linda Jackson



The minutes of the meeting held on 15 November 2023 were agreed as an accurate record.


2024 Medium Term Financial Strategy pdf icon PDF 477 KB

This report provides an update on the overall preparation and proposals for the 2024/25 revenue budget, risks, financial resilience, and the impact of those proposals. It also sets out the budget proposals for the services covered by the Health and Adult Social Care Policy and Accountability Committee and provides an update on any proposed changes in fees and charges.

Additional documents:


The Chair noted that the first part of the item would be devoted to the Council’s corporate budget and the second part would cover the Adult Social Care and Public Health departmental budget proposals.


Corporate Budget

Councillor Rowan Ree (Cabinet Member for Finance and Reform) introduced the item that detailed the proposals for the 2024/25 revenue budget – including the risks, financial resilience, and impact of those proposals.


Councillor Ree noted that it had been a difficult time for local government, with central government grant reductions and high inflation, but despite the constraints, the Council had delivered a balanced budget that protected core services and continued funding for the areas that were unique to borough such as free home care, universal free school breakfasts, and the Law Enforcement Team. He said this had been achieved through ruthless financial efficiency and reforming how services were delivered. He thanked Sukvinder Kalsi, the finance team, officers across departments, and his Cabinet colleagues for making that possible.


Sukvinder Kalsi (Strategic Director of Finance) gave a short presentation on the corporate budget. He highlighted the following:

  • The difficulties of the operating environment including high inflation, pressures on household budgets, new legislative burdens, and uncertainty around local government funding.
  • The key objectives of the financial plan were to protect statutory services, deliver services valued by residents, ensure people’s safety, promote prosperity, and be a modern and innovative Council with strong financial governance and resilience.
  • That council tax would increase by 4.99%, but an estimated 93,000 households in the borough would not pay the full amount due to discounts and exemptions.


The Chair thanked Councillor Ree and officers for delivering a budget that protected the most vulnerable residents.


Jim Grealy asked how sustainable it was to keep finding efficiencies year after year. He also asked how the budget would be communicated to residents. Councillor Ree said local government was not a priority for central government, as they continued to force councils to make savings without taking responsibility. He noted that the financial settlement from central government used to be delivered in November and cover multiple years, to help councils plan ahead. In the past six years the settlement had covered only one year at a time and had been delivered at the end of December, making the budget setting process far more difficult. Regarding sustainability, he said the Council had cut £118m from the budget over the last nine years and that couldn’t continue forever. He felt there needed to be a change in the way in way local government was funded.


Jim Grealy said it was important to find a way of showing residents the challenge of setting the budget and how the Council was managing more duties with fewer resources. Councillor Ree agreed and noted that the Council communicated budget setting through public meetings like the Policy and Accountability Committees, Councillors engaging with residents, and the council tax booklet.


Merril Hammer (Hammersmith & Fulham Save Our NHS) felt the Council could do more to highlight  ...  view the full minutes text for item 4.


Public Health Update

The Director of Public Health will provide a verbal update to the Committee.


Dr Nicola Lang (Director of Public Health) addressed the Committee and gave a presentation on work to improve vaccination rates. She noted that her team had more staff to work on measles. She discussed hesitancy around the MMR vaccine. An NHS exercise in Autumn 2023 to contact parents who had not elected to have their children vaccinated resulted in just 10 children being vaccinated. Since then, the team had been working closely with different community groups to improve take-up rates.


Dr Lang also noted that the Public Health team had questioned local data and raised concerns with the NHS that vaccinations for school-age children, and hospital vaccination work was not being recorded consistently on GP records. If confirmed, that would account for some of the low vaccination levels.


Jim Grealy asked if any progress had been made with pharmacies, and if not what the blocker was. Dr Lang said the pharmacies were keen to start delivering vaccinations, but systems and governance were issues. But she was confident that would change, and noted the issue was rising on the national political agenda.


Councillor Coleman said he had raised this issue at a recent ICB meeting and was told progress was being made. Dr Lang said although the issue hadn’t moved forward – the willingness was there but the systems were not in place. Councillor Coleman felt the partners should identify the difficulties and overcome them.


The Chair highlighted the actions from the last meeting and noted the efforts to improve the borough’s vaccination rates.


Work Programme

The Committee is asked to consider items for inclusion in its work programme.


Merril Hammer (Hammersmith & Fulham Save Our NHS) suggested an item on how the Health and Care Partnership was working, with particular focus on their efforts around co-production and engagement with residents. Councillor Coleman agreed and felt it should be a joint paper produced by the Council and the NHS. He also said it would be helpful to have some questions members would like addressed to help prepare the report.


ACTION: David Abbott


Victoria Brignell suggested an item on disabled people’s access to healthcare. It was suggested that Action on Disability could be commissioned to gather data to support the item.




  1. The draft work programme, with the additions noted above, was noted.


Dates of Future Meetings

To note the following dates of future meetings:

·       27 March 2024


The following dates of future meetings were noted:

  • 27 March 2024