Agenda item

To receive a report and presentation which provides an overview of the Adult Contact referral pathways, team structure, and referral routes. The report also outlines service improvements being implemented, based on customer feedback and good practice.

The Chair welcomed Councillor Baker-Rogers, Cabinet Member for Adult Care and Health, and Jayne Metcalfe, Head of Service – Access and Prevention to the meeting and invited them to introduce the presentation.

Cllr Baker-Rogers explained that an update on the Adult Social Care Adult Contact Team Referral Process was being shared to advise on the Adult Social Care referral pathway, Adult Contact Team (ACT) structure, ACT referral routes and to provide insight into challenges and planned developments to improve access to Adult Social Care and service users’ satisfaction.

The Head of Service – Access and Prevention thanked the Commission for the invitation.  They provided background information on the Adult Contact Team, previously known as First Contact, created as part of the Adult Social Care operating model in 2019.

They explained that the team's purpose was to receive, triage, and prioritise referrals for assessment, prevention, safeguarding, and Occupational Therapy (OT) .The service underwent redesign which concluded in April 2025 and was in the implementation stage. The Adult Contact Team served as a single point of contact for Adult Social Care, and offered the ability to make referrals 24/7 via an online form, during office hours by telephone, or in person at Riverside House. The team aimed to resolve support requests at the earliest opportunity, linking people to appropriate professionals, prioritising safeguarding concerns. They also supported individuals with no recourse to public funds and administered public health funerals.

The Supporting Independence Team was introduced to strengthen the initial response to contacts and manage demand. That team worked with individuals unlikely to meet the threshold for formal care but who nonetheless needed support to access community resources, reduce isolation, and maintain independence. The team comprised of community connectors, sensory workers who work with visually and hearing impaired and our carer's workers addressed standalone requests for carers assessments which aimed to maximise independence, reduce delay or prevent the need for formal care and support. The team could work with individuals for up to 20 weeks, but often less and began working with individuals from late September 2024. 

Between April and May 2025, sensory workers supported 101 people with visual, hearing or dual impairments. Community connectors worked with 195 people since September 2024, with only 8% needing a Care Act assessment and carers link officers conducted 182 carers assessments since October 2024, which significantly reduced the waiting list. Learning since implementation was still being embedded and data collection improved to better evidence the progress made.

During March 2025, the Adult Contact Team received 2,778 calls and 1,833 emails. They aimed to make a decision on the right pathway within five days of receiving a referral and achieved this in approximately 60% of cases. The team handled 285 monthly referrals for occupational therapy, with about a third of which required an urgent response. They had also supported 25 individuals without recourse to public funds and managed 25 Public Health funerals in the past year. When contact was received, individuals were supported with information and advice, signposted to a voluntary or community sector organisations, referred to the enablement team, the supporting independence team, or occupational therapy.

The multi -agency approach at the front door in Adult Social Care meant that the team could meet people's needs more quickly and effectively. For example, the co-location of occupational therapy colleagues at the front door meant that 91 urgent referrals were responded to at the point of referral in March 2025. The team also liaised with other departments, including housing and mental health services, and screened around 800 vulnerable adult forms from the police and in March 2025, the team received 350 safeguarding referrals, with 120 progressing to an initial enquiry and 59 to a full enquiry. They were allocated to the relevant community team after ACT had completed the initial screening and made safe.

The team was implementing various service improvements to enhance user experience and manage growing demand. They were updating the electronic referral form to integrate with the case management system and streamline processes and business processes were being reviewed to improve call response times and manage referral complexity.

The team explored had explored and were implementing the use of artificial intelligence (AI) to increase staff capacity, improve the user experience and more effectively manage demand. They also maintained close links with the Rothercare service and the new Rothercare tech partner to support assistive technology provision.

The safeguarding pathway was refreshed to strengthen referral screening and timeliness and the Public Health funeral function was being realigned to the Court of Protection team to free up ‘front door’ capacity. They were also reviewing triage processes for occupational therapy referrals to manage increased demand, which had risen significantly by approximately 23%, embedding strong links with the mental health enabling service and the Supporting Independence Team's offer was being expanded to support young people preparing for adulthood who did not meet the threshold for Adult Social Care support.

The Head of Service – Access and Prevention outlined feedback obtained which reflected satisfaction  rates above 90% and provided details of case studies which reflected the impact of the Adult Contact Team in operational delivery scenarios.

The Cabinet Member for Adult Care reflected that the presentation demonstrated what a positive impact the service had and that the improvements were going to mean that the Council had an even more positive impact on enabling residents to live their best lives but also to live where they want to for as long as they possibly could, as independently as they possibly could in their own homes.

Cllr Yasseen thanked the Cabinet Member for Adult Care and Health and the Head of Service – Access and Prevention for the report and presentation, and invited questions and comments from members.

Cllr Brent enquired about the list of screening and triaging in the report, specifically regarding sex and gender issues and referral points for contacts which presented those issues. The Head of Service – Access and Prevention explained that screening focused predominantly on Adult Social Care needs and issues. They linked with health colleagues when necessary and had good connections with community health services. They did not have specific work around sex and gender but referred to people as they preferred.

Cllr Brent sought further clarity regarding how calls that related to sexuality or gender issues were handled and referred onwards. The Head of Service – Access and Prevention confirmed that the Adult Contact Team operated a ‘no wrong front door policy’, which always tried to signpost individuals to appropriate services. Whilst there was no specific ‘pathway’ for sex and gender issues, if the service could not provide the advice and support needed, they would refer the person to the right professional or service, such as a GPs, health professionals, social prescribers or Voluntary and Community Sector organisations equipped to support them.

Cllr Brent agreed to channel any additional queries or points of clarification on that subject via the Governance Advisor at the request of the Chair.

Cllr Duncan wanted to know whether there was a target or KPI for resolving support requests at the earliest opportunity and if so, whether it had been met or if indicative figures which illustrated improved performance could be provided. The Head of Service – Access and Prevention advised that they tried to respond to email correspondence within 48 hours and aimed to gather information, screen, and triage to make a decision. They tried to link with the right professional, such as Housing services for example to resolve issues, which could sometimes take longer due to the range of requests received or due to referrals via third parties where background information was limited, or reluctance to engage on the part of the referee. They were working on improving their five-day response time.

Cllr Duncan also asked how interconnecting services were made aware of the ACT offer and pathway. The Head of Service – Access and Prevention explained that teams routinely attended various neighbourhood meetings and had strong links with social prescribers through the Transfer of Care Hub and community teams. They had a presence in Riverside every day and were easily accessible to housing colleagues due to close location within the Council offices. They were also working on improving their online presence and referral processes, were involved in place meetings or meetings with Public Health colleagues and pursued collaborative and joint working where appropriate. They also regularly attended meetings with relevant voluntary sector organisations.

Cllr Clarke asked about the categories for referrals and which was the most frequent type and referenced occupational therapy (OT), which they understood had represented around a third of referrals received. The Head of Service – Access and Prevention confirmed that OT was a significant proportion of referrals received, which had seen an approximately 23% increase in activity. They were looking at different ways to manage the demand. A lot of referrals were for support for more vulnerable adults where support was required to live well and independently at home, some of which included OT which was housed in the enabling service.

Cllr Clarke wanted to know about the service’s ability to track data, including call times and dropout rates. The Head of Service – Access and Prevention explained that their telephony system, had reporting functionalities which could track all calls including wait times, abandoned calls, call durations, and follow-up actions. They were working on improving their reporting processes and exploring the use of artificial intelligence (AI) to support performance improvements. There was an aspirational desire for daily call activity to be shared on screen so that managers had real time visual performance indicators.

Cllr Clarke asked about the use of AI, with particular respect to forward planning and demand management given the significant demands and anticipated trajectory. The Head of Service – Access and Prevention explained that AI helped transcribe conversations into written documents, saving time for staff. The AI could record a conversation or phone call and translate it into a written document, which the worker could then edit. This allowed workers to focus on listening rather than writing. They emphasised the importance of staff checking and challenging the AI transcriptions to ensure accuracy, provided an example involving an occupational therapist who used AI during an assessment and the time saving achieved. They were exploring other AI functionalities such as grouping emails from their inbox etc. to improve their services and were working with IT colleagues to progress this.  The Head of Service – Access and Prevention discussed the management of workflow and data collection. Whilst there was a 20% increase in demand, effective management within the service had meant that only approximately 6% of that demand had translated into onward referral for a care act assessment. They explained that they collected data and used it to plan for the next year. This data-driven approach led to the latest pathway redesign, which aimed to allocate resources based on the insights gathered.

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Cllr Clarke expressed her appreciation for the exploration of the benefits of AI technology in front line service delivery.

Cllr Garnett questioned the types of contact ACT received overall versus the low number of in-person contacts. The Head of Service – Access and Prevention  explained that many people preferred to email or call, but they did not deter in-person visits. They saw around 20 people per month in person, often referred by housing colleagues, and always ensured staff were available to supports those attending Council offices, drawing on support from Social Care Teams and Locality Teams as necessary.. They promoted their telephone number and online email form, which many people used to contact them. They explained that the service had noted changing trends around contact, with a notable ongoing gradual increase in online versus telephone contact.

Cllr Garnett also asked about data gathering concerning feedback pre and post-implementation and whether this reflected positive improvement that could be quantified as either a number or percentage. The Head of Service – Access and Prevention stated that the pathway redesign and changes remained in the implementation stage until early August 2025, though positive feedback had already been received, but not in a quantifiable state at that time. They planned to continue seeking feedback as they moved through the implementation process and collected feedback through surveys and "how did we do" cards. They emphasised the services commitment to striving for improved performance and used feedback from internal delivery partners and service users alike to make and evaluate further changes intended to improve performance and experience.  They were acutely aware that the service needed to work people contacting the Adult Contact Team, not just for the team itself.

Cllr Clarke sought clarity regarding the percentage of ‘no further action’ cases out of the circa 5,000 contacts received, and the reasons behind that outcome. The Head of Service – Access and Prevention explained that approximately 20% of referrals resulted in no further action, often because they were not the right team to help and cited some misunderstanding that existed concerning what Social Care can and cannot do. They always tried to signpost individuals to the appropriate services and would contact other professionals where necessary, particularly in relation to those who were vulnerable and may not be in a position to follow signposting advice and guidance. Around 50% of contacts received, circa 2200, progressed to community teams for a Care Act assessment.

Cllr Yasseen congratulated the Head of Service – Access and Prevention on the excellent and broad offer and asked about the drivers of increased demand on the service and the impact of diverse vulnerabilities and complex needs in the context of real terms funding cuts to front line services. The Head of Service – Access and Prevention attributed growth in demand and complexity to an aging population, post Covid changes in population health, and factors like housing issues and the cost-of-living impacting on health and well-being. They drew on data and expertise from Public Health colleagues to inform work and planning, but predicted that demand would continue to stay high and potentially increase over time.

Cllr Yasseen also wanted to know more about Public Health funerals, the apparent increase in deaths among individuals without access to funds, and the ways in which residents became aware of and gained access to that type of support. The Head of Service – Access and Prevention noted that information about public health funerals was available on the Council website, but were often referred to the Council by other services. The team worked sensitively with those affected to ensure people received dignified funerals, spending time to find out about the deceased and their relatives.  They added that where there was an estate but funds could not be accessed in a timely manner, the Council provided support but recouped costs at a later stage.  They acknowledged that it was a complicated process that the team go through, and a lot of expertise within the team around that, hence continued support for a period of time when the work moved to the Court of Protection to ensure a smooth transition.

Cllr Clarke complimented the service provided for its work around Public Health funerals and continued support during transition and expressed reassurance that the high standards would continue when the work moved over due to the supported handover.

Cllr Yasseen suggested improving the accessibility of the service’s online presence and integration with neighbourhood and locality working in regards to all of the Adult Contact Teams functions, citing the potential for more cohesive community services drawing on the local knowledge of ward members. The Head of Service – Access and Prevention agreed and mentioned that they were working on improving their website and ensuring better connections at the ward level.

Resolved:-

That the Health Select Commission:

1. Noted the contents of the report.

2. Noted the areas of development underway to further enhance the service offer.

3. Requested a further update around AI implementation within the service in the next 6-12 months, via means to be confirmed at a later date.