Issue - meetings

To consider a joint report of the Director of Adult Social Care and the

Deputy Director of Public Health

The Annual Portfolio Performance and Resource Reports (PPRRs) for the Adult Social Care and Health Portfolios are presented for consideration by the Committee. These provide a summary of progress in delivering the portfolio priorities, reform programme and other key projects since the final update reports, with a focus on the fourth quarter of the year (January to March). They include out-turn performance and financial data (where this is available) for the Portfolios, along with updates on the portfolio savings programmes.

Where significant activity or decisions have been made since the end of the fourth quarter, these have been included to ensure that the reports remain timely. These will also be referenced within the First Update Reports for 2018/19.

Scrutiny Committee is asked to:

·         Consider the Annual Portfolio Performance and Resource Reports;  

·         Review the progress against delivering key projects, priority outcomes, targets and budgets for 2017/18;

·         Highlight key areas of and responsibility for taking forward corrective action to address any performance or resource issues;

·         Highlight any significant issues or changes to be fed back to the Cabinet alongside the Corporate Performance and Resource Report;

·         Identify how areas of strong performance and good practice can be shared in other services.

Officer contact: Karen Kime/ Emma Bowe, 0161 474 3574 / 218 1026, karen.kime@stockport.gov.uk, emma.bowe@stockport.gov.uk

The Cabinet Members for Adult Social Care and for Health submitted the Annual Portfolio Performance and Resources Reports (copies of which had been circulated) summarising progress in delivering priorities, reform programme and other key projects and outturn positions for the Adult Social Care and Health portfolios during 2017/18, and in particular during the 4th quarter.

The Cabinet Member for Health highlighted the following issues:-

·         Preparations were already underway for next Winter and the flu vaccination programme, a significant aim of which was to prevent avoidable hospital admissions.

·         Improvements had been made toward achieving the 4 hour admission standard at the hospital, although work was ongoing.

·         Prevention had been a key driver for activity in the previous year. There had again been excellent overall performance with flu vaccinations but this masked geographical variations in reaching target groups.

·         The Public Health Team was researching further increased levels of mortality, reflective of a national trend, and would be reporting back to the Health & Wellbeing Board in due course.

The following issues were raised:-

·         What were the consequences to the Pooled Budget of not achieving the seemingly impossible 4-hour admission standard for ED? In response it was stressed that this was a relatively arbitrary national standard that did not reflect the particular circumstances in Stockport, although considerable efforts were going in to achieve this standard. Locally there was an older and aging population, and increasing number of whom were attending ED, who often took longer to treat. The challenge was therefore to prevent attendance if their needs could be better met out of hospital. Once there it was important to optimise the flow through the hospital, and credit was due to partners for their efforts that had improved rates of Delayed Transfer of Care (DTOC). Overall there was a 40-50% greater demand of services than the system was designed for. It was further commented that there was a level of maturity in the local health and care economy that the focus of partners was now broader than DTOC but also length of stay. For residents over 75 there was a significant and rapid deterioration of physical wellbeing from a 10 day stay in a hospital. This may therefore have a significant longer term impact the pooled budget through more costly interventions. As partners developed further their integrated approach, in particular the case management system, this would allow for quicker identification of those in need for earlier, more cost effective, interventions that would impact positively on the pooled budget. It was also commented that more detailed analysis of this information would be provided to the Health & Care Integrated Care Board in due course.

·         What were the lessons to be learnt from GP practices who were best at achieving good take up of health checks and other early intervention measures, given the variability in performance against a number of indicators, and were there any reasons for that variability? In response it was stated that the differing sizes of practices and therefore differing staffing and resource levels may impact on performance, as well as errors in capturing data that might lead to underreporting. The extension of GP operating hours was also being targeted to early intervention and preventative activity and the Public Health team would also support outreach activity in workplaces and events (capacity dependent).

·         Was there a quantifiable impact of the flu vaccination programme and if someone were not in the target group should they be vaccinated? In response it was commented that vaccinations were more effective for children than adults, but that it would nevertheless reduce the severity of an infection regardless of age so everyone should be encouraged to get a vaccination. It was difficult to quantify the impact, or determine the likely effect on admissions without a successful programme. The vaccine used nationally in the previous two years had unfortunately been less effective than hoped resulting in severe pressure on health services, demonstrating  ...  view the full minutes text for item 4