Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 1 December 2015.

The Minutes (copies of which had been circulated) of the meeting held on 1 December 2015 were approved as a correct record and signed by the Chair.

Councillors and officers were invited to declare any interests they had in any of the items on the agenda for the meeting.

The following interests were declared:-

Personal Interests

There were no call-ins to consider.

To consider a report of the Corporate Director for People.

The report includes the final update Portfolio Performance and Resource Report (PPRR) for the Independence and Wellbeing Portfolio. This provides an update on key activity during the third quarter of the year, with a summary of progress in delivering the portfolio priority outcomes through the Investing in Stockport programme and other key projects since the mid-year report. It includes forecast performance data (where this is available) and projected financial data for the Portfolio, along with an update on the portfolio savings programme. 

Scrutiny Committee is invited to:-

·         consider the Final Update Portfolio Performance and Resource Report;  

·         review the progress against delivering key projects, priority outcomes, targets and budgets for 2015/16;

·         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 Executive 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 or Susan Wood Policy, 0161 474 3574 / 0161 218 1032, karen.kime@stockport.gov.uk / susan.wood@stockport.gov.uk

The Executive Councillor (Independence & Wellbeing) (Councillor John Pantall) submitted a report of the Corporate Director for People (copies of which had been circulated) providing an update on progress in delivering the Independence & Wellbeing portfolio priority outcomes through the Investing in Stockport programme and other key projects during the third quarter of 2015/16.

The Service Director (Adult Social Services) updated the Scrutiny Committee on performance in responding to Deprivation of Liberty Safeguard applications. He stated that the backlog of applications requiring signatures had now been addressed although there remained outstanding assessments to complete.

In relation to Stockport Together it was reported that progress with the locality hubs was varied with only Cheadle fully operational. A shadow provider board had been established to address practical operational issues. Engagement with the preventative agenda had been encouraging. It was emphasised that Stockport Together was uniquely ambitious and was, in part, being developed iteratively.

Concerns were expressed about the short timescales involved for delivering the next phase of Stockport Together by the start of 2016/17, and that the governance arrangements had not yet been resolved. Further consideration also needed to be given to the Greater Manchester Health & Social Care Strategy.

The following additional comments were made/ issues raised:-

·         Members commended the consultation on the Joint Strategy Needs Assessment and the ease of understanding the consultation material. Concerns were expressed that the consultation on chronic conditions did not include common conditions, such as Crohns Disease, but did include less common conditions.

·         Further consideration was needed on the format and presentation of the data in performance reports in light of changing commissioning arrangements and Stockport Together. Further consideration should also be given to the indicators included as some were beyond the control of the Council.

·         Concerns were expressed about the future of the Shared Service for couples where one partner had dementia as its European funding was due to expire shortly. There were other examples of small groups who had relatively small running costs but had a significant value to their users. In response the Service Director (Adult Care Services) stated that he was aware of this and similar groups. He reiterated that the Council had taken a decision to commission preventative services in a different way to better achieve its priority outcomes, and stressed the importance of acting fairly toward all Third Sector organisations who had sought funding to ensure its activity was in accord with the preventative framework.

RESOLVED – That the report be noted.

To consider an update from the Chief Clinical Officer of the Stockport Clinical Commissioning Group.

The Scrutiny Committee will receive an update on the current developments and next steps with the Healthier Together programme.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

Dr Ranjit Gill, Chief Clinical Officer, Stockport Clinical Commissioning Group, attended the meeting to provide an update on progress with the Healthier Together Programme.

He reported that the recent Judicial Review of the decision of the Greater Manchester Clinical Commissioning Groups Committees in Common (CiC) had now been concluded and the judge had found in the favour or the CiC with none of the claimant’s arguments sustained. He confirmed that the Programme would now move ahead as planned.

RESOLVED – That the update be noted.

To consider a report of the Deputy Director of Public Health.

This report has been prepared following a request from the Health and Wellbeing Scrutiny Committee for an update on the current position in relation to breastfeeding in Stockport and provides:

·         an overview of the benefits of breastfeeding, particularly in terms of health;

·         information on the current rates in Stockport  for initiation of breastfeeding and maintenance at 6-8 weeks;

·         details of the support available from services in Stockport for mothers to initiate breastfeeding and to continue to breastfeed for as long as they wish;

·         consideration as to the challenges to breastfeeding uptake and what is being done locally to address these.

The Scrutiny Committee is invited to note the report and comment.

Officer contact: Duncan Weldrake, 0161 474 2443, duncan.weldrake@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) providing the Scrutiny Committee with information about breastfeeding, including an overview of its benefits, current rates in Stockport for initiation of breastfeeding and maintenance at 6-8 weeks; details of the support available in Stockport for mothers; and a explanation of the challenges to breastfeeding uptake and what was being done locally to address these.

Duncan Welldrake (Public Health Specialist), Julie Estcourt (Head of Midwifery, Stockport NHS Foundation Trust) and Laura Widdall (Community Infant Feeding Co-ordinator, Stockport NHS Foundation Trust) attended the meeting to answer questions.

The following issues were highlighted:-

·         Three in four women in Stockport initiate breastfeeding after birth, although there was a 20 percentage gap in initiation rates between the least and most deprived areas in Stockport.

·         Rates of maintenance of breastfeeding after 6 weeks were approximately 50% which was above the national average.

·         Stockport had 54 Breastfeeding Peer Support volunteers, and the team had recently been shortlisted for a Royal College of Midwifery award. This programme had been very successful.

·         The Foundation Trust sought to explain the benefits of breastfeeding to new mothers, and encouraged skin-to-skin contact after birth.

·         The Trust had achieved the UNICEF baby friendly standard for its maternity services, and was working to achieve this for other areas of Trust activity.

·         The breastfeeding service sought to normalise breastfeeding and ensure open access to services.

·         Stockport had a ‘breastfeeding welcome’ scheme to let mothers know that breastfeeding would be supported in that facility.

Councillors asked questions and made comments, including the following:-

·         Concerns were expressed about support available to new mothers immediately following birth when on the ward, and following discharge. In particular it was suggested that little information was available about how to resolve breastfeeding problems and concern that professionals were recommending formula feeding in the event of problems arising. In response it was stated that average stays in hospital were only 1.8 days, during which time it was unlikely that breastfeeding would become established. However, through midwife and health visitor visits support was available after discharge. Supplementing breast milk with formula would be recommended when baby had lost more than 10% of its birth weight.

·         In response to a question about the minimum length of time needed for benefit to be derived from breastfeeding, it was stated that any amount was beneficial, but more benefit would be accrued for longer maintenance. Reducing feeding frequency as baby grew would concentrate the benefits in those fewer feeds.

·         Councillors welcomed the use of peer supporters and emphasised the benefits this could provide, particularly for those in the most deprived communities where there was less prevalence. It was queried whether recruitment of volunteers was targeted at priority areas, given that maintenance rates varied by up to 60% between most deprived and less deprived wards. In response it was stated that this was done, but volunteers from all areas were welcomed.

·         There were deprived wards where maintenance rates were relatively high. It was important to understand what may be different in these areas and what could be learnt and adapted for use in areas where prevalence was less.

·         Councillors discussed the difficulties some mothers experienced when breastfeeding in public and welcomed the ‘Breastfeeding Welcome’ scheme. It was suggested that this could also be promoted through The Review.

·         It was commented that despite the obvious benefits to both child and mother, it was surprising that prevalence of breastfeeding was not greater, at least during the first months. It was commented that more effort was needed to overcome the cultural barriers that might discourage start-up and maintenance, and to re-normalise breastfeeding.

·         In relation to support for mothers at difficult times, such as in the night, it was suggested that having video content online might be a good way to offer support out-of-hours.

·         As public sector organisations, the Council and NHS partners should be doing all  ...  view the full minutes text for item 6.

To consider an update from the Director of Public Health.

On 8 January 2016 the Department of Health published the Chief Medical Officers’ proposed new guidelines to limit the health risks associated with the consumption of alcohol. The Department have also begun a consultation on the guidelines.

Included within the agenda are a summary of the guidelines, a copy of the full report to the Chief Medical Officers, and the public consultation document.

The Scrutiny Committee is invited to consider the content of the reports and the draft guidance and make comments.

Officer contact: Dr Donna Sager, 0161 474 3928, donna.sager:stockport.gov.uk

The Director of Public Health submitted a report (copies of which had been circulated) inviting the Scrutiny Committee to consider the recently published proposals of the Chief Medical Officer (CMO) to change the guidelines on the consumption of alcohol. The report set out a draft response of the Director to the guidelines that would inform his response to the consultation.

The Director highlighted that the CMO report was a scientific assessment of the risks of alcohol consumption, but that in translating this into a public health message there was a danger that relatively low risk consequences were over emphasised to the detriment of higher risk consequences of high consumption, thereby undermining the impact of the message.

The following comments were made/ issues raised:-

·         Concerns were expressed that while the scientific evidence indicated alcohol consumption at small levels carried a risk, this was in isolation from the wider social context of consumption. In some cases, the consumption of alcohol was a social activity, the harm from which would be somewhat mitigated by the benefit of being socially engaged.

·         It was commented that the alcohol molecule itself was poisonous, and were it to be newly discovered it would not be sanctioned for consumption.

·         Ensuring people were aware of the risk and the potential consequence of their consumption was important, as the alternative was to push the problem onto a health system with finite resources. It should also be remembered that performance in Stockport against alcohol admission indicators was poor.

·         There were many parts of Europe and the world where alcohol was consumed but without the scale of problem consumption as in the UK. Was this simply a cultural difference, or was the message about consumption more effective?

RESOLVED – That the Chief Medical Officers’ Report and draft guidelines, and the draft response of the Director of Public Health be noted.

Reports for information only.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

To note the minutes of the Joint Committee meeting held on 17 September 2015.

RESOLVED – That the Minutes of the Joint Health Overview and Scrutiny Committee for Pennine Care NHS Foundation Trust meeting held on 17 September 2015 be noted.

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) inviting the setting out planned agenda items for the Scrutiny Committee’s next meeting and any relevant Forward Plan items.

RESOLVED – That the report be noted.