Agenda item

To consider reports of the Corporate Director (Services to People)

PORTFOLIO PERFORMANCE AND RESOURCES – DRAFT PORTFOLIO AGREEMENTS 2017/18 

Policy priorities for 2017/18 were set out within the Council Plan, which was adopted at the Budget Council Meeting in February. This incorporates the shared outcomes from the Borough Plan alongside specific priorities of the Cabinet.

These priorities are articulated within the Portfolio Agreements, which form the basis for regular in-year reporting. Portfolio and Corporate Performance and Resource Reports (PPRRs and CPRRs) will assess progress against key objectives, priorities, outcomes and budgets, enabling Scrutiny Committees to hold the Cabinet to account and for the Cabinet to identify current and future risks to delivery.

This report presents the draft 2017/18 Agreements for the Adult Social Care and Health Portfolios for consideration and comment by the Committee.

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PORTFOLIO PERFORMANCE AND RESOURCES – ANNUAL REPORTS 2016/17 

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

The Report is based on the 2016/17 Portfolio Performance and Resource Agreement (PPRA). This was considered by the Committee on 28 June 2016 and approved by the Executive on 19 July 2016. Final drafts of the 2017/18 Portfolio Agreements are presented for consideration elsewhere on this agenda, and will be submitted for approval by the Cabinet on 13 June.

Recommendations

1.     Scrutiny Committee is asked to review and comment on the draft Portfolio Agreement.

2.     Consider the Annual Portfolio Performance and Resource Reports; 

3.     Review the progress against delivering key projects, priority outcomes, targets and budgets for 2016/17;

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

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

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

Officer contacts: Jovian Smalley, Strategy and Performance Manager jovian.smalley@stockport.gov.uk (474 3589)

Emma Bowe, Strategic Financial Advisor (Services to People) emma.bowe@stockport.gov.uk  (218 1026)

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 2016/17, and in particular during the 4^th quarter.

The draft Adult Social Care and Health Portfolio Agreements for 2017/18 were also submitted (copies of which had been circulated) for comment by the Scrutiny Committee prior to adoption by the Cabinet.

Adult Social Care Portfolio Performance and Resources Report

The Cabinet Member highlighted the following issues:-

·         Financial challenge facing the directorate

·         Ongoing work to ensure quality within the provider sector

·         Work to revise the Autism Strategy

The following comments were made/ issues raised:-

·         An update was requested in relation to the recruitment of neighbourhood support worker posts. In response it was stated that the process was ongoing and although posts remained to be filled the initial process had been positive.

·         Clarification was sought on ‘creative solutions’ to sleep-in arrangements. In response it was stated that this referred to a recent legal judgement requiring local authorities to pay a national minimum wage hour rate for staff who were ‘sleeping-in’ while providing care, and efforts to think of other alternatives, such as the use of technology, to make this more cost-effective. An assurance was then sought that care would not be compromised by the use of technology in these circumstances, and an assurance was provided.

·         Further clarification was sought on the role of health champions. In response it was stated that this programme sought to utilise volunteers to provide preventative activities working through GP surgeries. It was recognised that there were challenges in managing large numbers of volunteers, but that the opportunities this provided were nevertheless significant.

·         Examples from other parts of Greater Manchester demonstrated the impact volunteers could have on the ability to provide simple preventative interventions, such as walking groups, taking blood pressure readings or supporting home readings, or providing contact that addresses social isolation.

·         An update on progress in improving performance on Delayed Transfers of Care (DTOC) was requested. In response it was confirmed that significant efforts had been made by partners locally that had resulted in reduced levels of DTOC. This included additional investment in home care provision over the winter period that had then been extended. As previous discussed, additional neighbourhood based intermediate care support workers resources were being recruited, as well as the development of the an integrated discharge/ transfer team to better coordinate arrangements for patients. There had been intensive support from Greater Manchester colleagues to implement the SAFER initiative. It was also confirmed in response to further questioning that performance against related indicators would improve over time in light of these improvements.

·         Clarification was sought on whether the bid for additional community pharmacy capacity to the Medicine Optimisation Programme see a gain in service capacity or simply allow for the maintenance of current service levels in light of recent reductions in funding for community pharmacy. In response it was stated that this additional funding would be welcomed to allow greater focus on those patients with complex needs. The role of pharmacists were changing with increasing occurrences of pharmacist being employed directly by GP practices to work with this cohort, thereby relieving pressure on GPs.

·         Further information was sought on when it was anticipated that the arrangements at Hayes Court would be settled. In response it was confirmed that a review was ongoing of staff to ensure this was best able to provide for those service users transferring back to Stockport.

·         Clarification was sought on statements in the report that suggested there were no recurrent savings from Stockport Together in 2016/17. In response it was stated that earlier savings requirements from Stockport Together had been difficult to achieve so that additional non-recurrent expenditure had been allocated to relieve pressure on the service and assist in achieving the savings requirements across the programme, not just directly for the Council. Fundamental to achieving these savings was to ensure that as far as possible care was provided at home and the best use was being made of the intermediate care bed base.

·         Further information was sought on the capital programme within adult social care. In response it was stated that details were contained in the draft Portfolio Agreement later in the agenda.

Health Portfolio Performance and Resources Report

The Cabinet Member highlighted the following issues:-

·         The significant cross over of information and issues between the Health and Adult Social Care Portfolios.

·         Ongoing work on Stockport Together.

·         The need to ensure that preventative activity was continuing, as well as efforts to address health inequalities.

·         Continuing high performance of providing flu vaccinations to key at-risk cohorts, but further efforts needed to access all groups.

·         Development of new life-style services following changes arising from reductions in Public Health funding.

The following comments were made/ issues raised:-

·         Comment was sought on what more could be done to address the 20% of Healthy Living Pharmacies that were not currently providing evidence of interventions. In response it was emphasised that Healthy Living Pharmacies had a key role to play in the preventative agenda, and in supporting those with long term conditions, such as through medicine review. The challenge of encouraging all community pharmacies to engage in this agenda, including the 20% referred to in the question, was acknowledged and consideration was being given to how this might be improved.

·         Further comment was sought on trends in life expectancy, particularly in recent declines in life expectancy for over 65s. In response the concerns raised were acknowledged and echoed, and an assurance was given that work was underway to gather data to inform a further report on this issue.

·         It was asked what mechanisms were proposed to meet the aspiration of having older people being able to see the same GP on a regular basis, particularly in light of the other changes and pressures on the primary care. Concerns were expressed that much of the integration agenda appeared to be driven by financial considerations. In response it was stated that the context for the Stockport Together programme was the growing funding gap for health and social care. One of the key underlying principles of the Programme was to ensure that patients received care from the most appropriate health care professional to make the most efficient use of this resource. In was further clarified that expanding GP hours would be done on an area basis, rather than by each surgery, but that routine appointments and care would be delivered through regular GPs wherever possible. This should be seen within the context of the Neighbourhood Model of care in which the wider range of professionals were under consideration and those elements of care that needed continuity were prioritised.

·         Reducing levels of alcohol related hospital admissions was highlighted and comment sought on possible reasons. In response it was confirmed that there had been no changes in reporting methodology, but that new service arrangements had been put place to address the needs of individuals with often very complex problems.

·         Comment was sought on the levelling off of trends in cancer mortality for under 75s. In response it was emphasised that there significant efforts had been made to improving screening and to target those at risk. Nevertheless there remained challenges to encouraging people to take up free screening opportunities.

·         Clarification was sought on the reasons that Excess Winter Deaths were measured on three year averages. In response it was stated that this method provided better trend analysis possibilities.

Portfolio Agreements

The following comments were made/ issues raised:-

Adult Social Care

·         Concerns were expressed about the impact of reductions in overtime and vehicle allowances on the ability to retain staff, and the potential consequent increase in the use of agency staff. In response, it was commented that these proposals had been subject to extensive consultation with staff. The financial challenges facing the Council and service were significant, nevertheless the concerns raised were noted.

Health

·         Due to ‘purdah’ for the General Election there was not greater reference to Stockport Together within the Agreement.

·         The Greater Manchester Healthy Ageing Strategy would be significant.

·         In response to a question on progress with information governance and Stockport Together, it was stated that almost all GP Practices were now using the same ICT system and that this could be accessed by other services as appropriate. Discussions were ongoing to finalise information sharing protocols.

·         The implementation of the Joined-Up local services in the Heatons was welcomed.

RESOLVED – That Annual Portfolio Performance and Resources Reports 2016/17 and the Draft Portfolio Agreements for 2017/18 be noted.