Issue - meetings

To consider a joint report of the Director of Strategy and Deputy Place Based Lead.

The report provides an update on the work of Stockport Health and Care System to deliver local as well as regional aspirations to improve outcomes in population health and healthcare; tackle inequalities in outcomes, experience and access; enhance productivity and value for money; and help the NHS to support broader social and economic development. This work was facilitated by legislation outlined in the Health and Care Act 2022.

The Scrutiny Committee is recommended to comment upon and note the report.

Officer contact: Kathryn Rees on 0161 474 3174 or email: kathryn.rees@stockport.gov.uk

The Director of Strategy and the Deputy Place Based Lead submitted a joint report (copies of which had been circulated) providing an update on the work of Stockport Health and Care System to deliver local as well as regional aspirations to improve outcomes in population health and healthcare; tackle inequalities in outcomes, experience and access; enhance productivity and value for money; and help the NHS to support broader social and economic development. This work was facilitated by legislation outlined in the Health and Care Act 2022.

The Cabinet Member for Health & Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/ issues raised:-

·         Members commented that the report did not contain detail related to the changes and benefits for Stockport’s residents which had resulted from the work of Stockport’s Integrated Health system.

·         In response it was stated that the shift to preventative care, along with the requirement to collaborate with NHS partners, had benefitted services users. The neighbourhood model was designed to connect communities, tackle isolation and ensure GPs and other health care agencies provided tailored services. Each Primary Care Network (PCN) had a population care plan to shift resource to where it was most needed.

·         It was queried whether the predicted finance budget deficit was large in comparison to the overall budget and an update was requested on the integration of health and social care in budgets and in relation to budget accountability.

·         In response it was stated that the operating model was in development and that further details would be reported to a future meeting of this Committee. It was stated that Stockport’s Locality Board had excellent relationships with it partners along with a joined up leadership approach which boded well for future projects.

·         The ‘Thriving Places’ aspect of the report was welcomed as it was important in helping to people remain well or improve their situation. Members made reference to some of the third sector mental health organisations within the borough including Men’s Sheds and Woodbank Community Gardening and acknowledged the benefits of Stockport’s green spaces.

·         Members queried whether there had been an improvement in the areas of waiting times for neurodivergence assessments, timely discharge and capacity within mental health crisis teams.

·         In response it was reported that there were between 80 and 100 people currently in Stepping Hill Hospital who were medically fit for discharge on a daily basis; adult social care had an ongoing programme to support those patients to get home as quickly as possible and to provide care. The target was to reduce that number to 60 people.

·         It was confirmed that it remained the case that there were long waiting times for adults to undergo neurodivergent assessments. It was commented that autism does not have a cure and ongoing support is therefore required. Conversations were ongoing across Greater Manchester about the model for autism support.

·         In terms of community mental health, Pennine Care had an integrated arrangement resulting in a multidisciplinary approach. It was planned that the new mental health partnership board would to listen to feedback from those who had received mental health care in Stockport and offer them the opportunity to influence future care in an effort to make continuous improvements.

·         It was queried whether there had been any improvements related to the integration of primary care services.

·         In response it was stated that it was important to ensure that GP groups were on board and able to influence the direction of travel. The approach was to share best practise rather than adopt a top-down model. Each PCN had its own plan and was incentivised to adopt it through commissioning. The structure of the neighbourhood programme would support the different elements of primary care to work together. 

RESOLVED – That the report be noted.

To consider a joint report of the Director of Strategy and Director of Place Management.

The report provides an update on the work of Stockport health and care system to deliver local as well as regional aspirations to improve outcomes in population health and healthcare; tackle inequalities in outcomes, experience and access; enhance productivity and value for money and help the NHS to support broader social and economic development. This work was facilitated by legislation outlined in the Health and Care Act 2022.

The Committee is recommended to comment upon and note the report.

Officer contact: Kathryn Rees on 0161 474 3174 or email Kathryn.rees@stockport.gov.uk

The  Director of Strategy and the Director of Place Management submitted a joint report (copies of which had been circulated) providing an update on the work of Stockport Health and Care System to deliver local as well as regional aspirations to improve outcomes in population health and healthcare; tackle inequalities in outcomes, experience and access; enhance productivity and value for money; and help the NHS to support broader social and economic development. This work was facilitated by legislation outlined in the Health and Care Act 2022.

The Cabinet Member for Finance & Resources (Councillor Jilly Julian) attended the meeting to respond to councillors’ questions.

The following comments were made/ issues raised:-

·         Members commented on the complexity of this area of work and queried the finances, in particular efficiency savings and projected losses which suggested future challenges.

·         The NHS faces similar financial challenges to that of the council. The integrated care arrangement system disestablished the ten Clinical Commissioning Groups (CCGs) and operated at a Greater Manchester level in an attempt to improve delivery of service. The integrated system was undertaking a piece of work to look at efficiencies in areas such as elective care, prescribing and staffing budgets. The demand on services, coupled with the covid backlog had an impact on the finances of the service. The solution in many areas was preventative care and the work of the Neighbourhoods and Prevention Programme was key in working towards the integration of social work and district nursing with GPs and primary care to keep people well, independent and at home.

·         In relation to the reported concerns expressed by parents and carers over the long waiting times for neurodevelopmental assessments, Members referred to the multiplier effect and the potential to have a knock on effect upon children’s education where diagnoses did not take place at an earlier stage. Members asked what work was being carried out to address those waiting times.

·         It was stated that the already high waiting lists had been exacerbated by covid whn neurodevelopmental assessments had been paused. A programme of recovery work was underway to improve waiting times including the use of temporary resources. The Pennine Child and Adolescent Mental Health Service (CAMHS) had been housed at Stopford House enabling neurodevelopmental assessments to take place within the borough. It was also noted that post-diagnosis support was also required and services should not wait for a diagnosis in order to put support in place.

·         Pennine Care provided mental health services to five boroughs and it was commented that whilst it provided an excellent service, there was a crisis in terms of funding along with recruiting staff.

·         Clarification was requested on areas contained within the report, in particular how the Finance Recovery Group was managing the financial reduction exercise and the risk to the prescribing target, along with the work of the Greater Manchester medicines optimisation team.

·         It was reported that local NHS budgets were under significant pressure both at Greater Manchester and Stockport levels. The Finance Recovery Group looked at system-wide approaches to ensure efficient and effective use of resources. The reference to risk related to an efficiency target for containing growth within the prescribing budget where it was unlikely that the target would be met. The Greater Manchester optimisation team included professional pharmacists and GPs whose remit was to ensure that framework drugs and prescribing was carried out in the most efficient way.

·         Members requested less technical language for future reports.

RESOLVED – That the report be noted.