Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 12 September 2017.

The Minutes (copies of which had been circulated) of the meeting held on 12 September 2017 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.

Karen Moran, Head of Service Reform at Stockport Clinical Commissioning Group will attend the meeting and provide a presentation on the NHS England Rapid Testing Programme, sometimes referred to as ‘100 Day Review’ that is being used to as part of the development of the Stockport Together models of care.

The Scrutiny Committee is invited to consider the presentation and ask questions as appropriate.

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

Karen Moran, Head of Service Reform at Stockport Clinical Commissioning Group, attended the meeting and gave a presentation to the Scrutiny Committee on the NHS England Rapid Testing Programme that was being used as part of the development of the Stockport Together models of care.

The programme was developed as part of NHS England’s priority to deliver ‘timely access to high quality elective care’. The Rapid Testing programme would allow for initiatives to be tested, reviewed and refined in short periods of time, and embed evaluation to allow for these to be replicated elsewhere. The Stockport Together Programme was working closely with NHS England to use Rapid Testing to develop its new models of care.

Some of the key benefits of the programme included:-

·         increasing engagement with patients in decision making

·         working to engage patients with their needs through electronic means

·         virtual appointments, or telephone appointments, including ‘Consultant connect’

·         patient led follow-up, when patients needed them.

Specifically on work to improve the diabetes pathway, the Programme had led to the development of ‘buddy clinics’ with nurse practitioners training GP practice colleagues on the most appropriate support and treatment; GPs using virtual appointments for consultant input thereby avoiding the need for referral and waiting for an outpatient clinic appointment; refining and expanding access to the patient education programme to give greater focus on self-care.

The following comments were made/ issues raised:-

·         Given one of the elements of Stockport Together was to reduce the amount of unnecessary outpatient appointments this work was to be welcomed.

·         Further detail was requested about the purpose of programme sponsorship. In response it was stated that because of the limited resources available to support programmes of change, having a senior colleague who was able to unblock bureaucratic processes and act as a conduit to senior management to enable more rapid decisions.

·         It was queried whether the telephone consultations were also being done via video calling. In response it was stated that this was not currently supported although it may be in the future. Feedback from patients and clinicians had been very positive, and orthopaedic services were looking to expand their use of this facility. The need to ensure patients were comfortable with change was emphasised.

·         Further information was sought on how telephone consultations would reduce the pressure/ time demand on consultants. In response it was stated that because of how outpatient clinics functioned a telephone consultation would increase the number of people who could be contacted. There were also efficiencies in being able to more quickly refer patients to other specialties where they may be more appropriately treated.

RESOLVED – That Karen Moran be thanked for her attendance and presentation.

To consider a report of the Corporate Director for People.

The Mid-Year 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 in the first half of the year, with a particular focus on the second quarter (July to September). They include forecast performance and financial data (where this is available) for the Portfolios, along with an update on the portfolio savings programmes.

The Adult Social Care report includes an addendum with information relating to Adult Social Care complaints and compliments. This includes statutory complaints, some relating to services from other providers (e.g. Stockport Homes) along with complaints to the Local Government Ombudsman and Housing Ombudsman. This information is reported in summary form within the Corporate Complaints Report which is considered by CRMG Scrutiny Committee and Cabinet. It has been included at the request of the Portfolio Holder in order to provide additional consideration by this Scrutiny Committee. It is proposed that future Portfolio reports will incorporate this information.   

The Scrutiny Committee is asked to:

·         Consider the Mid-Year 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.

·         Note the additional information provided on Adult Social Care complaints and compliments, and the proposal to include this in future reports.

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 Portfolio Performance and Resources Reports (copies of which had been circulated) summarising progress in delivering priorities, reform programme and other key projects for the Adult Social Care and Health portfolios during the first half of 2017/18, with particular emphasis on the second quarter. The reports also included forecast performance and financial data for the portfolios, along with an update on the portfolio savings programmes.

Adult Social Care Portfolio Performance and Resources Report

The Cabinet Member highlighted the following issues:-

·         Useful feedback had been received on Transition Funding.

·         Thanks to all involved in the co-production of the Adult Autism Strategy.

·         Results of carer’s survey had been recieved.

·         Budget proposals would be submitted to the next Scrutiny Committee meeting.

·         The report included a section on the Disabled Facilities Grant, although the budget was within a different portfolio.

·         The report also included an addendum on complaints, complements and concerns.

The Chair highlighted the following positive elements of the report:-

·         The high success rate being achieved by Acorn recovery.

·         Stockport MIND’s ‘Get set to Go’ campaign to support physical health of those with mental health conditions.

·         The significant levels of unpaid support provided by carers.

·         The development of dementia friendly GP practices.

·         The ‘Take a seat’ campaign was important not just for older people but for those with mobility issues.

The following comments were made/issues raised:-

·         The progress made in developing the WIRE reablement service was welcomed.

·         The importance of supporting carers, whose contribution saves the public purse huge sums overall, meant that current levels of spend in this area should be maintained.

·         Would the use of reserves to support the adult social care budget continue into next year? In response it was stated that the budgetary challenges in the adult portfolio were well known, and the portfolio was currently projected to be in deficit. Proposals to address this and next year’s budget would be submitted to the scrutiny committee in the next cycle. The funding challenges were not unique to Stockport but were a national challenge and investment need.

·         The former Adults Care Services and Housing Scrutiny Committee had received feedback from frontline staff on how innovation in their job roles was supporting them in their work. It would be positive to have a similar mechanism for feedback at this committee.

·         To what extent was the EMIS viewer available to adult social care? In response it was stated that the aspiration was for acute and GP practices to use the EMIS system and that was progressing. Work was also underway to ensure this was available to out-of-hours services. Further work would be needed to integrate EMIS with whichever new children’s and adult’s case management system was eventually procured.

·         In relation to on-time transfers of care, what was the overall vacancy rate, and how was capacity managed in conjunction with non-medical discharge need? In response, complexity of the system was emphasised, as was the aspiration not to rely on beds. There had been significant recent work on flow through the hospital to address Emergency Department issues. Providers tended to operate at 90% capacity, although more than this would impact the flow rate. There was a clear need to look at alternative domiciliary and intermediate care.

·         Concerns were expressed that the financial tables on pages 26-27 of the report did not reconcile with the commentary, and that the use of iBCF funds to plug funding gaps will lead to problems at a later point.

·         Concerns were expressed that targets around discharge and support were not being met. In response it was stated that due to staff vacancies it had proved difficult to plan discharge early, but measures were in place and were being monitored closely.

·         What was being done to address staff travel and overtime overspend? In response it was stated that this would be addressed as part of the Cabinet’s budget  ...  view the full minutes text for item 5.

To consider a report of the Corporate Director for People.

The Adult Autism Strategy was co-produced by a wide range of professionals, people with autism and their carers over a period of months. This means the Strategy document looks different to traditional strategy documents. It states clearly what the people responsible for developing the Strategy intend to do in order to implement it. It also describes what the Council needs to do to support the delivery of the action plans.

The Strategy was endorsed by the Health & Wellbeing Board at its meeting on 27 September 2017.

The Scrutiny Committee is invited to note Stockport Adult Autism Strategy for 2017-2020.

Officer contact: Karen Kime, 0161474 3450, karen.kime@stockport.gov.uk

The Cabinet Member for Adult Social Care submitted the Stockport Adult Autism Strategy for 2017-2020 (copies of which had been circulated) for the Scrutiny Committee’s consideration. The Strategy had been co-produced with service users and their carers, and with Healthwatch Stockport, to make it as comprehensive and robust as possible. Although the Strategy was primarily aimed at adults, it covered age 14 upward to ensure consistency with service provision and to move toward the aspiration of an all-age Strategy.

It was suggested that the autism training opportunities be widened to include councillors.

Concerns were also expressed about the lack of an autism diagnostic pathway.

RESOLVED – That the Strategy be noted.

To consider a report of the Cabinet Members for Children & Family Services and for Education.

At the 3 October Cabinet Meeting an update on the Council’s Inclusive Growth and Reform Programme was provided which set out proposals to reduce spending by £4.15M in 2018/19.

This report outlines a summary of the suite of proposals for Children’s Services which form part of the Cabinet’s response to the Medium Term Financial Plan (MTFP).  Consultation is currently taking place with key stakeholders on the proposals, the outcome of which will be brought to the next meeting of this Scrutiny Committee.

The Scrutiny Committee is invited to comment on the proposals.

Officer contact: Andrew Webb, 0161 474 3808, Andrew.webb@stockport.gov.uk

A representative of the Corporate Director for People submitted a report (copies of which had been circulated) summaries a suite of proposals for Children’s Services which form part of the Cabinet’s response to the Medium Term Financial Plan (MTFP), and the Scrutiny Committee was being consulted on the proposals.

The Chair reminded the Scrutiny Committee that the majority of the proposals were within the remit of the Children & Families Scrutiny Committee and that this Committee should focus its questions on matters relating to health matters.

Concern was expressed about the potential loss of funding for school sport and the potential impact on children’s physical activity levels.

RESOLVED – That the report be noted.

To consider a response of the Cabinet Member for Health.

The attached report sets out the Cabinet’s formal response to the former Health & Wellbeing Scrutiny Committee’s review ‘Making the Most of Community Pharmacy’. The Cabinet agreed this response at its meeting on 3 October 2017.

The Scrutiny Committee is invited to note the response.

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

The Cabinet Member for Health submitted the Cabinet’s agreed response to the recommendations of the Scrutiny Review ‘Making the most of Community Pharmacy’ (copies of which had been circulated) for the Scrutiny Committee’s consideration. The response had been produced jointly with the Clinical Commissioning Group (CCG), but some recommendation were outside of the responsibilities of either organisation, although where appropriate the Council and CCG would lobby on these issues.

Councillors asked whether community pharmacies would be able to use the EMIS system being rolled out in the NHS locally. In response it was stated that although there were mechanisms for community pharmacies to interact with this system, because of the range of providers locally, some of whom were large multiple site providers with their own systems, it was difficult to co-ordinate an approach.

Further feedback was sought on the lack of support from the CCG for the recommendation that pharmacists not be required to remain on site. In response, it was stated that there were clinical governance and safety concerns that would need to be overcome to facilitate pharmacist being off-site. Efforts being made by GP practices to bring in pharmacist support would mitigate the need for this.

RESOLVED – That the response be noted.

To consider a report of the Democratic Services Manager.

The report sets out planned agenda items for the Scrutiny Committee’s next meeting and Forward Plan items that fall within the remit of the Scrutiny Committee.

The Scrutiny Committee is invited to consider the information in the report and put forward any agenda items for future meetings of the Committee.

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

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

The Chair reported that in future she would endeavour to ensure that during consideration of future agenda items there was appropriate representation from service users or other organisations to provide a different perspective.

RESOLVED – That the report be noted.