Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 27 March 2018

The Minutes (copies of which had been circulated) of the meeting held on 27 March 2018 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 interest was declared:-

Personal Interest

There were no call-ins to consider.

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.

To consider a report of the Deputy Chief Executive

This report contains a series of recommendations made by the Director to the Council in the 24th Annual Public Health Report is available at: https://www.stockport.gov.uk/public-health/annual-report-of-the-director-of-public-health. The Cabinet has responded to each of the recommendations directed towards the Council, either on its own or in partnership with other agencies with whom it shares a Public Health duty.

Scrutiny Committee is asked to:

·         Consider the 24th Annual Public Health Report;  

·         Review the 49 recommendations of this Report which the Cabinet has accepted in its response, including two which are updates to recommendations made in the previous year’s report;

·         Highlight any significant issues or challenges with the proposed response to be fed back to the Cabinet; and

·         Highlight areas of good practice in existing work which can be offered in support of the Cabinet’s response.

Officer contact: Karen Kime, 0161 474 3574, karen.kime@stockport.gov.uk

The Cabinet Member for Health submitted a report (copies of which had been circulated) inviting the Scrutiny Committee to consider the Cabinet’s draft response to the recommendations contained in the Director of Public Health’s 24th Annual Public Health report. The Scrutiny Committee were invited to comment on the response before the Cabinet considered the report.

The Director of Public Health was in attendance to respond to questions.

The following comments were made/ issues raised:-

·         Clarification was sought on whether it was proposed that everyone prescribed anti-biotics would receive a leaflet (recommendation 7 refers). It was clarified that this would only apply in the case of

Urinary Tract Infections, where there was a particular concerns as evidence indicated that repeated prescribing for persistent infections could exacerbate the condition. It was further commented that anti-biotic resistance was being passed on through agricultural methods.

·         How was it proposed to influence developers to provide more socially useful housing types (recommendation 25)? In response it was acknowledged that developers would build houses they thought would sell best, rather than would meet the needs of the population, but that the Local Plan and Greater Manchester Spatial Framework presented opportunities to steer developers appropriately. Discussions were also ongoing with social landlords to develop housing that were designed in such a way as to not require extensive modification should a resident’s needs change.

·         Was there any progress on identifying a designated traveller site (recommendation 30)? In response the difficulty of identifying and progressing a site was emphasised, given the public anxieties, but that the lack of such a facility placed pressure on the Council in responding to traveller incursions.

·         The suggestion of designing more easily adaptable homes was welcomed (recommendation 33). In response it was stated that this may actually be cheaper for developers, who perhaps were unsure of the marketability of such properties. It was further commented that this recommendation had been included in response to comments made by the Scrutiny Committee.

RESOLVED – That the report be noted.

To consider a report of the Director of Public Health.

The Stockport Health Promise is a set of commitments entered into by various departments of the Council and other agencies to improve health. The Promise has recently been revised and a range of promises have been agreed which cumulatively represent an important contribution to the health of the people.

Scrutiny Committee is asked to receive the report

Officer contact: Dr Stephen Watkins, 0161 474 2436, stephen.watkins@stockport.gov.uk

The Director of Public Health submitted a report (copies of which had been circulated) setting out revisions to the Stockport Health Promise, the set of commitments entered into by various Council departments and partner agencies and designed to improve the health of the population.

The Director highlighted the genuine commitment of partners to fulfilling the promises. It was also commented that even if staff were not always aware of particular promises they were often committed to delivering those improved outcomes.

The following comments were made/ issues raised:-

·         Further information was sought on promise 84 relating to stair location and design in planning applications. In response it was stated that the location of stairs in a home had an impact on the likelihood of accidents as well as impacting on the feasibility and cost of fitting stair lifts.

·         Was there scope for encouraging the use of very small parcels of land for allotments or community gardens where these were unlikely to be used for development? This was a particular challenge in less affluent areas. The example of community orchards was given. In response the importance of this suggestion was acknowledged and further examples of initiatives in Todmorden were given. The impact of very limited activity, even planting just one fruit tree, could be worthwhile.

·         In relation to anti-idling and improving air quality around schools (promise 72), was there scope for using civil enforcement officers to address this? In response, the challenge was acknowledged, although the resource implications for an already stretched and in-demand was emphasised.

RESOLVED – That the report 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 Services Manager submitted a report (copies of which had been circulated) setting out planned agenda items for the Scrutiny Committee’s next meeting and any Forward Plan items that feel within its remit.

The Scrutiny Committee restated its previous wish to receiving input from service users as part of consideration of appropriate agenda items.

RESOLVED – That the report be noted.