Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 16 June 2022.

The Minutes (copies of which had been circulated) of the meeting held on 16 June 2022 were approved as a correct record and signed by the Chair, subject to the addition of the following resolution within Minute 9 ‘Gambling Relation Harm’:-

It was requested that the Gambling Related Harm report be shared with the Licensing, Environment and Safety Committee.

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-in items to consider.

To consider a joint report of the Director of Public Health and Interim Director of Adult Social Care.

The report sets out the draft 2022/23 Portfolio Agreement for the Health and Adult Social Care Portfolio, the portfolio priorities, delivery plans and budgets for the current year, and will be presented to Cabinet for approval on 20 September.

The Scrutiny Committee is asked to comment on and note the report.

Officer contacts: Peter Owston on 0161 474 3274 or email: peter.owston@stockport.gov.uk and Paul Graham on 0161 474 4674 or email: paul.graham@stockport.gov.uk

The Director of Public Health and Interim Director of Adult Social Care submitted a joint report (copies of which had been circulated) outlining the draft 2022/23 Portfolio Agreement for the Health and Adult Social Care Portfolio, the portfolio priorities, delivery plans and budgets for the current year.

The Cabinet Member for Health and 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 welcomed the focus on prevention and early help and queried how this would be measured.

·         It was suggested that the measures be revised to be reflective of quantifiable data rather than aspirations of improving health outcomes.

·         In relation to the percentage of residents in Stockport who have depression or generalised anxiety disorders, it was queried what interventions the council takes with partners to affect those numbers and as a result, what were the aspirations.

·         In response it was stated that there was step change in the data in the number of people experiencing anxiety, broadly related to the pandemic, which there was no expectation that this would rapidly decline given the current context. Whilst it was expected that this proportion would remain relatively high, of those people experiencing high levels of anxiety there were a number of routes which people were able to explore with their GP or other health professionals including the IAP service. The IAP service was one of the service options, alongside other examples such as Living Life to the Full which was an online, self-help platform for people to receive support with their anxiety and medication options. It was reported that IAP was a national indicator which allowed comparison nationally with other Local Authorities, however all these options would be measured as part of the mental health programme.

·         Members raised concerns in relation to the high number of Deprivation of Liberty Safeguarding referrals awaiting assessment and queried the impact on residents of the implementation of the Liberty Protection Safeguard.

·         In response, Members were advised that the Liberty Protection Safeguard was a change in legislation which would significantly change the approach to how the council determined who was at risk of being deprived of their liberty, however the council were awaiting confirmation of when this change would be implemented. It was recognised that the number of Deprivation of Liberty Safeguarding referrals awaiting assessment was high and the corporate risk register identified the number of people who had been triaged, however the workforce challenges had meant that their assessment had not been completed.

·         In respect of the workforce challenges, it was queried whether the issues were a result of a number of unfilled vacancies.

·         In response it was stated that Stockport was in a similar position to many other Local Authorities in that there was national issue around appropriately trained staff required to complete the work and there had been an increase in the demand on Adult Social Care which had resulted in increased pressure on the service.

·         Members welcomed the priority to address health inequalities in the Borough which underpinned a number of the measures.

·         In response it was reported that when considering changes to the healthy life expectancy there was no expectation to see large changes in the short-term as this was a long-term change which would take years to affect and in the immediate, the service was exploring a way to use proxy measures to measure progress.

·         In relation to women’s health screening, Members noted the increase in the uptake rates, however noted that more work could be done around breast cancer screenings.

·         In response, Members were advised that screening was a good example of how the service can measure individual locality figures to invest more targeted work where it was required. Whilst cervical cancer screening uptake figures had increased, it was recognised that work was required to increase the figures around breast cancer screening and work was  ...  view the full minutes text for item 4.

At 6.35pm, it was

RESOLVED – That the meeting be adjourned.

The meeting reconvened at 6.00pm on 22 September 2022.

The following comments were made/ issues raised:-

·         Welcomed the expansion of the apprenticeship offer for Social Care and Occupational Therapy to support staff recruitment and retention.

·         It was queried how the single database system within neighbourhood working was progressing and raised concerns given the previous issues encountered with the Liquid Logic system.

·         In response, it was commented that from an Adult Social Care perspective any care management system such as Liquid Logic has its challenges, however it also had many benefits as it could interface with other databases and there was ongoing work around data sharing and information governance with the hospital and other community care colleagues at a local and Greater Manchester level. It was reported that there were examples across the country that had transitioned to a single database system that was working at a neighbourhood level.

·         It was reported that the new Integrated Care System arrangements provide advantages which include a much clearer understanding of the outcomes data and performance indicators that could be used across the system to measure improvements at a neighbourhood level.

·         It was requested that all reports submitted to future meetings of the Committee address the Black, Asian and Minority Ethnic sub-group specifically.

·         In relation to the partnership measures around weight management and smoking cessation, it was queried why the number of people who used the services was being measured as opposed to the number of people who had positive outcomes as a result of these services.

·         In response, Members were advised that the numbers reflected in the report in relation to smoking cessation was a measure of the successful outcomes which is the number of people who had successfully completed the course and quit smoking for at least 28 days as a result. In relation to those completing a weigh management intervention, those services work differently in respect of the decision being one of the clients where the service user sets themselves the goal and then receives support to achieve that goal.

·         In relation to the measure around the proportion of adults with a learning disability who live in their own home or with their family, it was queried why this was being measured as opposed to the number of people who were happy with where they were living.

·         In response, it was stated that the learning disability employment and independent living outcome was set nationally as part of the Adult Social Care Outcomes Framework. Over the last 12 months work was ongoing to update these at a national level as a result it was expected that a new outcomes framework would be released later in the year. It was commented that there was key evidence of achievement against the priority throughout the report in recognition that numerical data doesn’t always translate to how the outcome feels and an individual’s experience.

RESOLVED – That the report be noted.

To consider a report of the Director of Strategy.

The report includes the background and context information relating to Integrated Care Systems (ICS), including the opportunities for Stockport –

·         The Greater Manchester ICS model

·         The emerging Stockport integrated Health and Care model including;

o   The Stockport Locality Board

o   Transition arrangements for the Stockport Locality Team

o   The work of the Provider Partnership

The Scrutiny Committee is asked to comment on and note the progress that has been made and the arrangements in place.

Officer contact: Patrick McGee on 07920540167 or email: patrick.mcgee@nhs.net

The Director of Strategy submitted a report (copies of which had been circulated) providing the background and context information relating to Integrated Care Systems (ICS), including the opportunities for Stockport, the Greater Manchester ICS model, the emerging Stockport integrated Health and Care model including, the Stockport Locality Board, the transition arrangements for the Stockport Locality Team and the work of the Provider

Partnership.

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

The following comments were made/issues raised:-

·         It was queried when it could be expected that the legislation and regulations would be in place to enable the full delegation and integration of all health and social care decision making in one place.

·         In response it was stated that the delays were a result of government developing legislation as the system developed and considering the implications of how it works in practice in particular for Greater Manchester who were ahead of other regions in the arrangements that they already had in place. However, this was not a barrier to progress and development was underway to build on the partnership relations that were already well established.

·         It was queried how differences of opinions with partner organisations would be dealt with to reach a consensus.

·         In response, Members were advised that whilst discussions would sometimes be difficult and a challenge, partner organisations were unified in their objective to best serve the residents of the borough and a resolution would be found.

·         Members welcomed the consideration and noted the importance of greenspaces in terms of addressing social isolation and encouraging physical activity and requested additional information on the work taking place to maximise the use of greenspaces.

·         In response, Members were informed that ways to support individuals to access greenspaces was paramount to the initiatives. It was reported that Walkaday was a group in Stockport ran by volunteers which organised four walks a week, virtually every week of the year for varying levels of ability and was an opportunity for residents who weren’t necessarily confident going out for a walk on their own. It had been agreed that the group information would be published on the council’s website for residents to access. In addition, the Cabinet had introduced a Cabinet Member for Climate Change & Environment and Cabinet Member for Highways, Parks and Leisure Services who were passionate about improving the greenspaces and their access across the Borough.

·         It was also reported that there was a thriving voluntary and community sector contribution to support people to enjoy the greenspaces around Stockport and campaigning for improvements to these greenspaces. However, the challenge was making sure that residents were aware of these opportunities and this was a key priority to the council.

RESOLVED – (1) That the report be noted.

(2) Requested that an item relating to the roles, responsibilities and relationship of the Health & Wellbeing Board and One Stockport Health & Care Locality Board be programmed into the Scrutiny Committee’s work programme for the 2022/23 municipal year.

To consider a report of the Director of Public Health.

The Pharmaceutical Needs Assessment (PNA) looks at the current provision of pharmaceutical services across Stockport’s Health and Wellbeing Board (HWB) area, assesses whether this meets the current needs of the population and identifies any potential gaps to service delivery. The report provides Adult Social Care & Health Scrutiny Committee with an opportunity to discuss and comment on the draft 2022 PNA document and also to examine the consultation process.

The Scrutiny Committee is asked to comment on and note the report.

Officer contact: Eleanor Banister on 0161 474 2447 or email: eleanor.banister@stockport.gov.uk

A representative of the Director of Public Health submitted a report (copies of which had been circulated) providing the Pharmaceutical Needs Assessment (PNA) which outlined the current provision of pharmaceutical services across Stockport’s Health and Wellbeing Board (HWB) area, assessed whether this met the current needs of the population and identified any potential gaps to service delivery. The report provided Adult Social Care & Health Scrutiny Committee with an opportunity to discuss and comment on the draft 2022 PNA document and also to examine the consultation process.

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

The following comments were made/issues raised:-

·         It was noted that future pharmaceutical provision would be required on completion of the Woodford Aerodrome development and requested assurance that this would be considered.

·         In response, it was confirmed that this development would be kept under review and actioned as appropriate.

·         It was queried what work was being done to signpost people to the services provided by community pharmacies and what more could be done.

·         In response, Members were informed that the sector relied on a range of communication tools such as the NHS UK website to support and direct patients in the most appropriate way to meet their healthcare needs for the relevant conditions. The council was also encouraging and supporting GPs to ensure that the appropriate communications were on their practice websites and telephone systems to enable residents to consider the pharmacy option. It was also reported that ad-hoc leaflets were published and shared with residents, specifically round bank holidays, which seeks to provide information and inform people that pharmacies can be used an alternative health service when other services were temporarily closed.

·         That it would be useful to gauge feedback from colleagues in pharmacies as their workload increased in order to alleviate pressure on other health services.

·         It was queried how pharmacy services were monitored, supervised and audited.

·         In response it was stated that there was a Local Pharmaceutical Committee which meets regularly and reviews pharmacy services. Within pharmaceutical services there were different elements which commission different services. With the main pharmaceutical contracts being monitored through NHS England and their mechanisms for monitoring use partnership agencies, whereas the specialist services such as smoking cessation were commissioned through Local Authorities via a lead provider.  Where services were commissioned by the Local Authority or on behalf of the Local Authority there was performance monitoring information and systems such as Pharm Outcomes were used to record those interactions and were able to undertake audits of the records that were generated through these systems. Ongoing work with NHS England was also undertaken to assess the health system as a whole and whether people’s needs were being met. 

·         It was reported that whilst the council were unable to force pharmacies to provide services, it was their role as the commissioner of the services to support and develop the offers using their partner relationships to have positive discussions.

RESOLVED – That the report be noted.

To consider a report of the Strategic Head of Service & Monitoring Officer (Legal & Democratic Governance).

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: Georgia Latham on 0161 474 3229 or email: georgia.latham@stockport.gov.uk

A representative of the Strategic Head of Service & Monitoring Officer (Legal & Democratic Governance) submitted a report (copies of which had been circulated) setting out the planned agenda items for the Scrutiny Committee’s next meeting and any Forward Plan items.

The following comments were made/issues raised:-

·         That there was a large number of items to be programmed in the briefings/updates column and requested that these be assigned to a date of a future meeting.

·         Whether there was an update in relation to the progress of the Scrutiny Review on Ambulance Wait Times. In response, it was confirmed that the agenda had been published for the first meeting of the Scrutiny Review Panel which would take place on 27 September 2022.

·         It was reported that a number of the planned agenda items were likely to be delayed to a later meeting of the Committee due to a delay in government guidance and emerging workstreams.

RESOLVED – (1) That the report be noted.

(2) That the Strategic Head of Service & Monitoring Officer (Legal & Democratic Governance) be recommended to programme the following item into the Scrutiny Committee’s work programme for the 2022/23 Municipal Year:

·         Health & Wellbeing Board and One Stockport Health & Care Locality Board – roles, responsibilities and relationship.