Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 19 July 2016.

The Minutes (copies of which had been circulated) of the meeting held on 19 June 2016 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

To report any urgent action taken under the Constitution since the last meeting of the Executive.

Members of the public are invited to put questions to the Chair and Executive Councillors on any matters within the powers and duties of the Executive, subject to the exclusions set out in the Code of Practice.  (Questions must be submitted no later than 30 minutes prior to the commencement of the meeting on the card provided.  These are available at the meeting. You can also submit via the Council’s website at www.stockport.gov.uk/publicquestions)

Members of the public were invited to put questions to the Executive on any matters within its powers and duties, subject to the exclusions set out in the Code of Practice.

Two questions were asked.

(1)   The first question asked whether the Executive Councillor (Health), in light of the role of the Health & Wellbeing Board and his own role as its chair, shared the concerns expressed by the North West Regional Director of the Royal College of Nursing, as reported in the Stockport Express on 3 August 2016, that the proposed cost reduction measures by the Stockport NHS Foundation Trust would impact on patient care, create uncertainty for staff and increase waiting times; and whether the Executive Councillor would recommend that the Council Meeting opposes ward and bed closures and staff cuts?

In response the Executive Councillor (Health) acknowledged the points made about the role of the Health & Wellbeing Board in improving health and wellbeing in Stockport and seeking to secure improvements in health and social care services, but highlighted the specific challenges of ensuring an ageing population remained healthy, and healthy for longer, while reducing inequalities that existed across the borough. He stressed the importance of prevention and early invention to make best use of resources that were reducing year on year. He also acknowledged the wider challenges for the health and social care economy of suitable care provision and the delays in discharge from hospital.

The Executive Councillor than addressed the points raised by the Royal College of Nursing highlighted in the question:-

·           In relation to the closure of the B3 Ward, he stated that his understanding was that closure of this ward was a seasonal occurrence and was part of normal hospital operations.

·           He agreed that year on year reductions in resources across the NHS was putting additional pressures on the local Trust and on others, and was a challenge also facing the Council.

·           He reiterated the point already made about an ageing population locally but also highlighted that as well as a general increase in age, there were increasing numbers of the very old who had particular needs.

·           Rising demand at the hospital needed to be addressed as Stockport was a significant outlier in relation to the number of patients attending A&E and then being admitted.

·           He accepted the staff and trade unions had understandable concerns, but stated that the current situation could not continue. He added that he understood the Trust had been seeking to engage staff and other in a ‘conversation’ about the future direction of the Trust.

The Executive Councillor stated that since he was not part of the management of the Trust, and these matters were mostly outside the ability of the Council to influence, he could not unequivocally oppose the measures, but gave an assurance he would continue to seek to work with the Trust to make best use of resources both parties had, and to engage with the Government to seek to redress the funding shortfall.

(2)   That second question asked whether the Executive Councillor (Health), in light of role of the Health & Wellbeing Board and his own role as its chair, agreed with the view expressed by the Chief Executive of Stockport Healthwatch, as reported in the Stockport Express on 3 August 2016, that the failure of the Stockport NHS Foundation Trust Board to consult with patients and patients groups was ‘an outrage’; and whether the Executive Councillor would ensure that details of the jobs at risk and the impact and risk assessments relating to the these proposals were published.

In response the Executive Councillor (Health) stated that the requests for information were matters for the Trust’s management and not something the Council could influence. The Executive Councillor undertook to write to the Chief Executive of the Trust to ask for the release of this information.

The Executive Councillor further stated that the challenges with funding at  ...  view the full minutes text for item 4.

Representatives of Stockport NHS Foundation Trust have been invited to the meeting to answer questions from members of the Executive about their Financial Improvement Programme.

The Leader of the Council welcomed to the meeting Ann Barnes (Chief Executive) and James Sumner (Deputy Chief Executive) of the Stockport NHS Foundation Trust who had agreed to attend to answer questions from the Executive about the Trust’s Financial Improvement Programme to address their financial deficit, and the impact recent announcements were likely to have on Stepping Hill Hospital.

The Executive asked a number of questions and received responses. The issues covered included:-

The background to the financial deficit at the Trust and the reasons for the measures proposed

Most NHS Foundation Trusts were operating with a deficit, and the local causes were due to reductions in tariffs paid for activity and the challenge of stemming rising demand at the hospital. Although a number of innovative schemes had been developed to improve care, these had not been successful at preventing the rise in attendances and admissions that was reflective of a national trend.

As 71% of the Trust’s costs were associated with staffing, this area would need to be considered in order to achieve the saving needed, but the aim was to approach reductions on a voluntary basis. It was not known at this stage where redundancies might occur until a panel of senior Trust Managers and clinicians had assessed every application, including its potential impact on patient care.

Press reports that the number of potential redundancies was 410 were inaccurate as the Trust was planning for no more than 350, with the expectation of less should other cost reduction activity achieve the savings needed.

Potential impact of the bed closures and speed of implementation after announcement

The closure of the bed capacity was not unusual in the summer months as there was less demand for elective operations and less need for orthopaedic beds due to seasonal decline in fractures. The Trust had consolidated a number of unused elective beds which allowed for a ward closure, which would have closed in October in any case. Every decision to close beds is subject to a clinical assessment against a set of nationally prescribed criteria. NHS Improvement (the NHS Regulator) had assessed the Trust’s proposals and found them to be robust.

Extent to which closures were seasonal, reversible or part of the Financial Improvement Plan

Clarification was provided that what had taken place was a reduction as had been done in the past, not the stopping of a service, in advance of the service moving to the new surgical centre. Analysis had indicated that the bed closures had made no impact on A&E waiting times. A benefit that had been overlooked in the press was that the closure of a ward allowed staff to be redeployed onto other wards.

Whether communications with patients and staff had been appropriate

Contextually, the voluntary redundancies and bed closures amounted to 20% of savings challenge for the Trust, with the remaining 80% from improvements in other area. The NHS regulator required the Trust to resolve its funding gap this year, including the use of temporary funding, which would allow the Trust to better participate in the Stockport Together programme.

The measures being discussed were not service changes, and should be imperceptible to patients. The Trust had designed a consultation and communication plan based on previous feedback from staff, and had initially met with 200 line managers to explain the situation, and tasked them with communicating directly with their staff, but once the initial briefings had taken place it was difficult to control the sharing of information. Stakeholders were also informed promptly after this initial round.

The Stockport Together programme had highlighted the funding deficit in health and social care, and the financial challenges facing the Trust and the Financial Improvement Programme had also been the subject of public discussion at Scrutiny etc.

What the worst case scenario would be should the Trust not be able to contain costs and reduce demand

The future of  ...  view the full minutes text for item 5.

To consider a report of the Leader of the Council (Policy, Finance and Devolution)

The First Update Corporate Performance and Resource Report (CPRR) provides an overview of progress in delivering the Council’s Priority Outcomes and budget during the first quarter of 2016/17. It is the first report based on the new Council Plan 2016/17 and the Medium Term Financial Plan 2016/19, and also reflects the new Executive Portfolios and priorities.

Updates are included on delivery of policy priorities, alongside Reform Project updates. The report also includes forecast budget and performance data where this is available, along with an update on the refreshed Corporate Risk Register. It is supported by seven Portfolio Performance and Resource Reports which were considered by the most recent Scrutiny cycle.

The Leader’s Report highlights a number of the Council’s significant achievements over the last quarter, including significant decisions at GM level.

The Executive is asked to;

a)    Review progress against delivering the Council Plan, priority outcomes and capital schemes alongside budget and performance forecasts contained within the report;

b)   Identify key areas for further investigation and responsibility for taking forward corrective action to address any existing or forecast issues or risks;

c)    Approve the virements to the Revenue Budget set out in section 2.2.3;

d)   Note the cash limit and non-cash limit forecast positions for 2016/17 as set out in sections 2.3 and 2.6;

e)    Note the position on the 2016/17 budget savings programme set out in section 2.4;

f)     Note the Retained Schools Budget and Housing Revenue Account forecast positions as set out in sections 2.7 and 2.8;

g)   Approve the contributions to/from earmarked reserves and balances as set out in section 2.9 and note the forecast reserves and balances position;

h)   Note the forecast position for the 2015/16 Capital Programme as set out in section 3.1;

i)     Approve the changes to the Capital Programme as set out in 3.1.5;

j)     Approve the proposals for resourcing the Capital Programme as set out in 3.3.3, and;

k)    Note the treasury management review and activity during the first quarter as set out in section 4.

Officer contact: Steve Skelton/ Michael Cullen, 0161 474 3174 / 0161 218 1032, steve.skelton@stockport.gov.uk / Michael.cullen@stockport.gov.uk

The Leader of the Council (Policy, Finance and Devolution) submitted a report (copies of which had been circulated) providing the Executive with a report on the delivery of the Council’s Priority Outcomes and budget during the first quarter of 2016/17. The report was based on the Council Plan 2016/17 and the Medium Term Financial Plan 2016/19 and reflected the new Executive Portfolios and priorities.

The Leader’s Report for first quarter of 2016/17 was also included within the report and summarised decisions at Greater Manchester level.

The Leader of the Council highlighted the recent announcement of the award of £19m from the Transformation Fund to Stockport to support the development of new models of care; the £700,000 allocated for investment in parks and greenspaces; the intention to explore using resources to reduce borrowing costs and increasing income in order to safeguard vital public services; ongoing work following the June 2016 flooding.

The Executive Councillor (Children & Family Services) highlighted that the increasing spend on secure accommodation was subject to monthly monitoring; and that an independent audit of Child Protection Plans and referrals had confirmed the appropriateness of those decisions, which provided assurance that children were not being put at risk.

The Executive Councillor (Communities & Housing) reported that good progress was being made in establishing a housing company to deliver affordable housing in Stockport; and that work was ongoing to establish a housing commission to provide overarching governance for the housing strategy and to ensure that Stockport could realise the benefits of Greater Manchester activity.

RESOLVED – That in relation to the Corporate Performance and Resources First Update Report 2016/17:-

·         progress against delivering the Council Plan, priority outcomes and capital schemes alongside budget and performance forecasts contained within the report be noted;

·         the virements to the Revenue Budget set out in section 2.2.3 of the report be approved;

·         the cash limit and non-cash limit forecast positions for 2016/17 as set out in sections 2.3 and 2.6 of the report be noted;

·         the position on the 2016/17 budget savings programme set out in section 2.4 be noted;

·         the Retained Schools Budget and Housing Revenue Account forecast positions as set out in sections 2.7 and 2.8 of the report be noted;

·         the contributions to/from earmarked reserves and balances as set out in section 2.9 of the report be approved and the forecast reserves and balances position be noted;

·         the forecast position for the 2015/16 Capital Programme as set out in section 3.1 of the report be noted;

·         the changes to the Capital Programme as set out in 3.1.5 of the report be approved;

·         the proposals for resourcing the Capital Programme as set out in 3.3.3 of the report be approved, and;

·         the treasury management review and activity during the first quarter as set out in section 4 of the report be noted.

To consider a report of the Executive Councillor (Reform & Governance)

The purpose of this report is to provide an overview of complaints, as at the1^st quarter (April - June) 2016/17.

Executive is asked to:

·         Review performance information contained in this report, and

·         Comment on the performance measures reported and suggest any additional information that might be collected in future.

Officer contact: Anwar Majothi, 0161 474 3182, anwar.majothi@stockport.gov.uk

The Executive Councillor (Reform & Governance) submitted a report (copies of which had been circulated) providing the Executive with an overview of complaints received in the first quarter of 2016/17 and outlining any lessons learnt as a consequence.

RESOLVED – That performance in relation to complaints received in the first quarter of 2016/17 be noted.

To consider a joint report of the Executive Councillors (Adult Social Care) and (Health).

The report sets out the draft business case of the integrated model of care developed through the Stockport Together process, a collaboration between the Council, Stockport Clinical Commissioning Group, Stockport NHS Foundation Trust, Pennine Care NHS Foundation Trust and Viaduct Health (representing GPs in Stockport).

The collective vision of Stockport Together is for a sustainable health & care system for the people of Stockport delivering improved health outcomes, reduced health inequalities, greater independence and a lower need for bed-based care. To achieve this it is proposed to deliver new forms of care to specific cohorts of the population through a new form of organisation constructed from the GP registered list at neighbourhood level and incentivised by a new form of commissioning. The model of care will ultimately serve the whole population.

The business cases introduced here will specifically focus on the GP registered adult population (243,000 people) and the new forms of care proposed to deliver sustainability and improved outcomes. These new forms of care are collectively known as the Integrated Service Solution.

These proposals will be considered through the appropriate governance arrangements of each of the partner organisations.

The Executive is asked to

•        approve the approach to business case approval described in Section 3 of the Business Case Introduction document

•        approve the summary clinical model described in Section 3 of the Business Case Introduction document.

•        note the overall summary financial plan as described in Section 5 of the Business Case Introduction document subject to agreement of the final Business Cases in the context of the Council budget for the year in question.

•        note and further develop the approach to Consultation in Section 6.5 of the Business Case Introduction document.

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

A joint report of the Executive Councillors (Adult Social Care) and (Health) was submitted (copies of which had been circulated) inviting the Executive to consider a draft business case for the creation of the integrated model of care being developed through the Stockport Together process, a collaboration between the Council and local NHS partners. The collective vision set out in the draft business case set out a collective vision for a sustainable health and social care system for people in Stockport.

The Executive Councillor (Health) provided an overview of the business case and the background to the development of the Stockport Together programme and the financial challenges facing the health and social care economy.

The Executive Councillor (Adult Social Services) highlighted the importance of governance and accountability, the need for consultation with residents and patients, and concerns that had been raised at scrutiny committees about variability in services between the proposed neighbourhood models.

RESOLVED – That in relation to the Stockport Together Overview Design Business Case and appendices:-

·           the approach to business case approval described in Section 3 of the Business Case Introduction document be approved;

·           the summary clinical model described in Section 3 of the Business Case Introduction document be approved;

·           the overall summary financial plan as described in Section 5 of the Business Case Introduction document be noted, subject to agreement of the final Business Cases in the context of the Council budget for the year in question; and

·           the approach to Consultation in Section 6.5 of the Business Case Introduction document be noted and further developed.

To consider a joint report of the Leader of the Council (Policy, Finance & Reform) and the Executive Councillor (Communities & Housing)

The Safer Stockport Partnership (SSP) is Stockport’s statutory Community Safety Partnership. It has responsibility for reducing crime and disorder, substance misuse and re-offending.

The Partnership has refreshed its strategic plan, outlining key themes and priorities, and aligning to the wider priorities of the GM Police and Crime Commissioner (PCC), as well as the Strategic Plans of the partners involved in the SSP.  This plan will cover the period up to and beyond the 2017 GM Mayoral election, after which the newly-elected GM Mayor will take on responsibility for the OPCC, and a wider review of priorities is expected to be commissioned.

The Executive is asked to approve the draft SSP Plan for submission to the Council Meeting on 15 September 2016.

Officer contact: Steve Skelton, 0161-474-3174, steve.skelton@stockport.gov.uk

A joint report of the Leader of the Council (Policy, Finance & Devolution) and the Executive Councillor (Communities & Housing) was submitted (copies of which had been circulated) inviting the Executive to consider the draft Safer Stockport Partnership Strategic Plan prior to consideration by the Council Meeting. The Plan outlined the key themes and priorities for the Partnership, and aligned with member organisation’s own strategic plans.

Changes to the neighbourhood policing model, including the reopening of local police stations were highlighted, and the intention to engage with area committees.

RESOLVED – That the Council Meeting be recommended to approve the Safer Stockport Strategic Plan.

Leader of the Council (Policy, Finance & Devolution) and Executive Councillor (Reform & Governance)

The Medium Term Financial Plan Update provides two reports.  The first report proposes a realignment and consolidation of the Council’s reserves and the development of a Reserves Policy which will align the reserves to the Council’s corporate and strategic priorities over the MTFP.  The report also outlines the principles of a summer review of the Council’s Medium Term Financial Plan (MTFP) considering the current key assumptions underpinning the financial forecasts and whether these are still appropriate. 

The second report outlines the principles that will frame how the Executive engages with residents and businesses to inform how it proposes to address the severe financial challenges being imposed on Stockport by central Government.

In relation to the first report, the Executive is recommended to:-

·         consider a MTFP summer review being completed with updates to the MTFP to be reported back to the Executive in October;

·         note that the Council will need to complete and submit an Efficiency Plan to DCLG by 14 October to accept the four year settlement;

·         note the outcomes of the Borough Treasurer’s review of reserves; and

·         consider the proposed 2016/17 Reserves Policy.

In relation to the second report, the Executive is recommended to:-

·         request a summer review of the assumptions underpinning the MTFP;

·         engage with all councillors on the approach outlined above through Scrutiny and Area Committees and other local structures;

·         request that Area Committees encourage and provide opportunities for the public to comment on the underpinning principles in the public engagement part of the agenda;

·         request officers to continue to develop a programme based on the framework outlined, in response to the MTFP; and,

·         request comments from the next Scrutiny cycle on the proposed reserves policy.

Officer contact: Michael Cullen, 0161 474 4631, michael.cullen@stockport.gov.uk

The Leader of the Council (Policy, Finance & Devolution) submitted two reports (copies of which had been circulated), the first proposing a realignment and consolidation of the Council’s reserves and development of a Reserves Policy, as well as the principals for a summer review of the current assumptions underpinning the Medium Term Financial Plan. The second report set out the principals that would frame how the Executive would engage with stakeholders about how it proposes to address future financial challenges.

The Leader of the Council highlighted the significant financial challenge the Council continued to face and the need to set a balanced budget next year, while being cognisant of the needs of future years. He emphasised the need to consult with councillors and stakeholders to develop those proposals and provide a fair and transparent process through which difficult decisions would be taken.

The Leader also highlighted the changed approach to budget proposals this year, with proposals only being published once the detail and implications had been considered; the development of a policy on financial reserves that allowed the Council to make best use of its resources while taking a long term view; the offer of a four-year budget settlement from the Government subject to the submission of an efficiency  which would allow the Council to better plan for the likely loss of Revenue Support Grant.

RESOLVED – (1) That in relation to the Medium Term Financial Plan Update:-

·         approval be given to a Medium Term Financial Plan (MTFP) summer review being completed with updates to the MTFP to be reported back to the Executive in October;

·         the need for the Council to complete and submit an Efficiency Plan to DCLG by 14 October to accept the four year settlement be noted;

·         the outcomes of the Borough Treasurer’s review of reserves be noted.

·         the proposed 2016/17 Reserves Policy be noted.

(2) That in relation to the Addressing the Medium-Term report:-

·         a summer review of the assumptions underpinning the Medium Term Financial Plan be requested;

·         all councillors be engaged on the approach outlined above through scrutiny and area committees and other local structures;

·         that area committees be requested to encourage and provide opportunities for the public to comment on the underpinning principles in the public engagement part of their agendas;

·         officers be requested to continue to develop a programme based on the framework outlined, in response to the Medium Term Financial Plan; and,

·         comments be sought from the next Scrutiny cycle on the proposed Reserves Policy.

To consider a report of the Executive Councillor (Reform & Governance)

The report provides an update on plans for the Council to procure some framework contracts to deliver construction works, particularly for works relating to capital projects and schools which are not capable of being delivered under the Alliance Agreements with Carillion.

The Executive is asked to

·         approve the progression of the procurement in conjunction with STAR;

·         note that the award of each of the three framework contracts is to be reported to the Executive with a recommendation to delegate authority to the Borough Treasurer to finalise and agree the frameworks following consultation with Executive Member for Reform and Governance

·         approve the recommendation to delegate authority of subsequent call-off contracts under the frameworks to the Deputy Chief Executive or Borough Treasurer in consultation with the Executive Councillor (Reform & Governance).

Officer contract: Murray Carr, 0161-474-3019, murray.carr@stockport.gov.uk

The Executive Councillor (Reform & Governance) submitted a report (copies of which had been circulated) inviting the Executive to consider an update on proposals to procure some framework contracts to deliver construction works, particularly relating to capital projects and schools, that were not able to be delivered under the Alliance Agreement with Carillion.

RESOLVED - That in relation to the Multi-Disciplinary Design Frameworks:-

·           the progression of the procurement in conjunction with STAR be approved;

·           the award of each of the three framework contracts be reported to the Executive with a recommendation to delegate authority to the Borough Treasurer to finalise and agree the frameworks following consultation with Executive Councillor (Reform & Governance);

·           authority be delegated to the Deputy Chief Executive or Borough Treasurer in consultation with the Executive Councillor (Reform & Governance) of subsequent call-off contracts under the frameworks; and

·           officers be requested to submitted a further update report to the Executive prior to final appointments to the frameworks.

To consider a report of the Executive Councillor (Reform & Governance)

The purpose of this report is to update the on progress with the Estates workstream which forms part of the Enabling Better Care priority of the Greater Manchester Health and Social Care Strategic Plan. In particular it recommends for Stockport Council to approve its participation in the Memorandums of Understanding (MoUs) detailed in the report.

The Executive is asked to approve the MOUs to enable Greater Manchester to work with local partners and Central Government to enable local partners to effectively deliver the estates strategy.

Officer contract: Murray Carr, 0161-474-3019, murray.carr@stockport.gov.uk

The Executive Councillor (Reform & Governance) submitted a report (copies of which had been circulated) inviting the Executive to consider proposed Memoranda of Understanding (MoUs) between Greater Manchester local authorities and NHS bodies that had been developed as part of the Estates workstream of the Enabling Better Care Priority of the Greater Manchester Health & Social Care Strategic Plan. The MoUs would provide a framework to deliver an estates strategy to support health and social care reform.

RESOLVED – That the ‘Memorandum of Understanding – Estates between Greater Manchester and National Bodies’ and the ‘Memorandum of Understanding between GM Bodies – Estates’ be approved to enable partners in Greater Manchester to work together and with Central Government to enable effective delivery of the estates strategy.

To consider a report of the Leader of the Council (Policy, Finance and Devolution)

The Executive is invited to note the decisions of the Greater Manchester Combined Authority (GMCA) and the joint AGMA/ GMCA meetings held on 29 July 2016.

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

The Leader of the Council (Policy, Finance & Devolution) submitted a report (copies of which had been circulated) setting out decisions taken by the Greater Manchester Combined Authority & AGMA Executive Board Joint Meeting and the Greater Manchester Combined Authority meeting held on 29 July 2016.

The Leader of the Council highlighted the following issues that had been discussed:-

·         The outcome of the Joint Scrutiny Pool Task and Finish Group on Education, Employment and Skills.

·         The significant pilot on business rates retention.

·         Growth Deal 3 proposals

·         Transport for the North and the impact of devolution.

·         An evaluation of the Greater Manchester Road Activity Permit Scheme (GMRAPS)

·         Efforts to increase participation of young people in education, skills training and employment and reducing the number considered NEET

·         The Memorandum of Understanding between the GMCA, NHS Partners and Sports England to increase participation and activity as a means to prevent ill-health.

RESOLVED – That the report be noted.

On:-

(a)  Matters (if any) referred to the Executive Meeting

(b)  Any called-in Executive Decisions

There were none.