Agenda and minutes

The Minutes (copies of which had been circulated) of the meetings held on 1 November and 29 November 2011 were approved as correct records and signed by the Chair.

The following interests were declared:-

Personal Interests

The Chair reported that this would be the last meeting attended by Richard Popplewell, Managing Director of NHS Stockport and Corporate Director (Adults & Health), Stockport Council before his retirement. The Chair paid tribute to Mr Popplewell's service to the health economy in Stockport and for his support to the work of the Committee, and wished him well for the future.

There were no call-in items to consider.

Judith Morris, Director of Nursing and Midwifery (Stockport NHS Foundation Trust) will attend the meeting and make a presentation on the Foundation Trust’s Action Plan arising from the Care Quality Commission report published during the summer 2011 on dignity and nutrition for older people in hospitals.

Further details on the CQC report can be found at http://www.cqc.org.uk/public/reports-surveys-and-reviews/themes-inspections/dignity-and-nutrition-older-people

An update on the Trust’s actions to prevent a recurrence of medical product contamination will also be provided, as requested by the Scrutiny Committee at its last ordinary meeting.

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

Judith Morris, Director of Nursing and Midwifery (Stockport NHS Foundation Trust) attended the meeting and made a presentation on the Foundation Trust’s response to the Care Quality Commission’s (CQC) report ‘Dignity and Nutrition for Older People’.

Following a visit undertaken by the CQC, a number of areas for improvement at Stepping Hill Hospital had been identified around Outcome 1 ‘respecting and involving people who use services’ and Outcome 5 ‘meeting nutritional needs’of the CQC’s standards. In response the Trust had implemented an Action Plan to address these areas of concern and following a further visit by the CQC in November the feedback had been very positive.

The report and its findings had highlighted the need to ensure appropriate information was available to senior managers to ensure that where specific issues may arise these could be identified early and steps taken to prevent problems.

The following comments were made/ issues raised:-

·         The Trust had been unable to provide evidence of appropriate training on dignity and nutrition, which had now been addressed. Each ward had now had a ‘Champion’.

·         There were challenges to ensure busy staff on wards with challenging patients had sufficient time for supervision. Where senior nurses were absent it was important to ensure that appropriate additional support was available. Managing long term vacancies and absences was a challenge and was vital to ensure problems did not arise.

·         There was already a change taking place in the way food was delivered to wards, with colour coding being utilised to denote the differing levels of assistance required for individual patients to be provided by either nurses or trained volunteers.

Judith Morris also provided a brief overview of the interim response of the Trust to the recent contamination of medical products, including increasing the security of storage of saline products, ‘double handling’ within treatment rooms and increased CCTV. It was anticipated that the Strategic Health Authority would begin an inquiry following the conclusion of the Police investigation and the CQC had already indicated a number of areas for action.

The following comments were made/ issues raised:-

·         Discussions would soon take place between the Trust and the Chair of the Safeguarding Board.

·         Concern about the potential impact on the efficiency of the hospital and the cost implications of the additional security measures.

·         The incident had impacted staff morale, but the sense of ‘indignation’ amongst many staff had led to them pulling together.

·         There had been a very positive response to the challenges from all partners in the health economy.

·         The events had been exceptional, unforeseeable and potentially could have happened in any hospital. The measures implemented at Stepping Hill in response to the incident were likely to become standard practice nationally.

RESOLVED – That Judith Morris be thanked for her attendance and presentation.

To consider a report of the Service Director (Children & Child Protection)

The report seeks to brief the Scrutiny Committee on current progress to reduce under 18s conception rate and to provide an update concerning the risks identified in 2010 and how these risks have been managed. The report summarises progress towards the 2010 under 18s conception target and how the risks to the strategy identified in the last report have been managed.

The Scrutiny Committee is recommended to:-

·         note the progress in reducing the under 18s conception rate;

·         note the integrated programmes of work to manage the risks.

Officer contact: Michael Priestley, 07800 617521, michael.priestly@stockport.gov.uk

Representatives of the Service Director (Children & Child Protection) submitted a report (copies of which had been circulated) providing an update on progress in implementing the Teenage Pregnancy Strategy, in particular in achieving the under-18 conception target, and identifying the risks and challenges to the Strategy’s implementation.

The following comments were made/ issues raised:-

·         Despite concerns about the trend in conception and pregnancy rates the situation had improved. A large reduction was expected with the publication of the figures in February 2012.

·         Although there were challenges to the funding of advice and preventative services it was anticipated that many of the services would be mainstreamed in the future.

·         Evidence from the colleges in Stockport showed that where advice was offered as part of a wider pastoral support this had a positive impact on service usage.

·         Although the rates of pregnancy were highest in the Brinnington & Central Ward, there had been significant improvements made.

·         Although the Government-set target was over ambitious and was likely to be missed, significant improvements had been made.

·         Working with schools to identify those most vulnerable was vital, but it was a disappointment that more schools were not taking up the ‘relationship education’ model. Work was being undertaken to provide schools with a variety of teaching resources and models to assist them in finding the right methods to respond to the particular needs of their pupils.

·         The transfer of the Public Health function to the Council would mean it was the commissioner for all sexual health services.

RESOLVED – (1) That the report be welcomed and the progress in reducing the under-18s conception rate and the work to manage risk be noted.

(2) That the Service Director (Children & Child Protection) be requested to provide the Committee with updated figures on conception rates for Stockport once these have been published in February 2012.

(3) That the Corporate Director for People be requested to submit a report to a future meeting on progress with the Chlamydia/ HPV vaccination programme.

To consider a report of the Assistant Chief Executive (Policy, Strategy, Partnerships & Transformation)

The Draft Portfolio Priorities in relation to the Adults & Health and Children & Young People portfolios to be included within the Council Plan for 2012/13

The Scrutiny Committee is requested to comment on the draft portfolio priorities

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

A representative of the Assistant Chief Executive (Policy, Strategy, Partnerships and Transformation) submitted a report (copies of which had been circulated) setting out the draft Portfolio Priorities for the Adults & Health and Children & Young People executive portfolios to be included within the 2012/13 Council Plan.

The Executive Councillor (Adults & Health) reported that the Joint Strategic Needs Assessment and the future Joint Health & Wellbeing Strategy would provide the means for delivering on the priorities.

The following general comments were made/ issues raised on the draft priorities:

·         Increasing joint working across Council departments and between organisations would be welcomed.

·         It was important to ensure that these priorities were reflected in other strategies, particularly the emerging health strategies.

·         There was a difficult balance between providing strategic priorities and providing detail of how these would be achieved. A number of the priorities lacked substance in this respect.

RESOLVED – That the report be noted and comments be referred to the Executive for consideration in conjunction with the Draft Council Plan 2012/13.

To consider a report of the Corporate Director for People.

The report provides a summary the results of the consultation which relate to the portfolios under the remit of this Scrutiny Committee.

The Scrutiny Committee are invited to consider and comment on the consultation responses.

Officer contact: Donna Sager on 474 3928 or email donna.sager@stockport.gov.uk or Jim McMahon on 474 4800 or email jim.mcmahon@stockport.gov.uk

Representatives of the Corporate Director for People submitted a report (copies of which had been circulated) summarising the results of a range of consultations undertaken on the Executive’s saving proposals for the 2012/13 budget. The report included summaries of the consultations on the proposals within the Adults & Health and Children & Young People portfolios.

In relation to the consultation process there was discussion about the low response rate, particularly around the Children & Young People proposals, and whether any meaningful conclusions could be drawn from the responses received as in most of cases they would not be statistically significant. It was suggested that by choosing not to respond it could be inferred that those consulted (particularly parents) had no strong views on the proposals, although other members stressed caution in inferring anything by a non-response.

It was also commented that for many of the services under consideration, particularly for adults, there was little choice of alternative suppliers or providers available to users.

In relation to specific proposals the following comments were made/ issues raised:-

Transition – Children to Adults: Children’s Disability Database

·         Moving toward a system with live data was welcomed as long as capturing this data improved outcomes.

School Commissioning and Support: School Meals

·         Although the response rate was relatively low, there was likely to be disquiet amongst parents after any increase was introduced.

·         For families with two or more children, particularly those on low incomes, the proposed increase would have a more significant impact on their income.

·         It was important to maintain or improve the quality and nutritional value of school meals, particularly as this would impact children’s receptiveness to learning and every encouragement should be given to parents to take up school meals.

Streamlining Family Services

·         There had been supportive comments made by the Scrutiny Committee previously about targeting resources to those most in need of support, although it was recognised that this may cause concern to those who had benefitted from universal services in the past.

Personalisation – Transport

·         The proposed increase would be significant, particularly when considered as a two-legged journey. There was a danger that if the cost discouraged use of the service that this would lead to increased isolation and would result in individuals entering the social care system with acute needs.

Personalisation – Community Meals

·         There may be other more flexible options that could be explored for providing these services, such as through microbusinesses or community specific provision, especially in light of the personalisation agenda.

·         There was discussion about alternatives to delivered meals, including eating out at pubs which aimed at an older persons’ market, and the benefits this would have in reducing isolation.

·         Concerns were expressed that the proposed increase in the cost per meal was significantly greater than the rate of inflation.

RESOLVED – (1) That the report be noted and the comments of the Scrutiny Committee be referred to the Executive for consideration in conjunction with the Executive’s saving proposals.

(2) That the Corporate Director of People be requested to provide information to the next meeting on the level of charges for the services identified in the report comparing the charges of Stockport Council with those in comparable local authorities.

To consider an update from the Managing Director of NHS Stockport on progress with implementing NHS Reform (if any).

Officer contact: Richard Popplewell, 0161 426 5001, Richard.popplewell@nhs.net 

The Managing Director, NHS Stockport provided an update in respect of NHS Reform. The following issues were highlighted:-

·         The Health and Social Care Bill was currently with the House of Lords and enactment was expected in May 2012.

·         An integration plan was being developed for Public Health integration into the Council.

·         Clinical Commissioning Groups (CCG) were due to be fully operational by 2013. In Stockport the CCG would be heavily involved in commissioning decisions during the interim period.

·         There remained some uncertainty around the future shape of Commissioning Support Services and the shape and size of the CCG organisations.

·         Despite the uncertainty around NHS reform, the focus of the Scrutiny Committee should remain on improving outcomes.

RESOLVED – That the update be noted.

To consider a report of the Chair.

The report provides a note of the discussions at the extraordinary meeting of the Health Scrutiny Committee on 29 November 2011 on the future role of the Committee in light of ongoing reform of the NHS.

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

The Chair submitted a report (copies of which had been circulated) summarising the key themes to emerge from discussions on the future role of Health Scrutiny at the extraordinary meeting of the Scrutiny Committee held on 29 November 2011.

RESOLVED – That the report be referred to the Scrutiny Co-ordination Committee for consideration.

To consider a report of the Democratic Services Manager.

The Scrutiny Committee is recommended to note the resumes of the meetings of the Shadow Health and Wellbeing Board on 24 May and 5 October 2011.

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

RESOLVED – That the Resumes of the meeting of the Shadow Health and Wellbeing Board held on 24 May and 5 October 2011 be noted.

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 two meetings and any Forward Plan items that fell within its remit.

RESOLVED – (1) That the report be noted.

(2) That the Scrutiny Committee would welcome a report to a future meeting on the development of Allergy Services.