Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 24 July 2012.

The Minutes (copies of which had been circulated) of the meeting held on 24 July 2012 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.

Sue Wallis, Associate Director Partnership and Engagement, Service Transformation Directorate, NHS Greater Manchester will make a presentation to update the Scrutiny Committee on the Healthier Together Programme (formerly known as the Safe and Sustainable Programme).  The ‘Healthier Together – A review of health & care in Greater Manchester Programme’ is working to develop a clinically and professionally-led strategy that puts forward options for new ways of providing health care services in Greater Manchester.

The Scrutiny Committee is invited to ask questions and make comments on the presentation.

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

Leila Williams, Director of Service Transformation, NHS Greater Manchester, attended the meeting to make a presentation on the Health Together Programme (formerly known as Safe and Sustainable), a clinically and professionally led Greater Manchester wide project to provide strategic direction for the development of hospital services to address the significant variation in service provision and outcomes across the city-region.

The presentation heighted the following issues:-

·        The vision of the Programme was ‘For Greater Manchester to Provide the best health and care in the country.

·        Key outcomes for the Programme were to:

-       Improve the health and wellbeing of people in Greater Manchester.

-       Reduce inequalities of access to high quality care.

-       Improve people’s experience of healthcare services.

-       Make better use of healthcare resources.

·        The drivers for change included the increasing  demand for healthcare, changing needs with people often having complex and multiple conditions, changing demographic profile of the population

·        Challenge to improve the quality of services and the outcomes agains the background of challenging financial situation. The emphasis would need to be on whole system change.

·        Examples of progress with the reconfiguration of services to provide centralisation across Greater Manchester, such as with Stroke services.

·        The Programme Team were seeking to have a conversation with partners, stakeholders and users to inform them of the challenges, make the case for change and help shape the proposals before the start of formal consultation.

The following comments were made/ issues raised:-

·        Improving in acute care or hospital care was closely linked to primary and community care. Residents also need to take more responsibility for their own health through lifestyle choices.

·        There was a danger inherent in any consultation of this type because the views of residents as to what the best service would look like very often would be different from the views of professionals. Care that has traditionally been provided in a hospital setting can often be seen as second rate when provided in a community setting even though it may be a significant improvement. The experience of patients using the services in a community settings often changes this perception.

·        Framing the conversation around the financial context would be a useful to help the public understand the challenge of service redesign.

·        Stockport CCG was heavily involved in the developments and would seek to link the Greater Manchester developments with local service redesign.

RESOLVED – (1) That Leila Williams be thanked for her attendance and presentation.

(2) That the Scrutiny Committee would welcome a further report or update in the Spring of 2013 following the conclusion of the first round of public consultation.

To consider a report of the Older People's Joint Commissioning Manager, NHS Stockport

The report details progress with implementing the recommendations of the ‘Dementia Services: early diagnosis and access to support’ Scrutiny Review since the review was completed in 2010. This report has been prepared at the request of the Scrutiny Committee.

The report also highlights issues arising from the recommendations of the All-Party Parliamentary Group on Dementia's report 'Unlocking diagnosis’ published in July 2012, and identifying issues for Stockport.

The Scrutiny Committee is invited to ask questions and make comments on the report and identify any areas for future work.

Officer contact: Nicole Alkemade, 0161 426 5572, nicole.alkemade@nhs.net

The Older People’s Joint Commissioning Manager, NHS Stockport, submitted a report (copies of which had been circulated) updating the Scrutiny Committee on progress with implementing the recommendations of the Committee’s Scrutiny Review ‘Dementia Services: early diagnosis and access to support’ completed in 2010. The report also highlighted issues for Stockport arising from the All-Party Parliamentary Group on Dementia’s report ‘Unlocking Diagnosis’.

Representatives of NHS Stockport, Stockport Council, Pennine Care NHS Foundation Trust and Stockport NHS Foundation Trust attended the meeting to answer questions from councillors.

The following issues were highlighted:-

·        Stockport had the second highest rate of prevalence of dementia in Greater Manchester.

·        Areas of ongoing work included improving GP reviews; supporting ex-carers; public awareness campaign planned for October 2012; working to improve the hospital experience for those with dementia.

·        Multi-organisational working had lead to many simple but significant improvements, particularly in the hospital setting, and had lead to increased emphasis on dementia with staff training.

·        There had been the opportunity to invest in staffing which had increased the range of setting where care could be delivered and significantly when patients were being discharged from hospital but also to work with patients on the ward.

·        Significant efforts were being made to work with GPs to enable them to take on the management of early stage dementia.

The following comments were made/ issues raised:-

·        The importance of the role of GPs in diagnosis, referral and management was of great significance. The earlier Review had identified GP engagement as a particular weakness, but the move toward need models of care, changes in the management of primary care services and the increased integration of primary and secondary care would help to overcome some of these difficulties.

·        There remained great variability in rates of diagnosis and referral between GP practices; targeting training and providing GP Peer Support could be considered.

·        Although relatively small investments could lead to significant improvements, it needed to be borne in mind that despite the recent investment services had remained largely static against a backdrop of increasing demand and demographic change.

·        Trying to overcome the stigma attached to dementia may encourage those with symptoms to seek a diagnosis sooner.

RESOLVED – (1) That the report be welcomed.

(2) That those involved with the improvements in dementia services identified in the report be congratulated on their achievements.

To consider a report of the Corporate Director for People.

The report provides a detailed overview of performance of Council services which fall within the remit of this Scrutiny Committee.

The information is provided in the form of the Quarter 1 2012/13 Portfolio Performance and Resources Report for the Health & Wellbeing Portfolio and the Adult Care Services Portfolio.

The Scrutiny Committee is recommended to:-

·         Review the current levels of performance;

·         Highlight key areas of, and responsibility for, taking forward corrective action to address any existing or forecast performance issues;

·         Identify how areas of strong performance and good practice can be shared in other services.

Officer contact: Katy Forde, 07527 387232, katy.forde@stockport.gov.uk

A representative of the Democratic Services Manager submitted the Portfolio Performance and Resources Reports (copies of which had been circulated) for the first quarter of 2012/13 for the Adult Care Services and Health & Wellbeing Portfolios.

The Executive Councillor (Health & Wellbeing) attended the meeting to answer questions from councillors.

The following comments were made/ issues raised:-

·        More information in future reports on care homes and their impact on health would be welcomed, particularly in light of the integration of the monitoring regimes of the NHS and the Council.

·        The increase in the rate of hospital readmission would suggest that post-discharge care may be inadequate in these case. There were concerns about the temporary closure of reablement services and the impact this may have on readmission rates.

·        The efforts to improve the transition from children to adult care services was welcomed. This work was a key issue for the People Directorate particularly overcoming the difficult funding arrangements and providing a seamless service.

·        The lack of data from the Pennine Care NHS Foundation Trust was disappointing.

·        It was intended to submit further details of the Public Health budget to the Scrutiny Committee as soon as these were available.

RESOLVED – (1) That the report be noted.

(2)That the Service Director (Adult Social Care) be requested to circulate further information about the impact of the temporary suspension of the reablement service.

(3) That the Democratic Services Manager be requested to circulate information about Anchorpoint.

To consider a report of Stockport LINk

The report summarises LINk activity occurring during the first quarter of 2012/13.

The Scrutiny Committee is invited to note the report.

Contact: Stockport LINk, 0161 477 8479, links@pebbleenterprises.co.uk

The Chair of the Local Improvement Network (LINk) submitted a report (copies of which had been circulated) summarising the activity of the LINk in the first quarter of 2012/13.

Councillors commented on the breadth of activity undertaken by the LINk.

RESOLVED – That the report be noted.

To consider a report of the Democratic Services Manager.

The Scrutiny Committee is invited to note the resume of the Shadow Health & Wellbeing Board meetings held on 11 June and 8 August 2012.

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

RESOLVED – That the resumes of the Shadow Health & Wellbeing Board Meetings on 11 June and 8 August 2012 be noted.

The Executive Councillor (Health & Wellbeing), representatives of the Council, NHS Stockport and other stakeholders to provide a verbal update on NHS Reform, as appropriate.

The interim Chief Operating Officer of the Stockport Clinical Commissioning Group attended the meeting and provided an update on the emerging NHS architecture resulting from the Health & Social Care Act 2012.

The update highlighted the key changes to the commissioning arrangements and identified significant post holders in the new Clinical Commissioning Group (CCG).

It was emphasised that the aspiration of both the Council and CCG in Stockport was to integrate commissioning arrangements for health and social care services, particularly for complex care pathways.

Comments were made about the scope for engagement with the National Commissioning Board local representative, the need to ensure this relationship was successful and the risk associated with the loss of local knowledge in commissioning.

It was also suggested that greater engagement between the CCG Locality Chairs and the Council’s Area Committee’s would be welcomed.

RESOLVED – That the update be noted.

The Department of Health (DH) has launched a consultation on local authority health scrutiny, including proposal to update the “arrangements and regulations for local authority health scrutiny and help to ensure that the interests of patients and the public are at the heart of the planning, delivery and reconfiguration of health services”.

The report attached sets out a proposed response the consultation, drafted in consultation with the chair.

The Scrutiny Committee is invited

·         to comment on and suggest amendments (if necessary) to the proposed response.

·         agree that the finalisation of the response be delegated to the Democratic Services Manager, in consultation with the Chair, for submission to the Department of Health by the 7 September 2012 deadline.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk / Gaynor Alexander, 0161 474 3186, Gaynor.alexander@stockport.gov.uk

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) setting out a proposed response to the Department of Health’s consultation on Local Authority Health Scrutiny.

RESOLVED – That the response of the Health Scrutiny Committee to the consultation on Local Authority Health Scrutiny as detailed in the report be approved for submission to the Department of Health.

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 fell within it remit.

RESOLVED – That the report be noted.