Agenda and minutes

To approve as a correct record and sign the Minutes of the meetings held on:-

The Minutes (copies of which had been circulated) of the meetings held on 22 and 31 January 2013 were approved as a correct record and signed by the Chair.

No declarations of interest were made.

There were no call-ins to consider.

To consider a report the Joint Commissioning Lead (Mental Health), NHS Stockport

People with learning disabilities, their carers and the Valuing People Partnership Board have expressed concerns regarding access to psychiatry for people with Learning Disabilities (LD), particularly during crises.  These concerns were brought to the attention of the Health Scrutiny Committee at its meeting on 16 October 2012.  The Committee requested further information on the issues and the actions set out for addressing them.

This report will identify the issues raised by the Valuing People Partnership Board, carers and service user representatives and set out how commissioners will resolve them.

The Scrutiny Committee is asked to discuss and note the report.

Officer contact: Gina Evans (NHS Stockport), 0161 426 9900, ginaevans@nhs.net

Joint Commissioning Lead, Mental Health, NHS Stockport, submitted a report (copies of which had been circulated) providing an update on progress with addressing the concerns raised by the Scrutiny Committee and the Valuing People Partnership Board about the level of psychiatric support available to residents with learning difficulties.

The report detailed proposed actions to improve the service provided to service users. This included:-

·         agreement in principal for the recruitment of a full time psychiatry consultant specialising in Learning Disabilities (LD) covering Stockport and Tameside;

·         re-focussing of the Learning Disability Health Multidisciplinary Team through the recruitment of specialists and providing greater clinical leadership through the LD consultant  to ensure greater focus on assessment, interventions and specialist support;

·         development of a Crisis Response Unit;

It was stated that these changes were in advance of the wider service changes likely to arise from the ‘Making Choices Having Control’ review of disability services.

The Chair reported that he and Councillor Porgess had received correspondence from service users and their carers in relation to the services under discussion.

Councillors asked questions and made comments including:-

·         There were particular problems encountered by service users with autism and related conditions, particularly when having to access services and assessments in Sheffield. There was work ongoing to redesign certain elements of the Autism Service to make them more suited to client need as previous provision, such as the crisis service had not been well used. Many of the concerns raised about autism would be the subject of further work around this service.

·         An increased focus on early intervention was welcomed and progress had been made since the matter was considered in October 2012. The recruitment of a specialist LD Psychiatry consultant would assist in increasing capacity although it was recognised that this was a very specialist field and recruitment may be a challenge.

·         There were plans for greater joint working and commissioning around disability services more generally.

RESOLVED – (1) That the report and progress with enhancing the provision of Learning Disabilities Psychiatry be welcomed.

(2) That the Joint Commissioning Lead, Mental Health, NHS Stockport be requested to submit a further report to the relevant Scrutiny Committee in 12 months’ time outlining progress with the proposed changes to the provision of Learning Disabilities Psychiatry and the impact on outcomes.

(3) That the issues connected with the provision of Learning Disabilities Psychiatry be referred to the appropriate Executive Councillors and the Health & Wellbeing Board.

To consider a report of the Service Director (Strategy & Performance)

The purpose of this report is to provide a detailed overview of the performance relating to the Health Scrutiny Committee. The individual Portfolio Performance and Resources Report for the Health & Wellbeing Portfolio is enclosed.

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: Donna Sager, 0161 474 3928, donna.sager@stockport.gov.uk

The Service Director (Transformation & Commissioning) submitted the Health & Wellbeing Portfolio Performance and Resource Report (copies of which had been circulated) for the third quarter of 2012/13.

The following comments were made/ issues raised:-

·         Clarification was sought on the responsibilities for school nursing and immunisation/ screening in schools and the relationship between the two services. It was stated that school nursing would be commissioned locally with immunisation being commissioned by Public Health England.

·         In response to a question it was stated that rates for MMR vaccinations had improved since the previous drop, but that coverage was a concern and may be leading to increased rates of measles. The CCG would commission catch up immunisations through GPs.

·         Concerns were expressed about the upward trend in adult safeguarding meetings.

RESOLVED – (1) That the third quarter Health & Wellbeing Portfolio Performance and Resources Report be noted.

(2) That the Democratic Services Manager be requested to invite representatives of Public Health England to a future meeting to discuss their activity in Stockport.

(3) That the Service Director (Adult Social Care) be requested to provide further clarification of the increase in adult safeguarding meetings.

To consider a report of the Corporate Director for Corporate and Support Services.

The Executive Councillor (Supporting Communities) submitted a report (copies of which had been circulated) setting out the background to the Medium Term Financial Plan that had informed the recent decision on the 2013/14 budget. The report also detailed the proposed savings that fell within the remit of the Health Scrutiny Committee, namely Public Health transition.

The Director of Public Health emphasised that the proposals contained in the report had been developed to improve health outcomes for Stockport residents.

RESOLVED – (1) That the report be noted.

(2) That the Medium Term Financial Plan Executive Savings proposals in respect of Public Health transition be supported.

The Executive Councillor (Health & Wellbeing), representatives of the Council, NHS Stockport, Stockport Clinical Commissioning Group and other stakeholders to provide verbal updates on NHS reform, as appropriate.

The Service Director (Transformation & Commissioning) and Deputy Director of Public Health reported that the approach to Public Health transition had been approved by the Executive; that the Appointments Committee had approved the appointment of senior Public Health officers and that the staff and contract transfer documents would be signed by the end of the month.

The Chief Operating Officer and the Director Service Reform, Stockport Clinical Commissioning Group (CCG), attended the meeting and made a presentation on the ongoing service redesign work taking place at the CCG, including the Stockport One project, which was being developed in conjunction with other public sector partners including the Council and NHS Foundation Trusts, and would bring together staff from these organisations to provide more appropriate care for older people with complex needs to improve outcomes and reduce costly interventions.

The following comments were made/ issues raised:-

·                The development of Stockport One sought to build on existing partnership working, but was iterative and adaptable. It was not a ‘pilot’, it represented a change in approach to the delivery of care and services that was taking place. It also needed to be seen in the context of the wider reform agenda.

·                Models were being developed to demonstrate the costs and savings of the new approach.

·                Reducing the burden of collecting and storing data from a range of similar assessments was welcomed, although it was recognised that there were challenges to overcome in the differing language and cultures of each organisation.

·                The involvement and commitment of partners was welcomed as this would help in the sustainability of new delivery models. Integrating teams would hopefully avoid cost shunting between partners.

RESOLVED – (1) That the update be noted and officers be thanked for their attendance and presentation.

(2) That progress with the implementation of Stockport One be welcomed and the approach to service reform be endorsed.

To consider the final report of the Health Scrutiny Committee.

This is the final report of the Scrutiny Committee’s review of Mental Health, carried out since October 2012.

The Scrutiny Committee is invited to adopt the final report.

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

A representative of the Democratic Services Manager submitted the final report of the Scrutiny Committee’s review of mental health (copies of which had been circulated) for approval.

Suggested additional references suggested by the Director of Public Health in relation to mental wellbeing were circulated.

RESOLVED – That the final report of the Scrutiny Committee’s review of mental health be approved subject to the following further amendments:-

·         The title being “No Health Without Mental Health: the Stockport Way”;

·         The inclusion of additional comments about mental wellbeing;

·         The inclusion of a list of contributors; and

·         The provision of a summary of recommendations.

To consider a report of the Democratic Services Manager.

The report provides a summary of the discussions and conclusions of the workshops held at the Public Health/ Health Promotion event held at the last Health Scrutiny Committee meeting on 22 January 2013.

The Scrutiny Committee is recommended to note the report.

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) summarising the outcomes of the workshops held at the Health Promotion event at the Scrutiny Committee held on 22 January 2013.

RESOLVED – That the report be noted and the outcomes be referred to the Health & Wellbeing Board.

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 its remit.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to invite a representative of local Dentists to a future meeting.