Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 21 January 2014.

The Minutes (copies of which had been circulated) of the meeting held on 21 January 2014 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 Interests

There were no call-in items to consider.

Representatives of NHS England will attend the meeting to provide an overview of the arrangements for the commissioning of dental services since the reorganisation of the NHS in April 2013, highlighting any issues for Stockport.

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

Rose Peeling (Dental Commissioning Manager) Laura Browse (Head of Primary Care) and Nell Smith (Dental Adviser) from NHS England Local Area Team, attended the meeting to provide the Scrutiny Committee with an overview of dental services and commissioning in Stockport since responsibility passed from the Primary Care Trust to NHS England in April 2013.

The presentation highlighted the following areas:

·         Overall, oral health in Stockport was good. A recent survey of 5 year-olds found that oral health for this age group in Stockport was the best in the North West. There was a correlation between poor dental and oral health and deprivation.

·         A recent pilot to promote awareness of the importance of baby/milk teeth and to encourage more regular check-ups, had proved successful and this was being rolled out more widely.

·         In Stockport there was approximately 58% take-up of dental services, which reflected rates across Greater Manchester. Many people only visited the dentist when they were in need, rather than for regular check-ups.

·         An initiative was planned to promote gum health, working with other partners. This was the biggest cause of tooth loss in adults and was linked to other health complications.

·         In relation to orthodontic activity, there was a centralised Greater Manchester referral system for specialist services that made better use of resources and prevented duplication. There remained a challenge to reduce the number of inappropriate referrals made for these specialist services.

Councillors asked questions and made comments. The following comments were made/ issues raised:-

·         Questions were asked about perceived difficulties for accessing NHS Dentistry Services, particularly in areas of deprivation, and the impact of this on children and young people in particular. In response it was stated that access was generally good in Stockport, and that delays were often only experienced by those who were in need of urgent care. NHS England worked closely with dentists to create capacity. NHS England would seek to commission services in areas of greatest need.

·         Previous dentistry contracts encouraged greater frequency of check-ups as this generated income for the practice. Since 2006 the new contract gave greater emphasis to appointments based on need. Although people were used to 6-monthly check-ups, if they had good oral health, they need not be as frequent.

·         The Public Health Service worked with local schools and the Bridgewater Community Healthcare NHS Trust (which provided community dental services) to promote oral health, and this tended to be targeted to areas of highest need. Outreach work, such as undertaken by GPs, was not practical for dentists due to the equipment needed, and previous efforts to engage hard-to-reach groups tended not to result in follow-ups at the dentist surgery. Children’s attendance was often linked to parents, so targeting one should impact the other.

·         As in the NHS generally, there was scope to improve preventative activity to mitigate the need for more expensive interventions later. For example, the use of dentures was the cheapest solution to systematic tooth decay, but encouraging better oral health would prevent the need for dentures at all. Dentistry was also a useful source of identifying other serious medical conditions and had a wider preventative impact.

·         The public could get details of dentists via the NHS Choices website. Quality was monitored by NHS England (as the commissioner) but also be the Care Quality Commission and this information was available on their website.

·         There was a correlation between spend on dental services and fluoridation of water, and the variation could be significant. Locally, every effort was made to enrich products with fluoride. The issue of water fluoridation was an emotive subject for many people.

The Scrutiny Committee welcomed the work being done by NHS England and dentists locally and the reassurances given in relation to access to NHS Dental Services.

RESOLVED – That Rose Peeling, Laura Browse and Nell Smith be thanked for their attendance and presentation.

To consider a report of the Deputy Chief Executive.

The Director of Public Health presented the Public Health Report to the Executive on 11th February 2014. The report included a series of recommendations to the Executive. The attached report presents a response to each of the recommendations outlining those areas which the Executive endorses. Each of the responses includes a section that details how work will be taken forward in order to expedite the recommendations.

The Scrutiny Committee is asked to receive the report and provide any additional comments.

Officer contact: Gaynor Alexander, 0161 474 3184, Gaynor.alxander@stockport.gov.uk

The Democratic Services Manager submitted a report of the Deputy Chief Executive (copies of which have been circulated) setting out the draft Executive response to the recommendations of the Director of Public Health contained in his 21^st Annual Report. The document also included a response from Stockport Homes to those recommendations which had a bearing on its activities. The report would be submitted to the Executive Meeting on 18 March 2014 for adoption.

Councillors discussed the report and the following comments were made/ issues raised:-

·         Effectiveness of signage, particularly in public places, advising people not to smoke. Members discussed whether such signs would deter smoking around play areas or whether they would be ignored and become a target for vandalism. Members pointed to the example of signs outside schools in Merseyside that had succeeded in deterring smoking at the school gates. Engaging young people in the campaign would give it more impetus and ownership and discourage vandalism of signs etc. Using child-designed signs/ community art could be effective at modifying a range of behaviours, including parking outside schools.

·         Councillors discussed the role for the Council in lobbying for legislative change in connection with Minimum Unit Pricing for alcohol and plain packaging for tobacco products. It was emphasised that the Council should use all the means it had to lobby for change and curb the worst excesses.

·         Councillors emphasised the importance of Sex and Relationship Education (SRE), and the need for schools to share best practice and to avoid an overly narrow focus on biology at the expense of relationships, as had been recommended in a previous Scrutiny Review of the matter. The role of SRE in developing resilience in young people to protect against sexual exploitation was emphasised.

RESOLVED – (1) That the Executive be recommended to adopt the response, as detailed in the report, to the recommendations of 21^st Annual Report of the Director of Public Health.

(2) That Stockport Homes be commended for their commitment in providing a response to the recommendations of 21^st Annual Report of the Director of Public Health.

(3) That the Deputy Chief Executive and the Director of Public Health be requested to report back to the Scrutiny Committee in 12 months on progress with implementing the response to the recommendations of 21^st Annual Report of the Director of Public Health.

To consider a verbal update of the Deputy Director of Public Health.

The Deputy Director will update the Scrutiny Committee on work to implement the ‘Making Every Contact Count’ (MECC) approach in Stockport. MECC encourages conversations based on behaviour change methodologies (ranging from brief advice, to more advanced behaviour change techniques), empowering healthier lifestyle choices and exploring the wider social determinants that influence all of our health.

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

The Deputy Director of Public Health informed the Scrutiny Committee of a national initiative ‘Making Every Contact Count’ that encouraged conversations between public facing staff and the public about behaviour change to elicit healthier lifestyle choices. Prior to the roll-out of the training to Council Staff, the Scrutiny Committee was invited to participate in a training pilot.

RESOLVED – That the Deputy Director of Public Health be requested to arrange training on ‘Making Every Contact Count’ for Health & Wellbeing Scrutiny Committee members for after the 2014 election, and that arrangements be made to invite any former members of the committee, regular substitute members and councillors retiring in 2014.

To consider a report of the Corporate Director for People.

The third quarter Portfolio Performance and Resource Report (PPRR) for the Health and Wellbeing Portfolio is presented for consideration by the Committee. This provides an update on progress in delivering the portfolio priorities and budgets during 2013/14, and includes performance and financial projections for the year.

Scrutiny Committee is asked to:

·         consider the third quarter Portfolio Performance and Resource Report;  

·         review the progress against priorities, performance and budgets for 2013/14;

·         highlight key areas of and responsibility for taking forward corrective action to address any performance or resource issues.

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

Officer contact: Mike Harradine/ Simon Finch, 0161 474 4680/ 4019, mike.harradine@stockport.gov  / simon.finch@stockport.gov.uk

The Deputy Director of Public Health submitted a report of the Corporate Director for People (copies of which had been circulated) providing an update on the delivery of portfolio priorities, budgets and capital programmes for the Health & Wellbeing Portfolio during the third quarter of 2013/14.

RESOLVED – (1) That the report be noted.

(2) That the Director of Public Health be requested to submit a report to the next meeting with further detail on excess winter deaths.

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 two meetings and any relevant Forward Plan items.

RESOLVED – That the report be noted.

To consider a report of the Director of Public Health and the Service Director (Strategy & Commissioning)

(Note: the Chair was of the opinion that this item, although not included on the agenda, should be considered as a matter of urgency in accordance with Section100B(4)(b) of the Local Government Act 1972 to allow the matter to be considered promptly and in conjunction with the Executive Response to the Director of Public Health’s Annual Report)

The Deputy Director of Public Health submitted a report (copies of which had been circulated) setting out a commitment from the Council and its partners to improving the health of the public in Stockport. The Promise was divided into a number of themes, each with a number of specific commitments.

Councillors welcomed the commitments made by the Council and partners, and suggested that because of the broad range of areas covered consideration be given to including this on the agenda for the Adult Social Care & Housing and the Children & Young People scrutiny committees.

RESOLVED – (1) That the Stockport Health Promise be welcomed.

(2) That the Director of Public Health be requested to provide an update on the activity undertaken as part of the Promise in conjunction with the requested update on the recommendations of the Public Health Annual Report.