Agenda and minutes

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

The Minutes (copies of which had been circulated) of the meeting held on 21 October 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 interests were declared:-

Personal Interests

There were no call-in items to consider.

Representatives of Stockport Against Mental Health Cuts have asked to address the meeting in relation to the proposed reductions in community mental health services in Stockport.

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

Representatives of the Stockport Against Mental Health Cuts Group (SAMHC) attended the meeting to address the Scrutiny Committee in relation to their objections to proposed reductions in mental health budgets in Stockport and changes to service delivery models. A written submission from the Group had also been provided (copies of which had been circulated).

The following people addressed the Scrutiny Committee and their representations covered the following issues:-

Sandy Broadhurst (Stockport Against Mental Health Cuts Group)

·         Residents she had spoken to had opposed reductions in mental health services and privatisation of the NHS. She called on the Scrutiny Committee to listen to the views of residents.

·         Politicians had talked about establishing parity between mental health and physical health but the proposed budget reductions by the Pennine Care NHS Foundation Trust did not accord with that ambition.

·         Professionals had also expressed the view that the proposed cuts would be damaging to services and the residents they served.

·         If the proposed level of cuts were to be made to services such as cancer treatment there would be a public outcry, which further demonstrated the disparity between physical and mental health services.

·         The Scrutiny Committee was called upon to support the people of Stockport and to oppose the proposals.

Dr Robert Higgo (Consultant Psychiatrist)

·         Mental ill-health touched every family.

·         Mental health services had long been underfunded, despite clear evidence of the links with deprivation and poverty, economic challenge and premature death. This should lead to increased investment rather than less.

·         The Recovery Movement had a valuable role to play in mental health services, but could not replace other services as seemed to be the justification for budget reductions.

·         The Stockport Director of Public Health’s Annual Report emphasised the importance of mental health and the value of prevention. But prevention of mental ill-health was more challenging than other preventative activity.

·         Fragmented services subject to rapid change did not lead to good service to patients.

Joan Gibson (representing carers)

·         Carers were not in support of the proposed reductions.

·         20 years of underinvestment in mental health services should not be compounded by further cuts.

·         Carers already faced real challenges, and the proposed changes were worrying to them.

·         Residents would experience poorer health and wellbeing if they had poor mental health, and the proposals would result in less support for recovery, which in turn would lead to long-term challenges.

·         Carers were looking to the Local Authority and its duty of care toward this vulnerable group. While the voluntary sector provided excellent services, it would not be able to cope with the extra pressure caused by budget reductions.

·         ‘Parity’ was just a word.

Irene Harris (Rethink Mental Health Group and Stockport Against Mental Health Cuts)

·         It was the belief of Stockport Against Mental Health Cuts that the proposals would lead to the following consequences:-

-       More acute admissions

-       Greater use of the Mental Health Act powers

-       Increased use of institutional care and extra Social Care pressures and costs

-       Increased incidences of staff stress and sickness

-       Greater risk to staff and service users of untoward incidents

·         The Scrutiny Committee was urged to call on

-       the Clinical Commissioning Group to increase spending on mental health services appropriate to the needs of the population, to move toward parity with national spending levels and parity with physical health spend.

-       Pennine Care NHS Foundation Trust to not cut services when they were spending £1.2m on consultants.

The Chair then invited representatives of the Pennine Care NHS Foundation Trust (PCNHSFT) and Stockport Clinical Commissioning Group (CCG) to respond to the issues raised.

Stan Boaler (Mental Health Service Director, Pennine Care NHS Foundation Trust)

·         Clarification was provided in relation to the Trust’s spend on consultants. It was stated that the figure of £1.2m quoted had been provided by the Trust in response to a Freedom of Information Request but that further investigation had revealed that the actual figure  ...  view the full minutes text for item 4.

This report outlines the results from consultation exercises undertaken with service users, their families and carers, and providers on the following draft IIS business cases:

·                     Preventative commissioning strategy

·                     IPS Children and Family Services

·                     Integrated Care – Adult Social Care and Health

·                     0-25 SEND Review

·                     Learning Disability Review

The Scrutiny Committee will be asked to comment on the report prior to its consideration by the Executive on 16 December 2014.

Update: 21 November 2014

Previously the Scrutiny Committee has received reports on the Investing in Stockport business case working papers and members have previously commented on the Investing in Stockport Preventative Commissioning Strategy in which a number of high level proposals were identified for the Public Health contribution to the Business plan.

The Business Case for Public Health has now been revised and is included for further consideration. They include two areas:-

•             Drug and Alcohol service re- commissioning.

•             Further services and contracts in Public Health

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

A joint report of the Leader of the Council and the Executive Councillor (Corporate, Customer & Community Services) was submitted (copies of which had been circulated) detailing the outcome of consultations undertaken on the Draft Business Cases for the Executive’s Investing in Stockport Proposals, previously considered by the Scrutiny Committee.

The Executive Councillor (Health & Wellbeing) and appropriate project leads attended the meeting to answer questions.

The following comments were made/ issues raised:

Preventative Commissioning Strategy

·         Interesting feedback had been received from the focus groups in relation to the danger of ‘bureaucratisation’ of services.

Integrated Prevention and Safeguarding Services

·         Responses were less positive where they related to Children’s Centres for which responsibility was transferring. In response it was stated that many of the concerns had been about the future of services once responsibility had been transferred. As mitigation there would be a Partnership Agreement with the receiving organisation to ensure the maintenance of service.

·         The weight given to responses was queried, particularly in relation to the mitigation measures. Were mitigation measures proposed for all responses or only where there were a number of similar concerns? In response it was stated that the responses had been themed but that all feedback had been captured. No weighting was given, and any legitimate concern would have been considered and mitigation measures proposed if appropriate.

Integrated Health & Social Care

·         Concerns were expressed about how far the existing integrated hub was providing genuinely integrated services or whether there was simple co-location. In response it was stated that progress had been slower than hoped in respect of integration, and that there was not a completed integrated care model in place yet that could be rolled out to other localities. It was also emphasised that irrespective of progress, clients would notice better service.

0-25 SEND Review

In relation to the Short Breaks Consultation:-

·         The breakdown of responses in the report was useful.

·         Queries were raised in relation to the eligibility criteria that would be used should the Proposals be agreed. In response it was stated that it was proposed to limit eligibility to those who met the social care threshold. It was further proposed to make limited reductions in service in the first year of implementation allow existing clients to access alternative services. It was also emphasised that the Learning Disability Partnership’s local offer was now on-stream that would allow clients and new users to find other opportunities and services. This information was co-produced with carers.

·         Comments had been made that this service had a preventative role in avoiding families reaching crisis point and requiring more costly interventions. In response it was stated that this potential risk was recognised and mitigation measures were proposed in the report.

·         There was a query about the potential to change threshold levels and the enforcement of these thresholds. In response it was stated that this had been considered, but it was proposed to target the short breaks service to those in most need.

·         It should be recognised that there will be some families who will lose out on a service from which they previously benefited.

·         A question was asked about take-up of service and whether any eligible families failed to take up services. In response it was stated that the Aim Higher programme had led to an expansion of provision that went unused. The Service had worked hard to refocus this provision to ensure that capacity was being utilised. As a result, there were very few people failing to attend.

·         The report was comprehensive and the feedback message seemed clear.

In relation to Educational Psychology Service consultation:-

·         The waiting times for referrals to the service was queried. In response it was stated that there were no waiting times as such and that it was for the school to prioritise its pupils for the time with the Service. It was planned to explore ways to better inform and advise schools about how best  ...  view the full minutes text for item 5.

To consider a report of the Corporate Director for People.

The report sets Portfolio Performance and Resource Report (PPRR) for the Health and Wellbeing Portfolio for the first quarter of 2013/14. This provides a summary of progress in delivering the portfolio priorities and budgets during the first quarter of 2014/15, and includes early forecast performance and financial data for the Portfolio. The reports also include a progress report and updated risk assessment of the portfolio savings programme. 

Scrutiny Committee is asked to:

a)    Consider the Mid-Year Portfolio Performance and Resource Report,  

b)   Review the progress against priorities, performance, budgets and savings targets for 2014/15;

c)    Highlight key areas of and responsibility for taking forward corrective action to address any performance or resource issues;

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

Gaynor Alexander, Simon Finch, 0161 474 3186/ 4019, gaynor.alexander@stockport.gov.uk / simon.finch@stockport.gov.uk

A representative of the Corporate Director for People submitted a report (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 second quarter of 2014/15.

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

The following comments were made/ issues raised:-

·                   There was discussion about the future of the Healthier Together programme in light of the recently published NHS 5 Year Forward View. It was suggested that the 5 Year Forward View may now become the foundational document supporting future reform, but another suggestion was that the Forward View and Healthier Together dovetailed together so that the latter would continue to be the basis of future reform in Greater Manchester.

·                   There was discussion about the impact of medication on falls. It was stated that approximately 9% of hospital admissions were due to the effects of medication, which represented a real challenge for GPs to get the balance of medication right for those with severe conditions.

·                   Greater Manchester Fire and Rescue Service included fall reduction as part of their home safety checks.

RESOLVED – That the report be noted.

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 items for the Scrutiny Committee’s next meeting and Forward Plan items that fell within the remit of the Scrutiny Committee.

RESOLVED – That the report be noted.