Agenda and minutes

Representatives of the Council and partner organisations present at the meeting will be invited to identify any emerging issues that may be interest to the Scrutiny Committee during 2015/16.

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

The Chair invited representatives of the Stockport Clinical Commissioning Group (CCG), Stockport NHS Foundation Trust (FT), Public Health Service and Healthwatch Stockport to provide a brief outline of the key challenges or projects for their organisations in the upcoming year. The information would then inform the Scrutiny Committee’s programme of work for the 2015/16 municipal year.

Many of the areas discussed by partners overlapped between organisations.

Clinical Commissioning Group

Gaynor Mullins, Chief Operating Officer highlighted the following areas:-

·         Stockport Together – this was a major programme of reforming health and social care services in Stockport, bringing together the Council, CCG, FT and Pennine Care NHS Foundation Trust. The Programme was in line with the outcomes of the Health & Social Care Congress held in February 2015. It was anticipated that by Autumn 2015 new models of care would have been developed and consulted on.

·         Greater Manchester Devolution – further work was planned to develop and extend primary care services.

·         Healthier Together – a decision on the next phase of the programme was due from the CCG Committees in Common in Summer 2015.

Stockport NHS Foundation Trust

James Sumner, Director of Operations and Deputy Chief Executive, highlighted the following areas:-

·         In response to Stockport Together, the FT had redefined its strategic outlook to provide greater focus on Stockport and the population need for older people and people with cancer and other chronic conditions.

·         Greater emphasis would be given to providing services outside of the hospital setting.

·         In relation to Healthier Together, the Trust remained committed to wanting Stepping Hill Hospital to gain Specialist status.

Public Health

Dr Donna Sager, Deputy Director for Public Health, highlighted the following areas:-

·         In relation to Stockport Together, Public Health was leading on the Engagement and Prevention work stream.

·         Public Health would continue to work toward embedding prevention within Council services and working toward addressing the wider determinants of health, such as planning and environmental issues.

Healthwatch

Tony Stokes, Chair, highlighted the role of Healthwatch in scrutinising and acting as a critical friend toward both commissioners and providers. In particular the recent report on challenges with hearing aid usage called “It’s in the Drawer” was highlighted.

Adult Social Care

Mark Warren, Service Manager, highlighted the work of the service in conjunction with the CCG, FT and Pennine Care as part of the NHS England ‘Vanguard’ project into developing new models of care, including the development of multi-disciplinary/ speciality teams.

The following comments were made:-

·         In relation to queries raised about 7 day working, it was reported that Stockport Together, GM Devolution and Healthier Together included elements relating to expanding access to primary care. The proposals would not necessarily be simply increasing GP surgery opening hours, but would aim to provide a broader range of primary care services, as well as the clustering of surgeries to enhance access to a (limited) range of services. Mastercall would continue to provide urgent access to GP services out of hours.

·         The need to address data sharing and communications between partners was important to the success of collaborate services. A significant element of Stockport Together sought to address information management, as well as work to develop a common system for GPs to allow them to communicate with a community care system. Ensuring that staff understood the need to operate differently was also an important element of improving information sharing.

·         In relation to queries about the role of mental health in Stockport Together, it was reported that mental health services were part of each work stream and would form part of the models of care being developed. Concerns were raised about the training and knowledge of GPs in relation to mental health and the need to ensure not only that there was sufficient expertise within practices but that GPs were seeking to address underlying causes rather than simply seeking to treat symptoms.

·         The importance of self-care and the role of technology to support  ...  view the full minutes text for item 1.

To approve as a correct record and sign the Minutes of the meeting held on 31 March 2015.

The Minutes (copies of which had been circulated) of the meeting held on 31 March 2015 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-ins to consider.

To consider a report of the Executive Councillor (Health & Wellbeing)

The report sets out the Executive’s agreed response to this Scrutiny Committee’s review into Alcohol Misuse Services.

The Scrutiny Committee is invited to note the Executive’s response to the Scrutiny Review of Alcohol Misuse Services.

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

The Executive Councillor (Independence & Wellbeing) submitted the Executive’s agreed response (copies of which had been circulated) to the questions posed by the Scrutiny Committee as part of its Review of Alcohol Misuse Services in Stockport. The Final Report of the Review had been presented to the Executive and Clinical Commissioning Group Governing Body in March 2015 and the Executive had agreed its response at its meeting on 21 April 2015.

The Executive Councillor (Independence & Wellbeing), Deputy Director of Public Health and Chief Operating Officer of the Clinical Commissioning Group (CCG) attended the meeting to answer questions from the Scrutiny Committee.

The following comments were made/ issues raised:-

·         The Executive had welcomed the ‘question’ format of the final report, rather than specific recommendations.

·         The shortcomings in public health messages about safe levels of drinking were recognised, particularly confusion over units. Public Health England would be launching a new campaign in the Autumn and this would be subject to consultation with the Royal Colleges in an effort to ensure it was more effective.

·         There was ongoing work with Greater Manchester Police and the Licensing Forum to address problem areas for drinking. The Police would also refer those taken into custody for repeat drink related offences to a treatment assessment and these appointments were most often kept. It was suggested that the Police might consider using an ‘alcohol awareness’ course for those arrested for alcohol related reasons, similar to the ‘speed awareness’ course offered to those caught speeding.

·         The CCG welcomed the report and would be revisiting the issue later in the year. Although the CCG had no direct commissioning responsibility relating to alcohol misuses, there was scope to give the issue greater consideration as part of its wider service planning. The role of GPs in referrals and support also needed to be given further consideration. Members of the Scrutiny Committee repeated the importance of training for frontline staff.

·         Changes to the commissioning model and the current retendering exercise underway should ensure that there was capacity within the system to meet future rising demand as greater emphasis would be given to moving clients from treatment to recovery, and on earlier interventions.

RESOLVED – That the Executive’s response to the Scrutiny Review ‘Alcohol Misuse Services in Stockport’ be noted.

To consider a report of the Corporate Director for People.

The document is the Annual Portfolio Performance and Resource Report (PPRR) for the Health and Wellbeing Portfolio for 2014/15. This provides a summary of progress in delivering the portfolio priorities and budgets over the year and specifically during the fourth quarter of 2014/15. It includes full-year out-turn performance and financial data for the Portfolio, or forecast / provisional data where this is not yet available. The report also includes the final position for the 2014/15 portfolio savings programme.

Scrutiny Committee is asked to:

a)    Consider the Annual 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)   Highlight any significant issues or changes to be fed back to the Executive alongside the Corporate Performance and Resource Report;

e)    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

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 fourth quarter of 2014/15.

The Executive Councillor (Independence & Wellbeing) and a representative of the Service Director (Adult Social Care) attended the meeting to answer questions from the Scrutiny Committee.

The following comments were made/ issues raised:-

·         There remained considerable uncertainty about health devolution in Greater Manchester.

·         Future performance reports might usefully be structured around the four elements of the Stockport Together programme.

·         Health inequalities remained a cause for concern. There were also concerns about healthy life expectancy and the fact for those in deprived communities had shorter lives but the onset of ill-health was much earlier than for those in the least deprived areas.

Concerns were raised about the impact of Deprivation of Liberty Safeguards (DOLS) Supreme Court judgement and performance in Stockport. It was reported that it was anticipated that up to 200 individuals may meet the criteria. The significant number of care homes in the Borough also presented particular challenges. The Council had so far processed approximately 600 applications, with 130 in process and 300 awaiting allocation. There was a significant backlog with applications that the Council did not have the resource to process and so had taken on a private company to assist. The £750,000 allocation from Government had assisted with this process but fell short of meeting the additional costs associated with implementing the requirements of the judgement.

It was also reported that as a result of the judgement there were a number of unforeseen consequences, one of the most distressing of which was that those subject to a DOLS was considered to be in ‘state detention’ so when they died were subject to additional processes that families often found distressing. The Council was seeking to work with partners to ensure proportionate measures were in place for those on end-of-life care pathways.

It was also reported that the Law Commission was undertaking a significant project to review the current legislative basis for DOLS with a view to making recommendations to Government on possible reform. The Commission would be undertaking consultation during the summer of 2015.

Councillors expressed concern at the scale of the challenge presented by DOLS and the resource capacity to respond.

RESOLVED – (1) That the Health & Wellbeing Portfolio Performance Annual Report for 2014/15 be noted.

(2) That the Service Director (Adult Social Care) be requested to submit a report to the 28 July 2015 meeting setting out the background to the Deprivation of Liberty Safeguards and the current challenges facing the Council, with a view to this Scrutiny Committee providing a response or informing a response to the Law Commissioning Consultation on Mental Capacity and Detention.

(3) That the Democratic Services Manager be requested to arrange for agenda items at a future meeting on health inequalities and healthy life expectancy.

(4) That the Democratic Services Manager be requested to circulate the Stockport Clinical Commissioning Group Annual Report to members for their information.

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.

The Chair invited the Committee to suggest topics for further reports/ discussions at future meetings.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to arrange for reports to future meetings on the topics listed below, and in consultation with the Chair to programme these appropriately:-

·         Update on DOLs

·         Update on Preventative Commissioning Strategy

·         People Powered Health

·         Progress implemented the recommendations of the 21^st DPH report and update on activity connected to the Stockport Health Promise

·         North West trends in Smoking in Pregnancy and links with inequalities

·         Changes to Specialised Services commissioned by NHSE

·         Update on implementing the recommendations of the “Mind the Gap” Review of CAMHS services.

·         Implementation of new Drug and Alcohol Services after 12 months of implementation

·         Update on Unscheduled Care at Stepping Hill

·         Impact of changes to the Cultural Determinants Service 6 months after implementation

·         Analysis of Asthma prevalence by postcode

·         Self-Care and role of technology

·         Healthy Life-Expectancy and Inequalities

·         Legal Highs

·         Patient / Arriva Travel

·         Mastercall / out-of-hours GP services

·         Stockport Together

·         ‘Devo Manc’

·          Healthier Together