Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 15 September 2015.

The Minutes (copies of which had been circulated) of the meeting held on 15 September 2015 were approved as a correct record and signed by the Chair, subject to the replacement under Cllr Chris Gordon’s declaration of interest of the words ‘Disability Stockport’ and replacement with ‘Stockport Disability Forum’.

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 none to consider.

To consider a report of the Corporate Director for People

The Mid-Year Portfolio Performance and Resource Report (PPRR) for the Independence and Wellbeing Portfolio is presented for consideration by the Committee. This provides a summary of progress in delivering the portfolio priority outcomes through the Investing in Stockport programme and other key projects during the first half of 2015/16, with updates on key activity during the second quarter. It includes forecast performance data (where this is available) and projected financial data for the Portfolio, along with an update on the portfolio savings programme. 

Scrutiny Committee is asked to:

·         Consider the Mid-Year Portfolio Performance and Resource Report;  

·         Review the progress against delivering key projects, priority outcomes, targets and budgets for 2015/16;

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

·         Highlight any significant issues or changes to be fed back to the Executive alongside the Corporate Performance and Resource Report;

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

Officer contact: Karen Kime/ Susan Wood, 0161 3574/ 218 1032, karen.kime@stockport.gov.uk / susan.wood@stockport.go.uk

A representative of the Corporate Director for People submitted a report (copies of which had been circulated) providing an update on progress in delivering the Independence & Wellbeing portfolio priority outcomes through the Investing in Stockport programme and other key projects during the second quarter of 2015/16.

The Executive Councillor (Independence & Wellbeing) (Councillor John Pantall) attended the meeting to respond to questions from the Scrutiny Committee.

Concerns were expressed about performance in relation to admissions to hospital related to alcohol. In response it was stated that performance against this indicator was particularly challenging due in part to the cohort involved that was resistant to messages about moderating alcohol intake. It was hoped that following the recommissioning of alcohol services performance would begin to improve. It was also commented that the Council was working with Drink Aware to develop a local campaign that would seek to simplify the message on safe drinking levels.

RESOLVED – That the report be noted.

Representatives of Mastercall Healthcare have been invited to the meeting to discuss their activity in Stockport and their proposed change of premises.

Dr Michaela Buck (Chief Executive), Dr John O’Malley (Organisational Medical Director), Rick Downes (Finance Director) and Andrea Ferguson (Locality Business Manager) from Mastercall Healthcare attended the meeting to make a presentation on the work of Mastercall in providing out-of-hours primary care / GP services in Stockport. The presentation also set out the background to Mastercall’s move from their premises on the A6 in Stockport to Hazel Grove.

Dr Buck highlighted the benefits for the premises move, which included:-

·         Improved parking facilities with increased capacity.

·         Improved waiting room facilities with increased seating and an additional children’s area.

·         Improved consultation facilities to increase dignity during consultations.

·         New facilities being closer to hospital facilities, including ED facilities.

Dr Buck responded to concerns raised previously about potential difficulties that would be created by the move to new facilities given that the location was not as accessible to the public as the A6 location. It was stated that concerns about transport and accessibility were acknowledged, but that measures were in place to mitigate this impact. This included additional training to call-handlers to ask appropriate questions of clients and where appropriate to provide courtesy transport. It was further explained that in consultation prior to the move it was found that the number of service using arriving by public transport was relatively small but that those travelling by car found the parking a particular difficulty.

The following comments were made/ issues raised:-

·         The reasons for moving premises were acknowledged, and the additional measures to be put in place to assist those who might not have access to a car were welcomed.

·         Following the move, the procedures had now been changed so that trained call-handlers would be formally asking how the caller would be planning to get to the new facility. Clinicians would refer callers back to call-handlers where needed to ensure that arrangements could be made for transport. In effect these new procedures were formalising the arrangements that had been in place informally previously, whereby patients were assisted with travel where necessary. It was stated that it was not in the interests of Mastercall for its clients to not be able to access its facilities as this may lead to doctors having to make house-calls, which would in turn impact on waiting times and the ability to provide palliative care.

·         In response to questions about publicity it was stated that all GP Practices had been made aware of the changes, as this was the route into the service for clients. No further publicity had been planned as there was a danger of encouraging inappropriate attendance.

·         The proximity of the new premises to Stepping Hill Hospital would be of benefit to clients as it would mean emergencies could be dealt with more promptly and would allow for more easy diversions from the ED. A representative of the Clinical Commissioning Group stated that this was a useful arrangement for the development of a multi-agency provider model.

·         It was confirmed that there would be on-going monitoring and evaluation of the impact of the move on travel patterns, not least because this was a condition of planning permission.

RESOLVED – (1) That Dr Michaela Buck, Dr John O’Malley, Rick Downes and Andrea Ferguson be thanked for their attendance and presentation.

(2) That the Scrutiny Committee would welcome a further update from Mastercall on the success of their premises move.

Representative of Stockport NHS Foundation Trust have been invited to the meeting to update the Scrutiny Committee on their continuing efforts to reduce unscheduled admissions.

Ann Barnes (Chief Executive) and James Sumner (Director of Operations), Stockport NHS Foundation Trust, attended the meeting to update the Scrutiny Committee on the Trust’s performance against the 4-hour admission waiting time target.

It was reported that performance at the Trust had improved, but the Emergency Department 4-hour target was not being consistently met. The Trust performance was improving gradually and this was against a background of deteriorating performance nationally.

It was also reported that a change to the process for GP referring patients for admission was shortly to begin that would allow patients to be admitted directly to the department rather than going through the ED. This would affect approximately 25 patients per day, and while not necessarily contributing to the achievement of the admission target, would improve patient experience.

In relation to the recruitment of ED Consultants it was reported that this remained a challenge due to a shortage nationally, but the Trust had recruited additional advanced nurse practioners.

In relation to preparations for winter, partners were working together on a whole system plan that would allow all parts of the economy to remain resilient during increased pressure.

The following comments were made/ issues raised:-

·         The recent decision about Healthier Together and hospital designations, as well as the work around Stockport Together, had removed some uncertainty that may have been a barrier to recruitment. The conversations that had now begun about future service configuration and the opportunities for innovation could be an incentive for recruitment in some cases.

·         During the difficult winter period at the beginning of the year performance against the 4-hour target suffered, although all parts of the economy came together to respond and to ensure patients were safe.

·         The proximity of Mastercall’s new premises to the hospital would assist with managing pressures at the ED as the difficulties in parking at their previous premises had discouraged people using the facility.

The Chair acknowledged the efforts made by partners during the previous winter and recognised that while performance against the Monitor 4-hour admission target had been impacted, the Trust and other partners had taken these steps to ensure patient safety and quality of care.

RESOLVED – (1) That Ann Barnes and James Sumner be thanked for their attendance and presentation.

(2) That the Scrutiny Committee would welcome a further presentation from the Stockport NHS Foundation Trust on their future plans in light of the significant reform programmes taking place locally and across Greater Manchester.

To consider a report of the Deputy Chief Executive.

The report sets out an update on the actions taken by the Council in response to the recommendations contained in the 21st annual report of the Director of Public Health.

The Health & Wellbeing Scrutiny Committee is invited to comment on the report.

Officer contact: Karen Kime, 0161 474 3574, Karen.kime@stockport.gov.uk

A representative of the Deputy Chief Executive submitted a report (copies of which had been circulated) providing the Scrutiny Committee with an update on the actions taken by the Council in response to the recommendations contained in the 21st Annual Report of the Director of Public Health. The Executive had provided a formal response to the recommendations in March 2014 and this report set out progress against the commitments made.

The Director of Public Health was also in attendance to respond to questions. It was commented that overall progress in delivering on the response of the Executive had been good.

The following comments were made/ issues raised:-

·         The delivery of cancer screening questions by Stockport Homes staff during their assessments was a welcome development. This built on the Making Every Contact Count agenda but it took time to embed this approach within service delivery, although it was noted that Stockport Homes had shown significant commitment to this agenda.

·         Efforts to promote healthy ageing were welcomed. It was commented that the promotion of physical activity/ non-sedentary activity was an important aspect of this agenda as it was the only recorded treatment for frailty. It was also commented that Stockport had significant assets that made it relatively easy for people to be physically activity, such as parks and walking/ cycling routes, but that more could be done to promote these facilities and opportunities.

·         The ‘Stockport String’ campaign was welcomed as it was a simple idea but provided a talking point.

·         It was important that as well as public sector staff using contact with the public to deliver health messages, that the public themselves took greater responsibility for their own health and care. The contrast between levels of spend on health services as compared to outcomes between the UK and other European countries such as Sweden was illustrative of the different levels of health literacy amongst the general public.

RESOLVED – That the report be noted.

To consider a report of the Director of Public Health

As part of the comprehensive health service, as established under the National Health Services Acts, Stockport Council has responsibility for ensuring measures to improve the health of the people are undertaken. Whilst in part this is discharged by commissioning certain specific services, especially those funded by the Public Health Grant, it is also a function which requires the commitment of the whole of the Council and the collaboration of its partners to maximise the health benefit of the full range of public sector work.

The Stockport Health Promise was created in 2014/15 and sets out the breadth of commitment given by the Council and partners to improving health at this time.

This report reviews the progress towards these promises as at September 2015, with commentary provided by a range of services and partners for each of the promises, and provides Health & Wellbeing Scrutiny Committee with an overview of the impact.

The Scrutiny Committee is invited to comment on the report.

Officer contact: Dr Stephen Watkins, 0161 474 2436, stephen.watkins@stockport.gov.uk

The Director of Public Health submitted a report (copies of which had been circulated) providing the Scrutiny Committee with a review of progress toward achieving the items within the Stockport Health Promise, created in 2014/15, that set out the breadth of commitment given by the Council and partners to improving health. The report set out progress as at September 2015, with commentary provided by a range of services and partners for each of the promises.

The following comments were made/ issues raised:-

·         In relation to questions about the efficacy of the immunisation and vaccination programmes in light of changes to the programme at a regional level, it was commented that Stockport was still performing well. There were problems with data collected in respect of the MMR combined vaccine, although the view of the Infection Control Consultant, Dr David Baxter, would probably be that the level of immunisation was nearing population level protection, and that any outbreak could be contained.

·         It was disappointing that there was little mention of mental health within the promises. In response it was acknowledged that the promises themselves were not very substantial, but that this did not reflect the work being undertaken around mental health promotion.

·         Progress on addressing illicit tobacco had been disappointing.

RESOLVED – (1) That the report be noted.

(2) That Dr Baxter, Public Health Consultant, and all those involved in the flu vaccination programme be thanked for their hard work in maintaining Stockport’s high performance in vaccination levels.

(3) That the Director of Public Health be requested to provide the Scrutiny Committee with further details of the three promises where there had been no progress.

These reports are for information only.

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

To note the minutes of the Joint Committee meeting held on 18 June 2015.

RESOLVED – That the Minutes of the meeting of the Joint Overview and Scrutiny Committee for Pennine Care NHS Foundation Trust held on 18 June 2015 be noted.

To note the Minutes of the Committee held on 24 June 2015.

RESOLVED – That the Minutes of the meeting of the AGMA Health Scrutiny Committee held on 24 June 2015 be noted.

To note the recent update received by the AGMA Joint Health Scrutiny Committee on 14 October 2015 in relation to Healthier Together.

A representative of the Democratic Services Manager submitted a copy of a presentation made to the AGMA Health Scrutiny Committee on 18 June 2015 (copies of which had been circulated) providing an update on the Heathier Together Programme and an overview of the next steps.

The Chief Clinical Officer (Stockport Clinical Commissioning Group) reported that work was ongoing to develop business cases for those various strands of the Programme that were no subject to Judicial Review.

RESOLVED – That the report be noted.

To note the update considered by the AGMA Joint Health Scrutiny Committee on 14 October 2015 in relation to Greater Manchester Health & Social Care Devolution.

A representative of the Democratic Services Manager submitted a copy of a report to the AGMA Health Scrutiny Committee on 14 October 2015 (copies of which had been circulated) providing an update on the Greater Manchester Health and Social Care Devolution Programme.

The Chief Clinical Officer (Stockport Clinical Commissioning Group) highlighted that as part of the Strategic Plan that would underpin devolution there would be an element relating to ‘Social Movement for Change’ and self-care/ technological solutions.

A concern was expressed about too great a centralisation of medical research in specialist units and universities and way from hospitals where staff were working directly with patients.

The Chair emphasised the importance of scrutiny of the devolution proposals and resultant structures, both at a Greater Manchester and local level.

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 agenda items for the Scrutiny Committee’s next meeting and any relevant Forward Plan items.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to make arrangements for a themed meeting in March 2016 relating to mental health.