Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 27 October 2015.

The Minutes (copies of which had been circulated) of the meeting held on 27 October 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.

Personal Interests

To consider whether it is in the public to exclude the public during consideration of agenda item 10 ‘Sexual Health Service Contract’ which contains information “not for publication by virtue of Category 3 ‘Information relating to the financial or business affairs of any particular person (including the authority)’ as set out in the Local Government Act 1972 (as amended).

RESOLVED – That in order to prevent the disclosure of information which was not for publication relating to the financial or business affairs of the any particular person (including the authority), the disclosure of which would not be in the public interest, would not be fair and would be in breach of Data Protection principles, the public be excluded from the meeting during consideration of the ‘not for publication’ appendix to agenda item 10 ‘Sexual Health Service Contract’, in the event of the content of this appendix needing to be discussed.

There were no call-ins to consider.

To consider a report of the Leader of the Council and the Deputy Leader.

At its meeting on 18 August 2015, the Executive presented a report which included a Medium Term Financial Forecast for the period 2016/17 to 2020/21. That report illustrated the level of resources likely to be available in 2016/17 and the resulting budget position. In response to those forecasts the Executive brought forward the set of proposals for 2016/17 with the relevant proposals being considered by scrutiny committees, including the specific detailed business cases, in September 2015.

This report provides an update on each of the proposals relevant to this committee and reflects completed or ongoing consultation with members, stakeholders and the public. Scrutiny members are invited to consider and comment on the updated proposals appended to this report. Following scrutiny, proposals will proceed to the Executive on 16 December 2015 where they are presented for consideration and approval.

The Scrutiny Committee is asked to review the proposals and consultation findings relevant to this Committee and provide comments.

Officer contact: Andrew Webb or Steve Houston, 0161 474 3808 / 4000

A joint report of the Leader of the Council and the Deputy Leader of the Council was submitted (copies of which had been circulated) providing an update on those Investing in Stockport proposals considered by the Scrutiny Committee in September 2015, following completed or ongoing consultation with members, stakeholders and the public. The proposals had been brought forward by the Executive to respond to the financial challenges facing the Council and in response to the forecasts provided by the Corporate Director for Corporate and Support Services.

The accompanying documents to the report provided further detail on the following Investing In Stockport proposals:-

·         Preventative Commissioning Strategy

·         Health & Social Care (including the integration of health and social care, the redesign of the mental health and support work service, and the remodelling of the Stockport Learning Disability Services)

·         Information Advice and Guidance

The Executive Councillor (Health & Wellbeing) (Councillor John Pantall), the Deputy Director of Public Health and representatives of the Corporate Director for Corporate and Support Services and the Service Director (Adult Social Care) attended the meeting to present the revised proposals and to respond to questions from the Scrutiny Committee.

A revised Integrated Health & Social Care Business Case had been submitted prior to the meeting (copies of which had been circulated).

The following comments were made/issues raised in relation to the following proposals or updates:-

Integrated Health and Social Care

(a) Review of current Care Management Budget including procurement

It was reported that following the Comprehensive Spending Review and Autumn Statement, including announcements about the National Living Wage, it was unlikely that the savings target could be achieved within the timeframe. As a result, this element of the proposal would have to be revised and remodelled.

(b) Reduce size of hospital social work team

It was reported that the Stockport NHS Foundation Trust had expressed concerns about the impact of this proposal on discharges, and the Service was actively investigating ways to remodel the service as part of the wider Intermediate Tier Care Services review. This would take in a range of hospital related services, such as the pre-admission ward and post-discharge services.

A representative of the Stockport Clinical Commissioning Group expressed concern that the hospital based teams were an integral component of the resilience of the health economy and that any reductions in this service should only be made in the context of the wider system transformation and once other measures were in place.

The following comments were made/ issues raised:-

·         During the winter period in 2014/15 when hospital admissions increased, it became clear that there were instances of assessments and processes being duplicated. It was hoped the wider review of hospital-based services may address some of these inefficiencies.

·         Concerns were expressed at the September meeting that the potential costs of delayed discharge arising from the loss of this team may result in negligible savings being achieved and it was queried whether this potential impact had been mitigated. In response it was stated that Department of Health Guidance steered NHS Trusts away from seeking reimbursements for delayed discharge and instead encouraged collaboration and the establishment of protocols and processes to address delays. The Council’s assessments suggested that delays in discharges were in most cases attributable to the NHS rather than Adult Social Care.

·         It was suggested that representatives of Adult Social Care and the NHS would discuss further the proposals and how the impact could be mitigated. In response the Chair requested that should no agreement be reached before the Executive Meeting on 16 December 2015 that the matter be reconsidered by the Scrutiny Committee at its meeting on 26 January 2016.

(c) Review of current assessment process/ staff efficiencies

In response to a question about the risk associated with losing these staff/ posts, it was stated that this proposal was not deemed to be high risk.

(d) Review of current in-house services

In response to a question about the  ...  view the full minutes text for item 5.

To consider a report of the Director of Public Health.

The Stockport Health Promise is a set of commitments entered into by various departments of the Council and other agencies to improve health. The Promise has recently been revised. A range of promises have been agreed which cumulatively represent an important contribution to the health of the people this includes a range of new promises implementing the physical activity strategy. The draft Promise is included in the agenda.

The Scrutiny Committee is invited to comment.

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) inviting the Scrutiny Committee to consider the commitments proposed by the Council and partners that would form part of the Stockport Health Promise for 2015/16.

The following comments were made/ issues raised:-

·         It was disappointing that there were not more commitments relating to mental health and promoting mental wellbeing. In response it was stated that the Promise did not capture all the work being done by the Council and partners in this area. The Public Health Business Plan contained significant activity to promote mental wellbeing.

·         In relation to commitments relating to spatial planning, disappointment was expressed about there not being reference to limit the proliferation of fast food establishments near schools. In response it was commented that the legal framework within which such decisions were taken was complicated and this could not easily be achieved. It was commented that the commitments in this section were nevertheless significant.

·         Councillors discussed the importance of interventions in schools, including the vital role of teachers and staff in identifying concerns and making appropriate referrals to other agencies. It was commented that some schools used their resources to provide additional support for students.

·         While the commitments made by the Council and other partners were welcomed, the success of efforts to improve the health of the public was also heavily reliant on individuals taking responsibility for their own health.

·         Assurances were given that inequalities was a key consideration in the development of service delivery models and specifications, although it was acknowledged that the commitments contained in the Promise did not easily lend themselves to addressing inequalities specially. The idea of an inequalities matrix to accompany the Promise would be explored.

·         It was clarified that Stockport Homes had given a specific commitment to providing dementia awareness but this did not prevent other partners from providing this, although there may not be a specific commitment within the Promise.

·         Concerns were expressed that some of the commitments were based on subjective aesthetic judgements, where judgements of success would be divisive.

·         Assurances were given that suicide prevention was part of public health activity.

RESOLVED – (1) That the Stockport Health Promise 2015/16 be noted.

(2) That the Director of Public Health be requested to consider the comments of the Scrutiny Committee, in particular their comments about the need for more commitments relating to mental health and more general commitment from partners in relation to dementia awareness and training.

To consider a report of the Director of Public Health.

The Annual Public Health Report is an independent professional report which the Council is required to commission from its Director of Public Health and is legally required to publish. The purpose of this current report is to acquaint Scrutiny Committee with the process for finalising and presenting the 22^nd Annual Public Health Report and to afford them the opportunity to comment on some of the material included and on the draft recommendations before they are finalised. The Scrutiny Committee will have a further opportunity to consider the report when a final version is presented and at that time it will also see the Executive response and be able to comment formally.         

The Scrutiny Committee is asked to comment on this draft.

Officer contact: Dr Stephen Watkins, 0161-474-2450 stephen.watkins@stockport.gov.uk

The Director of Public Health submitted a report (copies of which had been circulated) inviting the Scrutiny Committee to consider the draft 22nd Annual Report of the Director of Public Health prior to its publication.

Councillors welcomed the new section in the report relating to behavioural economics and game theory and its role in behavioural change.

The importance of ensuing mental wellbeing of public sector staff was also acknowledged.

RESOLVED – That the draft 22nd Annual Report of the Director of Public Health be noted.

To consider a report of the Deputy Director of Public Health.

In December 2014, as part of the Investing in Stockport Preventative Commissioning Strategy, the Council Executive agreed to the redesign of Stockport’s drug and alcohol system.  The aim was to improve overall service provision at a reduced budget (saving £0.5 million from the Public Health Grant).  The majority of these savings came from the retender and redesign of adult community based drug and alcohol services.    

The new drug and alcohol system went live on 1 October 2015.  This report outlines the key aims of the new system and how it has been established, provides an update on progress so far and identifies the next steps.

The Scrutiny Committee is invited to consider the report and comment on the progress made in the delivery of the new model.

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

The Deputy Director of Public Health submitted a report (copies of which had been circulated) updating the Scrutiny Committee on progress within implementing the redesigned drug and alcohol treatment and recovering system following the changes agreed as part of the Investing in Stockport Preventative Commissioning Strategy. New services had been introduced from 1 October 2015.

The Chair reminded the Scrutiny Committee that it had been broadly supportive of the proposals as part of its Scrutiny Review into alcohol services.

The following comments were made/ issues raised:-

·         Councillors asked what involvement there was with pharmacists and GPs in the new service. In relation to pharmacists a specific query was raised about how they could work with new providers to address prescription and over-the-counter medication dependency. In response it was stated that part of the specification for the new service was for successful bidders to improve links with both pharmacists and GPs. It was also commented that Stockport Together was seeking to improve prevention through greater integration.

·         A question was asked about whether the transition to the new service had led to any clients being ‘lost’ to the service. In response it was stated that measures were put in place to minimise the disruption to existing clients. The new services had continued to be provided from existing premises, such as Cirtek House, and this had reduced the disruption.

RESOLVED – That the report be noted and progress with implementing the new Drug and Alcohol services be welcomed.

To consider a report of the Deputy Director of Public Health.

The purpose of this report is to provide an introduction to new psychoactive  substances, consider the law and trends, and outline what is being done in Stockport to address this issue.

The Scrutiny Committee is invited to consider and comment on the report.  

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

The Deputy Director for Public Health submitted a report (copies of which had been circulated) providing the Scrutiny Committee with information relating new psychoactive substances (NPS), including an update on legal measures introduced to control NPS, usage trends, and an outline of what was being done in Stockport to address this issue.

The following comments were made/ issues raised:-

·         The introduction of legislation to tackle NPS was welcomed, although there were concerns about whether the legislation was right and robust enough.

·         It was suggested that the problems with NPS were not new, as young people had been experimenting with similar substances for many decades and that unscrupulous people would seek to exploit this opportunity to make money.

·         A robust response was needed both nationally and locally to the growing danger NPS use represented, particularly to young people. A hard line had been taken with tobacco, including banning advertising and requiring products to be kept behind screens.

·         A Greater Manchester-wide approach was needed to address the selling of these products as customers could easily shop elsewhere in the conurbation should one local authority restrict sales.

·         Targeting preventative work at colleges would be useful as young people were often most at risk of taking NPS.

·         The Committee would welcome further feedback from the ‘Lethal Highs’ Working Group.

RESOLVED – (1) That the report be noted.

(2) That the Deputy Director of Public Health be recommended to submit the report to the Children & Young People Scrutiny Committee in view of the particular risk that new psychoactive substances posed to young people.

To consider a report of the Deputy Director of Public Health 

This report sets out a proposal for the joint procurement of an Integrate Sexual Health Service with other Greater Manchester Authorities. Following the transfer of commissioning responsibilities to the Council from the Primary Care Trust and changes to the procurement regulations, the Council must now undertake a procurement exercise for this service. It is proposed that local authorities within Greater Manchester undertake a joint procurement for this service to realise efficiencies in a service working across a larger footprint.

(NOTE: the report contains information ‘not for publication’ contained in its appendix that has been circulated to Committee Members only)

The Scrutiny Committee is invited to comment on the proposals.

Officer contact: Michael Priestley, 07800 617521, michael.priestley@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) informing the Scrutiny Committee of a proposal to procure a new Integrated Sexual Health Service jointly with Tameside and Trafford Councils, setting out the rationale for this proposal and the benefits to residents.

(Note: the report included information ’not for publication’ within its appendix that had been circulated to the scrutiny committee only).

The following comments were made/ issues raised:-

·         Clarification was sought as to whether services would be delivered locally under the jointly procured service. It was confirmed that this would be the case.

·         It was suggested that consideration should be given to the experiences of neighbouring local authorities in the development of the specification for the service as anecdotal evidence indicated that newly commissioned services did not adequately interact with secondary care services.

RESOLVED – That the proposal to jointly procure a new Integrated Sexual Health Service be noted and the comments of the Scrutiny Committee be forwarded to the Executive for their consideration.

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) inviting the setting out planned agenda items for the Scrutiny Committee’s next meeting and any relevant Forward Plan items.

RESOLVED – That the report be noted.