Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 29 November 2016.

The Minutes (copies of which had been circulated) of the meeting held on 29 November 2016 were approved as a correct record and signed by the Chair.

No declarations of interest were made.

There were no call-ins to consider.

To consider a report of the Director of Public Health.

The Stockport Suicide Prevention group (SSP) is a collaboration of local services, working together to prevent death and distress from suicide. The group has worked together for a number of years to raise awareness of suicide in Stockport. The attached Stockport Suicide Prevention Strategy has been prepared to highlight the work that the  suicide prevention group has progressed and to highlight further areas of work

The aims of the Strategy are:-

·         reduce the risk of suicide –using the evidence to target high risk groups

·         be a catalyst for change - ensure individuals, communities and services are able to recognise and respond to suicidal distress, including the needs of those affected by suicide

·         support action to enhance wellbeing and resilience in the population as a whole

An update on the work of the Samaritans and the Coroner’s Office will also be given.

The Scrutiny Committee is invited to receive, comment on and support the approval of the Prevention Strategy which will be endorsed by the Health and Wellbeing Board.

Officer contact: Elysabeth Williams, 0161 474 2462, elysabeth.williams@stockport.gov.uk

Elysabeth Williams (Mental Health Advisor, Stockport Council) and Chris Jeffries (Chair, Stockport Samaritans) attended the meeting to present the Stockport Suicide Prevention Strategy (copies of which had been circulated). The Strategy had been developed by the Stockport Suicide Prevention Group, a collaboration of local services.

The following issues were highlighted:-

·         There was approximately one suicide every two weeks in Stockport.

·         Suicide was a significant cause of deaths for males, particularly those under 55.

·         For every suicide, 10 people would be directly affected, and this increases their own risk of suicide by three times. This risk was greater for young people.

·         The Samaritans received approximately 60 calls per day, of which 12 would have suicidal feelings. The remaining 48 were often very distressed.

·         There was no systematic approach to supporting those affected by suicide, beyond informing them of a death.

·         Partners had developed a training programme for front line staff to help them identify someone at risk and to make appropriate referrals.

·         Of those people who commit suicide, only 50% would be known to mental health services, making it difficult for agencies to identify those at risk.

·         Efforts were underway to create a ‘Sanctuary’ in Stockport, as in other Greater Manchester areas, that would allow those at risk or in crisis to seek out-of-hours support.

·         Partners had developed a web-based resource for those at risk of suicide, those concerned about someone else, those bereaved by suicide and professionals and front-line staff who had concerns about clients. The resources could be found at www.stockportsuicideprevention.org.uk

Councillors welcomed the Strategy and the proposal for a ‘Sanctuary’.

The following comments were made/ issues raised:-

·         There was often a challenge for men to discuss their feelings with others, particularly their own family. There was often a fear that raising concerns about suicide might induce it, but the evidence suggested that it was more likely to be beneficial.

·         The impact on an employee after a client commits suicide could often be significant and was often overlooked.

·         Tribute was paid to the work of the Samaritans particularly in light of their modest budget.

·         Often agencies would be dealing with the same individuals who would be at risk, so it might be useful for partners to undertake training jointly to share good practice.

·         There was no reference in the report to those in the LGTB community who may be at high risk. In response this was acknowledged, but it was stated that there were groups at higher risk in Stockport, but work was being undertaken within Greater Manchester in relation to this specific cohort.

·         How did partners seek to overcome the cultural challenges around suicide? In response it was stated that evidence suggested that religion could act as a protective factor, and there was no evidence that those from the BME community were more at risk in Stockport. However, it was acknowledged that there could be wider challenges around mental health stigma within specific communities.

·         What more could be done for those affected by suicide? In response it was stated that there was currently little support, although there were national policy drivers to change this. Partners in Cheshire West had developed a service that provided an early response to sudden deaths. It was also commented that schools and colleges would have a rapid response of support for pupils and staff when a young person in that institution committed suicide. The Samaritans would also provide a support rapid support for schools.

·         Stockport was a high risk area for suicide due to its physical environment. There was a challenge with raising awareness of the dangers and risks in Stockport without drawing attention to the specifics. Partners worked with media companies to discourage them from publishing the particulars of suicides.

·         Members commented on recent ‘live’ coverage of suicide attempts and the pejorative comments made by the public about inconvenience to commuters. Tackling this was part of the wider challenge of overcoming  ...  view the full minutes text for item 4.

To consider a report of the Corporate Director for People.

The Final Update Portfolio Performance and Resource Report (PPRR) for the Health Portfolio is presented for consideration by the Committee. This provides a summary of progress in delivering the portfolio priorities, reform programme and other key projects since the mid-year report, with a focus on the third quarter of the year (October to December). It includes forecast performance data (where this is available) and projected financial data for the Portfolio, along with an update on the portfolio savings programmes.

Scrutiny Committee is asked to:

·           consider the Final Update Portfolio Performance and Resource Report;  

·           review the progress against delivering key projects, priority outcomes, targets and budgets for 2016/17;

·           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: Jovian Smalley/ Emma Bowe, 0161 474 3589 / 218 1026, jovian.smalley@stockport.gov.uk / emma.bowe@stockport.gov.uk

The Executive Councillor (Health) submitted a report (copies of which had been circulated) detailing the Portfolio Performance and Resources Report for the Health Portfolio, providing an update on key activity in the third quarter of 2016/17, with a summary of progress in delivering the portfolio priority outcomes through the Council’s investment programmes.  It also included forecast performance data and projected financial data for the Portfolio, along with an update on the portfolio savings programme.

The Executive Councillor highlighted ongoing work to train those working in the new Neighbourhood arrangements; there was an improvement in the uptake of flu vaccinations; there were examples of the positive use of the JSNA.

The following comments were made/ issues raised:-

·           A further update on the ambulatory care deflection from A&E was sought, and whether these additional measures to ease pressure were leading to an increase in demand. In response, it was stated that the triaging at A&E had been effective and that it was important to ensure that resources were used most appropriately. It was also stated that attendances had decreased, but this could be due to a number of causes. The suggestions that attendances were linked to difficulties in getting GP appointments was difficult to analyse because of the variation in the methods that data was kept and sorted by practices.

·           What could be learned from the recent closure of Bramhall High School due to flu? In response it was stated that it had demonstrated that Public Health systems and communications were robust and provided reassurance about their effectiveness should they be needed again. Questions still remained however about why the outbreak had occurred. In was further commented that there had been criticism of the decision to close but that the decision to do so had not been taken lightly, and was unprecedented in recent years in Stockport.

·           Comment was sought on the implications of recent announcements by the Prime Minister on mental health spending, and the impact on Stockport Together. In response it was stated that not enough detail about the announcements was known to give a full answer. The CCG were required to, and had, increased their spending on mental health. It was important to ensure that spending was appropriate so as to ensure there was intensive support when needed but also the resources to intervene earlier to prevent longer term treatment.

·           Stepping Hill Hospital was seen within the Greater Manchester Health & Social Care Partnership as being a ‘problem’ hospital because of productivity and targets, and therefore a concern about it being able to deliver its transformation plans. In response it was commented that in the recent spike in admissions, the hospital Trust did not declare an emergency unlike many Trusts in the country. The difficulties in achieving the 4-hour admissions target were not due to want of trying on the part of the Trust, but hospital staff were unwilling to compromise on care.

·           What measures were planned to address the variability in GP practices? In response it was acknowledged that this was a challenge but was something that was being addressed through the work on reducing health inequalities. There were challenges in the intelligence and data available from practices as this varied depending on the recording methodology used. GPs accepted that there remained training needs for those reception staff that have responsibility for triaging calls from patients.

·           An update was requested on the creation of new accountable care trust. In response it was stated that the Executive was keen to ensure all groups on the Council were supportive of the proposal, and a key element of this was to ensure sufficient democratic accountability when committing Council resources. Until the work on this was complete, the Executive would not be in a position to commit to this particularly option. Nevertheless, the aim was for a decision to be taken on the future arrangements within the current calendar year.  ...  view the full minutes text for item 5.

To consider a report of the Director for Public Health.

The Annual Public Health Report is an independent professional report of the Director for Public Health to the Council, the NHS and the people of Stockport which the Council is statutorily required to commission and to publish.

The 23^rd Report is currently in the process of being finalised and the Director of Public Health, in line with previous practice, is seeking comments from the Scrutiny Committee.

The Scrutiny Committee is invited to comment on the draft report.

Officer contact: Lucy Webster, 0161 474 2453, lucy.webster@stockport.gov.uk

The Director of Public Health submitted the draft 23^rd Annual Public Health Report for Stockport (copies of which had been circulated) seeking the views of the Scrutiny Committee before the report was finalised and submitted to partners for their consideration. The report made a number of recommendations to various partners for action to improve the health and wellbeing of residents in Stockport.

The following comments were made/ issues raised:-

·                The ‘health hub’ model outlined in the report was interesting, as there was often a challenge to discourage sedentary behaviour in those with disabilities. In response this was acknowledged, but it was also commented that physical activity should encompass more than simply gyms and swimming pools and greater emphasis should be given to the leisure component of physical activity.

·                The idea of ‘home zones’ was welcomed, particularly in those areas where brown field sites were being developed, as was the suggestion in relation to creating green living spaces and structures.

·                The Leisure chapter within the report emphasised the range of activity available and taking place, but overlooked the range of outdoor activity.

·                Concerns were expressed that the encouragement of 20mph zones may have a negative impact on air quality. In response, it was stated that air quality was most significantly worsened by the slowing traffic to a uniformly slower speed, but was rather caused by the speeding then slowing of traffic. It was also commented that the Scrutiny Committee had previously sought information on air quality, but there was a lack of data available. 

·                The value of young people walking to school should be emphasised.

·                Concerns were echoed about the relative lack of swimming facilities in the north of Stockport and encouragement given to any efforts to expand the leisure key scheme to cover the Arcadia facility in Levenshulme.

·                Surprised was expressed about the level of smoking in pregnancy and it was queried whether a more aggressive campaign was needed. It was further commented that peer-based Stop Smoking Champions were a powerful tool particularly for younger people, and these might usefully feature in the recommendations.

·                The incentivisation of pregnant women to change certain behaviours was interesting, but was it something that carried on after pregnancy? Was there scope for using incentivisation for other groups?

·                There had been recent media coverage of promising app based diagnosis tools that could potentially have a significant impact on patterns of care.

RESOLVED – That the report be noted.

To note the Minutes of the meeting of the Greater Manchester Joint Health Scrutiny Committee held on 19 October 2016.

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

RESOLVED – (1) That the Minutes of the Greater Manchester Joint Health Scrutiny Committee on 19 October 2016 be noted.

(2) That the agenda for the Greater Manchester Joint Health Scrutiny Committee on 11 January 2017 be circulated to scrutiny members for 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 meeting and any relevant Forward Plan items.

RESOLVED – That the report be noted.