Agenda item

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 risk associated with closing the in-house unit, it was stated that this proposal was deemed to be low risk because the clients involved were low dependency.

 

Redesign of the Mental Health and Support Work Services

 

The following comments were made/ issues raised:-

 

·         The work of officers in revising the proposals and addressing concerns from service users and staff was acknowledged.

·         Concern was expressed that despite funding for mental health being below spend on physical health, these cuts would further exacerbate the disparity at a time when the aspiration was for parity of esteem between physical and mental health.

·         Further discussions were needed across the health economy and with interested parties about how to address the general resourcing problems within mental health services.

·         It needed to be recognised that change in this area was inevitable.

 

Remodelling of Stockport Learning Disability Services

 

It was reported that the planned savings would be a challenging target and further proposals were being prepared to meet the projected shortfall.

 

The Chair expressed concern that there was not greater detail available to the Committee and he suggested this should be made available to the Adult Care Services & Housing Committee on 7 December 2015.

 

Preventative Commissioning Strategy

 

The following comments were made/ issues raised:-

 

·         Clarification was sought on the functioning of the redesigned lifestyle services triage facility. In response it was stated that this function would be undertaken by Council staff who would signpost to the most appropriate service.

·         Queries were raised in relation to potential opposition from service users and providers about relocating services, particularly where there was a strong local connection to that service. In response it was stated that the future lifestyle services model would be aligned with the Stockport Together locality areas and would form part of the locality team. It was also commented that the future contract specification for providers would require them to ensure access for residents from Priority areas.

 

Information, Advice & Guidance

 

It was confirmed that subject to approval from the Executive on 16 December 2015 this business case would be subject to further consultation with staff and stakeholders.

 

The following comments were made/ issues raised:-

 

·         Ensuring that face-to-face and supported access to information and advice services was available for as long a period during the day as possible was important to ensure accessibility.

·         In response to a question about how the Council intended to support the least technically-able residents, many of whom would be older people, it was stated that the service had in part been designed with a view to future demands. Office of National Statistics data indicated that over 65 year olds were increasingly using the internet and would be able to access these services. For those residents who were not internet active the provisions within the business case for support in Fred Perry House and within libraries would be introduced.

·         It was important that the future digital offer worked effectively and was useable. Feedback from councillors about online services was welcomed.

·         There were some residents for whom it was a choice not to access web-based services, rather than because they were unable.

·         In response to a question about maintaining services for 24 hours a day, it was stated that the systems were designed with redundancy to allow for maintenance etc., while still maintaining services. It was also stated that the development of truly integrated system would mean that services available online would put data directly into back office systems at any time of the day.

·         Concerns were expressed about the difficulty of finding telephone contact information on the Council website, and the frustration of being directed to a web form having been ‘on hold’ for some time. In response it was stated that it was hoped that once a resident was on the website they would be able to resolve their query without need to contact the Council by phone.

·         There were residents with very specific needs, such as those with a visual impairment, for whom further work was needed to ensure services were accessible.

 

RESOLVED – (1) That the report be noted.

 

(2) That the comments of the Scrutiny Committee in relation to the Investing in Stockport proposals be referred to the Executive for consideration.

 

(3) That in the event that discussions on reducing the size of hospital based teams not reaching a conclusion prior to consideration by the Executive on 16 December 2015 that the matter be considered by this Scrutiny Committee on 26 January 2016.