Members of the public are invited to put questions to the Chair and Executive Councillors on any matters within the powers and duties of the Executive, subject to the exclusions set out in the Code of Practice. (Questions must be submitted no later than 30 minutes prior to the commencement of the meeting on the card provided. These are available at the meeting. You can also submit via the Council’s website at www.stockport.gov.uk/publicquestions)
Minutes:
Members of the public were invited to put questions to the Chair and members of the Executive on any matters within its powers and duties, subject to the exclusions set out in the Code of Practice.
Eight questions were submitted.
(1) The first question related to Stockport Together and sought clarification on the proposed operation of the eight neighbourhood hubs. In particular clarification was sought on the impact on GP surgeries; whether GPs would be physically relocated to a central hub location and what the maximum distance people would be expected to travel to see their GP; and how the single point of access/ single phone number would work. Given that the thrust of the Health and Social Care Act 2012 was to put GP in control of the care of their patients, were these proposals an indication that they were no longer trusted to make decisions?
In response, the Executive Councillor (Health) explained that there would naturally be a change in the number, locations and size of GP Practices through normal processes outside of the Stockport Together programme, and these would be decisions taken by the practices themselves. In relation to the eight hubs, it was envisaged that each would work differently depending on the needs of the communities they served, but the physical locations hosting hub staff would not be treatment/ customer facing spaces but rather places for professionals to meet and work and as such there was no significance in the distances between hub locations. In relation to the single point of access it was planned to rationalise 20 different phone numbers into one, as well as rationalising working practices and hours of operation within those services, the aspiration being for a 24 hour service that would allow for speedier responses. It was further stressed that GPs would be in control of patient care and would lead the team of professions supporting patients. All other arrangements for contacting and make appointments with GPs would remain the same and were a matter for the practices themselves.
(2) The second question related to Stockport Together and sought detail on the consultation with the people of Stockport over the proposals for health and social care, and whether it would be targeted to specific groups such as Healthwatch Stockport or open to the public, and how they would be informed.
In response, the Executive Councillor (Adult Social Care) stated that, assuming all partners to the Stockport Together MCP Proposals agreed to proceed to the full business case for a Neighbourhood Led Accountable Care Trust, full consultation would be undertaken both with specific service user groups and the wider public, advertised and promoted through the usual range of media channels, including social media.
(3) The third question related to Stockport Together and sought an explanation for how the multi-speciality community provider would operate and the significance of the organisational form being suggested for approval at this meeting [see Minute 6 below] and whether it would involve any private providers. Clarification was sought on what contractual arrangements there would be with other providers and commissioners including Stepping Hill Hospital and the Council, and how many and the type of staff involved, and whether they would be employed directly or on secondment. Clarification was also sought on whether there would be public involvement in decisions to award contracts to private providers.
In response, the Executive Councillor (Health) stated that the significance of the organisational form would be that it was one that all partners believed would be best to meet the needs of that organisation and service users, all other options having been discounted. If the option chosen was a Neighbourhood Led Accountable Care Trust, this would involve a range of services currently provided by the Stockport NHS Foundation Trust (SNHSFT), Council and other partners. As yet, the governance arrangements of any further Trust has not been developed and was a key area for future work. The contractual arrangements would be with the Commissioners, the Council and Clinical Commissioning Group, commissioning jointly through the Health and Care Integrated Commissioning Board (HCICB). It was therefore clarified that SNHSFT would not be a commissioner but would be a provider. In relation to private providers, it was confirmed that there would be contractual arrangements with these, including GP Practices, and other private or Third Sector providers in a range of sub-contracting arrangements, but it was not expected to have any private sector partners. Specifically in relation to staff it was stated that discussions were ongoing with partners but that the arrangements would involve a significant number and that the Council’s preference was initially to use secondments to ensure greater flexibility. It was also stated that those meetings of the HCICB at which commissioning decisions were made would be public.
(4) The fourth question asked whether non-medical intermediate care would be stepped-up over the winter to try to divert ill patients from hospital, and whether the beds at Stepping Hill Hospital would be closed in coming years regardless of whether reductions in bed usage had been achieved. Confirmation was sought on the accuracy of the following figures provided by Stockport NHS Watch that had been calculated from figures in Stockport Together Business Case: up to 223 beds to close initially rising to 247 by 2021, representing 30% of beds in the hospital, and that these wards would be demolished not mothballed. Clarification was also sought on whether the bed reductions took account of the potential for 12,000 new houses in Stockport.
The Executive Councillor (Adult Social Care) responding by stating that the range and scope of intermediate tier services was being increased to meet needs of those who did not need full range of hospital services. It was also stated that bed reductions would only take place once it had been established they were not needed, and this would be planned for. The Executive Councillor stated that she was not able to comment on the actual number of beds involved at this stage.
(5)
The fifth question related to the ongoing consultation on the
Greater Manchester Spatial Framework. It was stated that complaints
had been received by a councillor that registering and commenting
online was complicated and unreliable, meaning some residents were
unable to engage, and the danger that this would be interpreted as
the public not being interested. It was asked whether the Leader of
the Council would undertake to ask the GMCA to review the online
consultation process to make it easier and more
user-friendly.
In response, the Leader of the Council (Policy, Finance & Devolution) stated that GMCA officers had been consulted about the issues raised, and it was reported although there were some problems with the website on the previous Friday, these had been addressed. So far 15,000 users had accessed the consultation portal. No specific instances of residents being unable to respond had been reported; nevertheless the Leader undertook to pass on these concerns. The Leader stated that any specific feedback from residents that councillors had could be passed directly to him for inclusion in the consultation.
(6) The sixth question related to Stockport Together and sought clarification on whether the proposed Neighbourhood Led Accountable Care Trust would run alongside the existing Stockport NHS Foundation Trust (SNHSFT) that was responsible for Stepping Hill or whether the responsibilities of SNHSFT would be incorporated into the new Trust, as running two parallel Trust structures would be complex, expensive and confusing.
In response, the Executive Councillor (Adult Social Care) stated that a number the issues raised in the question had already been addressed in previous questions, but reiterated that the new Multi-speciality Community Provider would undertake a number of functions of SNHSFT and Council. The Executive Councillor (Health) emphasised that the governance of the proposed Trust had not been finalised, but there would not unnecessary duplication.
(7) The seventh question asked whether the Council would follow the example of other councils and refuse to go along with Government plans that would amount to the privatisation of the NHS, by refusing to pursue Stockport Together proposals for a Multi-speciality Community Provider. It was also asked whether the Council wanted to administer government cuts and policies or to act as champion for the people of the Borough.
In response, the Executive Councillor (Health) stated that the Stockport Together programme had begun over two years ago, before the announcement of the Government’s Sustainability and Transformation Plans. The starting point of Stockport Together was a recognition that the funding future of social care and health partners was dire and the shortfall could best been addressed by working in cooperation. The Executive Councillor stated that he believed the Council were fighting on people’s behalf to ensure that partners could provide the best services possible in the circumstances, given cuts being imposed. He acknowledged that services would inevitably be provided differently and that without the funding pressures this programme might not otherwise have begun, and accepted that it may not be possible to satisfy everyone but that he believed this was the best way to protect as many services as possible in less than ideal circumstances.
(8) The eighth question related to the consultation on the Greater Manchester Spatial Framework. Clarification was sought on whether the final Framework document would require agreement of all ten Greater Manchester councils, including that of Stockport Council. It was also asked, in the context of proposals to allow development on a large proportion of the Green Belt on the southern edge of the Borough (as well as proposal by Cheshire East Council to release Green Belt in Handforth for development) and the consequent impact on the road network and public transport in this part of the Borough; and if details could be provided of planned or active work to evaluate these issues, including the impact on the A6-Manchester Airport Link Road which was designed before there was any consideration of large scale building in the Green Belt.
In response, the Leader of the Council confirmed that the agreement of the plan by Stockport Council was a matter for the Council Meeting and that agreement was needed by all ten Council’s for the adoption of the plan. The Leader reiterated statements he had previously made that without a majority of Stockport Council councillors supporting the Plan it would not go ahead. In relation to suggestions that the consultation was too short, the Leader clarified that the two month consultation exceeded the minimum legal requirement of six weeks, and that a further round of consultation would take place in the spring of 2017 following refinements to the plan arising from the current consultation. In relation to the issues raised about transport, it was acknowledged that this was a key measure of the feasibility of the plan, and that appropriate infrastructure would be a requirement for any site to be included. It was also confirmed that a refresh of the SEMMMS road study was underway to assess the impact of growth proposals within Greater Manchester and Cheshire East, and this was due to be completed in the Spring of 2017.