Agenda item

To consider a report of the Corporate Director for People.

The First Update Portfolio Performance and Resource Reports (PPRRs) for the Adult Social Care and Health Portfolios are presented for consideration by the Committee. These provide a summary of progress in delivering the portfolio priorities, reform programme and other key projects in the first quarter of the year (April to June). They include forecast performance and financial data (where this is available) for the Portfolios, along with an update on the portfolio savings programmes.

The Scrutiny Committee is asked to:

·         Consider the First Update Portfolio Performance and Resource Reports;  

·         Review the progress against delivering key projects, priority outcomes, targets and budgets for 2017/18;

·         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 Cabinet 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 / Emma Bowe, 0161 474 3574/ 218 1026, karen.kime@stockport.gov.uk / emma.bowe@stockport.gov.uk

The Cabinet Members for Adult Social Care and for Health submitted the Portfolio Performance and Resources Reports (copies of which had been circulated) summarising progress in delivering priorities, reform programme and other key projects for the Adult Social Care and Health portfolios during the first quarter of 2017/18. The reports also included forecast performance and financial data for the portfolios, along with an update on the portfolio savings programmes.

Adult Social Care Portfolio Performance and Resources Report

The Cabinet Member highlighted the following issues:-

·         The ongoing engagement with the public and stakeholders on the Stockport Together draft Outline Business Cases.

·         Proposed review of preventative services and the Alliance for Positive Relationships against the commissioning objectives.

·         Work to redesign and integrate mental health services was currently paused pending the completion of the refurbishment of premises at Baker Street.

·         In relation to Learning Disabilities work was continuing on the outsourcing of learning disability tenancies, engaging with users, families and support staff; it was hoped to move toward full staffing at Heys Court; Stockport was one of small number of pilot areas for a Department for Work and Pensions project to develop innovative ways to support people with additional needs into employment.

·         A recent recruitment day for care workers had been held that had good representation from providers.

·         Further recruitment was taking place to enhance the Adult Social Care quality team to support providers to raise standards.

·         Work had begun to develop business cases for how the enhanced Better Care Fund would be invested.

The following comments were made/issues raised:-

·         The work of the Adult Social Care Quality Team was commended, including their close working with Healthwatch and positive relationships with providers.

·         The Council’s development of the Autism Strategy was welcomed.

·         Clarity was sought on whether or not there was a particular problem with domestic homicide that had prompted the thematic review. In response it was stated that any incidents were too many, although no specific pattern had prompted the review.

·         At the previous meeting there was an assurance that the Core Neighbourhood team need not be GP lead, but the current report could be read to imply otherwise. Concern was expressed that a uniform approach to GP lead teams would medicalise social care and may marginalise preventative work. In response it was stated that General Practice was fundamental to the model, not least because it provided clinical leadership, but that leaderships of the teams could also come from community health and social care.

·         Clarity was sought on whether Stockport’s relatively high incidence of dementia was due to demographic pressures. In response it was commented that demographic profile was one contributing factor, but also that locally partners had worked hard to improve early diagnosis and treatment.

·         Concern was expressed about the deterioration in performance relating to new social care clients waiting for care packages. In response it was acknowledged that waiting lists did exist but that there were a number of initiatives to improve this situation, not least the Stockport Together programme. There had been increases in homecare provision but there continued to be increases in demand. Better understanding of the type of packages in demand was needed to ensure it matched capacity.

·         Clarification was sought on why performance was judged to be good when the proportion of social care bed capacity was in settings judged by the CQC as inadequate or requiring improvement. In response the apparent anomaly was acknowledged although the proportion was reducing from the previous year so performance was improving. It was further commented that those providers who were consistently judged as good tended to be those who had consistent management and leadership. Cost and price were not necessarily a useful measure for quality. The Council were also actively supporting providers to improve.

·         Emphasising the value of working as a carer was important as there were often negative news stories in the press that did not reflect the workforce.

·         Statements made by the Association of the Directors of Adult Social Services (ADASS) suggested that there was pessimism about the future for adult social care. In response it was stated that although ADASS had welcomed the funding announced through the Improved Better Care Fund and the recognition that Government had acknowledged the funding challenges, the pessimism was because any funding announcement were for non-recurrent resources.

·         In relation to the Improved Better Care Fund comment was made that its purpose was primarily hospital focussed, and so there would need to be constructive engagement between the Council and NHS partners to gain agreement to invest this in adult social care as a means to reduce pressure on acute services.

·         The challenge of balancing the budget and reducing reliance on reserves was emphasised. In response this was acknowledged, but comment was made that the anticipated Green Paper on adult social care funding at the end of the 2017 was hoped would improve the financial situation.

Health Portfolio

The Cabinet Member highlighted the following issues:-

·         Work continued on developing Stockport Together.

·         The development of the Healthy Aging Strategy.

·         The importance of addressing lifestyle in tackling long term health and wellbeing challenges was emphasised, and the embedding of the new Health Stockport services.

·         Preparations were underway for the winter flu vaccination programme.

·         Challenges remained in identifying savings to meet the further in-year reductions of the Public Health Grant of approximately £150,000.

·         The Greater Manchester School Games had recently taken place. While this was very positive, it was important to encourage young people to remain active as they got older.

The following comments were made/issues raised:-

·         Efforts to reduce the use of anti-biotics to maintain their efficacy would be difficult as many people had an expectation of a prescription when they visited the GP. In response it was stated that anti-biotic resistance would form a central part of the Public Health Annual Report as this was a significant challenge for medicine.

·         Further information was requested on the impact of GP triaging at the hospital. In response it was stated that the project was still relatively new, but early indications were that its effectiveness varied across the day. The Ambulatory Care Unit also had a key role in preventing avoidable admissions, and the value of community pharmacies for some treatments was emphasised.

·         Concerns were expressed that the co-location of the Neighbourhood Teams was not yet in place. In response it was stated that three of the eight teams had been co-located, but that there were challenges to find suitable accommodation that offered value for money.

·         Assurances were sought about whether GPs in Stockport would be able to offer extended hours. In response it was clarified that not all practices would offer extended hours, but in each locality there would be a surgery open to local patients. Discussions were taking place about how this access was managed, and whether this was simply extending existing services or to provide more targeted interventions during the additional hours.

RESOLVED – That the reports be noted.