Agenda item

To consider a report of the Corporate Director for People.

The Mid-Year 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 half of the year, with a particular focus on the second quarter (July to September). They include forecast performance and financial data (where this is available) for the Portfolios, along with an update on the portfolio savings programmes.

The Adult Social Care report includes an addendum with information relating to Adult Social Care complaints and compliments. This includes statutory complaints, some relating to services from other providers (e.g. Stockport Homes) along with complaints to the Local Government Ombudsman and Housing Ombudsman. This information is reported in summary form within the Corporate Complaints Report which is considered by CRMG Scrutiny Committee and Cabinet. It has been included at the request of the Portfolio Holder in order to provide additional consideration by this Scrutiny Committee. It is proposed that future Portfolio reports will incorporate this information.   

The Scrutiny Committee is asked to:

·         Consider the Mid-Year 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.

·         Note the additional information provided on Adult Social Care complaints and compliments, and the proposal to include this in future reports.

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 half of 2017/18, with particular emphasis on the second quarter. 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:-

·         Useful feedback had been received on Transition Funding.

·         Thanks to all involved in the co-production of the Adult Autism Strategy.

·         Results of carer’s survey had been recieved.

·         Budget proposals would be submitted to the next Scrutiny Committee meeting.

·         The report included a section on the Disabled Facilities Grant, although the budget was within a different portfolio.

·         The report also included an addendum on complaints, complements and concerns.

The Chair highlighted the following positive elements of the report:-

·         The high success rate being achieved by Acorn recovery.

·         Stockport MIND’s ‘Get set to Go’ campaign to support physical health of those with mental health conditions.

·         The significant levels of unpaid support provided by carers.

·         The development of dementia friendly GP practices.

·         The ‘Take a seat’ campaign was important not just for older people but for those with mobility issues.

The following comments were made/issues raised:-

·         The progress made in developing the WIRE reablement service was welcomed.

·         The importance of supporting carers, whose contribution saves the public purse huge sums overall, meant that current levels of spend in this area should be maintained.

·         Would the use of reserves to support the adult social care budget continue into next year? In response it was stated that the budgetary challenges in the adult portfolio were well known, and the portfolio was currently projected to be in deficit. Proposals to address this and next year’s budget would be submitted to the scrutiny committee in the next cycle. The funding challenges were not unique to Stockport but were a national challenge and investment need.

·         The former Adults Care Services and Housing Scrutiny Committee had received feedback from frontline staff on how innovation in their job roles was supporting them in their work. It would be positive to have a similar mechanism for feedback at this committee.

·         To what extent was the EMIS viewer available to adult social care? In response it was stated that the aspiration was for acute and GP practices to use the EMIS system and that was progressing. Work was also underway to ensure this was available to out-of-hours services. Further work would be needed to integrate EMIS with whichever new children’s and adult’s case management system was eventually procured.

·         In relation to on-time transfers of care, what was the overall vacancy rate, and how was capacity managed in conjunction with non-medical discharge need? In response, complexity of the system was emphasised, as was the aspiration not to rely on beds. There had been significant recent work on flow through the hospital to address Emergency Department issues. Providers tended to operate at 90% capacity, although more than this would impact the flow rate. There was a clear need to look at alternative domiciliary and intermediate care.

·         Concerns were expressed that the financial tables on pages 26-27 of the report did not reconcile with the commentary, and that the use of iBCF funds to plug funding gaps will lead to problems at a later point.

·         Concerns were expressed that targets around discharge and support were not being met. In response it was stated that due to staff vacancies it had proved difficult to plan discharge early, but measures were in place and were being monitored closely.

·         What was being done to address staff travel and overtime overspend? In response it was stated that this would be addressed as part of the Cabinet’s budget proposals.

·         Clarification was sought on the decision to end the Crisis Response service provided by Mastercall. In response it was stated that as part of a suite of changes, this call handling service was brought back ‘in-house’ because as an out-of-hours service the numbers were very low. Mastercall often provided short term support for initiatives to allow partners to build up necessary capacity before being taken back in-house. It was further commented that such schemes were often better used in rural areas where access to A&E departments was less convenient.

Health Portfolio Performance and Resources Report

The Cabinet Member highlighted the following issues:-

·         Ongoing work to develop Neighbourhood Care.

·         Improvements to better ensure flow through the hospital.

·         The new provider for lifestyle services was working well following the previous provider going into administration.

·         The Heatons Early Adopter work for joined up local services had elicited lots of public interest and engagement. 

·         The portfolio budget was in balance but had required the use of reserves.

The Chair highlighted the following additional issues:-

·         Hard work by partners to address DETOC and those involved be congratulated.

·         Very positive performance with flu immunisation.

·         A higher number of active people in Stockport than might have been anticipated.

·         Good progress with recruitment to new services.

The following comments were made/ issues raised:-

·         Although Stockport was one of the best performing economies for flu vaccinations, 1 in 4 people from the target groups were still not being immunised, and partners were doing good work to target those at risk.

·         Concern was expressed that smoke free tenancies would lead to prospective tenants being refused because they were smokers. In response it was stated that one of the GM priorities was to address tobacco use, and this was about supporting people to choose not smoke.. More work was needed to encourage and ensure smoke free events and facilities, such as play areas. Children were often more receptive to the idea of smoke free homes whereas those who lived on their own.

·         More information was sought on suggestions made at a recent Stockport Together engagement event that GPs would spend less time in prescribing. In response it was stated that as part of the work to address demand in primary care and maximise the efficiency of GP time work was ongoing to provide greater pharmacy support for undertaking medicine reviews.

·         Concerns were expressed that Health Champions were being used to mitigate the effect of cuts and that they should not replace access to a GP. In response it was stated that the Champions who had been recruited were because of their skills, knowledge or experience. The services they provided were additional, not instead of GP access, and people had been referred into the scheme.

·         Why was all-female, all-cause mortality increase considered a significant increase? In response it was stated that the trend analysis had indicated a blip in recent years but predicting this to reduce again. Nevertheless this was an issue across GM and was being monitored.

·         Why was the gap so large between health checks offered and taken up? In response the recent dip in performance was acknowledged. It was stated that previously any patient at a practice who presented for a check was paid for, which encouraged checking of those who were well. Changes to the payment regime had been introduced to encourage practices to target those who were not regular attenders. The new 7-day service expansion was anticipated to provide better access on weekends to encourage those who might struggle with mid-week appointments.

RESOLVED – That the reports be noted.