Agenda item

To consider reports of the Directors of Adult Social Care and of Public Health.

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 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 2018/19;

·         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: Peter Owston / Paul Graham, 0161 474 3274 / 4674, peter.owston@stockport.gov.uk / paul.graham@stocckport.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 2018/19, 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.

Health Portfolio

The following comments were made / issues raised:-

·           Concern was expressed about the number of new cases of AIDS/ HIV in Greater Manchester and clarification sought on what the impact for Stockport of the £1.3m Fast Track Cities network programme, and whether this would also include the roll-out of PREP. In response it was commented that further details were available in a recent report to the Health & Wellbeing Board. Support for the roll-out of PREP was also echoed.

·           Assurance was sought that contingency plans were being made for a no-deal Brexit. In response it was confirmed that the Council and partners were following NHS England guidelines on preparations. It was further commented that there was anecdotal evidence of concerns amongst staff about the uncertainty over Brexit and local hospitals were under increasing staffing pressures, with wider Greater Manchester efforts to recruit more nurses likely to take some time to realise improvements.

·           In relation to the differing rates smoking in pregnancy attributable by deprivation is was asked what more could be done to reduce rates in Stockport’s most deprived communities. In response it was stated that it was often difficult to deliver the message as the most persistent cases were due to the very chaotic lives being lived by these expectant mothers. The Family Nursing Partnership was one of the mechanisms through which partners were seeking to address this challenge. A further bid had been made to access Greater Manchester funds to provide additional support workers. It was also commented that it should not be forgotten that nicotine was an extremely addictive substance. A further question was asked about whether the reductions in SureStart provision had had an impact of rates. In response it was stated that no link could be proven although there was evidence that outcomes for women were better if they could access support closer to where they lived.

·           Had the devolution of the NHS budget to Greater Manchester been a success, or was it a means to pass on responsibility for cutting resources? In response it was stated that the devolution process was complex, with 38 local bodies involved, although the Council received very little directly from the NHS. Those NHS bodies involved were likely to answer that it had been better than had it not happened, but it may take time for the impact to be felt. The process nevertheless required partners to work differently to address the growing funding gap between available resources and demand.

·           Comment was sought on the national shortage of EpiPens. In response it was stated that Public Health had received the circular from manufacturers and had provided appropriate advice to schools and GPs.

·           Clarification was sought on the graph showing alcohol related admissions and whether or not young people were drinking less. In response it was stated that Stockport continued to be an outlier for rates of admission, including for young people, although prevalence/consumption was falling. It was further commented that the number of individuals behind these statistics might also be quite small, but were involved in multiple admissions.

·           Concerns were expressed about the impact of public spending reductions was having on health and wellbeing of the public, and the ability of public bodies to respond to those needs.

·           What would the response be if someone presented to A&E who was drunk but feeling suicidal? In response it was stated at Stepping Hill there was a specialist nurse who supported those who were drunk and would assess their needs, although the challenge was that often needed to be sober for a proper diagnosis. That in turn often meant that they were difficult to keep track of once they left the hospital.

Adult Social Care Portfolio

·           Clarification was sought on whether the Council had been Care Act compliant. In response it was stated that the references in the report were to strengthening the compliance, particularly where services were being provided by third parties, such as Pennine Care NHS Foundation Trust.

·           Assurance was sought that steps were being taken to ensure savings were being made, in addition to extra government resources, given the deficit on budgets in Adult Social Care. In response it was stated that there continued to be an increase in demand for services that was inescapable, but that it was nevertheless expected that the budgets would balance at year end. In response it was commented that those involved were doing well given the challenges facing them, and that there needed to be a long-term solution to adult social care funding.

·           Further detail was requested in relation to the Adult Social Care Innovation Award. In response it was stated that £800,000 had been made available from Adult Social Care Grant to encourage care homes to develop ways to deliver services that served the wider system needs and making them more responsive to need, an example being supporting hospital discharge over the weekend.

·           KH: Neighbourhood Services –The co-location of six of the integrated Neighbourhood Teams was welcomed and clarification sought on when this would take place for the two remaining localities. In response it was stated that no further update was available at this time but it would be reported back to Council when there was progress to report.

RESOLVED – (1) That the Mid Year 2018/19 Portfolio Performance Reports for Adult Social Care and for Health be noted.

(2) That the Democratic Services Manager be requested to circulate to members  for information a copy of the Sexual Health Services update from the Health & Wellbeing Board in September.