To receive from Members any declarations of interest and of any political whip in relation to any agenda item.

Cllr G Clarke declared an interest as a Member of her family worked for the Clinical Commissioning Group.

To receive any announcements from the Chairman and any matters of communication.

The Chairman advised the Committee that the next meeting of the Joint Health Overview and Scrutiny Committee would take place in the Chamber, Chicksands on Tuesday 17 February 2015 starting at 4pm.

To receive petitions from members of the public in accordance with the Public Participation Procedure as set out in Annex 2 of Part A4 of the Constitution.

None.

To receive any questions, statements or deputations from members of the public in accordance with the Public Participation Procedure as set out in Annex 1 of part A4 of the Constitution.

None.

To consider any decision of the Executive referred to this Committee for review  in accordance with Procedure Rule 10.10 of Part D2. 

None.

To consider any items referred to the Committee at the request of a Member under Procedure Rule 3.1 of Part D2 of the Constitution.

None.

To receive a brief verbal update from the Executive Member for Social Care, Health and Housing.

The Executive Member of Social Care, Health and Housing updated the Committee on their attendance at an event held at the Grove Theatre, Dunstable to showcase the Priory View development for older people and a briefing with Nadine Dorries MP and Andrew Selous MP.

To consider and comment on the outcomes of the Mental Health procurement process undertaken by the Bedfordshire Clinical Commissioning Group.

The Assistant Director, Mental Health and Learning Disabilities, Bedfordshire Clinical Commissioning Group (BCCG), introduced the Mental Health Procurement of Services report.  The East London Foundation Trust (ELFT) had been the successful bidder in each of the four key lots outlined in the procurement process and would commence their contract on 01 April 2015.

In light of the report and further clarification, Members raised the following:-

·         Concern whether ELFT would be able to support patients in a crisis situation.  The Assistant Director advised there were several requirements to be met by the provider to support patients in crisis, including a single point of access, a back into services number, an all age crisis service and a 24 hour crisis service.

·         Concern that patients with mental health problems had been detained in Police cells because suitable accommodation was not available.  The Assistant Director reported the number of patients detained in this way had been reduced by one third, however, work with SEPT to resolve this problem continued.

·         Whether the BCCG could provide assurance that the services promised were delivered to a high standard.  The Assistant Director advised an outcomes based service contract had been written and Public Health, Social Care and NHS England would monitor the contract.  ELFT were required to be transparent and open on their performance targets.

·         Concern whether the Trust could manage a Bedfordshire contract.  Members were advised ELFT had agreed to base its Bedfordshire Management Team in the County to achieve a close working relationship with all key partners and stakeholders.

·         What transitional arrangements had been made to ensure a smooth handover of services from SEPT.  The Assistant Director advised a detailed plan had been written and ELFT would shadow the work of SEPT during April.

RECOMMENDATION that the East London Foundation Trust be invited to attend the June 2015 meeting of the Committee to provide a further update on performance.

To consider and comment on the BCCG detailed financial recovery plan.

The Interim Chief Financial Officer, Bedfordshire Clinical Commissioning Group (BCCG) presented the Financial Recovery Plan that included actions undertaken to stabilise the current financial position, strengthen the Management Team and proposals in the recovery programme to tackle the deficit of £28.9m in 2014/2015.

In light of the presentation the Committee raised a number of concerns and questions regarding :-

·         Clarification on the failures that had been identified in the BCCG’s financial planning and what effect the deficit would have on the Bedfordshire and Milton Keynes Healthcare Review.  In response the Interim Director of Finance advised there had been a failure in governance arrangements and robust challenges had not be made on expenditure.  In the future the BCCG would look to implement the proposals of the Healthcare Review at a faster pace to achieve efficiencies and savings.

·         Concern the BCCG was under funded at the start of the organisation and whether NHS England would continue to fund the deficit as it had done in the past.  The Interim Director of Finance advised the BCCG had a statutory duty to maintain a balanced budget and a financial recovery plan would be submitted to NHS England on 31 January 2015 for approval that would include plans to repay the debt.

·         Whether the BCCG were expected to pay interest on the loan and what the relevant timescales for repayment of the loan were.  Members were advised that there was no interest on the loan and a period of 3-5 years in which to pay the money back.  The BCCG had recruited two lay members to their board who had experience in the field of finance and had challenged the Directors’ plans for recovery.

·         Clarification on the level of expenditure that had been included in the “other programmes” identified in the forecast financial summary. The Interim Finance Director advised this included £5m repayment of loans in addition to costs identified in prescribing drugs and supporting those with severe learning difficulties.

·         Concern that the 2014-2015 debt and the forecast for 2015-16 going forward was not feasible and £9m deficit missing in the 2013-14 budget was not shown in the forecast.  In response Members were advised that plans to address the deficit would be implemented.

The Executive Member for Social Care Health and Housing raised her concerns at the lack of transparency of NHS spend and surprise that details on 2013/2014 budget that was missing from the presentation.  Also missing were the pressures identified by the BCCG and what tough decisions the BCCG would need to take.  The Interim Director advised that Members would receive detailed proposals at a future meeting of the Committee.

RECOMMENDED the detailed recovery financial plan be made available to Members

To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 15 December 2014 and to note actions taken since that meeting.

RESOLVED

That the minutes of the meeting of the  Social Care Health and Housing Overview and Scrutiny Committee held on 15 December 2014 be confirmed and signed by the Chairman as a correct record.

To consider the draft Budget, updated Medium Term Financial Plan and Capital Programme pertaining to the Social Care Health and Housing Directorate only.  Information that is relevant to the other directorates will be considered in the other relevant OSC meetings.   Members are requested to submit their comments, observations and recommendations in respect of the Executive’s proposals with particular reference to the Social Care Health and Housing Directorate proposals, to the meetings of the Executive on 10 February 2015.

Papers relating to these items were circulated to Members in the Executive agenda for 13 January 2015 (items 8 and 9refer).  Members are requested to bring their copies of the Executive report with them to the meeting (hard copies will not be provided).  The report is available to view and print at the following website:-

http://www.centralbedfordshire.gov.uk/modgov/documents/g4645/Public%20reports%20pack%20Tuesday%2013-Jan-2015%2009.30%20EXECUTIVE.pdf?T=10

The Assistant Director Resources gave a presentation that outlined the Council’s draft Budget for 2015/16, Medium Term Financial Plan and Capital Programme which had been presented to the Executive on 13 January 2015.  The report also set out the efficiencies and pressures faced by the directorate, in particular the implications of the Care Act and introduction of the Better Care Fund.

The Committee also received a presentation that outlined the Public Health Revenue Budget, which had £11.4m of ring fenced grant for 2015/2016 and 2016/2017.  Of note was the re-commissioning of the Drugs and Alcohol contract.

In light of the report and the further clarification provided by the Executive Member the Committee discussed the following issues in detail:-

·         Concern that the rationalisation of contracts to draw efficiencies would result in job cuts.  The Assistant Director Resources advised that the Care Act would create a greater demand on services and there would be no impact on jobs.

·         Whether costs in association with the transition of Children to Adults were realistic.  The Assistant Director Resources advised that 98 customers with learning disabilities were looked after outside of Central Bedfordshire and had expensive care packages.  An effort to find suitable care within Central Bedfordshire was a priority.

·         Whether the forecast for the demand in Social Care service and assumptions made were accurate.  The Assistant Director explained the Joint Strategic Needs Assessment (JSNA) and Swift system data had been used to inform the assumptions made and anticipate demand. 

·         Whether provision had been made to support carers.  The Committee was advised that carers’ plans would be prepared in the case of a crisis and efforts to maximise support and information at the right time was also planned, however, it was difficult to accurately predict the demand.

·         Whether the ring fenced Public Health grant could be used to support efficiencies identified elsewhere in the Council’s budget.  The Head of Public Health Finance advised that subject to assurances that Public Health Grant benefited the population’s health, it could be used for this purpose.

·         Whether Health Checks and early intervention advice was making a difference to services.  The Head of Public Health Finance advised that investment in IT software would enable monitoring of data and early intervention advice delivered at GP surgeries.  Public Health would consider other providers to deliver this important service.

RECOMMENDED that the Council’s draft Budget for 2015/16, Medium Term Financial Plan and Capital Programme 2015/16 – 2018/19 in relation to Social Care Health and Housing be endorsed.

To consider the draft Housing Revenue Account Budget 2015/16. pertaining to the Social Care Health and Housing Directorate only.  Information that is relevant to the other directorates will be considered in the other relevant OSC meetings.   Members are requested to submit their comments, observations and recommendations in respect of the Executive’s proposals with particular reference to the Social Care Health and Housing Directorate proposals, to the meetings of the Executive on 10 February 2015.

Papers relating to these items were circulated to Members in the Executive agenda for 13 January 2015 (item 10 refers).  Members are requested to bring their copies of the Executive report with them to the meeting (hard copies will not be provided).  The report is available to view and print at the following website:-

http://www.centralbedfordshire.gov.uk/modgov/documents/g4645/Public%20reports%20pack%20Tuesday%2013-Jan-2015%2009.30%20EXECUTIVE.pdf?T=10

The Assistant Director Resources introduced the Housing Revenue Account Budget and Investment Plan 2015/16 – 2021.  The Assistant Director Housing Services delivered a presentation on the key issues that included a proposed rent increase of 2.20% in line with the national rental increase and Government guidance.  The Investment Plan proposals, endorsed by the Committee in May 2014, had been developed into a balanced programme of investment.

In light of the report and presentation, Members of the Committee discussed proposals to build Council Housing in the north of Central Bedfordshire in addition to schemes provided by Aragon Housing Association.  Members also welcomed the proposal to redevelop a site in Houghton Regis that had been well received by residents.

Recommended that the Housing Revenue Account Budget and Investment Plan for 2015/16 – 2021 be endorsed.

To consider and comment upon the Social Care Health and Housing Quarter 2 performance report.

The Committee received the Quarter 2 Performance Monitoring Report which highlighted the performance for the Social Care Health and Housing Directorate for Quarter 2 of 2014/15.  Members welcomed the achievement of 100% of Central Bedfordshire wards covered by a Village Care Scheme.  The Executive Member was requested to provide evidence that was available on the positive outcomes the schemes had provided to residents.  Members were advised that a Volunteers event at the Grove Theatre, Dunstable, on Tuesday 2 June would be held to thank the volunteers and hopefully recruit more.

With some village care schemes supporting more than one ward, a Member requested that officers liaise with the care schemes before creating a provision in each ward.

RECOMMENDED that a report on Village Care schemes and outcomes for residents be submitted to the Committee.

The report provides Members with details of the currently draft Committee programme and the latest Executive Forward Plan.

The Committee considered the current draft work programme.

RECOMMENDED that the work programme be approved subject to the additional items detailed in the Minutes above.