To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 20 October 2015 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 26 October 2015 be confirmed and signed by the Chairman as a correct record.

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

None.

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

The Chairman welcomed Cllr Paul Downing as the newly appointment Vice-chairman of the Committee.  Cllr Ghent was thanked for his work as the past vice-chairman and was wished well as the new Deputy Executive Member for Adult Social Care.  In light of these changes a position had become available on the Joint Health Overview and Scrutiny and it was agreed that Cllr Downing be appointed.

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.

The Chairman invited a Member of the Public to speak on the Greenacre Care Home consultation.  The speaker raised concerns about the process to access the financial credibility of the owners of care homes where the council was seeking to secure accommodation.  In response the Executive Member for Social Care and Housing agreed to a meeting with the member of the public to discuss the concerns and the information provided to the Executive and Overview and Scrutiny Members.

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 Members for:-

·         Social Care and Housing and

·         Health

The Executive Member for Social Care and Housing advised the Committee of her attendance at the Social Care Health and Housing staff awards.  There had been a number of challenging events that staff had been recognised for.  Members were advised that the Council had been complimented on a recent visit by the Care Quality Commission.  The Committee were also advised that details of a budget drop-in session would be circulated to Members of the Committee to meet the Executive Member and officers to raise any budget concerns or questions.

The Executive Member for Health welcomed Matthew Tait to the meeting, the newly appointed Chief Accountable Officer at the Bedfordshire Clinical Commissioning Group.  Members were advised of the positive and speedy changes implemented by The East London Foundation Trust for Mental Health Services.  In addition, steps to improve the Health and Wellbeing Board’s ways of working were underway.

To consider the BCCG’s detailed Financial Plan 2015/16 and QIUP information.

Matthew Tait, The Chief Accountable Officer at the BCCG introduced a report that outlined the Quality, Innovation, Productivity and Prevention programme (QIPP).  Members were advised that the new robust financial procedures implemented by the BCCG would deliver planned activity and savings as a result of new contracts, such as Mental Health.  Additional money to support the winter resilience period was required, despite the current mild conditions.  Andrew Moore, Interim Chief Operating Officer also advised Members that the QIPP programme set out to improve efficiency and had a detailed governance process that ensured selected schemes were delivered.

The areas of efficiency were outlined in the report and Members of the Committee raised the following queries:-

·         Concern that the switch from branded drugs to cheaper equivalents would have a negative affect on some patients.  The Interim Chief Operating Officer advised GPs would decide which drug to prescribe in full consultation with patients.

·         How the funding was allocated to those GP surgeries that crossed county boarders.  Members were advised that funding was given to each locality hub and was not distributed by post code.

·         The plans BCCG had in place for Biggleswade Hospital in light of its review of estates and property.  The Chief Accountable Officer advised that NHS Property Services owned Biggleswade Hospital and it would be used if required over the winter period.  The Executive Member advised early discussions had taken place to use the facility and the Committee would be updated at a future meeting.

·         What impact the changes to the IVF Service had on the number of service users.  The Interim Chief Operating Officer advised there had been no change.

·         The effect the changes at the Luton and Dunstable Hospital would have on the BCCG.  In response, the Chief Accountable Officer acknowledged there would be major challenges and patient needs would be carefully monitored.

RECOMMENDED

1.    That the new focus and the actions taken to keep to the budget be recognised; that further budget reports be given to future Scrutiny Committees.

2.    That it be ensured the Quality, Improvement, Productivity and Prevention Savings (QIPPs) produce the savings expected.

To receive a report from the Bedfordshire Clinical Commissioning Group on the Mental Health Crisis Care Concordat – a Pan Bedfordshire Authorities approach and scrutinise the impact of the service on local residents and service users.

The BCCG’s Assistant Director of Mental Health and Wellbeing presented a report that outlined the progress with partners to develop and deliver services.  A street triage service business case had been developed and approved in addition to improvements to facilities at Bedford Hospital’s Weller Wing and additional units for patients in Luton.  A dedicated Mental Health practitioner role had also been created to support and coordinate services in Central Bedfordshire and Bedford.

In light of the report, Members queried the following:-

·         The importance of a clear pathway for GPs wishing to make a referral.  The Assistant Director confirmed GPs had the correct details and advised that Mental Health nurses were available at surgeries. 

·         Whether a supply of safe housing was available to those patients who were aware they were in crisis and needed an access point and somewhere safe to stay.  The Assistant Director advised that housing supply nationally and locally was a challenge, however, the council made the best use of its stock to help adults at risk.

The active involvement of the Police in the training provided, which was not presently available for Magistrates or the Probation Service, although this would be investigated.

RECOMMENDED

1.    That the  Committee recognises the need to further promote services for mental health and ensure that individuals receive timely and constructive intervention and that the Concordat provide the means to achieve this.

That Magistrates and Probation Services be included in mental health services training.

To seek Member support on the approach to commission and award Adult Social Care services and contracts and to receive comments on the programme of planned activity.

The Head of Commissioning introduced a report that set out commissioning activities for the Voluntary and Community Sector and Housing Support Services that supported vulnerable adults and individual wellbeing.  The Committee’s comments were sought on the approach to refocus on funding and that some contracts had been extended to allow time to look in depth at finances and engage with staff and partners. 

In light of the report a Member raised a concern about information, advice and signposting for service users.  The Head of Commissioning advised that Advice Central had been set up to link people to services.  Each provider would be required to sign up to Advice Central to make it easier for residents to get to the right organisation.

A Member asked how ‘success’ was measured for these activities.  The Head of Commissioning advised it was a challenge to measure and officers were looking at high level outcomes and would focus on the numbers and what the services meant to people.  The Director explained that further work to develop the schemes was required in addition to changes to voluntary working.

RECOMMENDED

1.    That the Committee acknowledge the need for more time and to extend current contracts to enable outcome based commissioning with stakeholders and the realignment of contracts in particular along-side Council budgets.

2.    That the preventative nature of the services be applauded by the Committee.

To receive the annual report regarding customer feedback in relation to the Social Care Health and Housing directorate.

The Assistant Director Resources introduced the Customer Relations Annual Report 2013/14 that enabled the Council to review important customer feedback and identify how practices might be improved.  In light of the report a Member queried why it had taken 9 months for the report to come to Committee.   In response the Director advised it was a matter of capacity and efforts would be made to bring the report to Committee sooner next year.  A wish to increase the number of complaints and compliments received and changes to the process to make it easier to make a comment would be reviewed.

RECOMMENDED

1.    That the reduction in complaints and those settled by local resolution with the intent to learn from these complaints be noted. 

2.    That the compliments received be welcomed.

3.    That  the importance of good interpersonal relationships with clients by services for older people be stressed.

To provide comments and challenge to the Q2 Budget Monitoring Report for Social Care, Health and Housing.  More information can be accessed via the link below to the full Executive report.

http://centralbeds.moderngov.co.uk/mgChooseDocPack.aspx?ID=4945

The Assistant Director Resources introduced the Q2 budget monitoring report and drew attention to the current forecast revenue outturn for Social Care Health and Housing, which was £0.958m overspent.  The Executive Member advised that the  that a lot of work to address the overspend had been undertaken but it was still proving to be a challenge.  The service was in a strong position in relation to welfare reforms and additional time spent on the development of Priory View would ensure older people had a first class facility.

The Public Health Q2 budget monitoring report advised of a balanced budget following a proposed transfer to earmarked reserves of £46k to a total reserve of £1,542k.  There had been a lower take up of the Sexual Health service that had provided a £100k underspend.  In light of a request from a Member the Head of Public Health agreed to provide an update on the purpose of the £46k earmarked reserve.

RECOMMENDED that the reasoning behind the £1m overspend be noted and that the service be encouraged to come in on target.

To review and comment upon performance management arrangements pertaining to the 5-year plan and to scrutinise and provide guidance on the key performance indicators that should be applied to monitor the delivery of the five year plan.

The Leader of the Council delivered a presentation that outlined the 5 Year Plan key priorities agreed by Members.  Views were specifically sought on key performance metrics for Social Care Health and Housing that would open into Key Performance Indicators, targets and milestones.  In the first instance a lead metric had been proposed and the Leader welcomed feedback on these or suggestions to improve them.

Members discussed the following points in detail:-

·         The importance of communities  coming together to solve problems and the need for a mechanism to be put in place to share good practice.

·         The importance of planning and providing a mix of generational housing in communities.  To achieve this, the Council must  promote the idea of older residents moving to smaller homes to provide access to family homes.

·         That importance of local communities embracing community safety and crime reduction, which was the responsibility of a range of organisations.

RECOMMENDED

1.    That the approach to the Five Year Plan be welcomed and that the approach to prevention rather than cure be applauded.

2.    That exceptional performance be highlighted in blue in future performance score cards.

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

The Committee considered  the current work programme and were advised of additions that included:-

·         January – Winter Resilience (report by exception BCCG)

·         January/March – EFLT update on Mental Service provision

·         March – Winter Resilience, BCCG.

RECOMMENDED that subject to the addition of those items noted in the Minutes, the work programme be approved.